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The role of the partner and relationship satisfaction on treatment outcome in patients with chronic fatigue syndrome

Published online by Cambridge University Press:  03 March 2015

J. Verspaandonk*
Affiliation:
Expert Centre for Chronic Fatigue, Radboud University Medical Centre, Nijmegen, The Netherlands
M. Coenders
Affiliation:
Faculty of Social and Behavioural Sciences, Utrecht University, The Netherlands
G. Bleijenberg
Affiliation:
Expert Centre for Chronic Fatigue, Radboud University Medical Centre, Nijmegen, The Netherlands
J. Lobbestael
Affiliation:
Faculty of Clinical Psychological Science, Maastricht University, The Netherlands and RINO Zuid, Postdoctoral Education Institute, Eindhoven, The Netherlands
H. Knoop
Affiliation:
Expert Centre for Chronic Fatigue, Radboud University Medical Centre, Nijmegen, The Netherlands
*
*Address for correspondence: J. Verspaandonk, MSc, Expert Centre for Chronic Fatigue, Radboud University Medical Center, Nijmegen, The Netherlands. (Email: jverspaandonk@live.nl)

Abstract

Background

Cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS) leads to a significant decrease in CFS-related symptoms and disability. The primary objective of this study was to explore whether partners’ solicitous responses and patients’ and partners’ perceived relationship satisfaction had an effect on treatment outcome.

Method

The treatment outcome of a cohort of 204 consecutively referred patients treated with CBT was analysed. At baseline, CFS patients completed the Maudsley Marital Questionnaire. The Checklist Individual Strength subscale Fatigue and the Sickness Impact Profile total scores completed by CFS patients post-treatment were used as measures of clinically significant improvement. Partners completed the Family Response Questionnaire, the Maudsley Marital Questionnaire, the Brief Illness Perception Questionnaire, and the Causal Attribution List. Logistic regression analyses were performed with clinically significant improvement in fatigue and disability as dependent variables and scores on questionnaires at baseline as predictors.

Results

Solicitous responses of the partner were associated with less clinically significant improvement in fatigue and disability. Partners more often reported solicitous responses when they perceived CFS as a severe condition. Patients’ relationship dissatisfaction was negatively associated with clinically significant improvement in fatigue.

Conclusions

Partners’ solicitous responses and illness perceptions at the start of the therapy can negatively affect the outcome of CBT for CFS. We emphasize the importance of addressing this in therapy.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2015 

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References

Anderson, JS, Ferrans, CE (1997). The quality of life of persons with chronic fatigue syndrome. Journal of Nervous Mental Disease 185, 359367.CrossRefGoogle ScholarPubMed
Arrindell, WA, Boelens, W, Lambert, H (1983). On the psychometric properties of the Maudsley Marital Questionnaire (MMQ): evaluation of self-ratings in distressed and normal volunteer couples based on the Dutch version. Personality and Individual Differences 4, 293306.CrossRefGoogle Scholar
Blazquez, A, Alegre, J, Ruiz, E (2009). Women with chronic fatigue syndrome and sexual dysfunction: past, present, and future. Journal of Sex and Marital Therapy 35, 347359.CrossRefGoogle ScholarPubMed
Blazquez, A, Guillamo, E, Alegre, J, Ruiz, E, Javierre, C (2012). Psycho-physiological impact on women with chronic fatigue syndrome in the context of their couple relationship. Psychology, Health and Medicine 17, 150163.CrossRefGoogle ScholarPubMed
Broadbent, E, Petrie, KJ, Main, J, Weinman, J (2006). The brief illness perception questionnaire. Journal of Psychosomatic Research 60, 631637.CrossRefGoogle ScholarPubMed
Cano, A, Amanda, C, Williams, C (2010). Social interaction in pain: reinforcing pain behaviors or building intimacy? Pain 149, 911.CrossRefGoogle ScholarPubMed
Castell, BD, Kazantzis, N, Moss-Morris, E (2011). Cognitive behavioral therapy and graded exercise for chronic fatigue syndrome: a meta-analysis. Clinical Psychology; Science and Practice 18, 311324.Google Scholar
Chalder, T, Hill, K (2012). Emotional processing and chronic fatigue syndrome. Psychoanalytic Psychotherapy 26, 141155.Google Scholar
Cordingley, L, Wearden, A, Appleby, L, Fisher, L (2001). The family response questionnaire. A new scale to assess the responses of family members to people with chronic fatigue syndrome. Journal of Psychosomatic Research 51, 417424.Google Scholar
DiMatteo, MR (2004). Social support and medical adherence: a meta-analysis. Health Psychology 23, 207218.Google Scholar
Fukuda, K, Straus, SE, Hickie, I, Sharpe, MC, Dobbins, JG, Komaroff, A (1994). The chronic fatigue syndrome: a comprehensive approach to its definition and study. Annals of Internal Medicine 121, 953959.Google Scholar
Goodwin, SS (2000). Couples perceptions of wives’ CFS symptoms, symptom change, and impact on the marital relationship. Issues of Mental Health Nursing 21, 347363.Google Scholar
Jacobson, NS, Truax, P (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology 59, 1219.Google Scholar
Jason, LA, Brown, M, Evans, M, Brown, A (2012). Predictors of fatigue among patients with chronic fatigue syndrome. Journal of Human Behavior in the Social Environment 22, 822832.CrossRefGoogle ScholarPubMed
Jason, LA, Roesner, N, Porter, N, Parenti, B, Mortensen, J, Till, L (2010). Provision of social support to individuals with chronic fatigue syndrome. Journal of Clinical Psychology 66, 249258.CrossRefGoogle ScholarPubMed
Kaptein, AA, Van Korlaar, IM, Scharloo, M (2004). IPQ-K. Medical Psychology LUMC.Google Scholar
Kelly, KS, Soderlund, K, Albert, Ch, McGarrahan, AG (1999). Social support and chronic fatigue syndrome. Health communication 11, 2134.CrossRefGoogle ScholarPubMed
Knoop, H, Bleijenberg, G (2010). Het Chronisch Vermoeidheidssyndroom. Behandelprotocol Cognitieve Gedragtherapie voor CVS [Cognitive behaviour therapy for chronic fatigue syndrome: treatment protocol]. Bohn Stafleu van Loghum: Houten.Google Scholar
Knoop, H, Bleijenberg, G, Gielissen, MFM, van der Meer, JWM, White, PD (2007). Is a full recovery possible after cognitive behavioural therapy for chronic fatigue syndrome? Psychotherapy and Psychosomatics 76, 171176.Google Scholar
Knoop, H, Prins, JB, Moss-Morris, R, Bleijenberg, G (2010). The central role of cognitive processes in the perpetuation of chronic fatigue syndrome. Journal of Psychosomatic Research 68, 489494.CrossRefGoogle ScholarPubMed
Moss-Morris, R (2005). Symptom perceptions, illness beliefs and coping in chronic fatigue syndrome. Journal of Mental Health 14, 223235.CrossRefGoogle Scholar
Moss-Morris, R, Weinman, J, Petrie, KJ, Horne, R, Cameron, LD, Buick, D (2002). The revised ilness perception questionnaire (IPQ-R). Psychology and Health 17, 116.Google Scholar
Orathinkal, J, Vansteenwegen, A, Stroobants, R (2007). Further validation of the Maudsley Marital Questionnaire (MMQ). Psychology, Health and Medicine 12, 346352.Google Scholar
Prins, JB, Bleijenberg, G, Bazelmans, E, Elving, L, deBoo, T, Severens, JL, van der Wilt, GJ, Spinhoven, P, van der Meer, JWM (2001). Cognitive behaviour therapy for chronic fatigue syndrome. A multicenter randomised controlled trial. Lancet 257, 841847.CrossRefGoogle Scholar
Prins, JB, Bos, E, Huibers, MJH, Servaes, P, van der Werf, SP, van der Meer, JWM, Bleijenberg, G (2004). Social support and the persistence of complaints in chronic fatigue syndrome. Psychotherapy and Psychosomatics 73, 174182.CrossRefGoogle ScholarPubMed
Reeves, WC, Lloyd, A, Vernon, SD, Klimjas, N, Jason, LA, Bleijenberg, G, Evengard, B, White, PD, Nisenbaum, R, Unger, ER (2003). Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution. BMC Health Services Research 3, 25.CrossRefGoogle ScholarPubMed
Romano, JM, Jensen, MP, Schmaling, KB, Hops, H, Buchwald, DS (2009). Illness behaviors in patients with unexplained chronic fatigue are associated with significant other responses. Journal of Behavioral Medicine 32, 558569.CrossRefGoogle ScholarPubMed
Scheeres, K, Wensing, M, Knoop, H, Bleijenberg, G (2008). Implementing cognitive behavioral therapy for CFS in a MHC: a benchmarking evaluation. Journal of Consulting and Clinical Psychology 76, 163171.Google Scholar
Sperry, L (2012). Recognizing family dynamics in the treatment of chronic fatigue syndrome. Family Journal 20, 7985.CrossRefGoogle Scholar
Stadler, G, Snyder, KA, Horn, BA, Shrout, PE, Bolger, NP (2012). Close relationships and health in daily life: a review and empirical data on intimacy and somatic symptoms. Psychosomatic Medicine 74, 398409.Google Scholar
Steward, AL, Hays, RD, Ware, JE (1998). The MOS short form general health survey: reliability and validity in a patient population. Medical Care 26, 724735.CrossRefGoogle Scholar
Taylor, RR (2005). Can the social model explain all of disability experience? Perspectives of persons with chronic fatigue syndrome. American Journal of Occupational Therapy 59, 497506.Google Scholar
Tummers, M, Knoop, H, van Dam, A, Bleijenberg, G (2012). Implementing a minimal intervention for chronic fatigue syndrome in a mental health centre: a ranomized controlled trial. Psychological Medicine 42, 22052215.Google Scholar
Van Houdenhove, B, Luyten, P (2008). Customizing treatment of chronic fatigue syndrome and fibromyalgia: the role of perpetuating factors. Psychosomatics 49, 470477.Google Scholar
Vercoulen, JHMM, Alberts, M, Bleijenberg, G (1999). De Checklist Individual Strength (CIS) [in Dutch]. Gedragstherapie 32, 131136.Google Scholar
Vercoulen, JHMM, Swanink, CMA, Fennis, JFM, Galama, JMD (1996). Prognosis in chronic fatigue syndrome: a prospective study on the natural course. Journal of Neurology, Neurosurgery and Psychiatry 60, 489494.Google Scholar
White, K, Lehmann, DR, Hemphill, KJ, Mandel, DR (2006). Causal attributions, perceived control, and psychological adjustment: a study of chronic fatigue syndrome. Journal of Applied Social Psychology 36, 7599.CrossRefGoogle Scholar
Wiborg, JF, Knoop, H, Stulemeijer, M, Prins, JB, Bleijenberg, G (2010). How does cognitive behaviour therapy reduce fatigue in patients with chronic fatigue syndrome? The role of physical activity. Psychological Medicine 40, 12811287.Google Scholar