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Published on: June 30, 2014
Fatigue and physical disability in patients with multiple sclerosis: a structural equation modeling approach
Yvonne Bol1, Annelien A Duits, Richel Lousberg
1Department of Medical Psychology and Psychiatry, Orbis Medical Centre, PO Box 5500, 6130 MB Sittard, The Netherlands. Y.bol@maastrichtuniversity.nl
Journal of Behavioral Medicine
|May 29, 2010
Summary
This study found that an integrated cognitive-behavioral and biomedical approach, focusing on catastrophic thoughts, is beneficial for treating fatigue and physical disability in multiple sclerosis (MS) patients.
Area of Science:
- Neurology
- Psychology
Background:
- Fatigue is a common and disabling symptom in multiple sclerosis (MS).
- The pathogenesis of MS fatigue is poorly understood and difficult to treat.
- Cognitive-behavioral and biomedical models offer different explanations for MS fatigue and disability.
Purpose of the Study:
- To test cognitive-behavioral and biomedical models of fatigue and physical disability in MS.
- To compare the fit of separate models versus an integrated model.
- To identify key factors influencing fatigue and disability in MS patients.
Main Methods:
- Structural equation modeling was used.
- A sample of 262 MS patients was analyzed.
- Model fit was assessed and modified.
Main Results:
- Neither the cognitive-behavioral nor the biomedical model adequately fit the data alone.
- An integrated model combining both approaches showed a better fit.
- Fatigue is linked to depression and physical disability.
- Physical disability is associated with disease severity and fear-avoidance behavior.
- Catastrophic interpretations of fatigue, exacerbated by depression, mediate fear-avoidance behavior.
Conclusions:
- An integrated approach is beneficial for treating MS fatigue.
- Modifying catastrophic thoughts about fatigue is a key therapeutic target.
- Addressing depression and fear-avoidance behavior is crucial for managing MS fatigue and disability.
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