Psychological Adjustment of Adolescent Girls With Chronic Fatigue Syndrome

Abstract

ABSTRACT. Objective. To examine psychosocial problems and adaptation of adolescent girls with chronic fatigue syndrome (CFS).Methodology. Thirty-six adolescent girls with CFS (mean age: 15.2 years; mean syndrome duration: 19.7 months) who fulfilled the criteria of the Centers for Disease Control and Prevention were examined by interviews regarding premorbid problems and by questionnaires regarding psychosocial functioning and distress, psychological attitudes, and coping resources. Data were compared with normative data.Results. Of the adolescents, 86.1% reported 1 or more premorbid problems (58.3% physical, 38.9% psychological, and 52.8% familial). Normal adjustment was reported for psychosocial self-esteem, social abilities, and attentional abilities. High adjustment to adult social standards of behavior was found, but low perceived competence in specific adolescent domains, such as athletic ability, romance, and participation in recreational activities. The girls reported predominantly internalizing problems. Normal achievement motivation, no debilitating fear of failure, and high internal locus of control were observed. Palliative reaction patterns and optimism were predominantly used as coping strategies.Conclusions. The large number of premorbid problems suggests a possible contributing factor to the onset of the syndrome, although there were no reference data of healthy adolescents. In distinct domains of psychosocial adjustment, the adolescent girls with CFS showed strengths such as adequate self-esteem and scholastic and social abilities, and weaknesses such as low competence in adolescent-specific tasks and internalizing distress, which may partly be explained by syndrome-specific somatic complaints. The use of optimistic and palliative reaction patterns as coping strategies in this patient group indicates that the patients with CFS seem to retain an active and positive outlook on life, which may result in a rather adequate psychological adaptation to the syndrome, but also in maintenance of the syndrome by exceeding the physical limits brought about by the CFS. Our results on adjustment and coping strategies may be helpful to implement (individual) rehabilitation programs. Pediatrics 2001;107(3). URL: http://www. pediatrics.org/cgi/content/full/107/3/e35; chronic fatigue syndrome, adolescents, female, psychological adjustment, coping behavior.

Depression in paediatric chronic fatigue syndrome

“…Our study is consistent with previous smaller studies which have demonstrated a higher rate of depression in adolescents with CFS/ME than in healthy controls9 10 and higher depression scores in those with CFS/ME than in the general population 12. We found that children with higher HADS depression scores also had higher HADS anxiety scores, which is consistent with previous studies 8 24.…”

“…Several small case-control studies describe a higher rate of depression in adolescents with CFS/ME than in healthy controls9–11 and higher depression scores than seen in the general population 12. Rates of depression are higher in adolescents with CFS/ME than in adolescents with other chronic illnesses such as juvenile idiopathic arthritis and migraine 10 13.…”

Depression and anxiety in children with CFS/ME: cause or effect?

“…However, drawing firm conclusions from this literature is difficult, as some studies have been quite small (table 1). The studies were set within tertiary referral centres and one was based within a psychology department,17 so the patient group may not be representative of children and adolescents in the general population. Comparison was made with normative population data,11 12 age- and sex-matched healthy controls from a local school,14 young people registered with a local general practitioner9 and with children referred to tertiary services with migraine14 and JIA 13.…”

Generalized Joint Hypermobility Is More Common in Chronic Fatigue Syndrome Than in Healthy Control Subjects

“…12 The pathogenesis of the illness has not been completely delineated, 13 but it is most likely that CFS is characterized by a combination of both physiologic and psychologic impairments. 14 There is a growing international consensus that the CFS population should be subclassified because more homogeneous subgroups are less likely to reveal conflicting data among investigators. 15 Chronic fatigue syndrome with musculoskeletal system disorders such as widespread muscle and joint pain has been suggested as an important subclass of CFS.…”