Objective: The aim of this study was to determine the usefulness of the Self-Regulatory Model (SRM) of illness behaviour [Leventhal J, Meyer D, Nerenz D. The common-sense representation of illness danger. In: Rachman S, editor. Medical psychology. New York (NY): Pergamon, 1980, pp. 27-30.] as a framework for explaining prehospital delay in patients with acute myocardial infarction (AMI). Method: Data were collected from 61 patients with confirmed AMI regarding demographics, clinical history, distance from hospital and components of the SRM. Results: The median time from onset of symptoms to arrival at Accident and Emergency (A&E) was 4 h 4 min. A hierarchical multiple regression revealed that the components of the SRM explained 37% of the variance in prehospital patient delay. Males who viewed a heart attack as having serious consequences and who adopted an active-cognitive and problem-focused coping response to their symptoms had the shortest delay times. Conclusion: The SRM is a useful framework for partially explaining patient delay. There are, however, complex interactions between the physical manifestation of pain and symptomatology and patient response. Patients' perceptions of the severity of the consequences of an AMI appear to override the effects of an individual's emotional response to the acute event. Interventions should teach patients the skills associated with active-cognitive and problem-focused coping and take account of gender differences in their design. (C) 2004 Elsevier Inc. All rights reserved.