The relation between cognitive-behavioural responses to symptoms in long term medical conditions & the outcome of CBT for fatigue, 2022, de Gier

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Dolphin

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https://www.sciencedirect.com/science/article/pii/S0005796722002145

The relation between cognitive-behavioural responses to symptoms in patients with long term medical conditions and the outcome of cognitive behavioural therapy for fatigue – A secondary analysis of four RCTs

M.de Gier abgh
F.Picariello c
M.Slot a
A.Janse f
S.Keijmel e
J.Mentin gf
M.Worm-Smeitink f
H.Beckerman a
V.de Groot a
R.Moss-Morris c
H.Knoop dh

a
Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, MS Center Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, the Netherlands
b
Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Medical Psychology, Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, the Netherlands
c
Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, 5th Floor Bermondsey Wing, Guy's Campus, King's College London, UK
d
Amsterdam UMC Location University of Amsterdam, Department of Medical Psychology, Meibergdreef 15, 1105AZ, Amsterdam, the Netherlands
e
Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
f
Department of Medical Psychology, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
g
Amsterdam Neuroscience Research Institute, P.O. Box 7057, 1007 MB, Amsterdam, the Netherlands
h
Amsterdam Public Health Research Institute, P.O. Box 7057, 1007 MB, Amsterdam, the Netherlands


Received 27 September 2022, Revised 15 November 2022, Accepted 12 December 2022, Available online 15 December 2022.

https://doi.org/10.1016/j.brat.2022.104243Get rights and content
Under a Creative Commons license
Open access

Highlights


•
Similar beliefs and behaviour moderate effect of CBT on fatigue across conditions.

•
The mediators of the effect of CBT on fatigue are also similar across conditions.

•
The findings support a transdiagnostic approach in the treatment of fatigue.



Abstract

Background

Cognitive behavioural therapy (CBT) is effective in reducing fatigue across long-term conditions (LTCs). This study evaluated whether cognitive and behavioural responses to symptoms: 1) differ between LTCs and 2) moderate and/or mediate the effect of CBT on fatigue.

Method

Data were used from four Randomized Controlled Trials testing the efficacy of CBT for fatigue in Chronic Fatigue Syndrome/ME (N = 240), Multiple Sclerosis (N = 90), Type 1 Diabetes Mellitus (N = 120) and Q-fever fatigue syndrome (N = 155). Fatigue severity, assessed with the Checklist Individual Strength, was the primary outcome. Differences in fatigue perpetuating factors, assessed with the Cognitive Behavioural Responses to Symptoms Questionnaire (CBRQ), between diagnostic groups were tested using ANCOVAs. Linear regression and mediation analyses were used to investigate moderation and mediation by CBRQ scores of the treatment effect.

Results

There were small to moderate differences in CBRQ scores between LTCs. Patients with higher scores on the subscales damage beliefs and avoidance/resting behaviour at baseline showed less improvement following CBT, irrespective of diagnosis. Reduction in fear avoidance, catastrophising and avoidance/resting behaviour mediated the positive effect of CBT on fatigue across diagnostic groups.

Discussion

The same cognitive-behavioural responses to fatigue moderate and mediate treatment outcome across conditions, supporting a transdiagnostic approach to fatigue.

Keywords
Chronic fatigue
Long term conditions
Cognitive behavioural therapy
Transdiagnostic
 
Time well spent. Meanwhile GGZ is overloaded with patients that can't get help that might actually need some. Then again, I doubt they're "good" enough to actually help anyone if they believe the nonsense they write.
 
It's disturbing to see how much the same flawed CBT for fatigue trials with the same crap about catastrophising and fear avoidance of activity has been inflicted on people with fatigue as a symptom of diseases with known biological causes. And as far as the researchers are concerned, fatigue is the same regardless of cause.
 
NelliePledge said:
Transdiagnostic

is it me or is that their latest buzzword
Click to expand...
Yup. And it appears to be nothing but a buzzword. It's long been pointed out by patients that reducing many symptoms to a single one is dumb and obvious invalid. So now it seem they are "discovering" that patients have many symptoms. Or pretending to anyway. Even though the real model here is the one and only conversion disorder, so it's also a very insincere lie.

In hindsight, making mental disorders out of the most common symptoms of illness looks very foolish. It was and always looked very foolish, but it especially does in hindsight. But there is endless tolerance for failure in psychosomatics, so they can continue with their performance of basically mailing themselves anonymous confession letters, or whatever.
 
Merged thread

The relation between cognitive-behavioural responses to symptoms in patients with long term medical conditions and the outcome of cognitive behavioural therapy for fatigue – A secondary analysis of four RCTs

Knoop et al

Abstract
Background
Cognitive behavioural therapy (CBT) is effective in reducing fatigue across long-term conditions (LTCs). This study evaluated whether cognitive and behavioural responses to symptoms: 1) differ between LTCs and 2) moderate and/or mediate the effect of CBT on fatigue.

Method
Data were used from four Randomized Controlled Trials testing the efficacy of CBT for fatigue in Chronic Fatigue Syndrome/ME (N = 240), Multiple Sclerosis (N = 90), Type 1 Diabetes Mellitus (N = 120) and Q-fever fatigue syndrome (N = 155). Fatigue severity, assessed with the Checklist Individual Strength, was the primary outcome. Differences in fatigue perpetuating factors, assessed with the Cognitive Behavioural Responses to Symptoms Questionnaire (CBRQ), between diagnostic groups were tested using ANCOVAs. Linear regression and mediation analyses were used to investigate moderation and mediation by CBRQ scores of the treatment effect.

Results
There were small to moderate differences in CBRQ scores between LTCs. Patients with higher scores on the subscales damage beliefs and avoidance/resting behaviour at baseline showed less improvement following CBT, irrespective of diagnosis. Reduction in fear avoidance, catastrophising and avoidance/resting behaviour mediated the positive effect of CBT on fatigue across diagnostic groups.

Discussion
The same cognitive-behavioural responses to fatigue moderate and mediate treatment outcome across conditions, supporting a transdiagnostic approach to fatigue.

https://www.sciencedirect.com/science/article/pii/S0005796722002145?via=ihub


 
Last edited by a moderator:
Fear avoidance
Catastrophising
Damage beliefs
Embarrassment
Symptom focusing
All or nothing behaviour
Avoidance/resting behaviour
Click to expand...
This is all made-up stuff. Numeralisation barely covers it, this is fantasy painting-by-fake-numbers. Dungeons & dragons character attributes have more relation to reality than this new phrenology stuff.
 
Their evaluation is so poor and generic that it's basically random:
Patients with MS and QFS displayed significantly higher damage beliefs compared to patients with CFS and T1DM, which in MS may be caused by the unpredictable course of the illness where fatigue and other symptoms may be a sign of a disease relapse or progression
Click to expand...
It seems they are either unaware that ME (so the CFS and QFS groups) is very unpredictable, or don't care.

Absolute peak pseudoscience. None of the numbers are real, every patient is answering different questions since they are so ambiguous and weird on purpose. And there are already dozens of identical nonsense, all "exploring" the same corner of their own living room.
 
Discussion
The same cognitive-behavioural responses to fatigue moderate and mediate treatment outcome across conditions, supporting a transdiagnostic approach to fatigue.

All they are measuring are generic bias and confounders in self-report, and then relabelling it to make out it is some novel insight with significant clinical relevance.
 
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