title: Application of the high risk model of threat perception to medical illness and service utilization in a family practice.
abstract: This study was designed to test the High Risk Model of Threat Perception in a family practice population. Predisposing, triggering, and buffering factors were assessed in 165 patients using psychological inventories. The relationship between these factors and self-reported symptoms, diagnosed chronic problems, and utilization was assessed. Negative affect and number and intensity of life events increased the risk for chronic illness and reported symptoms, while social support and approach style of coping decreased the apparent risk. The numbers of encounters and telephone calls to the office, obtained from the office database, were statistically correlated with negative affect and inversely with social support. The regression analysis predicted 27% of the variance in reported symptoms with negative affect, life events, and avoidance coping as significant predictors. Only 8% and 16% of the variance of telephone calls and office visits, respectively, could be predicted with a similar regression model. These results emphasize the importance of psychosocial factors in medical illness. Routine assessment of psychosocial risk factors in family practice patients is suggested.
authors.affiliation: Department of Psychiatry, Medical College of Ohio, 3120 Glendale Avenue, Toledo, Ohio 43614, España.
authors.forename: Angele
authors.initials: A
authors.lastname: McGrady
authors.forename: Denis
authors.initials: D
authors.lastname: Lynch
authors.forename: Rollin
authors.initials: R
authors.lastname: Nagel
authors.forename: Elmer
authors.initials: E
authors.lastname: Wahl
mesh_terms: D000223:Adaptation, Psychological; D001294:Attitude to Health; D002908:Chronic Disease / Q000523:psychology*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology; D009819:Office Visits / Q000706:statistics & numerical data*; D010555:Personality Inventory / Q000706:statistics & numerical data; D012044:Regression Analysis; D012307:Risk Factors; D012944:Social Support; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires