Illness representations and psychological outcomes in chronic lymphocytic leukaemia

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