Department of Psychology, University of Giessen , Giessen , Germany.
Department of Psychology, University of Zurich , Zurich , Switzerland.
Stress. 2019 Nov;22(6):696-706. doi: 10.1080/10253890.2019.1625329. Epub 2019 Jun 14.
Stress is discussed as a risk factor in the manifestation and maintenance of functional somatic (FS) symptoms. However, there is a lack of evidence regarding the effects of cognitive-behavioral stress management training (CBSM) on FS symptoms and the (potentially mediating) role of the neuroendocrine system. This study aims to examine stress-related psychological and neuroendocrine changes after receiving a brief CBSM in individuals with FS symptoms. Forty-three participants of both sexes, who reported at least one current FS symptom, were analyzed (treatment group (TG) = 21, waitlist control group (WCG) = 22) using mixed models. Number of symptoms, psychological stress, and salivary cortisol levels were assessed at pretreatment, posttreatment, and 6 months later. Mixed model analyses did not reveal significant differences between the TG and the WCG regarding number of FS symptoms ( > 0.05), psychological stress measures ( > 0.05) or the cortisol awakening response (CAR) ( > 0.05). The TG presented lower diurnal cortisol levels at pretreatment, posttreatment and 6 months later ( < 0.05). We did not find significant beneficial effects that were specific to CBSM. Further research should be undertaken to investigate the effects of CBSM on real life stress or laboratory stressors in subjects with FS symptoms. Moreover, learning cognitive restructuring and establishing new coping strategies into everyday life might require more time. This study is a first step in filling the gap in understanding the influences of CBSM as a brief intervention on psychological and biological aspects of stress in participants with FS symptoms and will hopefully inform larger trials of CBSM for FS symptoms.
压力被认为是功能性躯体（FS）症状表现和维持的一个风险因素。然而，关于认知行为应激管理训练（CBSM）对 FS 症状的影响以及神经内分泌系统的（潜在中介）作用，目前还缺乏证据。本研究旨在探讨在 FS 症状患者接受简短 CBSM 后，与压力相关的心理和神经内分泌变化。分析了 43 名报告至少有一种当前 FS 症状的男女参与者（治疗组（TG）=21 人，候补名单对照组（WCG）=22 人），使用混合模型。在治疗前、治疗后和 6 个月后评估了症状数量、心理压力和唾液皮质醇水平。混合模型分析显示，TG 和 WCG 在 FS 症状数量（>0.05）、心理压力测量（>0.05）或皮质醇觉醒反应（CAR）（>0.05）方面没有显著差异。TG 在治疗前、治疗后和 6 个月后表现出较低的日间皮质醇水平（<0.05）。我们没有发现特定于 CBSM 的显著有益效果。应进一步开展研究，以调查 CBSM 在 FS 症状患者的现实生活压力或实验室应激源方面的效果。此外，将认知重构和建立新的应对策略纳入日常生活可能需要更多时间。本研究是了解 CBSM 作为一种简短干预对 FS 症状患者的压力的心理和生物学方面的影响的第一步，希望为针对 FS 症状的 CBSM 的更大规模试验提供信息。
