Cognitive appraisals, coping profiles and perceived stress and their relationship to illness burden and affect in chronic fatigue syndrome

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Michael H. Antoni - Committee Chair


It is recognized that Chronic Fatigue Syndrome (CFS) is a physically burdensome and psychologically debilitating disorder. The literature has focused primarily on studying immunological aberrations and ascertaining the presence of psychiatric disorders in this population. Few studies have focused on the coping style of CFS patients. Thus, the current study focuses on cognitive appraisals, coping profiles and perceived stress and their relationships to illness burden and affective state in a sample of 122 CFS patients. Subjects completed an extensive physical exam, immunological work-up and psychological battery which included clinical interview, neuropsychological tests, the Automatic Thoughts Questionnaire (ATQ), the Dysfunctional Attitudes Scale (DAS), a situationally-dependent coping measure (COPE), the Perceived Stress Scale (PSS), the Sickness Impact Profile and the Beck Depression Inventory (BDI). Results showed that DAS and ATQ scores were significantly higher in CFS patients with a concurrent Major Depressive Episode (MDE) than in the 2 other CFS groups that were not currently depressed. Through a combination of factor analysis and cluster analysis, 6 groups with distinctive coping profiles were identified. The groups differed on BDI scores and various SIP scales. Furthermore, the COPE factors were able to account for significant amounts of variance of BDI and SIP scale scores. Natural Killer Cell cytotoxicity (NKCC) did not appear to mediate the effects of COPE factors on illness burden, but PSS appeared to mediate the effects of two COPE factors: adaptive cognitive coping and behavioral disengagement/denial. Furthermore, mediating effects of PSS appeared to be limited solely to psychosocial aspects of illness burden. Treatment implications and future research directions are also discussed.


Psychology, Clinical; Health Sciences, Immunology

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