Fabiola Müller1,2,3,4,5, Mathilde G E Verdam6,7,8, Frans J Oort9, Heleen Riper10,11,12, Annemieke van Straten10,11, Irma M Verdonck-de Leeuw10,11,13, Mirjam A G Sprangers6,10,14,15, Hans Knoop6,10,14,16. 1. Medical Psychology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. f.mueller@amsterdamumc.nl. 2. Amsterdam Public Health, Global Health, Amsterdam, The Netherlands. f.mueller@amsterdamumc.nl. 3. Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands. f.mueller@amsterdamumc.nl. 4. Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands. f.mueller@amsterdamumc.nl. 5. Faculty of Science, School of Psychology, Quality of Life Office, The University of Sydney, Chris O'Brien Lifehouse (C39Z), Sydney, NSW, 2006, Australia. f.mueller@amsterdamumc.nl. 6. Medical Psychology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. 7. Amsterdam Public Health, Personalized Medicine, Amsterdam, The Netherlands. 8. Institute of Psychology, Department of Methodology and Statistics, Leiden University, Pieter de la Court Building, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands. 9. Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, The Netherlands. 10. Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands. 11. Department of Clinical, Neuro-, & Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. 12. Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands. 13. Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands. 14. Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands. 15. Aging & Later Life, Amsterdam Public Health, Amsterdam, The Netherlands. 16. Expert Center for Chronic Fatigue, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Cognitive behavioral therapy (CBT) is an evidence-based intervention for severe fatigue. Changes in patients' fatigue scores following CBT might reflect not only the intended relief in fatigue but also response shift, a change in the meaning of patients' self-evaluation. Objectives were to (1) identify the occurrence of response shift in patients undergoing CBT, (2) determine the impact of response shift on the intervention effect, and (3) investigate whether changes in fatigue-related cognitions and perceptions, targeted during CBT, are associated with response shift. METHODS: Data of three randomized controlled trials testing the efficacy of CBT in individuals with chronic fatigue syndrome (CFS, n = 222), cancer (n = 123), and diabetes (n = 107) were re-analyzed. Fatigue severity was measured with 8 items from the Checklist Individual Strength, a valid and widely used self-report questionnaire. Structural equation modelling was applied to assess lack of longitudinal measurement invariance, as indication of response shift. RESULTS: As expected, in all three trials, response shift was indicated in the CBT groups, not the control groups. Response shift through reprioritization was indicated for the items "Physically, I feel exhausted" (CFS) and "I tire easily" (cancer, diabetes), which became less vs. more important to the measurement of fatigue, respectively. However, this did not affect the intervention effects. Some changes in cognitions and perceptions were associated with the response shifts. CONCLUSIONS: CBT seems to induce response shift through reprioritization across patient groups, but its occurrence does not affect the intervention effect. Future research should corroborate these findings and investigate whether patients indeed change their understanding of fatigue.
BACKGROUND: Cognitive behavioral therapy (CBT) is an evidence-based intervention for severe fatigue. Changes in patients' fatigue scores following CBT might reflect not only the intended relief in fatigue but also response shift, a change in the meaning of patients' self-evaluation. Objectives were to (1) identify the occurrence of response shift in patients undergoing CBT, (2) determine the impact of response shift on the intervention effect, and (3) investigate whether changes in fatigue-related cognitions and perceptions, targeted during CBT, are associated with response shift. METHODS: Data of three randomized controlled trials testing the efficacy of CBT in individuals with chronic fatigue syndrome (CFS, n = 222), cancer (n = 123), and diabetes (n = 107) were re-analyzed. Fatigue severity was measured with 8 items from the Checklist Individual Strength, a valid and widely used self-report questionnaire. Structural equation modelling was applied to assess lack of longitudinal measurement invariance, as indication of response shift. RESULTS: As expected, in all three trials, response shift was indicated in the CBT groups, not the control groups. Response shift through reprioritization was indicated for the items "Physically, I feel exhausted" (CFS) and "I tire easily" (cancer, diabetes), which became less vs. more important to the measurement of fatigue, respectively. However, this did not affect the intervention effects. Some changes in cognitions and perceptions were associated with the response shifts. CONCLUSIONS: CBT seems to induce response shift through reprioritization across patient groups, but its occurrence does not affect the intervention effect. Future research should corroborate these findings and investigate whether patients indeed change their understanding of fatigue.
Authors: Jennifer M Jones; Karin Olson; Pamela Catton; Charles N Catton; Neil E Fleshner; Monika K Krzyzanowska; David R McCready; Rebecca K S Wong; Haiyan Jiang; Doris Howell Journal: J Cancer Surviv Date: 2015-04-16 Impact factor: 4.442
Authors: Juliane Menting; Stephanie Nikolaus; William M van der Veld; Martine M Goedendorp; Cees J Tack; Hans Knoop Journal: Diabetes Res Clin Pract Date: 2016-09-21 Impact factor: 5.602
Authors: J H Vercoulen; C M Swanink; J M Galama; J F Fennis; P J Jongen; O R Hommes; J W van der Meer; G Bleijenberg Journal: J Psychosom Res Date: 1998-12 Impact factor: 3.006
Authors: Hans Knoop; Gijs Bleijenberg; Marieke F M Gielissen; Jos W M van der Meer; Peter D White Journal: Psychother Psychosom Date: 2007 Impact factor: 17.659
Authors: H Prinsen; G Bleijenberg; L Heijmen; M J Zwarts; J W H Leer; A Heerschap; M T E Hopman; H W M van Laarhoven Journal: Support Care Cancer Date: 2013-03-22 Impact factor: 3.603
Authors: William C Reeves; Andrew Lloyd; Suzanne D Vernon; Nancy Klimas; Leonard A Jason; Gijs Bleijenberg; Birgitta Evengard; Peter D White; Rosane Nisenbaum; Elizabeth R Unger Journal: BMC Health Serv Res Date: 2003-12-31 Impact factor: 2.655