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.     

Development and Psychometric Evaluation of the Social Justice Scale (SJS)

The study describes the development of the Social Justice Scale (SJS). Practitioners, educators, students, and other members of the community differ on their attitudes and values regarding social justice. It is important to assess, not only individuals' attitudes and values around social values, but also other constructs that might be related to social justice behaviors. The implication of Ajzen in Organizational Behavior and Human Decision Processes 50:179-211, (1991) theory of planned behavior suggests that attitudes, perceived behavioral control, and social norms predict intentions, which then lead to behaviors. A scale was designed to measure social justice-related values, attitudes, perceived behavioral control, subjective norms, and intentions based on a four-factor conception of Ajzen's theory. Confirmatory factor analysis and analyses for reliability and validity were used to test the properties of the scale.     

Non-pharmacologic Interventions for CFS: A Randomized Trial

Non-pharmacological behavioral treatments for CFS have been suggested as promising. These trials have tested protocols composed of behavioral, cognitive and cognitive–behavioral interventions but there have been few efforts to differentially evaluate their outcomes. The primary purpose of the current study was to evaluate the effectiveness of nurse delivered non-pharmacologic interventions. In the present study, 114 participants diagnosed with CFS were randomly assigned to four 6-month interventions. The interventions were: cognitive–behavior therapy, cognitive therapy, anaerobic activity, and a relaxation control group. The study found that these interventions led to increases in several areas of functioning, with more consistent changes occurring among those participants in the cognitive condition. For the 25 variables in this study, significant change occurred for 28%, 20%, 16%, and 12% of the variables for the cognitive, cognitive behavior therapy, anaerobic activity, and relaxation conditions, respectively. However, the majority of participants continued to be diagnosed with CFS following the treatment trial. Implications of these findings are discussed.     

Culture in the context of intercultural negotiation.

This study explores culture's effect on behaviors and outcomes in intercultural negotiation and examines how those effects are moderated by role. Eighty U.S. and international students took part in a previously developed negotiation task (Pruitt, 1981) and completed Hui and Triandis's (1986) individualism‐collectivism (INDCOL) scale. Negotiation interactions were coded for information sharing, offers, and distributive tactics. Findings show that a negotiation dyad's collectivism is positively associated with higher joint profit. The effects of culture on both communication behaviors and joint outcomes, however, differ by role of the negotiator. In particular, seller collectivism has larger and more consistent effects on communication behavior and joint profit than buyer collectivism. Results support a ‘culture in context’ perspective of negotiation that takes into account negotiator qualities, contextual and structural features of the negotiation, and mediating processes in addition to cultural values.     

THE CONTROL OF BIAS IN RATINGS: A THEORY OF RATING

Based on several years of research and a careful analysis of the rating process Wherry developed a theory of rating. An accurate rating is seen as being a function of three major components: Performance of the ratee, observation of that performance by the rater, and the recall of those observations by the rater. Cast in a mold of classical psychometric theory each of these components is seen as consisting of a systematic portion and a random portion. The systematic portion of each component is further broken down. The performance of the ratee is a combination of true ability or aptitude for the job and the influence of the environment. What the rater observes is a function the performance of the ratee and bias of observation and what the rater recalls is a result of those observations combined with a bias of recall. The development of the theory of rating unfolds by defining the various factors that affect each of these components in a series of linear equations. Various theorems and corollaries are proposed which should lead to a maximization of the true ability component of the ratee and minimize environmental influence and the bias and error components. The theorems and corollaries suggest testable hypotheses for the researcher in performance evaluation.     

A Comparison of the 1988 and 1994 Diagnostic Criteria for Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS) is an illness that involves severe, prolonged fatigue as well as neurological, immunological, and endocrinological system pathology. Because the pathogenesis of CFS has yet to be determined, case definitions have relied on clinical observation in classifying signs and symptoms for diagnosis. In an attempt to address various criticisms and inconsistencies in diagnostic criteria, there have been several revisions of the CFS case definition. The current investigation examined the differences between 1988 and 1994 definitions as well as participants who had a psychiatric explanation for their fatigue. Dependent measures included psychiatric comorbidity, symptom frequency, and functional impairment. The 1988 criteria, compared to the 1994 criteria, appeared to select a group of participants with more symptomatology and functional impairment, but these groups did not significantly differ in psychiatric comorbidity. Implications of these findings are discussed.     

The Racial Microaggressions Scale (RMAS): a new scale to measure experiences of racial microaggressions in people of color

Racial microaggressions refer to the racial indignities, slights, mistreatment, or offenses that people of color may face on a recurrent or consistent basis. Racial microaggressions may represent a significant source of stress endured by people of color. The purpose of this study was to develop a scale to measure racial microaggressions. Exploratory factor analyses and confirmatory factor analyses were used to assess the dimensionality of the scale. The internal reliability, convergent validity, and concurrent validity of the scale were also explored. Results indicated that the Racial Microaggression Scale is a multidimensional tool to assess perceptions of racial microaggressions by people of color.