Stress and resilience in functional somatic syndromes--a structural equation modeling approach.
BACKGROUND
Stress has been suggested to play a role in the development and perpetuation of functional somatic syndromes. The mechanisms of how this might occur are not clear.


OBJECTIVE
We propose a multi-dimensional stress model which posits that childhood trauma increases adult stress reactivity (i.e., an individual's tendency to respond strongly to stressors) and reduces resilience (e.g., the belief in one's competence). This in turn facilitates the manifestation of functional somatic syndromes via chronic stress. We tested this model cross-sectionally and prospectively.


METHODS
Young adults participated in a web survey at two time points. Structural equation modeling was used to test our model. The final sample consisted of 3'054 participants, and 429 of these participated in the follow-up survey.


RESULTS
Our proposed model fit the data in the cross-sectional (χ2(21)  = 48.808, p<.001, CFI  = .995, TLI  = .992, RMSEA  = .021, 90% CI [.013.029]) and prospective analyses (χ2(21)  =  32.675, p<.05, CFI  = .982, TLI  = .969, RMSEA  = .036, 90% CI [.001.059]).


CONCLUSIONS
Our findings have several clinical implications, suggesting a role for stress management training in the prevention and treatment of functional somatic syndromes.
Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Hesse, Germany.
Susanne
S
Fischer
Methodology and Social Psychology, Department of Psychology, University of Marburg, Marburg, Hesse, Germany.
Gunnar
G
Lemmer
Methodology and Social Psychology, Department of Psychology, University of Marburg, Marburg, Hesse, Germany.
Mario
M
Gollwitzer
Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Hesse, Germany.
Urs M
UM
Nater
D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D055500:Resilience, Psychological; D013315:Stress, Psychological / Q000523:psychology*; D013577:Syndrome