| Summary: | The aim of the work described in this thesis was to investigate, in a number of related studies, the nature of illness representations and their relationship to health outcomes in people with Mild Cognitive Impairment (MCI). The first two studies investigated the validity of the dimensions of illness representation (expressed as illness perceptions) measured by the Illness Perception Questionnaire - Revised (IPQ-R), and the structural validity and reliability of an adapted version of the IPQ-R in Mel. The approach proved valid for participants with Mel and the adapted IPQ-R showed good validity and reliability. Illness perceptions, coping strategies, depression, anxiety and activities of daily living were measured at baseline and six months in 98 participants meeting criteria for Mel. The third and fourth studies supported hypotheses that illness perceptions and coping strategies would explain variance in help-seeking behaviour and variance in anxiety, depression, and impairment of instrumental activities of daily living. Illness perceptions explained significant variance in outcomes at baseline and six month follow-up with perceptions of a strong illness identity, negative emotional representation, serious consequences, and declining memory predicting poorer mental health. The causal relationships between illness perceptions, coping and outcomes proposed in the Self Regulatory Model were also investigated as part of the fourth study. Illness perceptions were found to have both direct relationships with outcomes, and indirect relationships, mediated by coping strategies. The fifth study investigated a further hypothesis that illness perceptions held by 49 close friends and relatives of patients with Mel would be related to outcomes in both the patient and significant others. Perceptions of strong illness identity, high social comparison, chronic timeline and serious consequences held by significant others were found to be associated with mental health outcomes in both the patient with MCI and their significant other. The relationships found between illness perceptions, coping styles and health outcomes in people with Mel and their significant others suggest that illness perceptions play an important role in determining outcomes in Mel. The findings of the studies have important implications for clinical interventions designed to alleviate depression and anxiety in people with MCI.
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