Introduction

Illness, disability, and in some cases treatment itself, can represent major threats to psychological adjustment. The growing prevalence of chronic disease in the ageing western population is increasing the numbers of people who need to adapt to living with conditions which are never likely to be cured, but only controlled, by medical treatment. The physical problems related to illness or treatment have the potential to curtail work, leisure activities or social life. Painful or life-threatening conditions can also take a severe emotional toll; research on cancer patients has suggested that as many as 50% may have sufficiently severe symptoms to warrant a diagnosis of psychiatric disorder (Derogatis et al., 1983). Patients with heart disease have also been shown to have raised depression and anxiety and impaired quality of life (Wiklund et al., 1984). Medical research has been directed principally towards management of symptoms or pathological processes, while the cognitive-emotional processes involved in coping with illness have attracted comparatively little attention. However, with the development of health psychology there has been a growing interest in how people cope with illness and disability, both in terms of the best strategies to ameliorate the stress of illness, and the mechanisms whereby coping behaviour might influence the development of illness. Some of the research on the psychophysiological mechanisms which link coping behaviour to physiology and pathology is discussed in Section 2, while the papers in this section illustrate the clinical utility of the coping concept.