# psychoogy of CFS



## trbell (Nov 1, 2000)

I think this also applies to IBS. May be reposted to IMEGA-e, FreeMEUk, and all Dutch lists.I have been asked by several people for my opinion of the new paper by Jasonet al (Journal of Mental Health, 2003, 12, 2, 109-118). For those who do notknow me, I am a trained health psychologist who specialises in ME and CFS,and who disagrees both with the concept of CFS as currently defined (anumbrella term covering a multitude of ills) and the CBT model of CFS (whichI do not believe is relevant to 'subgroups' like ME).I do not agree with those who see this paper as supporting the CBT model. Tothe contrary. I would note that the researchers used the standard criteriafor CFS, that they also used valid measures of coping plus an extremelyuseful coping scale designed specifically for people with MEPVFS (IMQ), andthat the comparison of people with CFS, fatigue due to medical disordersand a group with more general fatigue is sound. I certainly don't feel thatthis design indicates that the authors don't regard CFS as 'medical'.Since CFS remains an umbrella term, a significant number of people will beusing strategies like phobic avoidance, which is often correlated with poormental health. This does not mean that people with conditions like ME makeuse of the same strategies and that their results would be similar. This wasa study on CFS. So finding links between avoidance strategies likebehavioural disengagement and poor mental health is to be expected.I personally look forward to the day when colleagues become more interestedin the subgroups like ME, and compare and contrast these patients with thosefulfilling broader criteria for CFS. However, I can't say that this papershould be a cause for concern. If it were, I'd say so.Ellen Goudsmit C.Psychol.This is a summary of the paper, plus an editorial note with personalcomments.Jason, LA., Witter, E and Torres-Harding, S. Chronic fatigue syndrome,coping, optimism and social support. Journal of Mental Health, 2003, 12, 2,109-118.Prior studies indicate that problem-focused coping, a realistic optimisticexplanatory style, and appropriate social support appear to be related topositive health outcomes and greater well﷓being. It was hypothesizedthat coping styles, optimism, amount of social support and quality of socialsupport would significantly differ among those with CFS (CDC criteria '94),idiopathic chronic fatigue, chronic fatigue resulting from a medicalcondition, and a control group.Participants in the idiopathic chronic fatigue group had the lowest optimismscores and satisfaction with their social supports. Those in the medicallyexplained condition used significantly more venting and focusing on symptomsthan controls. The CFS group had higher levels of optimism and satisfactionwith social supports than the other two chronically fatigued groups, andbehavioral disengagement was related to worse mental composite scores (MOS),while maintaining activities and optimism was related to more positivemental composite scores. Thus psychological factors, such as coping styles,optimism, and perceived social support are correlated with mental andphysical health outcomes...[Ed. note: The CFS group did not have higher scores than the controls ormedically explained fatigue group for focusing on symptoms. This issignificant given the speculation about introspection. There were alsosimilar scores for maintaining activity. As a group, the scores forbehavioural disengagement were not significantly different from those ofthe medically explained fatigue group. Thus there is little evidence for thenotion of mass 'avoidance', promoted by the CBT school.]----------------------------------------------------------------------Dr. Ellen Goudsmit C.Psychol.For information about ME and CFS, see: http://freespace.virgin.net/david.axford/me/me.htm _________________________________________________________________Sign-up for a FREE BT Broadband connection today! http://www.msn.co.uk/specials/btbroadband --------------------------------------------- Co-Cure Web Site: http://www.co-cure.org/ Send posts to mailto:CO-CURE###listserv.nodak.edu Join or leave the list at http://www.co-cure.org/sub.htm Co-Cure is not a discussion list. Please do not reply to the list. ---------------------------------------------tom


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## kel1059 (Feb 28, 2003)

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