Relations between illness perceptions, coping, social support, and outcomes in the Chronic Fatigue Syndrome
Bibliographic record
Abstract
Chronic fatigue syndrome (CFS) is a disorder of unknown etiology characterized by fatigue, flu-like symptoms, and neurocognitive complaints. Due to the severe impairment associated with the illness patients are often unable to work and must rely on disability income. Few patients recover spontaneously although a sizeable proportion has reported improvement. Since no definitive treatment is available for CFS, it is essential to identify effective ways for patients to adjust to the illness. The purpose of the study was to describe how patients adapt to CFS. A sample of 100 patients diagnosed medically with CFS and meeting the Centers for Disease Control and Prevention (CDC) case definition were recruited primarily from the practices of two hospital-based internists. The respondents were screened for psychiatric conditions and completed a battery of questionnaires at four time points over a 21-month period. Guided by Leventhal's self-regulatory model, multiple regression analyses and ANOVA were utilized to assess the relations between respondents' illness representations, self-management strategies (coping and social support), perceived efficacy of self-management, and outcomes including functioning, psychological distress, and health care utilization. Analyses revealed pessimistic illness representations and coping characterized by catastrophizing, focusing on symptoms, avoidance, and venting predicted unfavorable outcomes. On the other hand, optimistic perceptions and coping by accommodating to the illness, approach strategies, and social support predicted favorable outcomes. Moreover, in addition to the direct associations between illness representations and outcomes, representations were also related to coping. Pessimistic representations predicted maladaptive coping (strategies that predicted unfavorable outcomes) and optimistic perceptions predicted adaptive coping (strategies that predicted favorable outcomes). Coping frequency was a better predictor of outcomes than perceptions of coping efficacy save for physical functioning. To examine change, analyses of differences within and between groups were conducted. When the sample was stratified into short (ill four years) and long illness duration groups (ill four years or more) the long duration group reported fewer health care visits. As a whole the respondents experienced little change in outcomes over a 21-month period but stratification demonstrated that the short illness duration group evidenced a small but statistically significant improvement in physical functioning while the long illness duration group reported less vitality. Coping and social support efficacy decreased over time although for the most part the frequency of self-management behaviors was quite stable. The implications of the study results for the management of CFS and future research were discussed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".