EXPECTATIONS AND DELAY IN SEEKING MEDICAL-CARE

Expectations about bodily states, symptoms, and diseases frequently produce delay in seeking medical care, and that delay is a serious social problem, one that takes its toll in unnecessary human suffering, premature mortality, and increased costs for medical care. Appraisal of whether an unusual bodily condition is indeed a symptom typically accounts for the major portion of delay. Expectations lengthen this period of appraisal in a variety of ways, including (a) attributing the cause of conditions to salient contextual stimuli, (b) an unrealistic optimism about the risk of contracting disease, (c) denial that a threat exists, and (d) biased monitoring of bodily changes. Expectations exert this influence, in part, because people are poor perceivers of internal states, and there is suggestive evidence that the symptom perceptions of those more finely attuned to their bodily states may be less influenced by expectations. Once a symptom has been clearly identified, the person must decide whether professional medical care is required. Here again, expectations stemming from several sources continue to guide the coping process. Several ways of reducing the detrimental effects of expectations on delay in seeking medical care are considered. 1990 The Society for the Psychological Study of Social Issues