A psychological model of predictive factors of distress following long COVID 2024 Brown et al

Highlights

• Cognitive, behavioural, and psychosocial processes impact distress in long COVID.
• CFS, RRS Brooding, BEAQ and IEQ outcomes predict psychological distress.
• Other psychological factors mediate the relationship between fatigue and distress.
• The relationship between fatigue and cognitive failures is moderated by avoidance.

Abstract

Background
Long COVID, described as “the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection”, is estimated to affect at least 10–20 % of all cases of acute SARS-CoV-2 infection. Because of its novelty, information regarding the experience of Long COVID is still emerging.

Methods
This study examines psychological distress in two long COVID populations, and their experience of fatigue, cognitive failures, experiential avoidance, rumination, and perceived injustice. Participants were recruited via a long COVID hospital clinic and online self-diagnosing samples. Participants completed a battery of scales to measure psychological distress, fatigue, cognitive dysfunction, avoidance and rumination behaviours and the experience of injustice.

Results
It was found that the regression model tested accounted for a significant amount of the variance in psychological distress (R2 = 0.675). Cognitive failures, avoidance, rumination, and injustice experiences significantly contributed to the experience of psychological distress and a moderated mediation accounted for the effect of fatigue on psychological distress.

Limitations
The self-report measures in this study did not include objective measures of symptom severity. Cross-sectional data collected at a single time-point may not capture the dynamic nature of long COVID symptoms.

Conclusions
These findings identify contributing factors to the experience of psychological distress in the long COVID population, providing direction to explore supportive interventions.

Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0165032724020378

 

"Parallels have been drawn between symptoms of long COVID and the symptoms experienced by individuals with other long-term conditions such as chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME [Alwan, 2021]). While long COVID has a clear medical underpinning, symptoms of CFS/ME such as fatigue and cognitive dysfunction have been identified as Medically Unexplained Symptoms (MUS), due to their unknown aetiology (Deary et al., 2007). CFS/ME models offer two advantages in working with novel phenomena like long COVID (i) there is a large literature on physical issues that impact psychological outcomes such as fatigue and cognitive dysfunction (Morriss et al., 1999; Rimes and Chalder, 2005; Van Houdenhove et al., 1995), and (ii) there is a range of previously identified psychological factors that may also occur for people with long COVID (Chaudhuri et al., 2023). Any similarity between CFS/ME models and long COVID needs to be validated by further research."

"Deary et al. (2007) identified cognitive (attentional/attributional processes and rumination), behavioural (avoidance and recuperative response), social (medical uncertainty and lack of explanation or guidance) and physiological factors that play a role in the experience of MUS and distress. Long COVID is a new phenomenon and presents with similar symptomatology to CFS/ME."

"This study aims to examine whether the adapted version of the cognitive behavioural model of CFS/ME can be applied to account for psychological distress in a long COVID population, see Fig. 1. Here we examine which, if any, of the cognitive, behavioural, and psychosocial processes, specifically avoidance, rumination, the experience of injustice, and the experience of fatigue and cognitive failures affect psychological distress in a long COVID population. Research suggests the aforementioned processes have the potential to perpetuate psychological distress, identifying how these processes fit in the context of long COVID has the potential to inform future intervention planning."

 

A cynical person might suspect that this study's primary objective was to provide something to prop up a grant application.

 

Maybe better not to give a grant to "researchers" that can't even get the name of a disease right.
Not CFS/ME, folks, it's called ME/CFS.

 

Aha. But they want their findings to apply to ME while keeping the hegemony of the CFS name that simplifies the condition down to chronic fatigue which makes it far easier to psychologise.

 

Ah, yes, lies, damned lies, and blatantly biased statistical analyses of BS data using even more BS models. Exactly what science is all about: take old BS, use advanced modern technology to produce that BS faster and cheaper than ever before.

You especially have to love that this predicts exactly nothing. Nothing at all. And they still call it that. When it's exactly as dumb as a rock-based weather technology:

 

"Your hair is short. You must have had your hair cut. It's likely because you use less shampoo. I'm a genius who can predict things!"

Actually, writing the comment above, I realized how this is exactly "bad predictions about the future". If you were to ask psychiatrists from a century ago and described computers to them, this is exactly how most would have describe clinical psychology would be done in the future: the same thing they were doing, but faster.

Almost all bad predictions about the future do the same thing: they take what they are currently doing, and simply assume it will be done exactly the same, but automated, faster, cheaper and bigger.

Despite all the advances in modern technology, they're still stuck doing all the things they were imagining back then, and nothing else. They even plug the gaps with the same mindless retroactive speculation to fill their giant gaps in their models.

It's like predicting the future wrong, but in the future. Despite the benefits of hindsight, they're not doing anything more than simply doing the exact same old BS, but with computers. It's mind-boggling to be stuck in time this much, incapable of even budging one tiny bit away from the same old nonsense.

 

The utter dishonesty of giving ill and exhausted people questionnaires with items like 'I keep wondering why I can't concentrate' and 'I keep thinking that I won't be able to do my job if I can't snap out of this' and then declaring that their answers reflect psychological maladaptations rather than illness. The total and utter bloody dishonesty of it.