{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:45:25Z","timestamp":1790937925412,"version":"4.1.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["DRF-2017-10-105"],"award-info":[{"award-number":["DRF-2017-10-105"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C7492\/A17219"],"award-info":[{"award-number":["C7492\/A17219"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Testing positive for human papillomavirus (HPV) at cervical cancer screening has been associated with heightened anxiety. To date, the cognitive determinants of heightened anxiety remain unclear, making it difficult to design effective interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study investigated latent illness representation profiles in women testing positive for HPV with no abnormal cells (normal cytology) and explored associations between these profiles and anxiety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women aged 24\u201366 (n = 646) who had tested HPV-positive with normal cytology at routine HPV primary screening in England completed a cross-sectional survey shortly after receiving their result.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Latent profile analysis identified three distinct profiles of illness representations (termed \u201cadaptive,\u201d \u201cnegative,\u201d and \u201cnegative somatic\u201d), which differed significantly in their patterns of illness perceptions. Hierarchal linear regression revealed that these latent illness representation profiles accounted for 21.8% of the variance in anxiety, after adjusting for demographic and clinical characteristics. When compared with adaptive representations (Profile 1), women with negative representations (Profile 2) and negative somatic representations (Profile 3) had significantly higher anxiety, with clinically meaningful between-group differences (mean difference [MD] = 17.26, confidence interval [CI]: 14.29\u201320.22 and MD = 13.20, CI: 9.45\u201316.96 on the S-STAI-6, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The latent illness representation profiles identified in this study provide support for the role of negative beliefs contributing to anxiety in women testing HPV-positive with normal cytology. Characteristics specific to subgroups of highly anxious women (Profiles 2 and 3) could be used by policymakers to target information in routine patient communications (e.g., test result letters) to reduce unnecessary burden. Future research should adopt longitudinal designs to understand the trajectory of illness representations from HPV diagnosis through to clearance versus persistence.<\/jats:p><\/jats:sec>","DOI":"10.1093\/abm\/kaab022","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T03:18:44Z","timestamp":1619061524000},"page":"78-88","source":"Crossref","is-referenced-by-count":15,"title":["Distinct Illness Representation Profiles Are Associated With Anxiety in Women Testing Positive for Human Papillomavirus"],"prefix":"10.1093","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9926-429X","authenticated-orcid":false,"given":"Emily","family":"McBride","sequence":"first","affiliation":[{"name":"Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A V","family":"Marlow","sequence":"additional","affiliation":[{"name":"Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6427-4690","authenticated-orcid":false,"given":"Joseph","family":"Chilcot","sequence":"additional","affiliation":[{"name":"Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rona","family":"Moss-Morris","sequence":"additional","affiliation":[{"name":"Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Waller","sequence":"additional","affiliation":[{"name":"Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,4,21]]},"reference":[{"key":"2021122116132462700_CIT0001","doi-asserted-by":"crossref","first-page":"l240","DOI":"10.1136\/bmj.l240","article-title":"Primary cervical screening with high risk human papillomavirus testing: Observational study","volume":"364","author":"Rebolj","year":"2019","journal-title":"BMJ."},{"key":"2021122116132462700_CIT0002","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1086\/657321","article-title":"Cervical human papillomavirus prevalence in 5 continents: Meta-analysis of 1 million women with normal cytological findings","volume":"202","author":"Bruni","year":"2010","journal-title":"J Infect Dis."},{"key":"2021122116132462700_CIT0003","first-page":"745","article-title":"Psychosexual distress following routine primary human papillomavirus testing: A longitudinal evaluation within the English Cervical Screening Programme","author":"Bennett","year":"2020","journal-title":"BJOG"},{"key":"2021122116132462700_CIT0004","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1002\/ijc.32540","article-title":"Anxiety and distress following receipt of results from routine HPV primary testing in cervical screening: The psychological impact of primary screening (PIPS) study","volume":"146","author":"McBride","year":"2020","journal-title":"Int J Cancer."},{"key":"2021122116132462700_CIT0005","first-page":"1","article-title":"Emotional response to testing positive for human papillomavirus at cervical cancer screening: A mixed method systematic review with meta-analysis","author":"McBride","year":"2020","journal-title":"Health Psych Rev."},{"key":"2021122116132462700_CIT0006","first-page":"17","article-title":"The common sense representation of illness danger.","volume-title":"Medical Psychology","author":"Leventhal","year":"1980"},{"key":"2021122116132462700_CIT0007","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1007\/s10865-016-9782-2","article-title":"The Common-Sense Model of Self-Regulation (CSM): A dynamic framework for understanding illness self-management","volume":"39","author":"Leventhal","year":"2016","journal-title":"J Behav Med."},{"key":"2021122116132462700_CIT0008","first-page":"219","article-title":"Illness representations and coping with health threats.","volume-title":"Handbook of Psychology and Health, Volume IV: Social Psychology Aspects of Health.","author":"Leventhal","year":"1984"},{"issue":"1","key":"2021122116132462700_CIT0009","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/08870440290001494","article-title":"The Revised Illness Perception Questionnaire (IPQ-R)","volume":"17","author":"Moss-Morris","year":"2002","journal-title":"Psychol Health."},{"key":"2021122116132462700_CIT0010","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1080\/08870446.2016.1153640","article-title":"Can illness beliefs, from the common-sense model, prospectively predict adherence to self-management behaviours? 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