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Illness beliefs and treatment outcome in chronic fatigue syndrome
Abstract
Longitudinal studies have shown that physical illness attributions are associated with poor prognosis in chronic fatigue syndrome (CFS). Speculation exists over whether such attributions influence treatment outcome. This study reports the effect of illness beliefs on outcome in a randomized controlled trial of cognitive-behavior therapy versus relaxation. Causal attributions and beliefs about exercise, activity, and rest were recorded before and after treatment in 60 CFS patients recruited to the trial. Physical illness attributions were widespread, did not change with treatment, and were not associated with poor outcome in either the cognitive-behavior therapy group or the control group. Beliefs about avoidance of exercise and activity changed in the cognitive behavior therapy group, but not in the control group. This change was associated with improved outcome. These findings suggest that physical illness attributions are less important in determining outcome (at least in treatment studies) than has been previously thought. In this study, good outcome is associated with change in avoidance behavior, and related beliefs, rather than causal attributions.
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“When these subjective explanatory models are primarily physical and not related to psychological processes (such as appraisals and dysfunctional coping behavior), they may be hesitant to engage in a therapy that emphasizes these aspects [19].”
From Efficacy and Acceptance of Cognitive Behavioral Therapy in Adults with Chronic Fatigue Syndrome: A Meta-analysis. (2024) · cites this paper as [19]
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Metadata
- Authors
- Deale, A., Chalder, T., & Wessely, S.
- Affiliations
- King's College Hospital (GB)
- Corresponding author
- Deale, Alicia
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 1998-07
- Volume
- 45
- Issue
- 1
- Pages
- 77-83
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W2070515730
- Cited by
- 159
- References
- 31
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 5 · 2019: 8 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 7 · 2014: 3 · 2013: 10 · 2012: 7
- FWCI
- 5.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Keywords
- chronic fatigue syndrome, illness beliefs, illness attribution, cognitive behavioral therapy, relaxation training, treatment outcomes, exercise avoidance, activity avoidance, causal attribution, prognosis
- MeSH terms
- Attitude to Health, Follow-Up Studies, Humans, Relaxation Therapy, Sick Role, Health Behavior, Exercise, Fatigue Syndrome, Chronic, Cognitive Behavioral Therapy, Chi-Square Distribution, Treatment Outcome, Statistics, Nonparametric
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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