A reexamination of the cognitive behavioral model of chronic fatigue syndrome, 2018, Madison Sunnquist, Leonard A Jason

http://onlinelibrary.wiley.com/doi/10.1002/jclp.22593/full

A reexamination of the cognitive behavioral model of chronic fatigue syndrome

Author Madison Sunnquist, Leonard A Jason

• 
  First published: 19 February 2018

DOI: 10.1002/jclp.22593

Abstract
Objective
The cognitive behavioral model of chronic fatigue syndrome (CFS) suggests that cognitions and reduced activity level perpetuate the fatigue and impairment that individuals with CFS experience. The two empirical evaluations of this model resulted in conflicting findings. The current study examines the influence of case definition fulfillment on the applicability of this model to CFS.

Method
A moderated mediation analysis was conducted on 990 individuals with CFS to reexamine the behavioral pathway of this model. Case definition fulfillment was entered as a moderator.

Results
Findings were generally inconsistent with the cognitive behavioral model of CFS. Case definition fulfillment significantly moderated the relation between activity level and physical impairment (β = –0.08, p = 0.03); individuals who met more stringent case definitions demonstrated a weaker relation between activity level and impairment.

Conclusions
This model may not accurately represent the experience of individuals with CFS, particularly those who fulfill more stringent case definitions.

 

This would make a basis for a great article. I'm thinking of pitching it myself.

 

Conclusions
This model does not accurately represent the experience of individuals with CFS, particularly those who fulfill more stringent case definitions.

Fixed!

How 'tired I feel' does not stop me from wanting to and/or undertake activities. An abnormal
rate of fatigability induced by even the most trivial levels of mental and/or physical activity, to the point that I have no further energy available to do any further activity, until I recover sufficiently well, is what stops me in my tracks. On this latter point, my ability to recover, even from trivial levels of activity, is severely impaired at my worst, and has no relationship to 'false illness beliefs', 'fear of exercise' or deconditioning.

Subjective fatigue questionnaires, in the absence of objective data, e.g. appropriate physical and neurological examinations/investigations noted over different time points in response to mental and physical activity, just doesn't cut it. Far too many patients have been caused serious harm by the 'scandalous' research undertaken by the BPS adherents, and how this so-called research has been used to inform the 'treatment' of PwME the world over, and is now being extended to other illnesses - the risks of serious harm with GET, directive CBT/GAT have been dismissed and ignored by far too many health professionals, and so many others. Far too many opportunities to pick up comorbidities and/or misdiagnoses have been missed, as well as benefits, care support needs, and health insurance claims wrongly denied.

Rant over, and back to the paper in question .. it was not until I read the ICC criteria in 2011, that I was able to develop some understanding of ME, and its relevance to my own health issues, experienced since September 2008. I recognise from my time online in the 'other place' and here, that 'consensus' criteria is not to everyone's liking. That said, I do think that it is a useful document, which can aid diagnosis and inform research practice, particularly in regard to identifying potential sub-groups of PwME.

My thanks to the authors for this paper.

Wishing everyone improved health and every happiness. John

 

My personal feeling is that this has been surreptitiously fostered by one of the most powerful forces there is - the political determination to cut financial costs, no matter what the human costs.

 

Results weren't as clear-cut as I would have liked. A result with p=0.08 is borderline in my view.

 

This is an interesting interpretation. Though I am not sure it is the only one possible.

 

Regarding the bolded bit, I would expect that activity level and impairment would correlate. I was surprised when the authors predicted they wouldn't.

 

The last sentence seems sympathetic though I'm not sure it is the only possibility.

An interesting suggestion. But it is only (fairly wild?) speculation at this stage.

 

Good

 

Concluding paragraph, but as I said I don't find the results that clear-cut.