Cognitive-behavior therapy in chronic fatigue syndrome: is improvement related to increased physical activity?
Friedberg F, Sohl S.
J Clin Psychol. 2009 Apr;65(4):423-42.
Stony Brook University.
Fred.Friedberg@stonybrook.edu
This multiple case study of cognitive-behavioral treatment (CBT) for chronic fatigue syndrome (CFS) compared self-report and behavioral outcomes. Eleven relatively high-functioning participants with CFS received 6-32 sessions of outpatient graded-activity oriented CBT. Self-report outcomes included measures of fatigue impact, physical function, depression, anxiety, and global change. Behavioral outcomes included actigraphy and the 6-minute walking test. Global change ratings were very much improved (n=2), much improved (n=2), improved (n=5), and no change (n=2). Of those reporting improvement, clinically significant actigraphy increases (n=3) and decreases (n=4) were found, as well as no significant change (n=2). The nature of clinical improvement in CBT trials for high-functioning CFS patients may be more ambiguous than that postulated by the cognitive-behavioral model.
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Compliance with Walking Assignments
During the post-treatment assessment week,
the participants’ daily diary reports of
completed walking assignments were compared with objective intra-day actigraphy
patterns to confirm enactment of activity assignments. It was assumed that assigned
walks of 6 or more minutes would show visible actigraphy patterns similar to those
identified during the 6-minute walking test. To obtain an overall compliance
proportion for the week, the total number of actigraphy-confirmed assignments was
divided by the total number of assignments.