Did you manage to see the colour of the blue sky, green grass, colour of the castle walls? Guess what? Those colours were never there. If you go back to 0:40 in the video after the bright screen you will see that in fact, all along the picture was in black and white. The trick works due to an effect known as an 'afterimage'. This strange optical illusion works by priming the receptors in the retina of our eyes so they recreate colour in the monochrome (black and white) image. By staring at a dot in the centre of the picture, the cells of the eye that see colour become desensitised and later attempt to 'fill' the monochrome scene with the colours that it is missing. This is where overexposure to a given colour causes the retina to become tired of that colour and desensitises the cone cells to it for a short period. When the colour stimulus is removed and the monochrome scene is restored, the remaining cone cells responsible for detecting other colours than the ones being staring at 'fill in' the scene, then the complementary colour is perceived for a brief period of time.

This little experiment has demonstrated that our perception (mind) can be easily fooled and influenced by external stimuli. What we perceive as "real" to us may not be necessarily so. On top of that, consider our tendency to choose to believe what we want to believe (e.g. Halo effect, Forer effect...etc.). This can pose a problem. The way we perceive a situation can influence our decision to take a specific course of action. Hence causing us to make good or bad choices.

(For example, a man who believes that it is the movement of the planets and stars (astrology) that determines the state of his health, may choose not to proactively seek treatment or be compliant to medication because he assumes that the state of his health is "fated".)

Illness Cognition Definition: a patient’s own implicit common sense beliefs about their illness.

Illness cognition provide patients with a framework for:

1. coping with their illness

2. understanding their illness

3. what to look out for if they are becoming ill

Consider the previous activity.

How do you think what we believe (perception) can affect how we think (cognition), and hence influence our course of action (behaviour)?

What is the link between perception and illness cognition?

It is thus increasingly important for us as researchers and healthcare professionals to understand how perceptions, experience and impact of having a medical condition might influence a patient's interpretation and response to it, so that we, in turn, can respond more appropriately.

For the patient, the greatest impact of the disease lies in the effect it has on their ability to continue with a ‘normal’ daily life and this will necessarily be their focus of interest. It is increasingly important for us as researchers and healthcare professionals to understand how the perceptions, experience and impact of having a medical condition might influence a patient's interpretation and response to it, so that we, in turn, can respond more appropriately.

Self-regulatory Model of Illness Behaviour is based on approaches to problem solving suggests that illnesses are dealt with in the same way as other problems.

A problem/change in the status quo → individuals motivated to solve the problem→ re-establish their state of normality.

Why is the model called self-regulatory?

The 3 components of the model (interpretation, coping, appraisal) interrelate in order to maintain the status quo (i.e. they regulate the self) if the individual’s health is disrupted by illness the individual is motivated to return the balance back to normality.

1. Identity: the label or name given to the condition and the symptoms that ‘appear’ to go with it. It can be argued that people like to have a label for their symptoms (for legitimization) although, conversely, once given, people are likely to interpret diverse symptoms as evidence of the label [6].

2. Cause: the individualistic ideas about the perceived cause of the condition, which may not be completely biomedically accurate. These representations will be based on information gathered from personal experience as well as the opinions and discourses of significant others, health professionals and media sources, reflecting issues such as stress, environmental pollution and other pathogens.

3. Time-line: the predictive belief about how long the condition might last, i.e. is it acute or is it going to be chronic? These beliefs will be re-evaluated as time progresses, and it has been suggested that ‘Inside every chronic patient is an acute patient wondering what happened’ [9].

4. Consequences: the individual beliefs about the consequences of the condition and how this will impact on them physically and socially. These representations may only develop into more realistic beliefs over time.

5. Curability/controllability: the beliefs about whether the condition can be cured or kept under control and the degree to which the individual plays a part in achieving this.

As people with a chronic illnesses obtain new information about their condition and evaluate their attempts to moderate, cure or cope with its effects, new representations are formed and develop based upon these experiences.

Illness representations are in effect cumulative, with information being adopted, discarded or adapted as necessary. These representations are, therefore, expected to be linked to the selection of coping procedures, action plans and outcomes. For example, focusing on dietary content and control is a way people with diabetes mellitus attempt to cure/control their symptoms.

Cardiac patients were more likely to attend rehabilitation if they held strong beliefs that their condition can be cured or controlled. And they are more likely to return to work within 6 weeks if they believed that their diagnosis had minimal negative consequences. On the other hand, patients who believed that their diagnosis are far more serious had a longer recovery period (Petrie et. al., 1996).

Application to smoking behaviour

Delay behaviour occurs when people experience symptoms, live with the symptoms for a prolonged period without seeking medical care. It is important to understand this as delay in seeking treatment means that a disease may worsen and the chance of a successful cure decreases.

Kassin, S., Fein, S. & Markus, H. R. (2017). Social Psychology 10th Edition. Cengage LearningEvers, A. W. M., Kraaimaat, F. W., van Lankveld, W., Jongen, P. J. H., Jacobs, J. W. G., & Bijlsma, J. W. J. (2001). Beyond unfavorable thinking: The Illness Cognition Questionnaire for chronic diseases. Journal of Consulting and Clinical Psychology, 69(6), 1026–1036. https://doi.org/10.1037/0022-006X.69.6.1026

Reges, O., Vilchinsky, N., Leibowitz, M., Khaskia, A., Mosseri, M., & Kark, J.D. (2013). Illness cognition as a predictor of exercise habits and participation in cardiac prevention and rehabilitation programs after acute coronary syndrome. BMC Public Health 13, 956. https://doi.org/10.1186/1471-2458-13-956

Taylor, S. E. (2017). Health psychology. Toronto: McGraw-Hill.

Walter, F., Webster, A., Scott, S., & Emery, J. (2012). The Andersen Model of Total Patient Delay: a systematic review of its application in cancer diagnosis. Journal of health services research & policy, 17(2), 110–118. https://doi.org/10.1258/jhsrp.2011.010113