Electronic Theses and Dissertations





Date of Award


Document Type


Degree Name

Doctor of Philosophy


Counseling Psychology

Committee Chair

Douglas Clark Strohmer

Committee Member

Daniel Charles Lustig

Committee Member

Terry Ishitani

Committee Member

Richard Owen Lightsey


Chronic illness affects nearly one in two Americans affected (CDC, 2009), often leading to psychological distress (Bohlmeijer, Prenger, Taal, & Cuijpers, 2010), including a rate of depression approximately 50% higher than the rate in peers without medical illness (Patten, 2001). Likewise, quality of life for those with chronic illnesses is lower than quality of life among healthy peers, measured by greater persistence of psychological distress, higher functional impairment, and medical services utilization (Aiarzaguena, Grandes, Salazar, Gaminde, & Sánchez, 2008; Feder et al., 2001). Despite continued medical advances, a significant portion of illness, pain and discomfort remains medically unexplained (Nettleton, Watt, O’Malley, & Duffey, 2005), creating challenges not only for those who experience illness distress, but for health care providers as well (Kroenke, 2000; Raine et al., 2002). Medically unexplained symptoms (MUS), defined as sets of symptoms that physical pathology does not adequately explain (Swanson, Hamilton, & Feldman, 2010), are both commonplace and problematic to health care providers (Kroenke, 2000; Swanson et al., 2010). Deary, Chalder, and Sharpe’s (2007) cognitive behavioral model of medically unexplained symptoms describes the process by which correlates of illness-related distress prime, trigger and perpetuate the experience of aversive symptoms even in the absence of direct physiological causes. Although , in recent years, the cognitive behavioral model of MUS has garnered increasing empirical support for predisposing and perpetuating variables, no published articles to date have investigated the role of precipitating factors in the context of this model, leaving a critical component of the theory unexamined. This study used a sample population of adults with Inflammatory Bowel Disease to test the role of body vigilance as a precipitating factor in the CBT model of MUS. Results indicated that the inclusion of body vigilance significantly improved explained variance. Although patterns of correlation between personality variables, illness cognitions, and health related quality of life were similar among persons with IBD and other diseases used to test the model, among adults with IBD, no personality variables explained significant variance in health-related quality of life. The implications of how these results may impact further research in MUS and chronic illness are provided.


Data is provided by the student.

Library Comment

dissertation or thesis originally submitted to the local University of Memphis Electronic Theses & dissertation (ETD) Repository.