Responses to physical exertion in Chronic Fatigue Syndrome / ME
Research type
Research Study
Full title
Cognitive and behavioural responses to physical exertion in Chronic Fatigue Syndrome / Myalgic Encephalomyelitis
IRAS ID
225160
Contact name
Samantha Lloyd
Contact email
Sponsor organisation
University of Bath
Duration of Study in the UK
1 years, 2 months, 26 days
Research summary
Research Summary
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is a condition defined by a marked loss of energy on physical or mental exertion. The cause of this illness is not yet fully understood. The purpose of this study is to look at how people with CFS/ME respond to a physically exerting task, and what thoughts and feelings they have while doing the task. Similar research has been done in chronic pain and has helped to improve treatment. We are therefore hoping to do the same in CFS/ME. This study will investigate what strategies may be used by people with CFS/ME in response to a physical exertion task and why. It aims to distinguish between strategies that may be unhelpful, and more adaptive coping strategies which reduce rather than maintain anxiety. Participants will complete a bag carrying task, designed to be mildly exerting, and asked to identify any strategies used and why. Participants will complete questionnaires before and after to investigate the intention and effects of behaviours. 40 individuals with CFS/ME and 20 individuals without CFS/ME will be recruited. The whole procedure will take approximately 90-120 minutes. £10 vouchers will be given. The wording of this summary has been changed to improve clarity of the project aims and rationale.
Summary of Results
: Current explanations of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) propose that fatigue and anxiety are maintained by fear-related thinking and behaviours. Existing studies support a relationship between increased fatigue and believing that fatigue will cause an extreme negative outcome, beyond what may ordinarily be expected in the context of CFS illness, e.g. having a stroke or becoming completely bed-ridden. What is not clear is why fear continues despite the feared catastrophe not happening.
In anxiety disorders, the concept of ‘’safety seeking behaviours’’ (SSBs) has addressed this and led to improved treatment outcomes. SSBs are strategies used in anxiety provoking situations to prevent a feared catastrophe. However this maintains beliefs, with the non-occurrence of the catastrophe attributed to this behaviour. Someone who believes that fatigue will lead to them becoming bed-ridden may avoid activity, with avoidance seen as preventing the catastrophe. Continued avoidance maintains fear and leads to body deconditioning and increased fatigue. This has also been applied to chronic pain and health anxiety (HA).
The high rate of anxiety in CFS/ME and overlap with chronic pain symptoms support the potential relevance of SSBs. Furthermore a recent study showed that cognitive behavioural treatment for CFS/ME including focus on SSBs had positive outcomes. However to date, safety seeking behaviours have not been tested in CFS/ME.
This study investigated what strategies are used by people with CFS/ME in response to a physical exertion task and why.
An experimental design was used with N = 10 individuals with CFS/ME and N = 15 healthy controls (HCs) carrying out a physical task twice. Participants were recorded while completing the task and asked to identify from the recording strategies used during the task and the function of these. Significant differences on the number of strategies defined as SSB were found between groups, with the CFS/ME group using significantly more SSB during the Task 2. In addition, a significant correlation was found between the number of SSB and increased score on a measure of health anxiety.
Overall the pilot study provides novel evidence for the use of SSB in CFS/ME and conceptualises type and function of such strategies, with SSB representing an important potential target for cognitive behavioural interventions for this condition.REC name
South West - Central Bristol Research Ethics Committee
REC reference
17/SW/0163
Date of REC Opinion
27 Sep 2017
REC opinion
Further Information Favourable Opinion