TY - JOUR
T1 - Towards personalized assessment of fatigue perpetuating factors in patients with chronic fatigue syndrome using ecological momentary assessment: A pilot study
AU - Worm-Smeitink, Margreet
AU - Monden, Rei
AU - Groen, Robin Nikita
AU - van Gils, Anne
AU - Bekhuis, Ella
AU - Rosmalen, Judith
AU - Knoop, Hans
N1 - Funding Information: All authors have completed the Unified Competing Interest form at http://www.icmje.org/coi_disclosure.pdf and declare that H. Knoop receives royalties for the treatment protocol used in the study. R.N. Groen was supported by the Dutch Organisation for Scientific Research (NWO Talent Grant; grant number 406.16.507). Publisher Copyright: © 2020 The Authors
PY - 2021/1/1
Y1 - 2021/1/1
N2 - Objective: This study aimed to explore the associations between cognitions, behaviours and affects and fatigue in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and their relation to reduction of fatigue after cognitive behaviour therapy (CBT). Methods: In CFS/ME patients, 22 behaviours, cognitions and affects, potentially perpetuating fatigue were registered 5 times a day using ecological momentary assessment (EMA) and an actigraphy. Simultaneous Components Analysis (SCA) was used to identify components of perpetuation, that were tested for their associations with fatigue in multilevel vector autoregressive (VAR) modelling. Fatigue severity was measured pre- and posttreatment with the Checklist Individual Strength. The relationship between perpetuation (the strength and direction of the possible associations between fatigue and the components) and therapy outcome was investigated. Results: 58 patients met inclusion criteria (m age = 36.5; 65.5% female) and data of 50 patients were analysed in the multilevel analysis. Two perpetuating components were found: “psychological discomfort” and “activity”. For the total group, both perpetuating components did not predict fatigue on a following time-point. For individual patients the strength and direction of the associations varied. None of the associations between perpetuating components and fatigue significantly predicted treatment outcome. Conclusion: Results suggest that there is heterogeneity in perpetuation of fatigue in CFS/ME. Investigating fatigue and perpetuators on an individual rather than group level could lead to new insights.
AB - Objective: This study aimed to explore the associations between cognitions, behaviours and affects and fatigue in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and their relation to reduction of fatigue after cognitive behaviour therapy (CBT). Methods: In CFS/ME patients, 22 behaviours, cognitions and affects, potentially perpetuating fatigue were registered 5 times a day using ecological momentary assessment (EMA) and an actigraphy. Simultaneous Components Analysis (SCA) was used to identify components of perpetuation, that were tested for their associations with fatigue in multilevel vector autoregressive (VAR) modelling. Fatigue severity was measured pre- and posttreatment with the Checklist Individual Strength. The relationship between perpetuation (the strength and direction of the possible associations between fatigue and the components) and therapy outcome was investigated. Results: 58 patients met inclusion criteria (m age = 36.5; 65.5% female) and data of 50 patients were analysed in the multilevel analysis. Two perpetuating components were found: “psychological discomfort” and “activity”. For the total group, both perpetuating components did not predict fatigue on a following time-point. For individual patients the strength and direction of the associations varied. None of the associations between perpetuating components and fatigue significantly predicted treatment outcome. Conclusion: Results suggest that there is heterogeneity in perpetuation of fatigue in CFS/ME. Investigating fatigue and perpetuators on an individual rather than group level could lead to new insights.
KW - Chronic fatigue syndrome
KW - Cognitive behaviour therapy
KW - Diary study
KW - Ecological momentary assessment
KW - Personalized medicine
KW - Time series analysis
UR - http://www.scopus.com/inward/record.url?scp=85097245156&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jpsychores.2020.110296
DO - https://doi.org/10.1016/j.jpsychores.2020.110296
M3 - Article
C2 - 33264751
SN - 0022-3999
VL - 140
JO - Journal of psychosomatic research
JF - Journal of psychosomatic research
M1 - 110296
ER -