Cognitive Behavioral Therapy Complemented With Emotion Regulation Training for Patients With Somatic Symptom Disorder: 3-Year Follow-Up to a Randomized Controlled Trial

This manuscript is a 3-year follow-up analysis of a multicenter, randomized, parallel group, controlled trial (N = 254) employed with individuals struggling with somatic symptom disorder (SSD; Kleinstäuber et al., 2019) comparing the effects of cognitive behavioral therapy (CBT) alone and enriching cognitive behavioral therapy with emotion regulation training (ENCERT). Results from Kleinstäuber et al. (2019) suggested that both of these interventions were similarly efficacious for SSD for symptom severity (primary outcome), with moderate to large effects at post treatment and 6-month follow-up. Further analysis of secondary outcomes and moderation effects demonstrated results suggesting ENCERT was superior to CBT-SOMA for the emotion regulation skills of emotional understanding and emotional acceptance, as well more generally for individuals with comorbid psychological disorders (anxiety and depression). Our 3-year follow up results continued to demonstrate both CBT and ENCERT efficacy for SSD, with positive improvements in symptom severity and nearly all secondary outcomes maintaining their impacts between post-treatment and 3-year follow- up with non-significant differences between groups. Moderator analysis at this time-point did not indicate that either intervention was more helpful than the other for individuals with comorbidity. The most novel and important finding from this follow-up analysis was how lasting treatment impacts were for both of these groups over this long period of time. Future research is needed to determine if these long-term impacts are indicated in other studies and deeper evaluations of the most germane mechanisms of change for SSD improvement are indicated as an effort to better understand differentiations between CBT and emotion regulation training.