The pathway from glandular fever to chronic fatigue syndrome, 2011, Moss-Morris et al

ME/CFS Skeptic

ME/CFS Skeptic

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Ravn said:
who claims to have found that depression, anxiety and perfectionism all increase the risk of developing CFS after glandular fever.
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This is the paper she is referring to: The pathway from glandular fever to chronic fatigue syndrome: can the cognitive behavioural model provide the map?

I think the paper is worth a discussion because it is one of the few papers that actually tried to test the CBT-model using a prospective design. My first impression is that they didn't correct for multiple comparisons, so many of the 'significant' results in the individual logistic regression analysis such as perfectionism should probably not have been reported as such.

When all these factors were tested in a Multivariate logistic regression analysis along with gender, age and symptoms, only 'all-or-nothing behavior' remained a significant predictor. With correction for multiple comparisons, this would also be questioned. So I don't think these results are robust. The sample was also a bit small with only 17 EBV-patients who developed CFS after 6 months.
 
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https://sci-hub.se/10.1017/S003329171000139X

Abstract

Background. The cognitive behavioural model of chronic fatigue syndrome (CFS) suggests that the illness is caused through reciprocal interactions between physiology, cognition, emotion and behaviour. The purpose of this study was to investigate whether the psychological factors operationalized in this model could predict the onset of CFS following an acute episode of infectious mononucleosis commonly known as glandular fever (GF).

Method. A total of 246 patients with GF were recruited into this prospective cohort study. Standardized self-report measures of perceived stress, perfectionism, somatization, mood, illness beliefs and behaviour were completed at the time of their acute illness. Follow-up questionnaires determined the incidence of new-onset chronic fatigue (CF) at 3 months and CFS at 6 months post-infection.

Results. Of the participants, 9.4% met the criteria for CF at 3 months and 7.8% met the criteria for CFS at 6 months. Logistic regression revealed that factors proposed to predispose people to CFS including anxiety, depression, somatization and perfectionism were associated with new-onset CFS. Negative illness beliefs including perceiving GF to be a serious, distressing condition, that will last a long time and is uncontrollable, and responding to symptoms in an all-or-nothing behavioural pattern were also significant predictors. All-or-nothing behaviour was the most significant predictor of CFS at 6 months. Perceived stress and consistently limiting activity at the time of GF were not significantly associated with CFS.

Conclusions. The findings from this study provide support for the cognitive behavioural model and a good basis for developing prevention and early intervention strategies for CFS.
 
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The predictors that were "significant" at 3 months disappeared at 6 months, suggesting they are not relevant.

"all or nothing" behavioural questionnaire answers could be interesting, but could also represent biases in participation, those who felt their illness was significant enough to participate initially might have be blaming their stronger than expected symptoms on this behaviour for example.
 
Amw66 said:
Oxford/ Fukada for CFS?
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'fraid so...
Snow Leopard said:
"all or nothing" behavioural questionnaire answers could be interesting, but could also represent biases in participation, those who felt their illness was significant enough to participate initially might have be blaming their stronger than expected symptoms on this behaviour for example.
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I strongly suspect that whether or not you engage in "all or nothing behaviour" is as likely caused by your external circumstances at the time as by any fixed "personality" trait. I also strongly suspect the questionnaires used to identify such behaviour didn't distinguish between those different types of possible causes.
 
Ravn said:
'fraid so...

I strongly suspect that whether or not you engage in "all or nothing behaviour" is as likely caused by your external circumstances at the time as by any fixed "personality" trait. I also strongly suspect the questionnaires used to identify such behaviour didn't distinguish between those different types of possible causes.
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Boom or bust by another name
 
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