Date of Award




Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Educational and Counseling Psychology


Counseling Psychology

Content Description

1 online resource (iv, 85 pages) : illustrations (some color)

Dissertation/Thesis Chair

Lisa M McAndrew

Committee Members

Michael V Ellis, Rachel E Brenner


behavioral interventions, chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, medically unexplained symptoms, meta-analysis, Medicine, Psychosomatic, Somatoform disorders, Chronic fatigue syndrome, Fibromyalgia, Irritable colon, Medicine and psychology

Subject Categories

Counseling Psychology


Medically unexplained symptoms (MUS) are common: 25 to 50% of patients seen in primary care present with MUS (e.g., fibromyalgia, irritable bowel syndrome, and chronic fatigue). Patients with MUS report higher symptom severity, psychological distress, and poorer functioning and quality of life than patients without MUS. To address the needs of patients with MUS, behavioral interventions (e.g., cognitive behavior therapy and exercise) have been used to improve patient outcomes including symptom severity, psychological distress, and quality of life. To date, behavioral interventions have been shown to be efficacious to improve patient outcomes; however, less is known about the comparative efficacy of different types of behavioral interventions for MUS. The primary aim of the current project is to determine the comparative and overall efficacy of behavioral interventions for MUS across three patient-related outcomes using a meta-analysis. The current meta-analysis included 37 studies with over 3,479 participants. Overall, I found that behavioral interventions were more efficacious in improving patient outcomes than control conditions (e.g., treatment as usual and waitlist) alone. I also found that behavioral interventions demonstrated similar improvement on patient outcomes, suggesting that active treatments are equally efficacious to one another. The findings of the current study suggest that behavioral interventions are efficacious and comparable to one another to treat MUS-related outcomes. Thus, integrating behavioral interventions into the treatment of MUS could be beneficial for patients with MUS and also suggests that provider recommendations of interventions can be based on organizational resources.