Abstract
Fatigue is a common and disabling symptom in patients with multiple sclerosis (MS), but its pathogenesis is still poorly understood and consequently evidence-based treatment options are limited. Bol et al. (J Behav Med 33(5):355-363, 2010) suggested a new model, which explains fatigue in MS from a biopsychosocial perspective, including cognitive-behavioral factors. For purposes of generalization to clinical practice, cross-validation of this model in another sample of 218 patients with MS was performed using structural equation modeling. Path analysis indicated a close and adequate global fit (RMSEA = 0.053 and CFI = 0.992). The cross-validated model indicates a significant role for disease severity, depression and a fear-avoidance cycle in explaining MS-related fatigue. Modifiable factors, such as depression and catastrophizing thoughts, propose targets for treatment options. Our findings are in line with recent evidence for the effectiveness of a new generation of cognitive behavioral therapy, including acceptance and mindfulness-based interventions, and provide a theoretical framework for treating fatigue in MS.
Original language | English |
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Pages (from-to) | 815–822 |
Number of pages | 8 |
Journal | Journal of Behavioral Medicine |
Volume | 39 |
Issue number | 5 |
Early online date | 28 May 2016 |
DOIs | |
Publication status | Published - Oct 2016 |
Keywords
- Multiple sclerosis
- Fatigue
- Catastrophizing
- Physical disability
- Structural equation modelling
- Biopsychosocial model
- PAIN CATASTROPHIZING SCALE
- DEPRESSION SCALE
- HOSPITAL ANXIETY
- CONTROLLED-TRIAL
- DISABILITY
- FEAR
- QUESTIONNAIRES
- IMPAIRMENT
- MOVEMENT
- THERAPY