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Response Shift After Cognitive Behavioral Therapy Targeting Severe Fatigue: Explorative Analysis of Three Randomized
Fabiola Müller1,2,3,4,5, Mathilde G E Verdam6,7,8, Frans J Oort9
1Medical Psychology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. f.mueller@amsterdamumc.nl.
International Journal of Behavioral Medicine
|July 22, 2022
Summary
Cognitive behavioral therapy (CBT) may cause response shift in patients with severe fatigue. This shift in self-evaluation does not impact the therapy
Area of Science:
- Psychology
- Medical Research
- Health Interventions
Background:
- Severe fatigue impacts quality of life and is addressed by Cognitive Behavioral Therapy (CBT).
- Patient-reported outcomes may be influenced by response shift, a change in self-evaluation meaning.
- Understanding response shift is crucial for accurately assessing CBT effectiveness in fatigue management.
Purpose of the Study:
- To identify the occurrence of response shift in patients undergoing CBT for fatigue.
- To determine the impact of response shift on the effectiveness of CBT interventions.
- To investigate the association between changes in fatigue-related cognitions and response shift.
Main Methods:
- Re-analysis of data from three randomized controlled trials on CBT for chronic fatigue syndrome, cancer, and diabetes.
- Utilized the Checklist Individual Strength questionnaire to measure fatigue severity.
- Applied structural equation modeling to detect longitudinal measurement invariance as an indicator of response shift.
Main Results:
- Response shift was observed in CBT groups across all three trials, but not in control groups.
- Reprioritization response shift occurred for specific fatigue items, altering their perceived importance.
- Observed changes in cognitions and perceptions were linked to response shifts, but intervention effects remained unaffected.
Conclusions:
- Cognitive Behavioral Therapy appears to induce response shift through reprioritization in diverse patient groups.
- The identified response shift did not alter the overall effectiveness of CBT interventions.
- Further research is recommended to confirm these findings and explore patients' evolving understanding of fatigue.
