PSYCHOSOCIAL CORRELATES OF ILLNESS BURDEN IN CHRONIC FATIGUE SYNDROME

We related reported physical symptoms, cognitive appraisals (e.g., neg ative style of thinking), and coping strategies (e.g., denial/disengag ement strategies) with illness burden across several functional domain s separately in subsets of chronic fatigue syndrome (CFS) patients wit h (n = 26) and without (n = 39) concurrently diagnosed major depressiv e disorder (MDD). In regard to cognitive appraisal measures, automatic thoughts and dysfunctional attitudes were strongly associated with a higher illness burden, as indicated in sickness impact profile (SIP) s cores. Active-involvement coping strategies measured on COPE scales (a ctive coping, planning, and positive reinterpretation and growth) were not associated with SIP scores, while other coping strategies (mental disengagement, behavioral disengagement, and denial) were positively correlated with psychosocial and physical SIP scales, especially those pertaining to interpersonal life-style arenas. After we accounted for the number of different CFS-specific physical complaints reported and DSM-III-R depression diagnosis status, cognitive appraisals and copin g strategies predicted a substantial proportion of the variance in the severity of illness burden. For the most part, the magnitude of these relationships between our predictor model variables and illness burde n severity was similar in the MDD and non-MDD subgroups.