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Open Access 01-10-2010

Fatigue and physical disability in patients with multiple sclerosis: a structural equation modeling approach

Authors: Yvonne Bol, Annelien A. Duits, Richel Lousberg, Raymond M. M. Hupperts, Michelle H. P. Lacroix, Frans R. J. Verhey, Johan W. S. Vlaeyen

Published in: Journal of Behavioral Medicine | Issue 5/2010

Abstract

Although fatigue is one of the most common and disabling symptoms in patients with multiple sclerosis (MS), its pathogenesis is still poorly understood and it is difficult to treat. The aim of the current study was to test the assumptions of a cognitive-behavioral model that explains fatigue and physical disability in MS patients, by comparing this approach with a more traditional biomedical approach. Structural equation modeling was applied to a sample of 262 MS patients. Neither the cognitive-behavioral, nor the biomedical model showed an adequate fit of our data. The modification indices supported an integration of both models, which showed a better fit than those of the separate models. This final model, is notable for at least three features: (1) fatigue is associated with depression and physical disability, (2) physical disability is associated with disease severity and fatigue-related fear and avoidance behavior, and (3) catastrophic interpretations about fatigue, fueled by depression, mediated the relationship between fatigue and fatigue-related fear and avoidance behavior. Our results suggest that an integrated approach, including the modification of catastrophic thoughts about fatigue, would be beneficial in the treatment of fatigue in MS patients.

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Title: Fatigue and physical disability in patients with multiple sclerosis: a structural equation modeling approach
Authors: Yvonne Bol
Annelien A. Duits
Richel Lousberg
Raymond M. M. Hupperts
Michelle H. P. Lacroix
Frans R. J. Verhey
Johan W. S. Vlaeyen
Publication date: 01-10-2010
Publisher: Springer US
Published in: Journal of Behavioral Medicine / Issue 5/2010
Print ISSN: 0160-7715
Electronic ISSN: 1573-3521
DOI: https://doi.org/10.1007/s10865-010-9266-8

At a glance: The STEP trials

Springer Medicine

Fatigue and physical disability in patients with multiple sclerosis: a structural equation modeling approach

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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