Chronic Fatigue Syndrome: The Need for Subtypes

Chronic fatigue syndrome (CFS) is an important condition confronting patients, clinicians, and researchers. This article provides information concerning the need for appropriate diagnosis of CFS subtypes. We first review findings suggesting that CFS is best conceptualized as a separate diagnostic entity rather than as part of a unitary model of functional somatic distress. Next, research involving the case definitions of CFS is reviewed. Findings suggest that whether a broad or more conservative case definition is employed, and whether clinic or community samples are recruited, these decisions will have a major influence in the types of patients selected. Review of further findings suggests that subtyping individuals with CFS on sociodemographic, functional disability, viral, immune, neuroendocrine, neurology, autonomic, and genetic biomarkers can provide clarification for researchers and clinicians who encounter CFS characteristically confusing heterogeneous symptom profiles. Treatment studies that incorporate subtypes might be particularly helpful in better understanding the pathophysiology of CFS. This review suggests that there is a need for greater diagnostic clarity, and this might be accomplished by subgroups that integrate multiple variables including those in cognitive, emotional, and biological domains.     

Psychometric evaluation of the restructured clinical scales of the MMPI-2

Conceptual overlap and heterogeneity have long been noted as weaknesses of the Minnesota Multiphasic Personality Inventory's clinical scales. Restructured clinical (RC) scales recently were developed to address these concerns (A. Tellegen et al., 2003). The authors evaluated the psychometric properties of the RC scales in psychology clinic clients (N=285) and military veterans (N=567). The RC scales were as internally consistent as the clinical scales and correlated strongly with their original counterparts (except for RC3/Hysteria). They also were less intercorrelated, produced conceptually clearer relations with measures of personality and psychopathology, and yielded somewhat greater incremental utility than the clinical scales. Thus, the RC scales demonstrated several psychometric strengths while utilizing 60% fewer items, but the 2 sets of scales cannot be used interchangeably. Interpretive considerations are discussed.     

Choosing or Being Chosen by Aggressive–Disruptive Peers: Do They Contribute to Children's Externalizing and Internalizing Problems?

The goal of this study was to investigate the extent to which aggressive-disruptive peers contribute to the development of externalizing and internalizing problems in children, while controlling for children's own behavior. We examined 2 sets of peers: (1) those that the child nominated as friends, and (2) those that nominated the child as a friend. The participants were 236 boys and girls attending 3rd to 5th grade at the beginning of the study, who were followed over a period of 2 years. Results showed that choosing more aggressive peers on the nomination procedure was associated with more externalizing problems and self-reported depressive symptomatology over time. On the other hand, being liked by more aggressive children generally was not associated with elevated externalizing or internalizing problems.     

Dietary ethyl-eicosapentaenoic acid but not soybean oil reverses central interleukin-1-induced changes in behavior, corticosterone and immune response in rats

Omega (n)-3 and n-6 fatty acids are important membrane components of neurons and immune cells, and related to psychiatric and inflammatory diseases. Increased ratio of n-6/n-3 in the blood has been reported in depressed patients and in students following stress exposure. The n-3 fatty acid, eicosapentaenoic acid (ethyl-EPA) suppresses inflammation and has antidepressant properties. Interleukin (IL)-1beta can stimulate corticosterone secretion, induce anxiety and stress-like behavior and inflammatory responses. This study was to evaluate the effect of diets enriched with coconut oil, ethyl-EPA and soybean oil on central IL-1beta induced stress and anxiety-like behavior, induced changes in the concentration of prostaglandin (PG) E2 and corticosterone and the release of IL-10. Groups of rats were fed with either 5% coconut oil (as control diet), 0.2% EPA with 4.8% coconut oil or 1% EPA with 4% coconut oil and 5% soybean oil for 7 weeks. The central administration of IL-1beta induced sickness, stress and anxiety-like behavior as indicated by a reduction in body weight, decreased time spent, and the number of entries, into the open arms of the elevated plus maze and decreased exploration and entry into the central zone of the "open field" apparatus. IL-1beta also increased PGE2 and corticosterone concentrations and decreased the release of IL-10 from leucocytes. Food enriched with ethyl-EPA but not soybean oil, significantly attenuated most of these changes. These results demonstrate that ethyl-EPA has anti-inflammatory, anti-stress and anti-anxiety effects in rats.     

Optimism, abstinence self-efficacy, and self-mastery: a comparative analysis of cognitive resources

The relationship between optimism, abstinence self-efficacy, and self-mastery was examined by investigating levels of these cognitive resources among two samples of recovering substance abusers: Oxford House residents who attended twelve-step groups and twelve-step members who had never lived in an Oxford House. Participants 'levels of optimism were significantly and positively related to both abstinence self-efficacy and self-mastery scores, as abstinence self-efficacy was significantly and positively related to participants' number of days abstinent. Participants who reported having more than 180 days abstinent reported significantly higher levels of abstinence self-efficacy than participants who reported having less than 180 days abstinent. In addition, among participants who reported having less than 180 days abstinent, Oxford House residents reported significantly higher levels of abstinence self-efficacy than twelve-step members. Overall, findings suggest that cognitive resources facilitate substance abusers' recovery and that the Oxford House model might provide high levels of support in their ongoing abstinence.     

Marital and Relationship Ministry (MRM) as a tenant of pastoral care

Although marital and relationship support programs are available for couples, few churches offer comprehensive marital and relationship ministry (MRM). This research examined MRM topics and formats desired by congregants and advocated adoption by clergy of MRM as a tenant of pastoral care. Eight faith communities in a Midwestern city were non-randomly selected for ethnic and denominational diversity. Overall analyses indicated congregants desired specific areas of marital and relationship ministry that included communication, family, and enrichment topics.     

Vicarious agency: experiencing control over the movements of others

Participants watched themselves in a mirror while another person behind them, hidden from view, extended hands forward on each side where participants' hands would normally appear. The hands performed a series of movements. When participants could hear instructions previewing each movement, they reported an enhanced feeling of controlling the hands. Hearing instructions for the movements also enhanced skin conductance responses when a rubber band was snapped on the other's wrist after the movements. Such vicarious agency was not felt when the instructions followed the movements, and participants' own covet movement mimicry was not essential to the influence of previews on reported control.     

Using logistic regression to estimate delay-discounting functions

The monetary choice questionnaire (MCQ) and similar computer tasks ask preference questions in order to ascertain indifference, the perceived equivalence of immediate versus larger delayed rewards. Indifference data are then fitted with a hyperbolic function, summarizing the decline in perceived value with delay time. We present a fitting method that estimates the hyperbolic parameterk directly from survey responses. Binary preferences are modeled as a function of time (X₂) and a transformed reward ratio (X ₁), yielding logistic regression coefficients β₂ and β₁. The hyperbolic parameter emerges ask = β₂/β₁, where the logistic predictedp = .5 (the definition of indifference). The MCQ was administered to 1,073 adolescents and was scored using both standard and logistic methods. The means for ln(k) were similar (standard, −4.53; logistic, −4.51), and the results were highly correlated (ρ = .973). Simulated MCQ data showed thatk was unbiased, except where β₁ ≥ −1, indicating a vague survey response. Jackknife standard errors provided excellent coverage.