Academic journal article Journal of Allied Health

The Role of Coping in the Relationship between Depression and Illness Severity in Chronic Fatigue Syndrome

Academic journal article Journal of Allied Health

The Role of Coping in the Relationship between Depression and Illness Severity in Chronic Fatigue Syndrome

Article excerpt

The self-regulatory model (SRM) proposes that both cognitive and emotional illness representations influence the coping processes adopted in response to an illness. Aim: This study used the SRM to explore the role of coping in the relationship between depression and self-appraisals of illness severity in a population of patients with chronic fatigue syndrome (CFS). Methods: The sample comprised 156 participants, 34 men and 121 women, aged between 18 and 78 yrs, who had been medically diagnosed with CFS. Participants were asked to complete three questionnaires: the Cardiac Depression Scale, Ways of Coping Questionnaire, and Severity Subscale of the Illness Perceptions Questionnaire-Revised. Results: Analyses revealed that almost 70% of the participants were moderately or severely depressed. Additionally, two particular subscales, social support seeking and positive reappraisals, emerged as positively contributing to self-appraisals of illness severity (ß = 0.20 \p < 0.05] and ß = 0.21 ? < 0.05], respectively), thereby supporting the SRM. Furthermore, results indicated that a combination of depression and coping was a better predictor of illness severity than depression alone, accounting for 22% of the variance compared with 8%, respectively. Conclusions: The findings suggest that focusing on depression, and particularly coping styles, during treatment interventions could have important implications for therapeutic interventions. This could lead to better treatment strategies for health professionals who work with patients with CFS. J Allied Health 2009; 38:91-99.

I was diagnosed quite early, but had no advice on coping, so just kept pushing to carry on with my life as usual, and probably hindered my chance of recovery. I have now had to change the way I live my life, including giving up work, to keep within my limitations. - Participant 009

CHRONIC FATIGUE SYNDROME (CFS) is an extremely debilitating chronic illness in which a diagnosis requires the presence of unexplained persistent fatigue for at least 6 mos.1 Globally, CFS is referred to by a multitude of names, including myalgic encephalomyelitis, chronic fatigue and immune deficiency syndrome, and postviral, posttoxic, and postimmunization syndromes; however, for the sake of consistency, the term CFS is used throughout this report. Symptoms of CFS include both cognitive and behavioral symptoms, such as impairments to memory and concentration, sore throat, muscle pain, tiredness, unrefreshing sleep, and headaches.1 Patients with CFS typically present to a variety of health care professionals, including doctors, nutritionists, psychologists, and rehabilitation specialists; therefore, information on factors related to CFS management is relevant to a wide range of clinicians. Additionally, it is noted that there is a substantial concurrence of depression with CFS, with 35% to 80% of patients with CFS reporting depression.2"5 The management of depression typically involves cognitive and behavioral coping strategies. However, the role of these coping strategies in outcomes, such as perceived chronic illness severity, has not been investigated widely. The aim of this study was to explore the role of coping strategies in the relationship between depression and self-appraisals of illness severity in a population of patients with CFS.

The Self-Regulatory Model (SRM) has been widely used to investigate the relationship between cognitive and emotional responses to illness, coping strategies, and appraisals of illness management.6 According to the SRM, illness representations consist of five identifiable dimensions: identity, cause, timeline, consequences, and curability/control.6,7 More recently, Moss-Morris et al.8 have identified several other important components of the model, including illness coherence, emotional representations, personal control, and treatment control.

Specifically, the SRM proposes that both cognitive and emotional responses to illness influence the coping processes adopted in response to an illness. …

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