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治疗相关的网络动态与球感症状患者:概念验证研究。

Treatment-associated network dynamics in patients with globus sensations: a proof-of-concept study.

机构信息

Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstrasse 62a, 4055, Basel, Switzerland.

Department of Clinical Psychology and Cognitive Behavioral Therapy, International Psychoanalytic University (IPU) Berlin, Stromstrasse 1, 10555, Berlin, Germany.

出版信息

Sci Rep. 2023 Sep 20;13(1):15615. doi: 10.1038/s41598-023-42186-y.

Abstract

In this proof-of-concept study, we used a systems perspective to conceptualize and investigate treatment-related dynamics (temporal and cross-sectional associations) of symptoms and elements related to the manifestation of a common functional somatic syndrome (FSS), Globus Sensations (GS). We analyzed data from 100 patients (M = 47.1 years, SD = 14.4 years; 64% female) with GS who received eight sessions of group psychotherapy in the context of a randomized controlled trial (RCT). Symptoms and elements were assessed after each treatment session. We applied a multilevel graphical vector-autoregression (ml GVAR) model approach resulting in three separate, complementary networks (temporal, contemporaneous, and between-subject) for an affective, cognitive, and behavioral dimension, respectively. GS were not temporally associated with any affective, cognitive, and behavioral elements. Temporally, catastrophizing cognitions predicted bodily weakness (r = 0.14, p < 0.01, 95% confidence interval (CI) [0.04-0.23]) and GS predicted somatic distress (r = 0.18, p < 0.05, 95% CI [0.04-0.33]). Potential causal pathways between catastrophizing cognitions and bodily weakness as well as GS and somatic distress may reflect treatment-related temporal change processes in patients with GS. Our study illustrates how dynamic NA can be used in the context of outcome research.

摘要

在这项概念验证研究中,我们采用系统观点来概念化和研究与常见功能性躯体综合征(FSS)即球感(GS)表现相关的症状和要素的治疗相关动态(时间和横断关联)。我们分析了 100 名接受团体心理治疗的 GS 患者的数据(M=47.1 岁,SD=14.4 岁;64%为女性),这些患者是一项随机对照试验(RCT)的一部分。在每次治疗后评估症状和要素。我们应用了多层次图形向量自回归(ml GVAR)模型方法,结果得到了分别用于情感、认知和行为维度的三个独立、互补的网络(时间、同期和个体间)。GS 与任何情感、认知和行为要素均无时间关联。从时间上看,灾难化认知预测身体虚弱(r=0.14,p<0.01,95%置信区间(CI)[0.04-0.23]),GS 预测躯体不适(r=0.18,p<0.05,95%CI [0.04-0.33])。灾难化认知与身体虚弱以及 GS 与躯体不适之间的潜在因果途径可能反映了 GS 患者治疗相关的时间变化过程。我们的研究说明了动态 NA 如何在结果研究中得到应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b28d/10511470/26b4aba86b6a/41598_2023_42186_Fig1_HTML.jpg

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