Illness Onset Characteristics in Children with Chronic Fatigue Syndrome and Idiopathic Chronic Fatigue

Background: Cognitive-behavioural models of chronic fatigue syndrome (CFS) suggest that personality factors such as perfectionism and high moral standards may contribute to the development of CFS. Aims: To investigate cognitive, behavioural and emotional processing risk factors for CFS. Method: CFS patients (n = 67) at a UK specialist clinic completed questionnaires about psychological characteristics both currently and retrospectively (6 months pre-CFS onset). Responses were compared with those of healthy individuals (n = 73) who rated their current characteristics. Forty-four relatives retrospectively rated the pre-morbid psychological characteristics of the CFS participants. Results: CFS patients showed similar levels of current perfectionism to controls, though higher pre-morbid perfectionism. CFS patients showed greater self-sacrificial beliefs and more unhelpful beliefs about experiencing and expressing negative emotions, both currently but more markedly prior to onset. In the 6 months pre-illness onset, CFS patients showed more disruption to their primary goal and greater general stress than controls. Ratings of pre-morbid psychological characteristics by relatives were consistent with patients’ self-reports. The extent of overinvestment in one goal was significantly associated with fatigue. Conclusions: Perfectionism, self-sacrificial tendencies, unhelpful beliefs about emotions, and perceived stress may be present to a greater extent pre-morbidly in CFS patients compared with healthy individuals.

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The ‘cognitive behavioural model’ of chronic fatigue syndrome: Critique of a flawed model

Health Psychology Open ◽

10.1177/2055102919838907 ◽

2019 ◽

Vol 6 (1) ◽

pp. 205510291983890 ◽

Cited By ~ 8

Author(s):

Keith Geraghty ◽

Leonard Jason ◽

Madison Sunnquist ◽

David Tuller ◽

Charlotte Blease ◽

...

Keyword(s):

Chronic Fatigue Syndrome ◽

Irrational Beliefs ◽

Chronic Fatigue ◽

Primary Treatment ◽

Behavioural Therapy ◽

Illness Onset ◽

Fatigue Syndrome ◽

Behavioural Model ◽

Cognitive Behavioural ◽

Change Beliefs

Chronic fatigue syndrome/myalgic encephalomyelitis is a debilitating illness that greatly impacts the lives of sufferers. A cognitive behavioural model attempts to explain illness onset and continuance with a hypothesis that the illness is perpetuated by patients’ irrational beliefs and avoidance behaviours. This theory underpins the promotion of cognitive behavioural therapy, a treatment that aims to change beliefs and behaviours. This article reports on a detailed review of the cognitive behavioural model. Our review finds that the model lacks high-quality evidential support, conflicts with accounts given by most patients and fails to account for accumulating biological evidence of pathological and physiological abnormalities found in patients. There is little scientific credibility in the claim that psycho-behavioural therapies are a primary treatment for this illness.

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The course of severe chronic fatigue syndrome in childhood

Journal of the Royal Society of Medicine ◽

10.1177/014107680009300306 ◽

2000 ◽

Vol 93 (3) ◽

pp. 129-134 ◽

Cited By ~ 71

Author(s):

L Rangel ◽

M E Garralda ◽

M Levin ◽

H Roberts

Keyword(s):

Chronic Fatigue Syndrome ◽

Bed Rest ◽

Chronic Fatigue ◽

Prognostic Indicators ◽

Illness Onset ◽

Fatigue Syndrome ◽

School Absence ◽

Duration Of Illness ◽

Severe Fatigue ◽

Recovery Assessment

Summary Little has been reported on prognostic indicators in children with chronic fatigue syndrome (CFS). We used interviews with children and parents, a mean of 45.5 months after illness onset, to follow up 25 cases of CFS referred to tertiary paediatric psychiatric clinics. At its worst, the illness had been markedly handicapping (prolonged bed-rest and school absence in two-thirds); mean time out of school was one academic year. Two-thirds, however, had recovered and resumed normal activities—mean duration of illness to recovery/assessment 38 months—and none had developed other medical conditions. Recovery was associated with specific physical triggers to the illness, with start of illness in the autumn school term and with higher socioeconomic status. Severe fatigue states in children can cause serious and longlasting handicap but most children recover.

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Housebound versus nonhousebound patients with myalgic encephalomyelitis and chronic fatigue syndrome

Chronic Illness ◽

10.1177/1742395316644770 ◽

2016 ◽

Vol 12 (4) ◽

pp. 292-307 ◽

Cited By ~ 22

Author(s):

Tricia Pendergrast ◽

Abigail Brown ◽

Madison Sunnquist ◽

Rachel Jantke ◽

Julia L Newton ◽

...

Keyword(s):

Chronic Fatigue Syndrome ◽

Bodily Pain ◽

Chronic Fatigue ◽

Health Impact ◽

Myalgic Encephalomyelitis ◽

Mental Functioning ◽

Immune Functioning ◽

Illness Onset ◽

Fatigue Syndrome ◽

Sf 36

Objectives The objective of this study was to examine individuals with myalgic encephalomyelitis and chronic fatigue syndrome who are confined to their homes due to severe symptomatology. The existing literature fails to address differences between this group, and less severe, nonhousebound patient populations. Methods Participants completed the DePaul Symptom Questionnaire, a measure of myalgic encephalomyelitis and chronic fatigue syndrome symptomology, and the SF-36, a measure of health impact on physical/mental functioning. ANOVAs and, where appropriate, MANCOVAS were used to compare housebound and nonhousebound patients with myalgic encephalomyelitis and chronic fatigue syndrome across areas of functioning, symptomatology, and illness onset characteristics. Results Findings indicated that the housebound group represented one quarter of the sample, and were significantly more impaired with regards to physical functioning, bodily pain, vitality, social functioning, fatigue, postexertional malaise, sleep, pain, neurocognitive, autonomic, neuroendocrine, and immune functioning compared to individuals who were not housebound. Discussion Findings indicated that housebound patients have more impairment on functional and symptom outcomes compared to those who were not housebound. Understanding the differences between housebound and not housebound groups holds implications for physicians and researchers as they develop interventions intended for patients who are most severely affected by this chronic illness.

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A twin study of cognitive function in chronic fatigue syndrome: The effects of sudden illness onset.

Neuropsychology ◽

10.1037/0894-4105.21.4.507 ◽

2007 ◽

Vol 21 (4) ◽

pp. 507-513 ◽

Cited By ~ 20

Author(s):

Keith H. Claypoole ◽

Carolyn Noonan ◽

Roderick K. Mahurin ◽

Jack Goldberg ◽

Tom Erickson ◽

...

Keyword(s):

Cognitive Function ◽

Chronic Fatigue Syndrome ◽

Twin Study ◽

Chronic Fatigue ◽

Illness Onset ◽

Fatigue Syndrome

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Long- and short-term blood pressure andRR-interval variability and psychosomatic distress in chronic fatigue syndrome: authors’ reply 1

Clinical Science ◽

10.1042/cs19990155 ◽

1999 ◽

Vol 97 (3) ◽

pp. 319 ◽

Cited By ~ 1

Author(s):

D.A. DUPREZ ◽

M.L. DE BUYZERE ◽

B. DRIEGHE ◽

F. VANHAVERBEKE ◽

Y. TAES ◽

...

Keyword(s):

Blood Pressure ◽

Chronic Fatigue Syndrome ◽

Chronic Fatigue ◽

Short Term ◽

Fatigue Syndrome

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Diagnostic Concordance Between Categorical and Dimensional Instruments to Assess Personality Disorder in Chronic Fatigue Syndrome

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000281 ◽

2017 ◽

Vol 33 (3) ◽

pp. 158-165

Author(s):

Natalia Calvo ◽

Naia Sáez-Francàs ◽

Sergi Valero ◽

Jesús Castro-Marrero ◽

José Alegre Martín ◽

...

Keyword(s):

Personality Disorder ◽

Chronic Fatigue Syndrome ◽

Personality Assessment ◽

Chronic Fatigue ◽

Specific Pattern ◽

Harm Avoidance ◽

Assessment Instrument ◽

Compulsive Disorder ◽

Fatigue Syndrome ◽

Self Transcendence

Abstract. The study examines the relationship between a categorical and a dimensional personality assessment instrument in patients with Chronic Fatigue Syndrome (CFS). A total of 162 CFS patients were included in the study (91.4% women; mean age 47.5 years). All subjects completed the Spanish versions of the Personality Diagnostic Questionnaire-4+ (PDQ-4+) and the Temperament and Character Inventory-Revised (TCI-R). Results: 78 (48.1%) of the patients presented a Personality Disorder (PD), the most frequent being Cluster C, specifically Obsessive-compulsive disorder, followed by Avoidant disorder. PDs showed a specific pattern of correlation with temperament scales. All PD clusters correlated positively with Harm Avoidance and Self-Transcendence, and negatively with Reward Dependence, Self-Directedness, and Cooperativeness. In a logistic regression analysis, Self-Directedness and Cooperativeness predicted PD presence. The findings are consistent with previous studies in non-CFS samples and suggest that the combination of the Temperament and Character dimensions (low Self-Directedness and Cooperativeness and high Harm Avoidance and Self-Transcendence) correlates with PD severity, and that Self-Directedness and Cooperativeness are associated with PD presence in CFS patients. The integration of these two perspectives expands the current comprehension of personality pathology in CFS patients.

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