Self-critical perfectionism and its relationship to fatigue and pain in the daily flow of life in patients with chronic fatigue syndrome.

BACKGROUND: Research suggests that the personality factor of self-critical or maladaptive perfectionism may be implicated in chronic fatigue syndrome (CFS). However, it is not clear whether self-critical perfectionism (SCP) also predicts daily symptoms in CFS. Method In the present study we investigated whether SCP predicted fatigue and pain over a 14-day period in a sample of 90 CFS patients using a diary method approach. After completing the Depressive Experiences Questionnaire (DEQ) as a measure of SCP, patients were asked each day for 14 days to complete Visual Analogue Scales (VAS) of fatigue, pain and severity of depression. Data were analysed using multilevel analysis. RESULTS: The results from unconditional models revealed considerable fluctuations in fatigue over the 14 days, suggesting strong temporal variability in fatigue. By contrast, pain was relatively stable over time but showed significant inter-individual differences. Congruent with expectations, fixed-effect models showed that SCP was prospectively associated with higher daily fatigue and pain levels over the 14-day period, even after controlling for levels of depression. CONCLUSIONS: This is the first study to show that SCP predicts both fatigue and pain symptoms in CFS in the daily course of life. Hence, therapeutic interventions aimed at targeting SCP should be considered in the treatment of CFS patients with such features.

[Stress research in psychiatry: a complex story]. / Stressonderzoek in de psychiatrie: een complex verhaal.

Research into the role of stress in psychiatric disorders faces major challenges. However, over the last few decades there has been considerable progress in this area as a result of methodological, technological and conceptual developments. The advent of recursive and non-linear models and research into the neurobiology of stress have made important contributions to this progress. Not only have these developments increased our insight into the aetiopathogenesis and classification of psychiatric disorders, they also have important implications for clinical assessment and treatment. In particular, renewed interest in the role of meaning-making has opened up a number of new avenues for clinical practice and research.