Exploring maladaptive cognitions and behaviors as perpetuating factors in patients with persistent somatic symptoms: a longitudinal study 2023 Barends

Andy

Andy

Senior Member (Voting rights)
Highlights
  • Maladaptive cognitions and behaviors were associated with somatic symptom severity over five-year time.

  • Associations were also found for maladaptive cognitions and behaviors and reduced physical and mental functioning.

  • Also, within subjects cognitions and behavior may play a role as perpetuating factors.
Abstract

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.

Open access, https://www.sciencedirect.com/science/article/pii/S0022399923002003
 
"Several ‘maladaptive’ cognitions and behaviors (e.g., catastrophizing cognitions and avoidance behavior) have been associated with higher symptom burden in pain syndromes and FSS such as chronic fatigue syndrome, irritable bowel syndrome and fibromyalgia"

"The questionnaire was validated in the UK in both adults [24] and adolescents [42] with chronic fatigue syndrome and has priory been applied in patients with e.g., multiple sclerosis, irritable bowel syndrome [14,39,43] and undifferentiated somatoform disorders"
 
Every time I see that word "cognitions" I automatically translate it to "thoughts" as I read it. Despite looking up the definition I'm still none the wiser as to whether "thoughts" is accurate, but I don't think it is.

According to the American Heritage Dictionary of the English Language :

cognitions
Plural form of cognition

kŏg-nĭsh′ən
noun
  1. The mental process of knowing, including aspects such as awareness, perception, reasoning, and judgment.
  2. That which comes to be known, as through perception, reasoning, or intuition; knowledge.
  3. Knowledge, or certain knowledge, as from personal view or experience; perception; cognizance.
Click to expand...

Could someone come up with another word for "cognitions"? I tried the thesaurus and wondered which alternative other people would choose :

https://www.thesaurus.com/browse/cognitions
 
In this case they seem to be using cognitions to mean beliefs, and specifically faulty beliefs.

I would expect cognitions to mean a combination of knowledge, understanding and reasoning.

Here's a dictionary definition:
cognition
noun
  1. the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses.
 
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