Susan Torres-Harding

Susan Torres-Harding, PhD, is the Director of the Clinical Psychology PsyD program, Roosevelt University, Department of Psychology, Chicago, Illinois, USA. Her research interests include racial microaggressions, social justice and social action, and Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. While working on her Masters and PhD degrees at DePaul University, she worked with Dr. Leonard Jason.

Awards

 * 2004, Junior Investigator Award to encourage young CFS/FM researchers in recognition of their work awarded by IACFSME.

Pediatric Case Definition

 * 2006, "A Pediatric Case Definition for Myalgic Encephalomyelitis and Chronic Fatigue Syndrome""'Summary: For a diagnosis of chronic fatigue syndrome (CFS), most researchers use criteria that were developed by Fukuda et al. (1994), with modifications suggested by Reeves et al. (2003). However, this case definition was established for adults rather than children. A Canadian Case Definition (ME/CFS; Myalgic Encephalomyelitis/CFS) has recently been developed, with more specific inclusion criteria (Carruthers et al., 2003). Again, the primary aim of this case definition is to diagnose adult CFS. A significant problem in the literature is the lack of both a pediatric definition of ME/CFS and a reliable instrument to assess it. These deficiencies can lead to criterion variance problems resulting in studies labeling children with a wide variety of symptoms as having ME/CFS. Subsequently, comparisons between articles become more difficult, decreasing the possibility of conducting a meta-analysis. This article presents recommendations developed by the International Association of Chronic Fatigue Syndrome Pediatric Case Definition Working group for a ME/CFS pediatric case definition. It is hoped that this pediatric case definition will lead to more appropriate identification of children and adolescents with ME/CFS.'"

Notable studies

 * 2009, Activity Logs as a Measure of Daily Activity Among Patients with Chronic Fatigue Syndrome. (Full text)
 * 2009, The impact of energy modulation on physical functioning and fatigue severity among patients with ME/CFS. (Full text)
 * 2008, Evidence for T-helper 2 shift and association with illness parameters in chronic fatigue syndrome (CFS)"Abstract: Few immunological markers have been consistently reported in CFS. However, a shift to a T-helper 2 (Th2) type immune response has been hypothesized for individuals with CFS. The current study investigated whether individuals with CFS who exhibited a stronger shift towards a Th2 type of immune response would also exhibit more severe symptoms, poorer neurocognitive functioning, and poorer physical and psychosocial functioning. The current investigation measured the percentage of Th1-like and Th2-like memory cells using cell surface flow cytometry in 114 individuals with CFS. The associations between the ratio of Th1 and Th2 memory cells and various illness parameters measures were then examined, including symptom severity, psychiatric functioning, neurocognitive functioning, salivary cortisol levels, and chronic pain status. Results indicated that individuals who exhibited a more extreme shift towards a Th2 immune response also exhibited poorer sleep and high levels of basal salivary cortisol. The implications of these findings are discussed."
 * 2008, The associations between basal salivary cortisol levels and illness symptomatology in [[chronic fatigue syndrome]. (Full text)] "'Abstract: Hypocortisolism has been reported in chronic fatigue syndrome (CFS), with the significance of this finding to disease etiology unclear. This study examined cortisol levels and their relationships with symptoms in a group of 108 individuals with CFS. CFS symptoms examined included fatigue, pain, sleep difficulties, neurocognitive functioning, and psychiatric status. Alterations in cortisol levels were examined by calculation of mean daily cortisol, while temporal variation in cortisol function was examined by means of a regression slope. Additionally, deviation from expected cortisol diurnal pattern was determined via clinical judgment. Results indicated that fatigue and pain were associated with salivary cortisol levels. In particular, variance from the expected pattern of cortisol was associated with increased levels of fatigue. The implications of these findings are discussed.'"
 * 2008, The Energy Envelope Theory and myalgic encephalomyelitis/chronic fatigue syndrome. (Full text)
 * 2008, The economic impact of ME/CFS: individual and societal costs"Abstract: Background - ME/CFS is characterized by debilitating fatigue in addition to other physical and cognitive symptoms. It is estimated to affect over 800,000 adults in the U.S. ME/CFS often results in diminished functionality and increased economic impact. The economic impact of an illness is generally divided into two categories: direct and indirect costs. Despite high prevalence rates and the disabling nature of the illness, few studies have examined the costs of ME/CFS at the individual and societal level. In fact, of the four studies examining the economic impact of ME/ME/CFS only two used a U. S. sample. The current study used community and tertiary samples to examine the direct costs of ME/CFS. Methods - Using archival data, Study 1 examined the direct cost of ME/CFS in a community-based sample in Chicago. Study 2 estimated the direct cost of ME/CFS in a tertiary sample in Chicago. Both Study1 and Study 2 assessed direct costs using office visit costs, medical test costs, and medication costs. Results - For Study 1, the annual direct total cost per ME/CFS patient was estimated to be $2,342, with the total annual direct cost of ME/CFS to society being approximately $2 billion. In Study 2, the annual direct was estimated to be $8,675 per ME/CFS patient, with the total annual direct cost of ME/CFS to society being approximately $7 billion. Conclusion - Using ME/CFS prevalence data of 0.42 and indirect costs estimates from Reynolds et al. (2004), the direct and indirect cost of ME/CFS to society was estimated to be $18,677,912,000 for the community sample and $23,972,300,000 for the tertiary sample. These findings indicate that whether or not individuals are recruited from a community or tertiary sample, ME/CFS imposes substantial economic costs."
 * 2007, The Effectiveness of Early Educational Intervention in Improving Future Physicians' Attitudes Regarding CFS/FM"'Abstract - Objective: To assess the effects of an early educational intervention program's ability to alter the perceptions and attitudes of future physicians regarding chronic fatigue syndrome/fibromyalgia (CFS/FM), improve their understanding and acceptance of these diseases, make them feel more comfortable in diagnosing and treating patients. Method: Third-year medical students were surveyed before and after an educational intervention program. The three questions posed to the students in the survey were: (1) How comfortable do you feel you are in diagnosing and treating patients with CFS /FM?, (2) Do you consider CFS/FM legitimate illnesses?, and (3) Do you want to treat patients with CFS/FM? Results: The educational intervention program helped about half of the future physicians feel comfortable in diagnosing and treating patients with CFS/FM and improved by over 25% their willingness to treat patients with CFS. Conclusion: An educational intervention program appeared to improve future physicians' understanding and appreciation of CFS/FM, made them feel more comfortable diagnosing and treating these diseases, and increased their willingness to treat patients with CFS/FM.'"
 * 2007, Baseline Cortisol Levels Predict Treatment Outcomes in Chronic Fatigue Syndrome Nonpharmacologic Clinical Trial"'Abstract - Objective: Understanding how nonpharmacologic interventions differentially affect the subgroups of patients with chronic fatigue syndrome (CFS) might provide insights into the pathophysiology of this illness. In this exploratory study, baseline measures of normal versus abnormal cortisol were compared on a variety of immune markers and other self-report measures. Normal versus abnormal cortisol ratings were used as predictors in a nurse-delivered nonpharmacologic intervention. Methods: Participants diagnosed with CFS were assigned to 6-month nonpharmacologic interventions. Individuals were classified as having abnormal or normal cortisol levels on the basis of scores over the five testing times. Cortisol levels were considered abnormal if they continued to rise, were flat, or were at abnormally low over time. Results: Across interventions, those with abnormal cortisol at the baseline appeared not to improve over time, whereas those with normal baseline cortisol evidenced improvements on a number of immunologic and self-report measures. Conclusion: It appears that, in subgroups of individuals with CFS, baseline cortisol markers are associated with outcome trajectories for nonpharmacologic treatment trials. The implications of these findings are discussed.'"
 * 2007, The Prevalence of Chronic Fatigue Syndrome in Nigeria
 * 2006, Psychosocial and Physical Impact of Chronic Fatigue in a Community-Based Sample of Children and Adolescents"'Abstract - Background: Few studies have examined the problem of chronic fatigue in children and adolescents and its potential impact on functioning. Chronic fatigue may have a negative impact on school functioning, family activities, psychological well-being, physical functioning, and severity of medical symptomatology. Objectives: This study compared psychosocial, family, and physical functioning between a randomly selected community based sample of 36 children and adolescents with chronic fatigue and a group of 21 children and adolescents without fatigue. Methods: Children and parents completed a comprehensive medical history questionnaire and questionnaires assessing psychological functioning, family functioning, and school attendance. Results: Results indicated that children with chronic fatigue tended to have more difficulties in overall physical and psychological functioning, as measured by the Child Health Questionnaire and the Child Behavior Checklist. In addition, children in the chronic fatigue group experienced disruptions in a range of activities and reported more severe physical symptomatology when compared to children without fatigue. Conclusions: Findings suggest that children and adolescents with chronic fatigue may have a range of associated difficulties, including limitations in physical and psychosocial functioning and a negative impact on the ability to engage in normative activities.'"
 * 2005, The Relationships among Coping Styles and Fatigue in an Ethnically Diverse Sample (Open Access/Full Text)
 * 2004, Family Medical History of Persons with Chronic Fatigue Syndrome"'Abstract - Background: Little research has examined the family history of persons with CFS, although a few studies have found people with CFS may be more likely to have family members with fatigue or CFS-like conditions, cancers, autoimmune illness, and early parental death. Research into the family history of fatigue, chronic fatigue syndrome, and other medical or psychiatric illness may help inform the etiology of this illness. Objectives: The present investigation examined the occurrence of medical and psychiatric illness in the family history of persons with CFS, and then compared these results with the family history of medical illness reported by a control group of persons without fatigue. Methods: Family medical history data was obtained from questionnaire responses, a medical assessment, and medical records, and were then classified into specific illness categories, using the International Classification of Diseases, Tenth Revision (ICD-10). Family history data was compared among three groups using logistic regression analyses. Results: Results indicated that persons with chronic fatigue syndrome were significantly more likely to report a family history of endocrine/ metabolic disorders when compared to the control group. Conclusions: Findings suggest an underlying familial predisposition toward the development of both CFS and endocrine/metabolic disorders. This finding is consistent with the hypothesis that CFS represents a deregulation of the endocrine system."

Online presence

 * Susan Torres-Harding @ Roosevelt University Blog
 * PubMed
 * ResearchGate

Learn more

 * Curriculum Vitae