Abstract
Chronic fatigue syndrome (CFS) is a poorly understood illness that is characterized by profound and prolonged exhaustion and has no clear pathological marker. This study investigated the role of illness severity and secondary beliefs in depression among a CFS cohort, using the A–B–C framework of Rational Emotive Behavioral Therapy. Empirical research has consistently found that CFS patients tend to hold more negative cognitions about their illness, which could be associated with greater severity and emotional deficits. Specifically, secondary beliefs were explored as a mediating factor; as evidence suggests that secondary beliefs can result in dysfunctional emotions and/or behaviors, such as depression. Furthermore, it is estimated that up to 80% of CFS patients concurrently have depression. There were 156 participants with CFS who completed a questionnaire pack, which included the revised version of the Illness Perception Questionnaire, the Secondary Beliefs Scale (SBS), and the Cardiac Depression Scale. Hierarchical regression analysis revealed that secondary beliefs mediated the relationship between illness severity and depression. Specifically, the approval and comfort subscales of the SBS were significantly associated with depression. The current findings indicated that secondary beliefs could be an important focus in treatment of depression in chronic illness. As the mediating role of secondary beliefs is a new research finding, it is advised that further exploratory research is required.
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Appendix: Secondary Belief Scale (Sbs)
Appendix: Secondary Belief Scale (Sbs)
This section asks about your beliefs. Please circle the response that indicates how much you agree with each of the statements from 5 = I strongly agree to 1 = I strongly disagree.
Strongly agree | Agree | Disagree | Strongly disagree | ||
|---|---|---|---|---|---|
1. I see the potential in others | 5 | 4 | 3 | 2 | 1 |
2. I don’t like it when people don’t like me | 5 | 4 | 3 | 2 | 1 |
3. I need to have knowledge of where everything is in my surroundings | 5 | 4 | 3 | 2 | 1 |
4. I like it when everyone is happy | 5 | 4 | 3 | 2 | 1 |
5. There is a correct way to do everything | 5 | 4 | 3 | 2 | 1 |
6. I hold my peers opinion of me in high regard | 5 | 4 | 3 | 2 | 1 |
7. I can normally define things as right or wrong | 5 | 4 | 3 | 2 | 1 |
8. Putting myself out for others is good | 5 | 4 | 3 | 2 | 1 |
9. I will allow myself to be distracted when I think someone does not like me | 5 | 4 | 3 | 2 | 1 |
10. I will look for ways to improve the situation of others | 5 | 4 | 3 | 2 | 1 |
11. I like to be the centre of attention | 5 | 4 | 3 | 2 | 1 |
12. Tasks are very important | 5 | 4 | 3 | 2 | 1 |
13. My mind is all over the place at times | 5 | 4 | 3 | 2 | 1 |
14. You are what you achieve | 5 | 4 | 3 | 2 | 1 |
15. There is normally a number of solutions to a problem | 5 | 4 | 3 | 2 | 1 |
16. I tend to see the world in “black and white” terms | 5 | 4 | 3 | 2 | 1 |
17. People are very important | 5 | 4 | 3 | 2 | 1 |
18. It is important for me to be liked by my friends | 5 | 4 | 3 | 2 | 1 |
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Noonan, M., Lindner, H. & Walker, K. Chronic Fatigue Syndrome Severity and Depression: The Role of Secondary Beliefs. J Rat-Emo Cognitive-Behav Ther 28, 73–86 (2010). https://doi.org/10.1007/s10942-009-0101-5
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DOI: https://doi.org/10.1007/s10942-009-0101-5