Personality Features and Personality Disorders in Chronic Fatigue Syndrome: A Population-Based Study

Abstract

Background: Chronic fatigue syndrome (CFS) presents unique diagnostic and management challenges. Personality may be a risk factor for CFS and may contribute to the maintenance of the illness. Methods: 501 study participants were identified from the general population of Georgia: 113 people with CFS, 264 with unexplained unwellness but not CFS (insufficient fatigue, ISF) and 124 well controls. We used the Personality Diagnostic Questionnaire, 4th edition, to evaluate DSM-IV personality disorders. We used the NEO Five-Factor Inventory to assess personality features (neuroticism, extraversion, openness, agreeableness and conscientiousness). The Multidimensional Fatigue Inventory measured 5 dimensions of fatigue, and the Medical Outcomes Survey Short Form 36 measured 8 dimensions of functional impairment. Results: Twenty-nine percent of the CFS cases had at least 1 personality disorder, compared to 28% of the ISF cases and 7% of the well controls. The prevalence of paranoid, schizoid, avoidant, obsessive-compulsive and depressive personality disorders were significantly higher in CFS and ISF compared to the well controls. The CFS cases had significantly higher scores on neuroticism, and significantly lower scores on extraversion than those with ISF or the well controls. Personality features were correlated with selected composite characteristics of fatigue. Conclusions: Our results suggest that CFS is associated with an increased prevalence of maladaptive personality features and personality disorders. This might be associated with being noncompliant with treatment suggestions, displaying unhealthy behavioral strategies and lacking a stable social environment. Since maladaptive personality is not specific to CFS, it might be associated with illness per se rather than with a specific condition.

Accuracy and bias in retrospective symptom reporting

“…First, momentary assessments reveal experiential knowledge or information provided by an experiencing self in a "here-and-now" context. They are therefore more closely related than retrospective measures to objective measures of biobehavioral processes involved in being and behaving in that context, such as parameters of autonomic, neuro-endocrine and immune functioning as well as to affective networks in the brain that are associated with experiencing a particular state [63][64][65].…”

A Psychometric Study of the Multidimensional Fatigue Inventory to Assess Fatigue in Patients with Schizophrenia Spectrum Disorders

“…The scale has shown good psychometric properties for several diagnostic groups, such as Chronic Fatigue Disorder, Parkinson´s disease, Cancer, Chronic widespread pain and Fibromyalgia (Elbers, van Wegen, Verhoef, & Kwakkel, 2012;Ericsson & Mannerkorpi, 2007;Lundh Hagelin, Wengström, Runesdotter & Fürst, 2007;Smets et al 1995). MFI-20 has also been compared to assessments of depression, anxiety, personality disorders, cognitive impairments, health status (SF-36) and different physiological variables such as vital capacity (Alsén et al 2010;Breukink et al 1998;Bol, Duits, Hupperts, Verlinden, & Verhey, 2010;Lin et al 2009;Nater et al 2010). The MFI-20 has been shown to have an overlapping variance with scores for depression, anxiety but also seems to reflect fatigue as a unique experience, as the opposite to vitality (Lin et al 2009;Schneider, 1998;Stepnowsky et al 2011).…”

Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism

“…In particular the trait 'neuroticism', which is characterized as the degree of emotional instability, associated with a tendency to experience negative emotions, a vulnerability for stress and for psychopathology, may be relevant [33]. First, neuroticism is presumed to be one of the predisposing factors of CFS in [4][5]34] in biopsychosocial accounts. Second, there is preliminary evidence that neuroticism negatively influences illness acceptance and mental wellbeing in CFS [31].…”