The role of illness perception and behaviour in the treatment of adolescents with multiple functional somatic syndromes: A mediation analysis of AHEAD

Objective Psychological interventions have been shown to reduce symptom load and disability in young people with various functional somatic syndromes (FSS). However, the mechanisms of change are less investigated, especially in young patients presenting with multi-organ symptomatology. The objective...

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Bibliographic Details
Published in:Journal of psychosomatic research 2022-06, Vol.157, p.110863, Article 110863
Main Authors: Kallesøe, K., Ørnbøl, E., Wellnitz, K., Rask, C.
Format: Article
Language:English
Subjects:
Adolescents
Avoidance behavior
Change agents
Disability
Group therapy
Health behavior
Health status
Illnesses
Patients
Perception
Psychological flexibility
Teenagers
Treatment programs
Youth
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Summary:Objective Psychological interventions have been shown to reduce symptom load and disability in young people with various functional somatic syndromes (FSS). However, the mechanisms of change are less investigated, especially in young patients presenting with multi-organ symptomatology. The objective was to examine whether changes in illness perception, illness behaviour (i.e. all-or-nothing and limiting) and psychological flexibility (i.e. avoidance and fusion) mediated changes in self-perceived physical Method Data from 91 adolescents (15–19 years) with multiple FSS of at least 1 year's duration from the randomized trial 'ACT for Health in Adolescents' (AHEAD) were used in a parallel growth process mediation analysis. Assessment of mediators was performed at baseline (before assessment), 2 months (prior to start of group-therapy), 4 months, 5.5 months (2 weeks after end of treatment (EOT)), and at 8 months (3 months after EOT). Results Improvement of illness perception and avoidance, but not illness behaviour and fusion, mediated the effect of AHEAD on physical health 3 months after end of treatment. Baseline levels of negative illness perception and avoidance did not moderate the mediation. Conclusions AHEAD reduced negative illness perception and avoidance and, consequently, improved physical health in young people with multiple FSS. Reducing these factors seems to be viable treatment targets and therefore beneficial to integrate in future treatment programs for this patient group.
ISSN:0022-3999
1879-1360
DOI:10.1016/j.jpsychores.2022.110863