Illness Expectations Assessment in People with Asthma: A Tool for Explicit and Implicit Beliefs

Abstract

Background Illness expectations are cognitive schemas, both explicit and implicit, describing how symptoms are expected to be in the future. They can be particularly relevant to disease in a mind/body framework. Asthma is a condition in which the psychological aspects can highly influence the body, but no study has directly explored these specific expectations, and no dedicated assessment tools are available. Methods We developed a questionnaire to assess the illness expectations, together with an ad hoc version of the Implicit Association Test (IAT). We tested its factorial structure, and the internal and test–retest validity, recruiting a sample of 183 asthmatic people. We also explored the convergent validity and the correlations with objective and subjective clinical assessments. Results Data suggested a three-factorial structure of the questionnaire into expectations about future symptoms, change in current health status, and rigidity of these expectations. The questionnaire showed good psychometric properties and strong associations with the other considered outcomes, including implicit expectations. The implicit evaluation, however, lacked test–retest reliability. Conclusion The questionnaire is a valid tool to assess illness expectations in people with asthma. The two expectation scales are highly related, and the implicit expectations are moderately associated with the explicit ones. The lack of stability related to IAT results may reflect a lack of stability of the implicit expectations. The implications for the mind/body framework still need to be fully explored.

ERS International Congress 2022: highlights from the Allied Respiratory Professionals Assembly

“…Similarly, P agnini et al . [ 87 ] developed a new instrument to detect implicit and explicit illness expectations in individuals with asthma, the Illness Expectations Test [ 88 ], finding that these expectations can influence asthma progression and adherence. Finally, d' A ncona et al [ 89 ] emphasised that to effectively support patients’ transition to inhalers with a lower global warming potential, physicians must recognise patients’ individual choices and concerns about the effectiveness of the new inhaler on their asthma control.…”

The Experience of Living with Severe Asthma, Depression and Anxiety: A Qualitative Art-Based Study

“…Whilst there are tools to screen for symptoms of depression and anxiety 9 and validated tools to assess illness expectations in asthma, 10 little is known about the experience of living with severe asthma 11 in conjunction with psychological comorbidity. It is recognised that life experiences are multi-sensory, multifaceted, and related in complex ways to time, space, ideologies, and relationships with others; 11 therefore, difficult to capture in an instrumented way.…”