ABSTRACT
Over the past decade, a debilitating chronic illness characterised by unremitting or relapsing fatigue has been a subject of intense debate. Early reports in the 1980’s labelled the illness “yuppie flu”, regarding the malady as a psychosomatic reaction to the stressors of modern society (Polca, 1991). Sufferers of the illness and their advocates strongly opposed these aspersions, insisting that the cause of the illness was organic. Since 1980 a series of names for the condition have been advanced, such as chronic mononucleosis, postviral fatigue syndrome and myalgic encephalomyelitis (ME), reflecting assumptions about the possible organic nature of the illness (Steincamp, 1988). In response to the nomenclature controversy and in an attempt to define a homogeneous group of patients for research purposes, the Centre for Disease Control in Atlanta renamed the condition chronic fatigue syndrome (CFS) and published the first standardised diagnostic criteria for the illness (Holmes et al., 1988). Despite this attempt at standardisation, research to date has been unable to establish a definitive aetiology and treatment for CFS. Empirical findings have been diverse and studies have found support for the role of both psychological and organic factors in the illness. To make sense of these disparate findings, cognitive behavioural models of CFS have been proposed which provide multicausal, interactive explanations of the illness (Surawy et al., 1995; Wessely et al., 1991). Key factors in these models are patients’ illness perceptions and coping responses, which are seen to have an important role in both the onset and perpetuation of the condition. CFS patients who participate in treatment programmes based on these paradigms report substantial reductions in their levels of fatigue and disability (Butler et al., 1991; Deale et al., in submission; Sharpe et al., 1996). As no other form of treatment has been able to demonstrate such positive effects, it does indeed appear that cognitive behavioural factors are important in CFS.
