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https://www.sciencedirect.com/science/article/abs/pii/S0165032719334561
Journal of Affective Disorders
Available online 22 May 2020
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Research paper
Do adolescents with Chronic Fatigue Syndrome (CFS/ME) and co-morbid anxiety and/or depressive symptoms think differently to those who do not have co-morbid psychopathology?
Dr Maria ELoadesab
Prof PaulStallardc
Prof RichardMorrisb
Prof DavidKesslerb
Prof EstherCrawleyb
a
Department of Psychology, University of Bath, United Kingdom
b
Bristol Medical School, University of Bristol, United Kingdom
c
Department of Health, University of Bath, United Kingdom
Received 15 January 2020, Revised 25 March 2020, Accepted 17 May 2020, Available online 22 May 2020.
https://doi.org/10.1016/j.jad.2020.05.113
Highlights
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Adolescents with CFS with co-morbid anxiety and/or depression symptoms more strongly endorsed general negative cognitive errors.
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They also more strongly endorsed fatigue-specific damage beliefs, embarrassment avoidance, catastrophising and symptom focusing thinking patterns.
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Adolescents with CFS with co-morbid psychopathology did not differ significantly on fatigue-specific fear avoidance responses from those without co-morbid psychopathology.
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Both negative cognitive errors and unhelpful responses to symptoms made independent contributions to the variance in psychopathology.
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This may have implications for the sequencing of cognitive and behavioural strategies to address both general and fatigue specific negative thinking for those with co-morbid psychopathology.
Abstract
Background
Co-morbid anxiety and/or depression is common in adolescents with Chronic Fatigue Syndrome (CFS/ME). Adolescents with psychopathology typically endorse more negative cognitive errors. We don't know whether they make negative cognitive errors in response to fatigue. We examined the thinking patterns of adolescents with CFS/ME and co-morbid psychopathology compared to those without this co-morbidity.
Methods
This cross-sectional study recruited 205 adolescents (age 11-18) with CFS/ME, who completed measures of anxiety and depression, information processing biases and responses to fatigue. We grouped participants as having co-morbid psychopathology (or not) by applying a threshold score. We compared groups’ thinking pattern subscale scores using independent samples T tests. We examined the association between psychopathology and general negative thinking and specific responses to fatigue symptoms.
Results
Adolescents with CFS/ME with co-morbid psychopathology more strongly endorsed general negative cognitive errors (d = 0.61-1.31). They also more strongly endorsed damage beliefs (d = 0.49), embarrassment avoidance (d = 1.05), catastrophising (d = 0.97) and symptom focusing (d = 0.75) in response to fatigue but did not differ significantly on fear avoidance from those without co-morbid psychopathology. Both negative cognitive errors and unhelpful responses to symptoms explained 43% of the variance in psychopathology.
Conclusions
Adolescents with CFS/ME with co-morbid psychopathology tend to be negatively biased in their thinking, both generally and about their symptoms of fatigue specifically. This may have implications for the sequencing of cognitive and behavioural strategies to address both fatigue and psychopathology.
Keywords
Paediatric
CFS/ME
Mood
depression
Anxiety
Cognitions
Psychopathology