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Coping styles in people with chronic fatigue syndrome identified from the general population of Wichita, KS.

Nater UM, Wagner D, Solomon L, Jones FJ, Unger ER, Papanicolaou DA, Reeves WC, Heim C.
Coping styles in people with chronic fatigue syndrome identified from the general population of Wichita, KS.
Journal of Psychosomatic Research 2006, 60:597-573

Summary

Studies to identify the pathophysiology of CFS must consider that the illness most likely involves contributions of multiple biological, psychological, social and environmental factors. Cognitive-behavioral factors, such as maladaptive coping styles, may contribute to the pathogenesis and maintenance of CFS and we conducted this analysis to identify and describe coping styles associated with CFS. This analysis included 43 persons with CFS, 61 persons with medically and psychiatrically unexplained fatiguing illness – not CFS, and 60 non fatigued controls; all subjects were identified from the general population of Wichita. We used the Ways of Coping Questionnaire to measure coping styles. This is a standardized, validated 66-item self-report questionnaire that evaluates 8 coping strategies: 1) Escape-Avoidance; 2) Confrontation; 3) distancing; 4) Self-Controlling; 5) Social Support; 6) Accepting Responsibility; 7) Planful Problem Solving; 8) Positive Reappraisal. Both of the fatigued groups were significantly more likely to use Escape-Avoidance coping strategies than the non-fatigued controls, but the two fatigued groups were similar. Escape-Avoidance scores were also associated with illness severity. The association of Escape-Avoidance with illness severity suggests this maladaptive means of coping may associated with persistence of CFS symptoms.

Abstract

Objective : Studies of primary and tertiary care patients suggest that maladaptive coping styles contribute to the pathogenesis and maintenance of chronic fatigue syndrome (CFS). We assessed coping styles in persons with unexplained fatigue and nonfatigued controls in a population-based study.

Methods : We enrolled 43 subjects meeting the 1994 Research Case Definition of CFS, matching them with 61 subjects with chronic unexplained fatigue who did not meet criteria for CFS [we term them insufficient symptoms or fatigue (ISF)] and 60 non-ill (NI) controls. Coping styles and clinical features of CFS were assessed using standard rating scales.

Results : Subjects with CFS and ISF reported significantly more escape-avoiding behavior than NI controls. There were no differences between the CFS and ISF subjects. Among participants with CFS, escape-avoiding behavior was associated with fatigue severity, pain, and disability.

Conclusions : We demonstrate significantly higher reporting of maladaptive coping in a population-based sample of people with CFS and other unexplained fatiguing illnesses defined by reproducible standardized clinical empirical means in comparison to NI controls.

Page last modified on October 24, 2007

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