Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-23T01:38:25.889Z Has data issue: false hasContentIssue false
  • English
  • Français

Treatment Outcome and Metacognitive Change in CBT and GET for Chronic Fatigue Syndrome

Published online by Cambridge University Press:  21 April 2015

Bruce A. Fernie ,
Gabrielle Murphy ,
Adrian Wells ,
Ana V. Nikčević  and
Marcantonio M. Spada
Bruce A. Fernie
Affiliation:
King's College London, Institute of Psychiatry, Psychology and Neuroscience, and Cascaid, South London and Maudsley NHS Foundation Trust, UK
Gabrielle Murphy
Affiliation:
Royal Free Hampstead NHS Foundation Trust, London, UK
Adrian Wells
Affiliation:
University of Manchester, UK
Ana V. Nikčević
Affiliation:
Kingston University, Kingston upon Thames, UK
Marcantonio M. Spada*
Affiliation:
London South Bank University, UK
*
Reprint requests to Marcantonio M. Spada, School of Applied Sciences, London South Bank University, 103 Borough Road, London SE1 0AA, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Studies have reported that Cognitive Behavioural Therapy (CBT) and Graded Exercise Therapy (GET) are effective treatments for Chronic Fatigue Syndrome (CFS). Method: One hundred and seventy-one patients undertook a course of either CBT (n = 116) or GET (n = 55) and were assessed on a variety of self-report measures at pre- and posttreatment and follow-up. Aims: In this paper we present analyses on treatment outcomes for CBT and GET in routine clinical practice and evaluate whether changes on subscales of the Metacognitions Questionnaire-30 (MCQ-30) predict fatigue severity independently of changes in other covariates, and across the two treatment modalities. Results: Both CBT and GET were equally effective at decreasing fatigue, anxiety, and depression, and at increasing physical functioning. Changes on the subscales of the MCQ-30 were also found to have a significant effect on fatigue severity independently of changes in other covariates and across treatment modalities. Conclusion: The findings from the current study suggest that CFS treatment protocols for CBT and GET, based on those from the PACE trial, achieve similar to poorer outcomes in routine clinical practice as in a RCT.

Keywords

Cognitive behavioural therapychronic fatigue syndromegraded exercise therapymetacognitionsmetacognitive changeoutcomes evaluation
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 44 , Issue 4 , July 2016 , pp. 397 - 409
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aggarwal, V. R., McBeth, J., Zakrzewska, J. M., Lunt, M. and Macfarlane, G. J. (2006). The epidemiology of chronic syndromes that are frequently unexplained: do they have common associated factors? International Journal of Epidemiology, 35, 468–476. doi: 10.1093/ije/dyi265 Google Scholar
Chalder, T., Berelowitz, G., Pawlikowska, T., Watts, L., Wessely, S., Wright, D., et al. (1993). Development of a fatigue scale. Journal of Psychosomatic Research, 37, 147–153.Google Scholar
Chalder, T., Goldsmith, K. A., White, P. D., Sharpe, M. and Pickles, A. R. (2015). Rehabilitative therapies for chronic fatigue syndrome: a secondary mediation analysis of the PACE trial. The Lancet Psychiatry, 2, 141–152.Google Scholar
Cooney, G. M., Dwan, K., Greig, C. A., Lawlor, D. A., Rimer, J., Waugh, F. R., et al. (2013). Exercise for depression. Cochrane Database of Systematic Reviews, 9.Google Scholar
Deale, A., Chalder, T. and Wessely, S. (1998). Illness beliefs and treatment outcome in chronic fatigue syndrome. Journal of Psychosomatic Research, 45, 77–83.Google Scholar
Fernie, B. A., Maher-Edwards, L., Murphy, G., Nikčević, A. V. and Spada, M. M. (2014). The Metacognitions about Symptoms Control Scale: development and concurrent validity. Clinical Psychology and Psychotherapy. doi: 10.1002/cpp.1906 Google Scholar
Guy, W. (1976). ECDEU Assessment Manual for Psychopharmacology. Rockville, MD: US Department of Health, Education, and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute of Mental Health, Psychopharmacology Research Branch, Division of Extramural Research Programs.Google Scholar
Hou, R., Moss-Morris, R., Bradley, B. P., Peveler, R. and Mogg, K. (2008). Attentional bias towards health-threat information in chronic fatigue syndrome. Journal of Psychosomatic Research, 65, 47–50.Google Scholar
IBM (2011). Statistical Package for the Social Sciences Version 20: SPSS. Chicago: SPSS Inc. Google Scholar
Knoop, H., Prins, J. B., Moss-Morris, R. and Bleijenberg, G. (2010). The central role of cognitive processes in the perpetuation of chronic fatigue syndrome. Journal of Psychosomatic Research, 68, 489–494.Google Scholar
Maher-Edwards, L., Fernie, B. A., Murphy, G., Nikčević, A. V. and Spada, M. M. (2012). Metacognitive factors in chronic fatigue syndrome. Clinical Psychology and Psychotherapy, 19, 552–557. doi: 10.1002/cpp.757 Google Scholar
Maher-Edwards, L., Fernie, B. A., Murphy, G., Wells, A. and Spada, M. M. (2011). Metacognitions and negative emotions as predictors of symptom severity in chronic fatigue syndrome. Journal of Psychosomatic Research, 70, 311–317. doi: 10.1016/j.jpsychores.2010.09.016 CrossRefGoogle ScholarPubMed
Moss-Morris, R. and Petrie, K. J. (2003). Experimental evidence for interpretive but not attention biases towards somatic information in patients with chronic fatigue syndrome. British Journal of Health Psychology, 8 (Pt 2), 195–208. doi: 10.1348/135910703321649169 CrossRefGoogle Scholar
Moss-Morris, R., Sharon, C., Tobin, R. and Baldi, J. C. (2005). A randomized controlled graded exercise trial for chronic fatigue syndrome: outcomes and mechanisms of change. Journal of Health Psychology, 10, 245–259.Google Scholar
Mykletun, A. (2001). Hospital Anxiety and Depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. The British Journal of Psychiatry, 179, 540–544. doi: 10.1192/bjp.179.6.540 Google Scholar
NICE (2007). Diagnosis and Management of Chronic Fatigue Syndrome. CG53. London: National Institute for Health and Clinical Excellence (NICE).Google Scholar
Prins, J. B., Bleijenberg, G., Bazelmans, E., Elving, L. D., de Boo, T. M., Severens, J. L., et al. (2001). Cognitive behaviour therapy for chronic fatigue syndrome: a multicentre randomised controlled trial. The Lancet, 357 (9259), 841–847.Google Scholar
Quarmby, L., Rimes, K. A., Deale, A., Wessely, S. and Chalder, T. (2007). Cognitive-behaviour therapy for chronic fatigue syndrome: comparison of outcomes within and outside the confines of a randomised controlled trial. Behaviour Research and Therapy, 45, 1085–1094.CrossRefGoogle ScholarPubMed
Sharpe, M. C., Archard, L. C., Banatvala, J. E., Borysiewicz, L. K., Clare, A. W., David, A., et al. (1991). A report - chronic fatigue syndrome: guidelines for research. Journal of the Royal Society of Medicine, 84, 118–121.Google Scholar
Spada, M. M., Mohiyeddini, C. and Wells, A. (2008). Measuring metacognitions associated with emotional distress: factor structure and predictive validity of the metacognitions questionnaire 30. Personality and Individual Differences, 45, 238–242.Google Scholar
Stahl, D., Rimes, K. A. and Chalder, T. (2014). Mechanisms of change underlying the efficacy of cognitive behaviour therapy for chronic fatigue syndrome in a specialist clinic: a mediation analysis. Psychological Medicine, 44, 1331–1344. doi: 10.1017/S0033291713002006 Google Scholar
Ware, J. E. and Kosinski, M. (2001). SF-36 Physical and Mental Health Summary Scales: a manual for users of version 1. Lincoln, RI: Quality Metric.Google Scholar
Ware, J. E. Jr and Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection. Medical Care, 473–483.Google Scholar
Wells, A. (2011). Metacognitive Therapy for Anxiety and Depression: New York: Guilford Press.Google Scholar
Wells, A. and Cartwright-Hatton, S. (2004). A short form of the metacognitions questionnaire: properties of the MCQ-30. Behaviour Research and Therapy, 42, 385–396. doi: 10.1016/S0005-7967(03)00147-5 Google Scholar
White, P., Goldsmith, K., Johnson, A., Potts, L., Walwyn, R., DeCesare, J., et al. (2011). Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. The Lancet, 377 (9768), 823–836.Google Scholar
White, P. D., Sharpe, M. C., Chalder, T., DeCesare, J. C. and Walwyn, R. (2007). Protocol for the PACE trial: a randomised controlled trial of adaptive pacing, cognitive behaviour therapy, and graded exercise as supplements to standardised specialist medical care versus standardised specialist medical care alone for patients with the chronic fatigue syndrome/myalgic encephalomyelitis or encephalopathy. BMC Neurology, 7, 6.Google Scholar
Wiborg, J. F., Knoop, H., Prins, J. B. and Bleijenberg, G. (2011). Does a decrease in avoidance behavior and focusing on fatigue mediate the effect of cognitive behavior therapy for chronic fatigue syndrome? Journal of Psychosomatic Research, 70, 306–310.Google Scholar
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavia, 67, 361–370.Google Scholar
Submit a response

Comments

No Comments have been published for this article.