The following case study outlines results from the assessment and treatment of a 32-year-old African American woman with chronic fatigue syndrome. The case history describes a client who is demoralized as a result of having endured worsening symptomatology for the past 3 years with little help from the health care professionals she has consulted. Following evaluation, the client completed a series of eight empowermentoriented, peer counseling groups. Central issues addressed in treatment included issues surrounding expectations fromhealth care providers, issues of denial versus acceptance, identity integration, and irregular patterns of activity. The case study demonstrates the necessity for an individualized and integrative approach to treatment that addresses both medical and psychological aspects of the illness. Findings indicated that a peer-facilitated group therapy intervention was effective in enabling the client to educate herself and gain some acceptance of her condition, modify negative fatigue-related cognitions, improve self-care, and regulate her activity levels.
Anderson, J. S.
,& Ferrans, C. E. (1997). The quality of life of persons with chronic fatigue syndrome. Journal of Nervous and Mental Disease, 185, 359-367.
2.
Beck, A. J.
(1967). Depression: Clinical, experimental, and theoretical aspects. New York: Harper & Row.
3.
Brazier, J. E.
, Harper, R., Jones, N.M.B., O'Cathain, A., Thomas, K. J., Usherwood, T., & Westlake, L. (1992). Validating the SF-36 Health Survey Questionnaire. Quality of Life Research, 2, 169-180.
4.
Buchwald, D.
, Pearlman, T., Umali, J., Schmaling, K., & Katon, W. (1996). Functional status in patients with chronic fatigue syndrome, other fatiguing illnesses, and healthy individuals. American Journal of Medicine, 101(4), 364-370.
5.
Deale, A.
, Chalder, T., Marks, I.,& Wessely, S. (1997). Cognitive behaviour therapy for chronic fatigue syndrome: A randomized controlled trial. American Journal of Psychiatry, 154, 408-414.
6.
Farmer, A.
, Chubb, H., Jones, I., Hillier, J., Smith, A., & Borysiewicz, L. (1996). Screening for psychiatric morbidity in subjects presenting with chronic fatigue syndrome. British Journal of Psychiatry, 168, 354-358.
7.
Fennell, P. A.
(1993, Summer). A systematic, four-stage progressive model for mapping the CFIDS experience. The CFIDS Chronicle, 6, 40-46.
8.
Friedberg, F.
, & Jason, L. A. (1998). Understanding chronic fatigue syndrome: An empirical guide to assessment and treatment. Washington, DC: American Psychological Association.
9.
Friedberg, F.
,& Krupp, L. B. (1994). Acomparison of cognitive behavioral treatment for chronic fatigue syndrome and primary depression. Clinical Infectious Diseases, 18(Suppl. 1), S105-S110.
10.
Fukuda, K.
, Strauss, S. E., Hickie, I., Sharpe, M. C., Dobbins, J. G., & Komaroff, A. (1994). The chronic fatigue syndrome: A comprehensive approach to its definition and study. Annals of Internal Medicine, 121, 953-959.
11.
Goldstein, J. A.
(1990). Chronic fatigue syndrome: The struggle for health. Beverly Hills, CA: Chronic Fatigue Syndrome Institute.
12.
Jason, L. A.
, Fricano, G., Taylor, R. R., Halpert, J., Fennell, P. A., Klein, S., & Levine, S. (2000). Chronic fatigue syndrome: An examination of the phases. Journal of Clinical Psychology, 56, 1-12.
13.
Jason, L. A.
, Richman, J. A., Friedberg, F., Wagner, L., Taylor, R.,& Jordan, K. M. (1997). Politics, science, and the emergence of a new disease: The case of chronic fatigue syndrome. American Psychologist, 52, 973-983.
14.
Jason, L. A.
, Richman, J. A., Rademaker, A. W., Jordan, K. M., Plioplys, A. V., Taylor, R. R., McCreedy, W., Huang, C., & Plioplys, S. (1999). A community-based study of chronic fatigue syndrome. Archives of Internal Medicine, 159, 2129-2137.
15.
Jason, L. A.
, Ropacki, M. T., Santoro, N. B., Richman, J. A., Heatherly, W., Taylor, R., Ferrari, J. R., Haney-Davis, T. M., Rademaker, A., Dupuis, J., Golding, J., Plioplys, A. V.,& Plioplys, S. (1997). Ascreening scale for chronic fatigue syndrome: Reliability and validity. Journal of Chronic Fatigue Syndrome, 3, 39-59.
16.
Jason, L. A.
,& Taylor, R. R. (in press). Chronic fatigue syndrome. In A. M. Nezu, C. M. Nezu,& P. A. Geller (Eds.), Comprehensive handbook of psychology, volume 9: Health psychology. New York: Wiley.
17.
Jason, L. A.
, Tryon, W. W., Frankenberry, E. L.,& King, C. P. (1997). Chronic fatigue syndrome: Relationship to self-ratings and actigraphy. Psychological Reports, 81, 1223-1226.
18.
Johnson, S. K.
, DeLuca, J.,& Natelson, B.H. (1996). Depression in fatiguing illness: Comparing patients with chronic fatigue syndrome, multiple sclerosis and depression. Journal of Affective Disorders, 39, 21-30.
19.
Joyce, J.
, Hotopf, M.,& Wessely, S. (1997). The prognosis of chronic fatigue and chronic fatigue syndrome: A systematic review. Quarterly Journal of Medicine, 90, 223-233.
20.
Kaplan, H. B.
(1991). Social psychology of the immune system: A conceptual framework and review of the literature. Social Science Medicine, 33(8), 909-923.
21.
Kiecolt-Glaser, J. K.
, Garner, W., Speicher, C. E., Penn, G.,& Glaser, R. (1984). Psychosocial modifiers of immunocompetence in medical students. Psychosomatic Medicine, 46, 7-14.
22.
Kiecolt-Glaser, J. K.
,& Glaser, R. (1989). Psychoneuro-immunology: Past, present, and future. Health Psychology, 8, 677-682.
23.
King, C. P. (2001). The development of a diagnostic instrument for chronic fatigue syndrome. Unpublished doctoral dissertation, DePaul University, Chicago.
24.
King, C. P.
, Jason, L. A., Frankenberry, E. L., Jordan, K. M., & Tryon, W. W. (1997). Management of chronic fatigue syndrome through behavioral monitoring of energy levels and fatigue. CFIDS Chronicle, 10, 10-14.
25.
Komaroff, A. L.
(2000). The biology of chronic fatigue syndrome. American Journal of Medicine, 108, 169-171.
26.
Maier, S. F.
, Watkins, L. R., & Fleshner, M. (1994). Psychoneuroimmunology. The interface between behavior, brain, and immunity. American Psychologist, 49, 1004-1017.
27.
Manu, P.
, Lane, T. J.,& Matthews, D. A. (1988). The frequency of the chronic fatigue syndrome in patients with symptoms of persistent fatigue. Annals of Internal Medicine, 109, 554-556.
28.
McHorney, C. A.
, Ware, J. E., Lu, R. L., & Sherbourne, D. (1994). The MOS 36-ItemShort-FormHealth Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Medical Care, 32(1), 40-66.
29.
McHorney, C. A.
, Ware, J. E., & Raczek, A. E. (1993). The MOS 36-ItemShort FormHealth Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care, 313, 247-263.
30.
Pesek, J. R.
, Jason, L. A.,& Taylor, R. R. (2000). An empirical investigation of the envelope theory. Journal of Human Behavior in the Social Environment, 3, 59-77.
31.
Russo, J.
, Katon, W., Clark, M., Kith, P., Sintay, M., & Buchwald, D. (1998). Longitudinal changes associated with improvement in chronic fatigue patients. Journal of Psychosomatic Research, 45, 67-76.
32.
Saphier, D.
(1994, October). A role for interferon in the psychoneuroendocrinology of chronic fatigue syndrome. Paper presented at the American Association of Chronic Fatigue Syndrome Research Conference, Ft. Lauderdale, FL.
33.
Sharpe, M.
, Hawton, K., Simkin, S., Surawy, C., Hackmann, A., Klimes, I., Peto, T., Warrell, D., & Seagroatt, V. (1996). Cognitive behavior therapy for the chronic fatigue syndrome: A randomized controlled trial. British Medical Journal, 312, 22-26.
34.
Shlaes, J. L.
,& Jason, L. A. (1996). A buddy/mentor program for people with chronic fatigue syndrome. The CFIDS Chronicle, 9, 21-25.
35.
Spitzer, R. L.
, Williams, J.B.W., Gibbon, M., & First, M. B. (1995). Structured clinical interview for DSMIV—Non-patient edition(SCID-NP, Version 2.0). Washington, DC: American Psychiatric Press.
36.
Stewart, J. M.
(in press). Orthostatic intolerance in the chronic fatigue syndrome. In L. A. Jason, P. A. Fennell, & R. R. Taylor (Eds.), Handbook of chronic fatigue syndrome and fatiguing illnesses. New York: Wiley.
37.
Taylor, R. R.
, Friedberg, F.,& Jason, L. A. (2001). Aclinician's guide to controversial illnesses: Chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivities. Sarasota, FL: Professional Resource Press.
38.
Taylor, R. R.
,& Jason, L. A. (1998). Comparing the DIS with the SCID: Chronic fatigue syndrome and psychiatric comorbidity. Psychology and Health, 13, 1087-1104.
39.
Van Houdenhove, B.
, Onghena, P., Neerinckx, E.,& Hellin, J. (1995). Does high “action-proneness” make people more vulnerable to chronic fatigue syndrome? A controlled psychometric study. Journal of Psychosomatic Research, 39, 633-640.
40.
Ware, J. E.
, Kosinski, M., & Keller, S. D. (1994). SF-36 Physical and Mental Health Summary Scales: A user's manual. Boston: Health Assessment Lab, New England Medical Center.
41.
Ware, J. E.
,& Sherbourne, C. D. (1992, June). TheMOS36-itemShort-FormHealth Survey (SF-36): Conceptual framework and item selection. Medical Care, 473-483.
42.
Ware, N. C.
(1998). Sociosomatics and illness course in chronic fatigue syndrome. Psychosomatic Medicine, 60, 394-401.
43.
Wilson, A.
, Hickie, I., Lloyd, A., Hadzi-Pavlovic, D., Boughton, C., Dwyer, J.,& Wakefield, D. (1994). Longitudinal study of outcome of chronic fatigue syndrome. British Medical Journal, 308, 756-759.
