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. 2018;6(1):56-65.
doi: 10.1080/21635781.2017.1337594. Epub 2017 Jul 11.

Telephone-Based versus In-Person Delivery of Cognitive Behavioral Treatment for Veterans with Chronic Multisymptom Illness: A Controlled, Randomized Trial

Lisa M McAndrew  1   2 , Lauren M Greenberg  1 , Donald S Ciccone  3 , Drew A Helmer  1   4 , Helena K Chandler  1
Affiliations

Telephone-Based versus In-Person Delivery of Cognitive Behavioral Treatment for Veterans with Chronic Multisymptom Illness: A Controlled, Randomized Trial

Lisa M McAndrew et al. Mil Behav Health. 2018.

Abstract

Background: The goal of this randomized clinical trial was to examine the efficacy of a cognitive behavioral stress reduction treatment for reducing disability among veterans with chronic multisymptom illness (CMI).

Method: Veterans (N=128) who endorsed symptoms of CMI were randomized to: usual care (n=43), in-person (n=42) or telephone-delivered cognitive behavioral stress management (n=43). Assessments were conducted at baseline, three months, and twelve months. The primary outcome was limitation in roles at work and home (i.e., 'role physical'). Reductions in catastrophizing cognitions were evaluated as a mechanism of action.

Results: Intent-to-treat analyses showed no statistically significant main effect (F(2, 164)=.58, p=.56) or interaction effect (F(4,164)=.94, p=.45) for role physical. Over time, veterans improved in their physical function (F(2,170)=5.34, p<.01; ὴ2 partial=.06), PTSD symptoms (F(2,170)=9.39, p<.01; ὴ2 partial=.10), depressive symptoms (F(2,170)=10.81, p<.01, ὴ2 partial=.11), and physical symptoms (F(2, 172)=12.65, p<.01; ὴ2 partial=.13), but these improvements did not differ across study arms over time. Completer analyses yielded similar results. There were no differences in catastrophizing between arms.

Conclusion: Findings suggest stress reduction may not be the right target for improving disability among veterans with CMI. Veterans with CMI may need intervention that directly impacts medical self-management to improve disability.

Keywords: chronic multisymptom illness; clinical trial; cognitive behavioral therapy; disability; null results; stress management.

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References

    1. Afari N, Ahumada SM, Wright LJ, Mostoufi S, Golnari G, Reis V, & Cuneo JG (2014). Psychological Trauma and Functional Somatic Syndromes: A Systematic Review and Meta-Analysis. Psychosomatic Medicine, 76(1), 2–11. doi: 10.1097/psy.0000000000000010 - DOI - PMC - PubMed
    1. Association AP (1994). Diagnostic and statistical manual of mental disorders: DSM-IV (4th ed.): Washington, DC: American Psychiatric Association.
    1. Blanchard EB, J.-A. J; Buckley TC; Forneris CA (1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy, 34, 669–673. - PubMed
    1. Blanchard MS, Eisen SA, Alpern R, Karlinsky J, Toomey R, Reda DJ, … Kang HK (2006). Chronic Multisymptom Illness Complex in Gulf War I Veterans 10 Years Later. Am J Epidemiol, 163(1), 66–75. doi: 10.1093/aje/kwj008 - DOI - PubMed
    1. Donta ST, Clauw DJ, Engel CC Jr., Guarino P, Peduzzi P, Williams DA, … Feussner JR (2003). Cognitive behavioral therapy and aerobic exercise for Gulf War veterans’ illnesses: a randomized controlled trial. [Clinical Trial Randomized Controlled Trial Research Support, U.S. Gov’t, Non-P.H.S.]. JAMA, 289(11), 1396–1404. - PubMed

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