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HOW VALID IS THE MODEL BEHIND COGNITIVE BEHAVIOR THERAPY FOR CHRONIC FATIGUE SYNDROME? AN EVALUATION OF THE ADDITIONAL DATA FROM THE TRIAL BY PRINS ET AL.

 

B. Stouten 1*, PhD
Ellen M. Goudsmit 2, PhD FBPsS

 

 

1. Einsteindreef 67A, Utrecht, The Netherlands

2. University of East London, UK
                                                     



 

ABSTRACT

The cognitive behavior therapy (CBT) program studied by Prins et al. is based on a model of chronic fatigue syndrome that posits that fatigue and functional impairment are perpetuated by physical inactivity, somatic attributions, focusing on bodily symptoms and a low sense of control. A recent analysis of the data from three trials based on a model devised by Vercoulen et al. concluded that the effect of CBT on fatigue could not be attributed to a persistent increase in physical activity. We therefore examined the effect of treatment on the remaining three variables in the model using data from one of the trials, available in the public domain. The results from the groups given CBT, Guided Support and treatment as usual revealed that CBT had no significant impact on somatic attributions and focusing on bodily symptoms, and that in line with established guidelines, these two variables were not mediating factors. The only variable in the model showing an effect of CBT was sense of control. We submit that there is now sufficient evidence to warrant a review of CFS guidelines which advocate interventions aimed particularly at increasing physical activity and challenging somatic attributions, and that more flexible programs which address loss of control deserve further consideration and evaluation.



Bulletin of the IACFS/ME. 2010;18(2):82-89. © 2010 IACFS/ME

 

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HOW VALID IS THE MODEL BEHIND COGNITIVE BEHAVIOR THERAPY FOR CHRONIC FATIGUE SYNDROME? AN EVALUATION OF THE ADDITIONAL DATA FROM THE TRIAL BY PRINS ET AL.

 

B. Stouten 1*, PhD
Ellen M. Goudsmit 2, PhD FBPsS

 

 

1. Einsteindreef 67A, Utrecht, The Netherlands

2. University of East London, UK
                                                     



 

ABSTRACT

The cognitive behavior therapy (CBT) program studied by Prins et al. is based on a model of chronic fatigue syndrome that posits that fatigue and functional impairment are perpetuated by physical inactivity, somatic attributions, focusing on bodily symptoms and a low sense of control. A recent analysis of the data from three trials based on a model devised by Vercoulen et al. concluded that the effect of CBT on fatigue could not be attributed to a persistent increase in physical activity. We therefore examined the effect of treatment on the remaining three variables in the model using data from one of the trials, available in the public domain. The results from the groups given CBT, Guided Support and treatment as usual revealed that CBT had no significant impact on somatic attributions and focusing on bodily symptoms, and that in line with established guidelines, these two variables were not mediating factors. The only variable in the model showing an effect of CBT was sense of control. We submit that there is now sufficient evidence to warrant a review of CFS guidelines which advocate interventions aimed particularly at increasing physical activity and challenging somatic attributions, and that more flexible programs which address loss of control deserve further consideration and evaluation.



Bulletin of the IACFS/ME. 2010;18(2):82-89. © 2010 IACFS/ME

 

Read full article

Download a PDF of this abstract

Return to Bulletin of the IACFS/ME, Volume 18, Issue 2

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