TY - JOUR
T1 - Exploring maladaptive cognitions and behaviors as perpetuating factors in patients with persistent somatic symptoms
T2 - a longitudinal study
AU - Barends, Hieke
AU - Dekker, Joost
AU - van Dessel, Nikki Claassen-
AU - Twisk, Jos W. R.
AU - van der Horst, Henriëtte E.
AU - van der Wouden, Johannes C.
N1 - Funding Information: This work was supported by grants of ZonMw (The Netherlands Organization for Health Research and Development , funding number 839110018 ] and the Stoffels-Hornstra Foundation . The funding sources had no role in the design, analyses and interpretation of this study. We want to thank our research assistants for their help and assistance in gathering all necessary data. We are particularly thankful to all the participants that took (and are still taking) part in the PROSPECTS study for their time and efforts. Publisher Copyright: © 2023 The Authors
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Objective: Maladaptive cognitions and behaviors may influence symptoms and impairment in patients with persistent somatic symptoms (PSS). Aims of this study were to examine: (i) whether maladaptive cognitions and behaviors are associated with symptom severity and functional health over time; (ii) if these associations are the result of changes within individuals over time or of differences between individuals; (iii) directions of changes within individuals over time. Methods: Longitudinal data of a heterogeneous sample of patients with PSS were analyzed (n = 322 patients enrolled in the PROSPECTS cohort study). Cognitive and behavioral responses to symptoms (CBRQ), symptom severity (PHQ-15) and physical and mental functioning (RAND-36 PCS and MCS) were assessed seven times over a five-year period (0, 6 months, 1, 2, 3, 4, 5 year). Longitudinal mixed model and hybrid model analysis with and without time-lag were applied. Results: Maladaptive cognitions and behaviors were associated with more severe symptoms and reduced physical and mental functioning over time. Both changes within individuals over time and differences between individuals were associated with higher symptom severity and reduced physical and mental functioning. The between-subject component was about twice the effect size of the within-subject component. Changes in several specific maladaptive cognitions and behaviors were associated with more severe symptoms and reduced physical and mental functioning later in time and vice versa. Conclusion: This study shows that maladaptive cognitions and behaviors are associated with symptom severity and reduced physical and mental functioning over time in patients with PSS.
AB - Objective: Maladaptive cognitions and behaviors may influence symptoms and impairment in patients with persistent somatic symptoms (PSS). Aims of this study were to examine: (i) whether maladaptive cognitions and behaviors are associated with symptom severity and functional health over time; (ii) if these associations are the result of changes within individuals over time or of differences between individuals; (iii) directions of changes within individuals over time. Methods: Longitudinal data of a heterogeneous sample of patients with PSS were analyzed (n = 322 patients enrolled in the PROSPECTS cohort study). Cognitive and behavioral responses to symptoms (CBRQ), symptom severity (PHQ-15) and physical and mental functioning (RAND-36 PCS and MCS) were assessed seven times over a five-year period (0, 6 months, 1, 2, 3, 4, 5 year). Longitudinal mixed model and hybrid model analysis with and without time-lag were applied. Results: Maladaptive cognitions and behaviors were associated with more severe symptoms and reduced physical and mental functioning over time. Both changes within individuals over time and differences between individuals were associated with higher symptom severity and reduced physical and mental functioning. The between-subject component was about twice the effect size of the within-subject component. Changes in several specific maladaptive cognitions and behaviors were associated with more severe symptoms and reduced physical and mental functioning later in time and vice versa. Conclusion: This study shows that maladaptive cognitions and behaviors are associated with symptom severity and reduced physical and mental functioning over time in patients with PSS.
KW - Cognitions and behavior
KW - Course
KW - Functional health
KW - Medically unexplained symptoms
KW - Persistent somatic symptoms
UR - http://www.scopus.com/inward/record.url?scp=85159487002&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jpsychores.2023.111343
DO - https://doi.org/10.1016/j.jpsychores.2023.111343
M3 - Article
C2 - 37201294
SN - 0022-3999
VL - 170
JO - Journal of psychosomatic research
JF - Journal of psychosomatic research
M1 - 111343
ER -