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date: 19 January 2019

Abstract and Keywords

Chronic illnesses carry important psychological and social consequences that demand significant psychological adjustment. The literature is providing increasingly nuanced conceptualizations of adjustment, demonstrating that the experience of chronic disease necessitates adaptation in multiple life domains. Heterogeneity in adjustment is apparent between individuals and across the course of the disease trajectory. Focusing primarily on cancer and rheumatic diseases, we review longitudinal investigations of proximal (personality attributes, cognitive appraisals, coping processes, interpersonal relationships) and distal (socioeconomic variables, culture/ethnicity, gender-related processes) risk and protective factors for adjustment across the illness trajectory. We conclude that the past decade has seen a surge in research that is longitudinal in design, involves adequately characterized samples of sufficient size, and includes statistical control for initial values on dependent variables. A progressively convincing characterization of risk and protective factors for favorable adjustment to chronic illness has emerged. We identify important issues for future application and research.

Keywords: Coping, adjustment, adaptation, social support, personality, chronic disease, cancer, arthritis, clinical intervention, biopsychosocial model

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