Psychological adjustment of adolescent girls with chronic fatigue syndrome

Objective. To examine psychosocial problems and adaptation of adolescent gi rls with chronic fatigue syndrome (CFS). Methodology. Thirty-six adolescent girls with CFS (mean age: 15.2 years; me an syndrome duration: 19.7 months) who fulfilled the criteria of the Center s for Disease Control and Prevention were examined by interviews regarding premorbid problems and by questionnaires regarding psychosocial functioning and distress, psychological attitudes, and coping resources. Data were com pared with normative data. Results. Of the adolescents, 86.1% reported 1 or more premorbid problems (5 8.3% physical, 38.9% psychological, and 52.8% familial). Normal adjustment was reported for psychosocial self-esteem, social abilities, and attentiona l abilities. High adjustment to adult social standards of behavior was foun d, but low perceived competence in specific adolescent domains, such as ath letic ability, romance, and participation in recreational activities. The g irls reported predominantly internalizing problems. Normal achievement moti vation, no debilitating fear of failure, and high internal locus of control were observed. Palliative reaction patterns and optimism were predominantl y used as coping strategies. Conclusions. The large number of premorbid problems suggests a possible con tributing factor to the onset of the syndrome, although there were no refer ence data of healthy adolescents. In distinct domains of psychosocial adjus tment, the adolescent girls with CFS showed strengths such as adequate self -esteem and scholastic and social abilities, and weaknesses such as low com petence in adolescent-specific tasks and internalizing distress, which may partly be explained by syndrome-specific somatic complaints. The use of opt imistic and palliative reaction patterns as coping strategies in this patie nt group indicates that the patients with CFS seem to retain an active and positive outlook on life, which may result in a rather adequate psychologic al adaptation to the syndrome, but also in maintenance of the syndrome by e xceeding the physical limits brought about by the CFS. Our results on adjus tment and coping strategies may be helpful to implement (individual) rehabi litation programs.