Journal
BRITISH JOURNAL OF HEALTH PSYCHOLOGY
Volume 21, Issue 4, Pages 917-936Publisher
WILEY
DOI: 10.1111/bjhp.12206
Keywords
functional somatic syndrome; neuroticism; symptom catastrophizing; cognitive-behavioural therapy; mechanisms of change
Categories
Funding
- TrygFonden [7-12-1039]
- Torkil Steenbeck's Legat
- University of Copenhagen
Ask authors/readers for more resources
ObjectivesThe cognitive-behavioural model of functional somatic syndromes (FSS) proposes a multifactorial aetiology consisting of predisposing, precipitating and perpetuating factors. In this study, we sought to investigate three questions that can be drawn from this model: (1) Do patients with FSS show high levels of neuroticism? (2) Does neuroticism affect physical health and social functioning, either directly or indirectly through maladaptive coping? (3) Does more adaptive coping mediate the effect of cognitive-behavioural therapy (CBT) on outcome? DesignSecondary analysis of a randomized controlled trial (RCT) using additional data. MethodWe used yet unpublished data on neuroticism (measured with Temperament and Character Inventory, Revised) and coping (measured with Coping Strategies Questionnaire) together with already reported outcomes (physical health and social functioning measured with SF-36) from an RCT comparing group CBT with enhanced usual care in 120 patients with a range of FSS. Neuroticism was measured at referral, while coping and outcomes were measured at referral, baseline, 4 and 16months after randomization. Our hypotheses were explored through a series of cross-sectional (linear regression and structural equationmodels) and longitudinal (mediation) analyses. ResultsPatients with FSS showed higher levels of neuroticism than two healthy comparison groups. At referral, symptom catastrophizing partly mediated the negative association between neuroticism and outcome. Reduction in symptom catastrophizing during group CBT partially mediated its long-term effect. ConclusionsThe results give support to a generic cognitive-behavioural model of FSS. Targeting symptom catastrophizing may be an essential component in CBT for patients with FSS, regardless of their specific diagnosis.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available