Developing representations of a ‘new’ illness using the Common Sense Model: Evolving Covid-19 illness representations and their associations with protective behaviours in the Scottish population

TY - JOUR

T1 - Developing representations of a ‘new’ illness using the Common Sense Model

T2 - Evolving Covid-19 illness representations and their associations with protective behaviours in the Scottish population

AU - Daas, Chantal den

AU - Johnston, Marie

AU - Dixon, Diane

AU - Hubbard, Gill

N1 - © 2025 the author(s)

PY - 2025/9/10

Y1 - 2025/9/10

N2 - Objective: There is a lack of research on how illness representations as represented in the Common Sense Self-Regulation Model (CS-SRM) emerge and develop. We aimed to describe the evolution of COVID-19 illness representations over time, and to explore associations with sociodemographic characteristics and protective behaviours. Methods and measures: This study (June 2020 release from lockdown to February 2021 after vaccine roll-out) used 17 independently recruited cross-sectional cohorts. Telephone interviews with randomly selected Scottish adults (N total = 8455) assessed illness representations and adherence to protective behaviours (physical distancing, wearing face covering, hand washing). Results: Multivariable regression showed that beliefs in consequences and longer duration initially increased but later reduced. Overall females (Beta’s = −.067–.226), older people (Beta’s =.002–.014) and people from deprived areas (Beta’s = −.200–.072) represented COVID-19 as more threatening and time did not change most of these associations. People who felt more threatened [F(9, 4587) = 55.746, p <.001, R 2 =.099] or believed COVID-19 was caused by lacking protective behaviours [F(8, 4804) = 59.738, p <.001, R 2 =.090] were more likely to adhere to protective behaviours. Believing not keeping distance as a cause was associated with adherence; this association strengthened over time. Conclusion: Illness representations changed over time, mirroring increasing knowledge and improved medical management, but also reflecting population anxiety and sense of control. Sociodemographic differences may relate to social roles and vulnerability. Illness representations predicted protective behaviours.

AB - Objective: There is a lack of research on how illness representations as represented in the Common Sense Self-Regulation Model (CS-SRM) emerge and develop. We aimed to describe the evolution of COVID-19 illness representations over time, and to explore associations with sociodemographic characteristics and protective behaviours. Methods and measures: This study (June 2020 release from lockdown to February 2021 after vaccine roll-out) used 17 independently recruited cross-sectional cohorts. Telephone interviews with randomly selected Scottish adults (N total = 8455) assessed illness representations and adherence to protective behaviours (physical distancing, wearing face covering, hand washing). Results: Multivariable regression showed that beliefs in consequences and longer duration initially increased but later reduced. Overall females (Beta’s = −.067–.226), older people (Beta’s =.002–.014) and people from deprived areas (Beta’s = −.200–.072) represented COVID-19 as more threatening and time did not change most of these associations. People who felt more threatened [F(9, 4587) = 55.746, p <.001, R 2 =.099] or believed COVID-19 was caused by lacking protective behaviours [F(8, 4804) = 59.738, p <.001, R 2 =.090] were more likely to adhere to protective behaviours. Believing not keeping distance as a cause was associated with adherence; this association strengthened over time. Conclusion: Illness representations changed over time, mirroring increasing knowledge and improved medical management, but also reflecting population anxiety and sense of control. Sociodemographic differences may relate to social roles and vulnerability. Illness representations predicted protective behaviours.

KW - Illness representations

KW - protective behaviours

KW - sociodemographic characteristics

KW - time

KW - COVID-19

U2 - 10.1080/08870446.2025.2553192

DO - 10.1080/08870446.2025.2553192

M3 - Article

C2 - 40928070

SN - 0887-0446

JO - Psychology & Health

JF - Psychology & Health

M1 - 2553192

ER -