Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-22T15:38:44.143Z Has data issue: false hasContentIssue false
  • English
  • Français

Self-critical perfectionism and its relationship to fatigue and pain in the daily flow of life in patients with chronic fatigue syndrome

Published online by Cambridge University Press:  30 August 2012

S. Kempke ,
P. Luyten ,
S. Claes ,
L. Goossens ,
P. Bekaert ,
P. Van Wambeke  and
B. Van Houdenhove
S. Kempke*
Affiliation:
Department of Psychology, University of Leuven, Belgium
P. Luyten
Affiliation:
Department of Psychology, University of Leuven, Belgium Research Department of Clinical, Educational and Health Psychology, University College London, UK
S. Claes
Affiliation:
Department of Psychiatry, University Hospitals Leuven, University of Leuven, Belgium
L. Goossens
Affiliation:
Chronic Fatigue Syndrome Reference Centre, University Hospitals Leuven, University of Leuven, Belgium
P. Bekaert
Affiliation:
Chronic Fatigue Syndrome Reference Centre, University Hospitals Leuven, University of Leuven, Belgium
P. Van Wambeke
Affiliation:
Chronic Fatigue Syndrome Reference Centre, University Hospitals Leuven, University of Leuven, Belgium
B. Van Houdenhove
Affiliation:
Department of Psychiatry, University Hospitals Leuven, University of Leuven, Belgium Chronic Fatigue Syndrome Reference Centre, University Hospitals Leuven, University of Leuven, Belgium
*
*Address for correspondence: S. Kempke, Department of Psychology, University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Background

Research suggests that the personality factor of self-critical or maladaptive perfectionism may be implicated in chronic fatigue syndrome (CFS). However, it is not clear whether self-critical perfectionism (SCP) also predicts daily symptoms in CFS.

Method

In the present study we investigated whether SCP predicted fatigue and pain over a 14-day period in a sample of 90 CFS patients using a diary method approach. After completing the Depressive Experiences Questionnaire (DEQ) as a measure of SCP, patients were asked each day for 14 days to complete Visual Analogue Scales (VAS) of fatigue, pain and severity of depression. Data were analysed using multilevel analysis.

Results

The results from unconditional models revealed considerable fluctuations in fatigue over the 14 days, suggesting strong temporal variability in fatigue. By contrast, pain was relatively stable over time but showed significant inter-individual differences. Congruent with expectations, fixed-effect models showed that SCP was prospectively associated with higher daily fatigue and pain levels over the 14-day period, even after controlling for levels of depression.

Conclusions

This is the first study to show that SCP predicts both fatigue and pain symptoms in CFS in the daily course of life. Hence, therapeutic interventions aimed at targeting SCP should be considered in the treatment of CFS patients with such features.

Keywords

Chronic fatiguedepressiondiary methodologyfibromyalgiapainpersonality
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 5 , May 2013 , pp. 995 - 1002
Copyright
Copyright © Cambridge University Press 2012

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

Blatt, SJ (2004). Experiences of Depression: Theoretical, Clinical and Research Perspectives. American Psychiatric Association: Washington, DC.CrossRefGoogle Scholar
Blatt, SJ, D'Afflitti, JP, Quinlan, DM (1976). Experiences of depression in normal young adults. Journal of Abnormal Psychology 85, 383–389.CrossRefGoogle ScholarPubMed
Blatt, SJ, Luyten, P (2009). A structural-developmental psychodynamic approach to psychopathology: two polarities of experience across the life span. Development and Psychopathology 21, 793–814.CrossRefGoogle ScholarPubMed
Blatt, SJ, Zuroff, DC, Hawley, LL, Auerbach, JS (2010). Predictors of sustained therapeutic change. Psychotherapy Research 20, 37–54.CrossRefGoogle ScholarPubMed
Bolger, N, Davis, A, Rafaeli, E (2003). Diary methods: capturing life as it is lived. Annual Review of Psychology 54, 579–616.CrossRefGoogle ScholarPubMed
Brooks, SK, Rimes, KA, Chalder, T (2011). The role of acceptance in chronic fatigue syndrome. Journal of Psychosomatic Research 71, 411–415.CrossRefGoogle ScholarPubMed
Carruthers, BM, van de Sande, MI, De Meirleir, KL, Klimas, NG, Broderick, G, Mitchell, T, Staines, D, Powles, AC, Speight, N, Vallings, R, Bateman, L, Baumgarten-Austrheim, B, Bell, DS, Carlo-Stella, N, Chia, J, Darragh, A, Jo, D, Lewis, D, Light, AR, Marshall-Gradisbik, S, Mena, I, Mikovits, JA, Miwa, K, Murovska, M, Pall, ML, Stevens, S (2011). Myalgic encephalomyelitis: International Consensus Criteria. Journal of Internal Medicine 270, 327–338.CrossRefGoogle ScholarPubMed
Clauw, DJ, Chrousos, GP (1997). Chronic pain and fatigue syndromes: overlapping clinical and neuroendocrine features and potential pathogenic mechanisms. Neuroimmunomodulation 4, 134–153.CrossRefGoogle ScholarPubMed
Creed, F (2007). Cognitive behavioural model of irritable bowel syndrome. Gut 56, 1039–1041.CrossRefGoogle ScholarPubMed
Deary, V, Chalder, T (2010). Personality and perfectionism in chronic fatigue syndrome: a closer look. Psychology and Health 25, 465–475.CrossRefGoogle ScholarPubMed
Deary, V, Chalder, T, Sharpe, M (2007). The cognitive behavioural model of medically unexplained symptoms: a theoretical and empirical review. Clinical Psychology Review 27, 781–797.CrossRefGoogle ScholarPubMed
Dendy, C, Cooper, M, Sharpe, M (2001). Interpretation of symptoms in chronic fatigue syndrome. Behaviour Research and Therapy 39, 1369–1380.CrossRefGoogle ScholarPubMed
Dittner, AJ, Rimes, K, Thorpe, S (2011). Negative perfectionism increases the risk of fatigue following a period of stress. Psychology and Health 26, 253–268.CrossRefGoogle ScholarPubMed
Dunkley, DM, Blankstein, KR, Masheb, RM, Grilo, CM (2006). Personal standards and evaluative concerns dimensions of ‘clinical’ perfectionism: a reply to Shafran et al. (2002, 2003) and Hewitt et al. (2003). Behaviour Research and Therapy 44, 63–84.CrossRefGoogle ScholarPubMed
Flett, GL, Hewitt, PL (2002). Perfectionism and maladjustment: an overview of theoretical, definitional, and treatment issues. In Perfectionism. Theory, Research, and Treatment (ed. Flett, G. L. and Hewitt, P.L.), pp. 5–31. Guilford Press: New York.CrossRefGoogle Scholar
Flett, GL, Hewitt, PL (2008). Treatment interventions for perfectionism – a cognitive perspective: introduction to the Special Issue. Journal of Rational-Emotive and Cognitive-Behavior Therapy 26, 127–133.CrossRefGoogle Scholar
Fukuda, K, Straus, SE, Hickie, I, Sharpe, MC, Dobbins, JG, Komaroff, A (1994). The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Annals of Internal Medicine 121, 953–959.CrossRefGoogle ScholarPubMed
Fukuda, S, Kuratsune, H, Tajima, S, Takashima, S, Yamagutchi, K, Nishizawa, Y, Watanabe, Y (2010). Premorbid personality in chronic fatigue syndrome as determined by the Temperament and Character Inventory. Comprehensive Psychiatry 51, 78–85.CrossRefGoogle ScholarPubMed
Hambrook, D, Oldershaw, A, Rimes, K, Schmidt, U, Tchanturia, K, Treasure, J, Richards, S, Chalder, T (2011). Emotional expression, self-silencing, and distress tolerance in anorexia nervosa and chronic fatigue syndrome. British Journal of Clinical Psychology 50, 310–325.CrossRefGoogle ScholarPubMed
Harvey, SB, Wadsworth, M, Wessely, S, Hotopf, M (2008). Etiology of chronic fatigue syndrome: testing popular hypotheses using a national birth cohort study. Psychosomatic Medicine 70, 488–495.CrossRefGoogle ScholarPubMed
Heim, C, Nater, UM, Maloney, E, Boneva, R, Jones, JF, Reeves, WC (2009). Childhood trauma and risk for chronic fatigue syndrome: association with neuroendocrine dysfunction. Archives of General Psychiatry 66, 72–80.CrossRefGoogle ScholarPubMed
Hox, JJ (2010). Multilevel Analysis. Techniques and Applications. Routledge: New York.CrossRefGoogle Scholar
Jason, L, Benton, M, Torres-Harding, S, Muldowney, K (2009). The impact of energy modulation on physical functioning and fatigue severity among patients with ME/CFS. Patient Education and Counseling 77, 237–241.CrossRefGoogle ScholarPubMed
Jones, DE, Gray, J, Frith, J, Newton, JL (2011). Fatigue severity remains stable over time and independently associated with orthostatic symptoms in chronic fatigue syndrome: a longitudinal study. Journal of Internal Medicine 269, 182–188.CrossRefGoogle ScholarPubMed
Kanaan, RA, Lepine, JP, Wessely, SC (2007). The association or otherwise of the functional somatic syndromes. Psychosomatic Medicine 69, 855–859.CrossRefGoogle ScholarPubMed
Kempke, S, Goossens, L, Luyten, P, Bekaert, P, Van Houdenhove, B, Van Wambeke, P (2010). Predictors of outcome in a multi-component treatment program for chronic fatigue syndrome. Journal of Affective Disorders 126, 174–179.CrossRefGoogle Scholar
Kempke, S, Luyten, P, Van Houdenhove, B, Goossens, L, Bekaert, P, Van Wambeke, P (2011 a). Self-esteem mediates the relationship between maladaptive perfectionism and depression in chronic fatigue syndrome. Clinical Rheumatology 30, 1543–1548.CrossRefGoogle ScholarPubMed
Kempke, S, Van Houdenhove, B, Luyten, P, Goossens, L, Bekaert, P, Van Wambeke, P (2011 b). Unraveling the role of perfectionism in chronic fatigue syndrome: is there a distinction between adaptive and maladaptive perfectionism? Psychiatry Research 186, 373–377.CrossRefGoogle Scholar
Knoop, H, Stulemeijer, M, Prins, JB, van der Meer, JW, Bleijenberg, G (2007). Is cognitive behaviour therapy for chronic fatigue syndrome also effective for pain symptoms? Behaviour Research and Therapy 45, 2034–2043.CrossRefGoogle ScholarPubMed
Lerman, SF, Rudich, Z, Shahar, G (2010). Distinguishing affective and somatic dimensions of pain and depression: a confirmatory factor analytic study. Journal of Clinical Psychology 66, 456–465.CrossRefGoogle ScholarPubMed
Lerman, SF, Shahar, G, Rudich, Z (2012). Self-criticism interacts with the affective component of pain to predict depressive symptoms in female patients. European Journal of Pain 16, 115–122.CrossRefGoogle ScholarPubMed
Luyten, P, Blatt, SJ (2011). Integrating theory-driven and empirically-derived models of personality development and psychopathology: a proposal for DSM V. Clinical Psychology Review 31, 52–68.CrossRefGoogle ScholarPubMed
Luyten, P, Kempke, S, Van Wambeke, P, Claes, S, Blatt, SJ, Van Houdenhove, B (2011). Self-critical perfectionism, stress generation, and stress sensitivity in patients with chronic fatigue syndrome: relationship with severity of depression. Psychiatry 74, 21–30.CrossRefGoogle ScholarPubMed
Luyten, P, Sabbe, B, Blatt, SJ, Meganck, S, Jansen, B, De Grave, C, Maes, F, Corveleyn, J (2007). Dependency and self-criticism: relationship with major depressive disorder, severity of depression, and clinical presentation. Depression and Anxiety 24, 586–596.CrossRefGoogle ScholarPubMed
Luyten, P, Van Houdenhove, B, Cosyns, N, Van den Broeck, AL (2006). Are patients with chronic fatigue syndrome perfectionistic – or were they? A case-control study. Personality and Individual Differences 40, 1473–1483.CrossRefGoogle Scholar
Magnusson, AE, Nias, DK, White, PD (1996). Is perfectionism associated with fatigue? Journal of Psychosomatic Research 41, 377–383.CrossRefGoogle ScholarPubMed
Meeus, M, Nijs, J (2007). Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome. Clinical Rheumatology 26, 465–473.CrossRefGoogle ScholarPubMed
Meeus, M, Nijs, J, Meirleir, KD (2007). Chronic musculoskeletal pain in patients with the chronic fatigue syndrome: a systematic review. European Journal of Pain 11, 377–386.CrossRefGoogle ScholarPubMed
Morlion, B, Kempke, S, Luyten, P, Coppens, E, Van Wambeke, P (2011). Multidisciplinary Pain Education Program (MPEP) for chronic pain patients: preliminary evidence for effectiveness and mechanisms of change. Current Medical Research and Opinion 27, 1595–1601.CrossRefGoogle ScholarPubMed
Moss-Morris, R, Petrie, KJ (2001). Discriminating between chronic fatigue syndrome and depression: a cognitive analysis. Psychological Medicine 31, 469–479.CrossRefGoogle ScholarPubMed
Moss-Morris, R, Petrie, KJ (2003). Experimental evidence for interpretive but not attention biases towards somatic information in patients with chronic fatigue syndrome. British Journal of Health Psychology 8, 195–208.CrossRefGoogle Scholar
Moss-Morris, R, Spence, MJ, Hou, R (2010). The pathway from glandular fever to chronic fatigue syndrome: can the cognitive behavioural model provide the map? Psychological Medicine 41, 1099–1107.CrossRefGoogle ScholarPubMed
Nater, UM, Jones, JF, Lin, JM, Maloney, E, Reeves, WC, Heim, C (2010). Personality features and personality disorders in chronic fatigue syndrome: a population-based study. Psychotherapy and Psychosomatics 79, 312–318.CrossRefGoogle ScholarPubMed
Peugh, JL, Enders, CK (2005). Using the SPSS mixed procedure to fit cross-sectional and longitudinal multilevel models. Educational and Psychological Measurement 65, 717–741.CrossRefGoogle Scholar
Picavet, HS, Vlaeyen, JW, Schouten, JS (2002). Pain catastrophizing and kinesiophobia: predictors of chronic low back pain. American Journal of Epidemiology 156, 1028–1034.CrossRefGoogle ScholarPubMed
Rimes, KA, Chalder, T (2010). The Beliefs about Emotions Scale: validity, reliability and sensitivity to change. Journal of Psychosomatic Research 68, 285–292.CrossRefGoogle ScholarPubMed
Rudich, Z, Lerman, SF, Gurevich, B, Weksler, N, Shahar, G (2008). Patients' self-criticism is a stronger predictor of physician's evaluation of prognosis than pain diagnosis or severity in chronic pain patients. Journal of Pain 9, 210–216.CrossRefGoogle ScholarPubMed
Shiffman, S, Stone, AA, Hufford, MR (2008). Ecological momentary assessment. Annual Review of Clinical Psychology 4, 1–32.CrossRefGoogle ScholarPubMed
Stoeber, J, Otto, K (2006). Positive conceptions of perfectionism: approaches, evidence, challenges. Personality and Social Psychology Review 10, 295–319.CrossRefGoogle ScholarPubMed
Surawy, C, Hackmann, A, Hawton, K, Sharpe, M (1995). Chronic fatigue syndrome: a cognitive approach. Behaviour Research and Therapy 33, 535–544.CrossRefGoogle ScholarPubMed
Turk, DC, Swanson, KS, Tunks, ER (2008). Psychological approaches in the treatment of chronic pain patients – when pills, scalpels, and needles are not enough. Canadian Journal of Psychiatry 53, 213–223.CrossRefGoogle ScholarPubMed
Van Campen, E, Van Den Eede, F, Moorkens, G, Schotte, C, Schacht, R, Sabbe, BG, Cosyns, P, Claes, SJ (2009). Use of the Temperament and Character Inventory (TCI) for assessment of personality in chronic fatigue syndrome. Psychosomatics 50, 147–154.CrossRefGoogle ScholarPubMed
Van Houdenhove, B, Bruyninckx, K, Luyten, P (2006). In search of a new balance. Can high ‘action-proneness’ in patients with chronic fatigue syndrome be changed by a multidisciplinary group treatment? Journal of Psychosomatic Research 60, 623–625.CrossRefGoogle ScholarPubMed
Van Houdenhove, B, Kempke, S, Luyten, P (2010). Psychiatric aspects of chronic fatigue syndrome and fibromyalgia. Current Psychiatry Reports 12, 208–214.CrossRefGoogle ScholarPubMed
Van Houdenhove, B, Luyten, P (2008). Customizing treatment of chronic fatigue syndrome and fibromyalgia: the role of perpetuating factors. Psychosomatics 49, 470–477.CrossRefGoogle ScholarPubMed
Van Houdenhove, B, Luyten, P (2009). Central sensitivity syndromes: stress system failure may explain the whole picture. Seminars in Arthritis and Rheumatism 39, 218–219.CrossRefGoogle ScholarPubMed
Van Houdenhove, B, Luyten, P (2010). Chronic fatigue syndrome reflects loss of adaptability. Journal of Internal Medicine 268, 249–251.CrossRefGoogle ScholarPubMed
Van Houdenhove, B, Stans, L, Verstraeten, D (1987). Is there a link between ‘pain-proneness’ and ‘action-proneness’? Pain 29, 113–117.CrossRefGoogle Scholar
West, BT (2009). Analyzing longitudinal data with the linear mixed models procedure in SPSS. Evaluation and the Health Professions 32, 207–228.CrossRefGoogle ScholarPubMed
White, C, Schweitzer, R (2000). The role of personality in the development and perpetuation of chronic fatigue syndrome. Journal of Psychosomatic Research 48, 515–524.CrossRefGoogle ScholarPubMed
Wirtz, PH, Elsenbruch, S, Emini, L, Rudisuli, K, Groessbauer, S, Ehlert, U (2007). Perfectionism and the cortisol response to psychosocial stress in men. Psychosomatic Medicine 69, 249–255.CrossRefGoogle ScholarPubMed
Yunus, MB (2007). Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Seminars in Arthritis and Rheumatism 36, 339–356.CrossRefGoogle ScholarPubMed