The 3Ps model

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The 3Ps model or Cognitive Behavioral Model (CBM) of chronic fatigue syndrome is a theory that proposes that CFS can be explained by predisposing, precipitating and perpetuating factors.[1][2][3]

The 3Ps model is a biopsychosocial hypotheses, and has been used to justify the use of a form of psychotherapy called cognitive behavioral therapy in patients with ME/CFS, irrespective of whether a co-existing mental illness is present.

The Cognitive Behavioral Model of ME/CFS
Source: Geraghty et al (2019). Health Psychology Open, 6(1), 2055102919838907. License: CC-BY-4.0

Wessely's CBM[edit | edit source]

Vercoulen's CBM[edit | edit source]

Predisposing factors[edit | edit source]

Precipitating factors[edit | edit source]

Perpetuating factors[edit | edit source]

Evidence[edit | edit source]

Song and Jason (2005) attempted to replicate Vercoulen's original CBM model, but were unable to fit the model to data collected from patients.[4]

The controversial PACE trial was the largest trial of cognitive behavioral therapy and graded exercise therapy, and was based on the cognitive behavioral model of chronic fatigue syndrome. Two of the three PACE trial principle investigators, Trudie Chalder and Michael Sharpe, were among the original authors of the CBM for CBT and both authored or co-authored books on the approach prior to the PACE trial. The PACE trial initially reported moderate improvements in symptoms, but a later Freedom of Information Act request provided crucial data that disputed this.[citation needed]

Criticism[edit | edit source]

The 3Ps model has been described as fundamentally flawed.[1]

Books[edit | edit source]

1989, Chronic Fatigue and its Syndromes[5]

Notable studies and articles[edit | edit source]

  • 1989, Management of chronic (post-viral) fatigue syndrome[2](Full text)
  • 1998, The Persistence of Fatigue in Chronic Fatigue Syndrome and Multiple Sclerosis: The Development of a Model[6](Abstract)
  • 1995, Chronic fatigue syndrome: A cognitive approach[3](Full text)
  • 2005, A population-based study of chronic fatigue syndrome (CFS) experienced in differing patient groups: An effort to replicate Vercoulen et al.'s model of CFS[4](Full text)

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. 1.01.11.2 Geraghty, Keith; Jason, Leonard; Sunnquist, Madison; Tuller, David; Blease, Charlotte; Adeniji, Charles (Jan 1, 2019). "The 'cognitive behavioural model' of chronic fatigue syndrome: Critique of a flawed model". Health Psychology Open. 6 (1): 2055102919838907. doi:10.1177/2055102919838907. ISSN 2055-1029. 
  2. 2.02.1 Chalder, T.; Butler, S.; David, A.; Wessely, S. (Jan 1989). "Management of chronic (post-viral) fatigue syndrome". The Journal of the Royal College of General Practitioners. 39 (318): 26–29. ISSN 0035-8797. PMID 2553945. 
  3. 3.03.1 Surawy, Christina; Hackmann, Ann; Hawton, Keith; Sharpe, Michael (Jun 1, 1995). "Chronic Fatigue Syndrome: A cognitive approach". Behaviour Research and Therapy. 33 (5): 535–544. doi:10.1016/0005-7967(94)00077-W. ISSN 0005-7967. 
  4. 4.04.1 Song, Sharon; Jason, Leonard A (Jun 2005). "A population-based study of chronic fatigue syndrome (CFS) experienced in differing patient groups: An effort to replicate Vercoulen et al.'s model of CFS" (PDF). Journal of Mental Health. 14 (3): 277–289. doi:10.1080/09638230500076165. ISSN 0963-8237. 
  5. Wessely, Simon; Hotopf, Matthew; Sharpe, Michael (1999). Chronic fatigue and its syndromes. Oxford: Oxford University Press. ISBN 978-0192630469. OCLC 41028978. 
  6. Vercoulen, J. H. M. M; Swanink, C. M. A; Galama, J. M. D; Fennis, J. F. M; Jongen, P. J. H; Hommes, O. R; van der Meer, J. W. M; Bleijenberg, G (Dec 1, 1998). "The persistence of fatigue in chronic fatigue syndrome and multiple sclerosis: Development of a model". Journal of Psychosomatic Research. 45 (6): 507–517. doi:10.1016/S0022-3999(98)00023-3. ISSN 0022-3999. 

ME/CFS - An acronym that combines myalgic encephalomyelitis with chronic fatigue syndrome. Sometimes they are combined because people have trouble distinguishing one from the other. Sometimes they are combined because people see them as synonyms of each other.

chronic fatigue syndrome (CFS) - A controversial term, invented by the U.S. Centers for Disease Control, that generally refers to a collection of symptoms as “fatigue”. There have been multiple attempts to come up with a set of diagnostic criteria to define this term, but few of those diagnostic criteria are currently in use. Previous attempts to define this term include the Fukuda criteria and the Oxford criteria. Some view the term as a useful diagnostic category for people with long-term fatigue of unexplained origin. Others view the term as a derogatory term borne out of animus towards patients. Some view the term as a synonym of myalgic encephalomyelitis, while others view myalgic encephalomyelitis as a distinct disease.

PACE trial - A controversial study which claimed that CBT and GET were effective in treating "CFS/ME", despite the fact that its own data did not support this conclusion. Its results and methodology were widely disputed by patients, scientists, and the peer-reviewed scientific literature.

cognitive behavioral therapy (CBT) - A type of psychotherapy geared toward modifying alleged unhealthy thinking, behaviors or illness beliefs. One of the treatment arms used in the controversial PACE trial.

chronic fatigue syndrome (CFS) - A controversial term, invented by the U.S. Centers for Disease Control, that generally refers to a collection of symptoms as “fatigue”. There have been multiple attempts to come up with a set of diagnostic criteria to define this term, but few of those diagnostic criteria are currently in use. Previous attempts to define this term include the Fukuda criteria and the Oxford criteria. Some view the term as a useful diagnostic category for people with long-term fatigue of unexplained origin. Others view the term as a derogatory term borne out of animus towards patients. Some view the term as a synonym of myalgic encephalomyelitis, while others view myalgic encephalomyelitis as a distinct disease.

chronic fatigue syndrome (CFS) - A controversial term, invented by the U.S. Centers for Disease Control, that generally refers to a collection of symptoms as “fatigue”. There have been multiple attempts to come up with a set of diagnostic criteria to define this term, but few of those diagnostic criteria are currently in use. Previous attempts to define this term include the Fukuda criteria and the Oxford criteria. Some view the term as a useful diagnostic category for people with long-term fatigue of unexplained origin. Others view the term as a derogatory term borne out of animus towards patients. Some view the term as a synonym of myalgic encephalomyelitis, while others view myalgic encephalomyelitis as a distinct disease.

Oxford University - a prestigious university located in Oxford, England renowned for its teaching and research in health and medicine

The information provided at this site is not intended to diagnose or treat any illness.
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.