Chronic fatigue in the community: ‘A question of attribution’

Abstract

SynopsisThirty-eight subjects identified in a large community survey were found to attribute their fatigue to ‘myalgic encephalomyelitis’ (ME). They were matched randomly to two other groups of subjects who attributed their fatigue to either psychological or social factors. All three groups were followed up 18 months later and were asked to complete a series of questionnaires that examined fatigue, psychological distress, number of symptoms, attributional style and levels of disability. At onset the ‘ME’ group were found to be more fatigued, had been tired for longer but were less psychologically distressed than the other two groups. At follow-up the ‘ME’ group were more handicapped in relation to home, work, social and private leisure activities, even when controlling for both duration of fatigue and fatigue at time 1, but were less psychologically distressed. The relationships between psychological distress, specific illness attributions, attributional style and their effect on the experience of illness and its prognosis are discussed. Attributing fatigue to social reasons appears to be most protective.

Costs, correlates and consequences of fatigue in children and adults

“…Three of the significant predictions were consistent with studies of CFS in secondary care (Sharpe et al 1992 ;Wilson et al 1994 ;Clark et al 1995;Chalder et al 1996 ;Vercoulen et al 1996). The novel finding was the lack of memory of a previous emotional reason for attending their GP.…”

Managing Sexual Difficulties: A Qualitative Investigation of Coping Strategies

“…And better communication with a partner about sexual needs was shown to be inversely associated with sexual distress in a postal survey of Australian women (Hayes et al, 2008). Finally, attribution has been shown to be important for adjustment to female dyspareunia (Meana, Binik, Khalife, & Cohen, 1999), as well as other chronic conditions (see Chalder, Power, & Wessely, 1996, for example). The relationship context is particularly important here.…”

The prognosis of different fatigue diagnostic labels: a longitudinal survey

“…28 A study comparing matched fatigued patients found that those who attributed their fatigue to ME had a worse prognosis than patients who attributed their fatigue to psychological or social factors. 29 It is possible that the label ME with its suggestion of an untreatable pathological process may somehow render the patient less able to combat their symptoms and disability than other labels. The second explanation is that those who are destined to have a worse prognosis preferentially attract the label ME, perhaps by self-diagnosis.…”