Journal of Chronic Fatigue Syndrome: Volume 1, Issue 3-4, 1995

Volume 1, Issue 3-4, 1995

 * Announcement: International Workshop Results in Established Network
 * Functional Neuroimaging in CFS: Applications and Limitations
 * Neurocognitive Testing in Chronic Fatigue Syndrome
 * Diagnosis of Chronic Fatigue Syndrome in Children and Adolescents: Special Considerations"Abstract - It has been a common occurrence that children with chronic, unexplained fatigue receive no specific diagnosis because of difficulties posed by the 1988 research criteria for chronic fatigue syndrome (CFS). The lack of a specific diagnosis creates medical uncertainty and may lead to increased psychosocial and educational disruption. With the recent publication of new research criteria these problems may be improved as the new criteria are less restrictive. In the process of developing new research criteria, data was collected for children who presented for evaluation of chronic unexplained fatigue over a two year period. Diagnosis of CFS was based upon the 1988 CDC criteria or clinical criteria based upon activity limitation and the associated symptom complex. Comparison of these two groups showed differences in symptom severity and degree of activity limitation, while demographics, psychosocial variables, and symptom pattern were similar. These results would suggest that chronic fatigue syndrome exists in a continuum of severity and that definition based solely upon severity of fatigue is arbitrary. While severe and debilitating fatigue should remain the basis of any research definition, clinical criteria based upon the symptom pattern of CFS may improve long term management by providing a working clinical diagnosis."
 * Alternative Medicine: Part of the Mainstream
 * How Useful Are the Alternative Therapies for Chronic Fatigue Syndrome?
 * Clinical Assessment of Coping in CFS Patients Summary - The controversy regarding psychosocial factors in the onset and maintenance of chronic fatigue syndrome (CFS) is briefly outlined. The primary purpose of this presentation is to describe coping assessments and possible cognitive-behavioral interventions for CFS patients.
 * Coping Reports of Patients with Long-Term Chronic Fatigue Syndrome"Summary - Two hundred sixty-five patients with chronic fatigue syndrome, who had been ill for a minimum of 10 years, responded to an open-ended questionnaire with detailed descriptions of major illness issues and coping techniques. Their predominant illness concerns and personal accounts of coping strategies as well as an analysis of style of coping and illness progression will be presented."
 * The four progressive stages of the CFS experience: A coping tool for patients"Summary - The CFS experience may be construed as a series of adaptations and adjustments that begin at the onset of symptoms. The ability of the CFS-affected individual to cope with symptoms and disabilities is strongly influenced by sociocultural factors. The purpose of this paper is to present a comprehensive multistage model of the CFS experience that recognizes the influences of cultural, psychosocial and medical factors in CFS assessment and treatment. The patient's awareness of these stages of adjustment can be an important coping tool in reconstructing the illness experience."
 * General Approaches to the Rehabilitation of Chronic Fatigue Syndrome
 * Occupational Therapy
 * Cognitive/Linguistic Deficits Associated with Chronic Fatigue Syndrome
 * Rehabilitation of the Patient with Chronic Fatigue Syndrome
 * Chronic Fatigue Syndrome and Vocational Rehabilitation: Unserved and Unmet Needs "Summary - Individuals with chronic fatigue syndrome (CFS) are largely unserved by the health care and rehabilitation professions. Their numbers are growing and their needs are complex and extensive. Some persons with CFS (PWCs), who have the least functional impairment, may benefit from vocational rehabilitation services. While employment options or accommodations, as well as support services, may be available to PWCs, their disabilities are gravely misunderstood, requiring long-term, intermittent, knowledgeable, professional counseling, and support. Given the frequency of reports by consumers and advocates concerning unserved, unmet needs of PWCs, a survey was conducted among PWCs throughout Wisconsin to identify their needs both for independent living support services and for employment accommodations. A weighted scale was developed based upon self-reports of 119 respondents regarding importance and satisfaction levels for such services. Results provided rankings of PWC needs, to the degree that such needs were perceived as unserved and unmet. Furthermore, subjects reported the number of good days and bad days experienced monthly, describing dfferential levels of symptoms and function for these days on a CFIDS Disability Scale, created by David Bell, M.D. Results indicated the devastating impact of CFS upon health, daily activities, personal relationships, income, and work. PWC's reported significantly-unmet or highly-unmet needs for the great majority of the selected support services and employment accomodations."
 * Summary and Discussion of Rehabilitation Section
 * Using Exercise Testing to Document Functional Disability in CFS
 * Development and Evaluation of Claims Involving Chronic Fatigue Syndrome (CFS) Under the Social Security Disability Provisions
 * NIH and the Women's Health Agenda
 * The Stress/Fatigue Link in Chronic Fatigue Syndrome"Summary - This paper cites preliminary evidence for the relationship between fatigue and stress in chronic fatigue syndrome. Stress may intensify symptoms of CFS and erode positive mood and affect. A model of the stress/fatigue link in CFS will be presented and a specific coping technique will be described as a tool to interrupt the stress/symptom interaction in CFS."
 * Interpersonal Stressors in Chronic Fatigue Syndrome: A Pilot Study"Summary - This paper reports two preliminary studies on interpersonal influences in CFS. The first study explored histories of abuse in patients with CFS and the second report assessed fatigue activity level and relationship satisfaction in CFS patients. The results of the first study indicated that the patients with CFS reported high levels of prior abuse compared to prior experiences of healthy controls. In the second study, higher levels of fatigue were moderately correlated with inactivity for CFS individuals in satisfied relationships, but not among patients in dissatisfied relationships. These findings suggested that solicitous partners may be inadvertently reinforcing disability. The results of the two studies support a biopsychosocial model of CFS."
 * CFS sociocultural influences and trauma: Clinical considerations"Summary - An integrated model of the assessment and treatment of the CFS population needs to include the sociocultural influences that affect CFS patients as well as their treating clinicians. These sociocultural factors include: (1) the pre-existing cultural climate toward disease, (2) cultural intolerance of ambiguity, (3) cultural intolerance of chronic vs. acute illness, (4) the ongoing psyche-soma duality among health care providers, and (5) initial disease illegitimacy and subsequent enculturation. These specific influences, as well as the patient's medical status, need to be carefully considered in the assessment and treatment of CFS patients and their families. The traumatogenic effects of these sociocultural influences on CFS patients will be discussed and specific treatment strategies will be suggested."
 * Epidemiology
 * Interdisciplinary Studies
 * Physiology
 * Clinical
 * Immunology
 * Immunology Workshop Summary