Date sent:      	Sat, 29 Sep 2001 

Measuring Attributions About Chronic Fatigue Syndrome

J of Chronic Fatigue Syndrome, Vol. 8, Numbers 3/4, 2001, pp.
31-40

Leonard A. Jason, PhD; Renée R. Taylor, PhD

Department of Psychology, DePaul University
Address correspondence to: Leonard A. Jason, PhD, Department of
Psychology, DePaul University, 2219 North Kenmore, Chicago, IL 60614.

Financial support for this study was provided by NIAID grant number
AI36295.

SUMMARY. Three studies explored the effects of different diagnostic
labels and different types of recommended treatments for Chronic Fatigue
Syndrome upon attributions regarding its cause, nature, severity,
contagion, prognosis, and treatment. Attributions for Chronic Fatigue
Syndrome appear to change based upon the diagnostic label given for the
syndrome and the type of treatment recommended. 

Results suggest that, in
comparison to the Chronic Fatigue Syndrome label, the Myalgic
Encephalopathy label prompts attributions that this syndrome is a serious
condition associated with a physiologically-based etiology, a poor
prognosis, and decreased potential for organ donation. Results also
suggest that, compared with cognitive coping skills treatment, treatment
with ampligen appears to be associated with perceptions of Chronic
Fatigue Syndrome as an accurate diagnosis and as a severely disabling
condition.


KEYWORDS. Attributions, Ampligen, Myalgic Encephalomyelitis


Introduction.
The presence of stigma among individuals with Chronic Fatigue Syndrome
(CFS) has been formally assessed by several investigators. For example,
Green, Romei, and Natelson( 1999) found that 95% of individuals seeking
medical treatment for CFS reported feelings of estrangement, 70% believed
that others attributed their CFS symptoms to psychological causes, 39%
felt a need to be secretive about their symptoms in certain
circumstances, and many participants reported having been labeled as
having a primary psychological difficulty by one or more physicians
consulted. Anderson and Ferrans (1997) found that 77% of individuals with
CFS reported past negative experiences with health care providers. Survey
findings from a CFS organization indicated that 57% of respondents were
treated badly or very badly by their doctors (David, Wessely, and Pelosi,
1991).

There is a relationship between beliefs about the degree to which people
with CFS are responsible for their illness, beliefs about the relevance
of CFS as a valid illness, and beliefs about the personality traits of
people with CFS. For example, Shlaes, Jason and Ferrari (1999) found that
if someone believes that people with CFS are responsible for their
illness, it is likely that they will also believe that people with CFS
have negative personality characteristics, such as being compulsive or
overly driven. It is possible that negative attitudes might be a function
of past government and media portrayals of CFS as either non-existent or
as a function of a neurotic, overworked, stressed lifestyle, as was
depicted in the labels such as the "Yuppie Flu" (Jason et al., 1997). It
is also possible that the negative stigma that is associated with CFS
could in part be due to the trivializing name that has been given to this
disorder. The name selected to characterize an illness, such as Chronic
Fatigue Syndrome, can influence how patients are perceived and ultimately
treated by medical personnel, family members and work associates.

The patient community has felt that the term Chronic Fatigue Syndrome
trivializes the seriousness of this illness, as the illness is typified
by many severe symptoms in addition to fatigue, and fatigue is generally
regarded as a common symptom experienced by many otherwise healthy
individuals in the general population (Taylor, Friedberg, & Jason, 2001).
In addition, CFS is frequently confused with chronic fatigue, which is a
symptom of many illnesses, including some psychiatric disorders. Although
it was expected that the CFS name would be eventually replaced as more
information became available, this name has remained and has become the
most commonly used label within the United States (Friedberg & Jason,
1998).

During the summer of 1997, The Chronic Fatigue and Immune Dysfunction
Syndrome (CFIDS) Association of America conducted a survey of its members
to determine their opinion about charging the name CFS. Eighty-five
percent of respondents indicated they wanted the name changed
(Name-Change Survey Results, 1997). Another survey of 182 respondents by
the editor of a newsletter indicated that 92% wanted the CFS name changed
(Burns, 1998). Many medical personnel and research scientists feel that
if the name were to be changed, it would be best to have a scientific
basis for the change. Unfortunately, few data have been collected to help
guide the process of revising the name.

Two studies reviewed herein investigated whether different names for CFS
indeed prompt different attributions regarding its cause, nature,
severity, contagion, prognosis, and recommended treatment among samples
of medical trainees and university undergraduates.