Abstract

Objective:

Understanding psychological mechanisms of change is essential to advance treatments for patients suffering from medically unexplained physical symptoms (MUPS). This study aimed to test the role of selected change mechanisms (incl. interoceptive awareness, emotional regulation skills, symptom acceptance, relational needs satisfaction, clarification of meaning, working alliance, and group cohesion) in the modification of patients’ somatic symptom intensity and well-being.

Method:

N = 290 patients suffering from MUPS participated in a multi-component group-based treatment at seven clinical sites. Data were collected weekly. Multi-level modeling was used to test cross-lagged relationships between the hypothesized mechanisms and outcomes in terms of Granger causality (with lags of 1, 2, and 3 weeks).

Results:

None of the mechanisms predicted a time-lagged change in outcomes in the expected direction. In fact, there was a consistent pattern of negative time-lagged relationships (i.e., an increase in a mechanism predicted worsening of the outcome). Findings consistent with the hypothesized role of the mechanisms were found only in concurrent relationships between mechanisms and outcomes.

Conclusion:

This study did not support time-lagged relationships under the condition of weekly measurement and many methodological factors remain to be considered (e.g., a finer time resolution).

中文翻译：

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医学上无法解释的躯体症状患者多组分分组治疗的变化机制

摘要

目的：

了解变化的心理机制对于推进对患有医学上无法解释的身体症状 (MUPS) 的患者的治疗至关重要。本研究旨在测试选定的改变机制（包括内感受意识、情绪调节技能、症状接受、关系需求满足、意义澄清、工作联盟和团队凝聚力）在改变患者躯体症状强度和良好状态中的作用。 -存在。

方法：

N  = 290 名患有 MUPS 的患者在七个临床地点参加了基于多组分组的治疗。每周收集数据。多层次建模用于根据格兰杰因果关系（滞后 1、2 和 3 周）测试假设机制和结果之间的交叉滞后关系。

结果：

没有一种机制预测到预期方向的结果会出现时间滞后的变化。事实上，负时间滞后关系存在一致的模式（即预测结果恶化的机制的增加）。与机制的假设作用一致的发现仅在机制和结果之间的并发关系中被发现。

结论：

该研究不支持每周测量条件下的时间滞后关系，许多方法学因素仍有待考虑（例如，更精细的时间分辨率）。