The following is a summary of “Exploring maladaptive cognitions and behaviors as perpetuating factors in patients with persistent somatic symptoms: a longitudinal study,” published in the July 2023 issue of the Psychosomatic Research by Barends et al.

In patients with persistent somatic symptoms (PSS), maladaptive cognitions and behaviors may affect symptoms and impairment. This study aimed to examine whether maladaptive cognitions and behaviors are associated with symptom severity and functional health over time, whether these associations are due to changes within individuals over time or differences between individuals, and the directions of changes within individuals. The longitudinal data of a heterogeneous sample of PSS patients (n = 322 patients enrolled in the PROSPECTS cohort research) were analyzed. 

Over five years, cognitive and behavioral responses to symptoms (CBRQ), symptom severity (PHQ-15), and physical and mental functioning (RAND-36 PCS and MCS) were evaluated seven times (0, 6 months, 1, 2, 3, 4 years)—application of longitudinal mixed and hybrid model analysis with and without time latency. Over time, maladaptive cognitions and behaviors were linked to more severe symptoms and decreased physical and mental functioning. Both intra-individual alterations and inter-individual differences were associated with increased symptom severity and reduced physical and psychological functioning. 

The effect magnitude of the between-subject component was roughly twice that of the within-subject part. Changes in several maladaptive cognitions and behaviors were associated with worsening symptoms and diminished physical and mental functioning over time, and vice versa. This study demonstrates that maladaptive cognitions and behaviors are related to symptom severity and diminished physical and mental functioning over time in PSS patients.

Source: sciencedirect.com/science/article/pii/S0022399923002003