Psych Adjustment of Teen Girls With CFS

Discussion in 'Fibromyalgia Main Forum' started by cureforpain, Sep 2, 2003.

  1. cureforpain

    cureforpain New Member

    Doh! How do I change the icon? LOL

    Here is an excerpt from a study I found interesting, especially in view of the topic of mental attitudes and health, because this article seems to be suggesting that a positive attitude could be blamed for perpetuating the illness (are they just blaming the victims?):

    PEDIATRICS Vol. 107 No. 3 March 2001, p. e35

    Psychological Adjustment of Adolescent Girls With Chronic Fatigue Syndrome

    Henriet van Middendorp, Msc*, =A7, Rinie Geenen, PhD=A7, Wietse Kuis, MD, PhD, Cobi J. Heijnen, PhD, and Gerben Sinnema, PhD*

    From the Departments of * Pediatric Psychology and Pediatric Immunology/Rheumatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, The Netherlands; and the =A7 Department of Health
    Psychology, Utrecht University, The Netherlands

    Psychological Attitudes and Coping Resources

    With respect to attributional style, the adolescent girls showed an internal locus of control, contradictory to the reported external locus of control regarding illness representations in adults.20-22 A possible explanation of this difference could be that previous studies have made use
    of specific illness-related locus of control measures, whereas this study has made use of a global measure of locus of control. Furthermore, it is possible that the adolescent girls, in contrast to their adult counterparts,
    have not accepted the powerlessness or helplessness associated with CFS.

    Compared with the norm group, the adolescent girls with CFS used significantly more palliative reaction patterns such as distraction and optimism, which includes comforting thoughts as coping strategies when confronted with problems. Studies on coping styles in adults with
    CFS9,20-23 have found significantly more use of avoidance as a coping strategy, which in our study only showed to be a trend. It may be that the coping questionnaire used (the UCL-A) has separated the escape and avoidance scales, combined in the adult questionnaires. Thus, a palliative reaction pattern could represent the aspect of escape.

    These ways of coping with life stressors could have both positive and negative consequences. On the positive side, an internal locus of control keeps patients active in the control of their disease. Palliative and optimistic reaction patterns are both ways of coping in which problems are more or less neglected or attenuated. In this way, the girls can retain a positive outlook on life. This does not lead to passivity regarding possibilities for recovery. It may suggest that these adolescent patients are able to put the syndrome into perspective, leading to the reported
    moderate psychological problems. On the negative side, remaining active in trying to return to normal activities when the body does not allow it, by underrating or neglecting significant warning symptoms, may lead to relapse
    and may play a role in the maintenance of CFS.1 The effects of the use of certain attitudes and coping resources on psychological and physical adaptation should be examined in prospective longitudinal designs (preferably starting at onset of the syndrome). This would provide valuable
    information regarding adaptive and nonadaptive ways to manage the syndrome and its accompanying problems.

    This study has some restrictions. First, a clinical sample of medically referred adolescents was used. This group might not be representative of the female adolescent population with CFS, implicating restrictions
    regarding generalization to the population. Second, this study makes use of normative data. Through the use of control groups, more generalizations could have been made with regard to interaction effects and mediating variables.

    The present study has offered an extensive description of a relatively large patient group, which has led to several new findings, suggestions for possible syndrome-maintaining factors, and additional research. The large extent of premorbid problems suggests a possible contributing factor to the onset of the syndrome. The study reported problems in the areas of psychological distress, internalizing problems, and adolescence-related activities, offering substantial indications for psychological guidance of
    this patient group. It was also demonstrated that in other areas, such as self-esteem and externalizing problems and attitudes, the adolescent girls with CFS did not deviate from the norm, suggesting normal development in
    these relevant areas. In coping with the syndrome, new findings were reported, directing attention to possibly maintaining factors in CFS in adolescent girls. The adolescent 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.

    [This Message was Edited on 09/02/2003]