Does a decrease in avoidance behavior and focusing on fatigue mediate the effect of cognitive behavior therapy for chronic fatigue syndrome?
Abstract
Objective Cognitive behavior therapy (CBT) leads to a significant reduction in fatigue severity and impairment in patients with chronic fatigue syndrome (CFS). The purpose of the present study was to determine whether the effect of CBT for CFS on fatigue and impairment is mediated by a decrease in avoidance behavior and focusing on fatigue.Methods For this purpose, we reanalyzed a randomized controlled trial which was previously conducted to test the efficacy of CBT for CFS. Two hundred nineteen patients completed assessment prior and subsequent to treatment or a control group period.Results Mediation analysis revealed that a decrease in focusing on fatigue mediated the effect of CBT for CFS on fatigue and impairment. Avoidance of activity and avoidance of aversive stimuli were not significantly changed by treatment and were therefore excluded from mediation analysis.Conclusion A decrease in the focus on fatigue seems to contribute to the treatment effect of CBT for CFS.
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Support groups without therapy do not yield similar outcome results as CBT.
“support groups without therapy do not yield similar outcome results as CBT [12].”
From Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism. (2013) · cites this paper as [12]
CBT aimed at increasing functioning, and its objective and content are comparable with manuals of other CBT trials.
“CBT aimed at increasing functioning, and its objective and content are comparable with manuals of other CBT trials [9,12].”
From Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism. (2013) · cites this paper as [12]
Several aspects of the treatment (structure of the programme, activity management, psycho-education on CFS and stress, and stress management) effectively diminish a dominant focus on symptoms, extinguish avoidance, and also stimulate acceptance.
“We suspect that several aspects of the treatment (structure of the programme, activity management, psycho-education on CFS and stress, and stressmanagement) effectively diminish a dominant focus on symptoms, extinguish avoidance, and also stimulate acceptance [12-14].”
From Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism. (2013) · cites this paper as [12]
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References 29 · Cited by 56
- Authors
- Wiborg, J. F., Knoop, H., Prins, J. B., & Bleijenberg, G.
- Affiliations
- Radboud University Medical Center (NL)
- Corresponding author
- Wiborg, Jan F.
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2011-04
- Volume
- 70
- Issue
- 4
- Pages
- 306-310
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W1996331388
- Cited by
- 56
- References
- 29
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 6 · 2016: 7 · 2015: 9 · 2014: 3 · 2013: 7 · 2012: 5
- FWCI
- 4.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- chronic fatigue syndrome, cognitive behavioral therapy, fatigue, avoidance behavior, mediation analysis, treatment effects, fatigue severity, functional disability
- MeSH terms
- Adult, Fatigue, Female, Humans, Male, Middle Aged, Severity of Illness Index, Fatigue Syndrome, Chronic, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome
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