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https://psyarxiv.com/7c4yf/
Putting the Vicious Cycle to the Test: Evidence for the Cognitive Behavioral Model of Persistent Somatic Symptoms from an Online Study
Alexander H. J. Sahm1* , M.Sc., https://orcid.org/0000-0002-1401-4329 Michael Witthöft2 , PhD, https://orcid.org/0000-0002-4928-4222 Josef Bailer3 , PhD, https://orcid.org/0000-0002-2196-2482 & Daniela Mier1 , PhD, https://orcid.org/0000-0003-2518-7492
1 Department of Psychology, University of Konstanz, Konstanz, Germany
2 Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg-University Mainz, Mainz, Germany
3 Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg / Medical Faculty Mannheim, Mannheim, Germany
Abstract
Objective:
In clinical practice, persistent somatic symptoms are regularly explained using a cognitive-behavioral model (CBM).
In the CBM, predisposing, perpetuating, and precipitating factors are assumed to interact and to cause the onset and endurance of somatic symptoms.
However, these models are rarely investigated in their entirety.
Methods:
We conducted an online-survey during the Corona pandemic.
2,114 participants from the general German population completed a number of questionnaires that measured different factors of the CBM.
We used negative affectivity and neuroticism as predisposing factors, the fear of a COVID-19 infection as precipitating factor, and somatic symptoms, misinterpretation of bodily symptoms, attention allocation to bodily symptoms, and health anxiety as perpetuating factors.
Moreover, we added behavioral variables (safety and avoidance behavior) as endpoints to the model. We tested the assumptions of the CBM by evaluating a structural equation model (SEM) that incorporated all factors of the model.
Further, we conducted a psychological network analysis to exploratively study the relationships between the model’s different factors.
Results:
Our SEM showed adequate fit.
Network analyses revealed clustering in our data: Health anxiety and different cognitive factors are closely related, while somatic symptoms and negative affectivity are strongly associated.
Conclusions:
Our findings from a confirmatory and an exploratory approach give empirical support for the CBM, suggesting it as a suitable model to guide clinical practice.
The network model additionally demonstrates the necessity to apply an individualized CBM for patients, depending on a preponderance of either PSS or health concerns.
Putting the Vicious Cycle to the Test: Evidence for the Cognitive Behavioral Model of Persistent Somatic Symptoms from an Online Study
Alexander H. J. Sahm1* , M.Sc., https://orcid.org/0000-0002-1401-4329 Michael Witthöft2 , PhD, https://orcid.org/0000-0002-4928-4222 Josef Bailer3 , PhD, https://orcid.org/0000-0002-2196-2482 & Daniela Mier1 , PhD, https://orcid.org/0000-0003-2518-7492
1 Department of Psychology, University of Konstanz, Konstanz, Germany
2 Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg-University Mainz, Mainz, Germany
3 Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg / Medical Faculty Mannheim, Mannheim, Germany
Abstract
Objective:
In clinical practice, persistent somatic symptoms are regularly explained using a cognitive-behavioral model (CBM).
In the CBM, predisposing, perpetuating, and precipitating factors are assumed to interact and to cause the onset and endurance of somatic symptoms.
However, these models are rarely investigated in their entirety.
Methods:
We conducted an online-survey during the Corona pandemic.
2,114 participants from the general German population completed a number of questionnaires that measured different factors of the CBM.
We used negative affectivity and neuroticism as predisposing factors, the fear of a COVID-19 infection as precipitating factor, and somatic symptoms, misinterpretation of bodily symptoms, attention allocation to bodily symptoms, and health anxiety as perpetuating factors.
Moreover, we added behavioral variables (safety and avoidance behavior) as endpoints to the model. We tested the assumptions of the CBM by evaluating a structural equation model (SEM) that incorporated all factors of the model.
Further, we conducted a psychological network analysis to exploratively study the relationships between the model’s different factors.
Results:
Our SEM showed adequate fit.
Network analyses revealed clustering in our data: Health anxiety and different cognitive factors are closely related, while somatic symptoms and negative affectivity are strongly associated.
Conclusions:
Our findings from a confirmatory and an exploratory approach give empirical support for the CBM, suggesting it as a suitable model to guide clinical practice.
The network model additionally demonstrates the necessity to apply an individualized CBM for patients, depending on a preponderance of either PSS or health concerns.