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Psychiatric symptoms, personality and ways of coping in chronic fatigue syndrome


This study aimed to investigate the psychological characteristics of chronic fatigue syndrome (CFS: Holmes et al. 1988). A battery of psychometric instruments comprising the General Health Questionnaire (GHQ), the Beck Depression Inventory (BDI), the Minnesota Multiphasic Personality Inventory (MMPI) and the Lazarus Ways of Coping (WoC) inventory, was administered to a sample of clinically-defined CFS sufferers (N = 58), to a comparison group of chronic pain (CP) patients (N = 81) and to a group of healthy controls matched for sex and age with the CFS sample (N = 104). Considerable overlap was found between CFS and CP patients at the level of both physical and psychological symptoms. This raises the possibility that CFS sufferers are a sub-population of CP patients. However, while there was some commonality between CFS and CP patients in terms of personality traits, particularly the MMPI ‘neurotic triad’ (hypochondriasis, depression and hysteria), CFS patients showed more deviant personality traits reflecting raised levels on the first MMPI factor, emotionality. Moreover, results were not consistent with the raised emotionality being a reaction to the illness, but rather were consistent with the hypothesis that emotionality is a predisposing factor for CFS. The majority of CFS patients fell within four personality types, each characterized by the two highest MMPI scale scores. One type (N = 20) reported a lack of psychological symptoms or emotional disturbance contrary to the overall trend for the CFS sample. This group conformed to the ICD-10 classification of neurasthenia.

Corresponding author
1Address for correspondence: Dr R. Howard, Department of Psychological Medicine, University of Otago Medical School, PO Box 913, Dunedin, New Zealand.
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

A. T. Beck & R. W. Beck (1972). Screening depressed patients in family practice. A rapid technique. Postgraduate Medicine 52, 8185.

A. T. Beck , C. H. Ward , M. Mendelson , J. Mock & J. Erbaugh (1961). An inventory for measuring depression. Archives of General Psychiatry 4 561571.

K. W. Bridges & D. P. Goldberg (1986). The validation of the GHQ-28 and the use of the MMSE in neurological in-patients. British Journal of Psychiatry 148, 548553.

R. C. Colligan , D. Osborne , W. M. Swenson & K. P. Offord (1985). Using the 1983 norms for the MMPI: code-type frequencies in four clinical samples. Journal of Clinical Psychology 41, 629633.

N. Corah (1964). Neuroticism and extraversion in the MMPI: empirical validation and exploration. British Journal of Social and Clinical Psychology 3, 168174.

G. B. Cox , C. R. Chapman & R. G. Black (1978). The MMPI and chronic pain: the diagnoses of psychogenic pain. Journal of Behavioral Medicine 1, 437443.

A. S. David , S. Wessely & A. J. Pelosi (1988). Postviral fatigue syndrome: time for a new approach. British Medical Journal 296, 696699.

W. J. Eichman (1961). Replicated factors on the MMPI with female NP patients. Journal of Consulting and Clinical Psychology 25, 5560.

R. A. Finlay-Jones & E. Murphy (1979). Severity of psychiatric disorder and the 30-item General Health Questionnaire. British Journal of Psychiatry 134, 609616.

S. Folkman & R. S. Lazarus (1985). If it changes it must be a process: study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology 48, 150170.

S. Folkman , R. S. Lazarus , R. Gruen & A. DeLongis (1986). Appraisal, coping, health status and psychological symptoms. Journal of Personality and Social Psychology 50, 571579.

C. W. Freeman , D. A. Calsyn & J. Louks (1976). The use of the MMPI with low back patients. Journal of Clinical Psychology 32, 294298.

F. H. Giedt & L. Downing (1961). An extraversion scale for the MMPI. Journal of Clinical Psychology 17, 156159.

S. R. Hathaway & J. C. McKinley (1940). A multiphasic personality schedule (Minnesota): construction of the schedule. Journal of Psychology 10, 249254.

G. P. Holmes , J. E. Kaplan , M. Nelson , N. M. Gantz , A. L. Komaroff , L. B. Schonberger , S. E. Strauss , J. F. Jones , R. E. Dubois , C. Cunningham-Rundles , S. Pahwa , G. Tosato , L. S. Zegans , D. T. Purtilo , N. Brown , R. T. Schooley & I. Brus (1988). Chronic fatigue syndrome: a working case definition. Annals of Internal Medicine 108, 387389.

J. B. Imboden , A. Canter & L. E. Cluff (1961). Convalescence from influenza. Archives of Internal Medicine 108, 393399.

G. S. Kassebaum , A. R. Couch & P. E. Slater (1959). The factorial dimensions of the MMPI. Journal of Consulting and Clinical Psychology 23, 226236.

A. L. Komaroff (1988). Chronic fatigue syndromes: relationship to chronic viral infections. Journal of Virological Methods 21, 310.

K. B. Little & J. Fisher (1958). Two new experimental scales of the MMPI. Journal of Consulting and Clinical Psychology 22, 305306.

A. W. Love & C. L. Peck (1987). The MMPI and psychological factors in chronic low back pain: a review. Pain 28, 112.

P. Manu , D. A. Mathews & T. J. Lane (1988). The mental health of patients with a chief complaint of chronic fatigue. Archives of Internal Medicine 148, 22132217.

R. J. Mathew , L. W. Maxine & M. Mirabi (1981). Physical symptoms of depression. British Journal of Psychiatry 139, 293296.

C. Millon , F. Salvato , N. Blaney , R. Morgan , E. Mantero-Atienza , N. Klimas & M. Fletcher (1989). A psychological assessment of chronic fatigue syndrome/chronic Epstein-Barr virus patients. Psychology and Health 3, 131141.

J. E. Moore , M. E. McFall , D. R. Kivlahan & F. Capestany (1988). Risk of misinterpretation of MMPI schizophrenia scale elevations in chronic pain patients. Pain 32, 207213.

A. L. Stout & J. F. Steege (1985). Psychological assessment of women seeking treatment for premenstrual syndrome. Journal of Psychosomatic Research 29, 621629.

G. S. Taerk , B. B. Toner , I. S. Salit , P. E. Garfinkel & S. Ozersky (1987). Depression in patients with neuromyasthenia (benign myalgic encephalomyelitis). International Journal of Psychiatric Medicine 17, 4956.

D. Watson (1982). Neurotic tendencies among chronic pain patients: an MMPI item analysis. Pain 14, 365385.

S. Wessely & R. Powell (1989). Fatigue syndromes: a comparison of chronic ‘Postviral’ fatigue with neuromuscular and affective disorders. Journal of Neurology, Neurosurgery and Psychiatry 52, 940948.

P. White (1989). Fatigue syndrome: neurasthenia revived. British Medical Journal 298, 11991200.

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