A reexamination of the cognitive behavioral model of chronic fatigue syndrome

Sunnquist, Madison; Jason, Leonard A.

doi:10.1002/jclp.22593

Cited by 10 publications

(8 citation statements)

References 33 publications

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“…This has led to the predominant recommendation of CBT and GET as effective treatments. However, reviews by Song and Jason in 2005 [ 15 ] and Sunnquist and Jason in 2018 [ 16 ] showed that, if patients are selected who fulfil more stringent case definitions, so that ME/CFS patients are selected instead of those with a fatiguing psychiatric illness, then they do not possess the behavioural characteristics targeted by the CB model. Also, Geraghty et al [ 17 ] concluded that “the CBM [CB model] is not fit for purpose, as it poorly reflects the accounts given by patients and it ignores the wealth of evidence showing biological, immune and neurological dysfunction in ME/CFS”.…”

Section: Introductionmentioning

confidence: 99%

Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID?

Vink¹,

Vink-Niese

2022

Healthcare

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For the last few decades, medical guidelines have recommended treating patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) with graded exercise therapy (GET) and cognitive behavioural therapy (CBT). Moreover, doctors have questioned the recovery behaviour of these patients and stimulated them to follow these treatments so that they would be able to go back to work. In this article, we reviewed trials of GET and CBT for ME/CFS that reported on work status before and after treatment to answer the question of whether doctors should continue to question the recovery behaviour of patients with ME/CFS. Our review shows that more patients are unable to work after treatment than before treatment with CBT and GET. It also highlights the fact that both treatments are unsafe for patients with ME/CFS. Therefore, questioning the recovery behaviour of patients with ME/CFS is pointless. This confirms the conclusion from the British National Institute for Health and Care Excellence (NICE), which has recently published its updated ME/CFS guideline and concluded that CBT and GET are not effective and do not lead to recovery. Studies on CBT and GET for long COVID have not yet been published. However, this review offers no support for their use in improving the recovery of patients with an ME/CFS-like illness after infection with COVID-19, nor does it lend any support to the practice of questioning the recovery behaviour of these patients.

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Section: Introductionmentioning

confidence: 99%

Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID?

Vink¹,

Vink-Niese

2022

Healthcare

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“…Challenges to the CBM, in terms of efficacy and applicability, are scant in the literature and have not addressed the CBM in totality. Various studies have shown that patients do not possess some of the personality or behavioural characteristics deemed targets of treatment in the CBM (Song and Jason, 2005; Sunnquist and Jason, 2018). More recently, the model has come under scrutiny following publication of controversial clinical trials of CBT-GET, such as the PACE trial (Pacing, graded Activity, and Cognitive behaviour therapy: a randomised Evaluation) and the FINE trial (Fatigue Intervention by Nurses Evaluation) (Wearden et al, 2010; White et al, 2011) that sought to validate the CBM.…”

Section: Introductionmentioning

confidence: 99%

The ‘cognitive behavioural model’ of chronic fatigue syndrome: Critique of a flawed model

Geraghty

Jason

Sunnquist

et al. 2019

Health Psychology Open

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Chronic fatigue syndrome/myalgic encephalomyelitis is a debilitating illness that greatly impacts the lives of sufferers. A cognitive behavioural model attempts to explain illness onset and continuance with a hypothesis that the illness is perpetuated by patients’ irrational beliefs and avoidance behaviours. This theory underpins the promotion of cognitive behavioural therapy, a treatment that aims to change beliefs and behaviours. This article reports on a detailed review of the cognitive behavioural model. Our review finds that the model lacks high-quality evidential support, conflicts with accounts given by most patients and fails to account for accumulating biological evidence of pathological and physiological abnormalities found in patients. There is little scientific credibility in the claim that psycho-behavioural therapies are a primary treatment for this illness.

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“…Davinton et al, 2004 ; Wessely et al, 1991 ). The methodology applied by Vercoulen et al (1998) was subsequently criticized, because the model could not be replicated for people fulfilling the ME/CFS case definitions ( Sunnquist and Jason, 2018 ), and CBT and GET have been shown to have null effects or even aggravate ME/CFS symptoms (e.g. Kindlon, 2017 ; Wilshire et al, 2018 ).…”

Section: The Role Of Causal Attributions For Stigma In Me/cfsmentioning

confidence: 99%

Causal attributions and perceived stigma for myalgic encephalomyelitis/chronic fatigue syndrome

Froehlich

Hattesohl²,

Cotler

et al. 2021

J Health Psychol

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Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic disease with the hallmark symptom of post-exertional malaise. Evidence for physiological causes is converging, however, currently no diagnostic test or biomarker is available. People with ME/CFS experience stigmatization, including the perception that the disease is psychosomatic. In a sample of 499 participants with self-diagnosed ME/CFS, we investigated perceived stigma as a pathway through which perceived others’ causal attributions relate to lower satisfaction with social roles and activities and functional status. Higher perceived attributions by others to controllable and unstable causes predicted lower health-related and social outcomes via higher perceived stigma.

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A reexamination of the cognitive behavioral model of chronic fatigue syndrome

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

Cited by 10 publications

References 33 publications

Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID?

Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID?

The ‘cognitive behavioural model’ of chronic fatigue syndrome: Critique of a flawed model

Causal attributions and perceived stigma for myalgic encephalomyelitis/chronic fatigue syndrome

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