- Published
- 10 September 2025
- Journal article
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
- Authors
- Source
- Psychology & Health
Abstract
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 (Ntotal = 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, R2 = .099] or believed COVID-19 was caused by lacking protective behaviours [F(8, 4804) = 59.738, p < .001, R2 = .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.
Rights
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
Cite as
Johnston, M., Dixon, D., Hubbard, G. & den Daas, C. 2025, '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', Psychology & Health. https://doi.org/10.1080/08870446.2025.2553192