Nicole Sullivan1, L Alison Phillips2, Wilfred R Pigeon3, Karen S Quigley4,5, Fiona Graff6, David R Litke6,7, Drew A Helmer6,8, Joseph F Rath7,9, Lisa M McAndrew6,10. 1. War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, 385 Tremont Avenue, East Orange, NJ, 07018, USA. Nicole.Sullivan4@va.gov. 2. Department of Psychology, Iowa State University, Ames, IA, USA. 3. Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, USA. 4. Edith Nourse Rogers Memorial VA Hospital, Bedford, MA, 01730, USA. 5. Department of Psychology, Northeastern University, Boston, MA, 02115, USA. 6. War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, 385 Tremont Avenue, East Orange, NJ, 07018, USA. 7. Department of Rehabilitation Medicine, New York University School of Medicine, New York, NY, USA. 8. Department of Medicine, Rutgers University- New Jersey Medical School, Newark, NJ, USA. 9. Rusk Institute of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, USA. 10. Department of Educational and Counseling Psychology, University at Albany, 1400 Washington Ave Ext, Albany, NY, 12222, USA.
Abstract
BACKGROUND: Medically unexplained syndromes (MUS) are both prevalent and disabling. While illness beliefs and behaviors are thought to maintain MUS-related disability, little is known about which specific behavioral responses to MUS are related to disability or the way in which beliefs and behaviors interact to impact functioning. The purpose of the present study was to examine the relationship between illness beliefs and disability among patients with MUS, and assess the extent to which behaviors mediate this relationship. METHODS: The study examined data from the baseline assessment of a multi-site randomized controlled trial (RCT). Participants were 248 veterans with MUS. Illness beliefs, behavioral responses to illness, and disability were assessed through self-report questionnaire. Data were analyzed using mediation analysis. RESULTS: Threat-related beliefs predicted greater disability through decreased activity and increased practical support seeking. Protective beliefs predicted less disability through reductions in all-or-nothing behavior and limiting behavior. CONCLUSIONS: These outcomes suggest that all-or-nothing behavior, limiting behavior, and practical support seeking are important in the perpetuation of disability among those with MUS. This has implications for improving MUS treatment by highlighting potential treatment targets. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02161133.
RCT Entities:
BACKGROUND: Medically unexplained syndromes (MUS) are both prevalent and disabling. While illness beliefs and behaviors are thought to maintain MUS-related disability, little is known about which specific behavioral responses to MUS are related to disability or the way in which beliefs and behaviors interact to impact functioning. The purpose of the present study was to examine the relationship between illness beliefs and disability among patients with MUS, and assess the extent to which behaviors mediate this relationship. METHODS: The study examined data from the baseline assessment of a multi-site randomized controlled trial (RCT). Participants were 248 veterans with MUS. Illness beliefs, behavioral responses to illness, and disability were assessed through self-report questionnaire. Data were analyzed using mediation analysis. RESULTS: Threat-related beliefs predicted greater disability through decreased activity and increased practical support seeking. Protective beliefs predicted less disability through reductions in all-or-nothing behavior and limiting behavior. CONCLUSIONS: These outcomes suggest that all-or-nothing behavior, limiting behavior, and practical support seeking are important in the perpetuation of disability among those with MUS. This has implications for improving MUS treatment by highlighting potential treatment targets. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02161133.
Authors: Carolina Climent-Sanz; Genís Morera-Amenós; Filip Bellon; Roland Pastells-Peiró; Joan Blanco-Blanco; Fran Valenzuela-Pascual; Montserrat Gea-Sánchez Journal: J Clin Med Date: 2020-12-10 Impact factor: 4.241
Authors: Naomi S Kane; Nicole Anastasides; David R Litke; Drew A Helmer; Stephen C Hunt; Karen S Quigley; Wilfred R Pigeon; Lisa M McAndrew Journal: PLoS One Date: 2021-12-07 Impact factor: 3.240