Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2022 May;27(2):553-570.
doi: 10.1111/bjhp.12562. Epub 2021 Oct 4.

Illness representations and psychological outcomes in chronic lymphocytic leukaemia

Nicole A Arrato  1 , Thomas R Valentine  2 , John C Byrd  3 , Jeffrey A Jones  4 , Kami J Maddocks  4 , Jennifer A Woyach  4 , Barbara L Andersen  1
Affiliations
Free article
Randomized Controlled Trial

Illness representations and psychological outcomes in chronic lymphocytic leukaemia

Nicole A Arrato et al. Br J Health Psychol. 2022 May.
Free article

Abstract

Objectives: Chronic lymphocytic leukaemia (CLL) is a lifelong cancer with subtle symptoms. Treatment is not curative and often involves repeated relapses and retreatments. Illness perceptions - cognitive and emotional representations of illness stimuli - were studied in CLL patients to: 1) identify illness perception 'profiles' prior to treatment; and 2) test whether profile membership predicts psychological responses 12 months later as treatment continued.

Design: CLL patients (N = 259), randomized to one of four cancer treatment trials testing targeted therapy, were assessed before starting treatment and at 12 months.

Methods: The Brief Illness Perception Questionnaire (BIPQ) assessed perceived consequences, timeline, personal/treatment control, identity, comprehension, concern, and emotions toward CLL. Psychological outcomes were depressive symptoms (PHQ-9/BDI-II), negative mood (POMS), and cancer stress (IES-R). Latent profile analysis (LPA) determined number of profiles and differential BIPQ items for each profile. Multilevel models tested profiles as predictors of 12-month psychological outcomes.

Results: LPA selected the three-profile model, with profiles revealing Low (n = 150; 57.9%), Moderate (n = 21; 8.1%), and High-impact (n = 88; 34.0%) illness representations. Profiles were defined by differences in consequences, identity, concern, and emotions. Profile membership predicted all psychological outcomes (ps<.038). Low-impact profile patients endorsed minimal psychological symptoms; High-impact profile patients reported substantial symptoms.

Conclusions: Results of the first CLL illness representation study provide directions for future clinical efforts. By identifying differences among patients' perceptions of CLL consequences, symptom burden, concerns, and emotional responses, an at-risk patient group might receive tailored psychological treatment. Treatments may address negative perceptions, to reduce psychological risk associated with chronic cancer.

Trial registration: ClinicalTrials.gov NCT02427451 NCT02518555 NCT02296918 NCT01589302.

Keywords: chronic lymphocytic leukaemia; depression; illness perceptions; latent profile analysis; stress.

PubMed Disclaimer

References

    1. Andersen, B. L., Goyal, N. G., Weiss, D. M., Westbrook, T. D., Maddocks, K. J., Byrd, J. C., & Johnson, A. J. (2018). Cells, cytokines, chemokines, and cancer stress: A biobehavioral study of patients with chronic lymphocytic leukemia. Cancer, 124, 3240-3248. https://doi.org/10.1002/cncr.31538
    1. Aujla, N., Walker, M., Sprigg, N., & Vedhara, K. (2018). Do individual versus illness belief schema differ in the prediction of post-stroke recovery? Journal of Health Psychology, 25, 2118-2128. https://doi.org/10.1177/1359105318785446
    1. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory-II. San Antonio, TX: The Psychological Corporation.
    1. Berry, E., Davies, M., & Dempster, M. (2017). Illness perception clusters and relationship quality are associated with diabetes distress in adults with type 2 diabetes. Psychology, Health, and Medicine, 22, 1118-1126. https://doi.org/10.1080/13548506.2017.1281976
    1. Broadbent, E., Petrie, K., Main, J., & Weinman, J. (2006). The brief illness perception quesionnaire. Journal of Psychosomatic Research, 60, 631-637. https://doi.org/10.1016/j.jpsychores.2005.10.020

Publication types

Associated data