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1
Alberts, Terri Lynn. "Chronic fatigue and immune dysfunction syndrome: its relationship to underlying emotional and psychological issues." CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1181.
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This post-positivist research study explored the possible relationship between Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) and the presence of underlying psychological and emotional issues. An exploratory design with naturalistic methods of inquiry was utilized to investigate whether the presence, or absence, of these issues had any impact on the overall disease process.
2
Dendy, Catherine. "Cognitive aspects of chronic fatigue syndrome." Thesis, Open University, 1997. http://oro.open.ac.uk/57681/.
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Recent interest in cognitive behavioural therapy techniques for treatment of Chronic Fatigue Syndrome (CFS) has highlighted the contribution of psychological approaches to alleviating the debilitating symptoms of this illness. In previous research sufferers from CFS have been compared with depressed patients and patients with neuromuscular disease, as they share similar symptoms, but not diagnosis. This study attempts to compare four groups including a normal working group. A new measures was developed and piloted, designed to measure interpretations of symptoms in CFS. In addition standard instruments were used to focus on the measurement of high personal standards, perfectionism, emotional control and conscientiousness and levels of autonomy. Results showed the CFS group were similar to the normal working group on all standard scales and scored low on autonomous personality traits. Reasons for this result, and the clinical implications for treating such a heterogeneous patient group are discussed. Measures on the symptom interpretation scale show CFS patients are less likely to give an emotional explanation for their symptoms than the other participant groups. This has implications for communication between physician and patient, and the treatment of CFS with a psychological model.
3
Williams, Nancy. "Neuropsychological and psychosocial aspects of chronic fatigue syndrome." Thesis, University of Stirling, 1994. http://hdl.handle.net/1893/1785.
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This Thesis reports a full scale study of cognition and mood in Chronic Fatigue Syndrome (CFS) longitudinally during recovery. Previous studies fail to cover the scope of this study and/or fail to define adequately the syndrome for subject selection. 47 CFS patients were compared with 41 normal and 26 Crohns/colitis controls in a longitudinal study of cognitive performance and depression/anxiety scores. CFS patients performed significantly worse than controls on many of the cognitive tests at first testing. Small but significant differences between CFS and normal controls were found on memory tests (Logical Memory, Word Recognition and, more significantly, Rey Complex Figure) but Crohns/colitis patients scored similarly to CFS, suggesting that this might relate to a general problem such as attention. Much larger and more significant differences between CFS and both control groups were found on tests involving a psychornotor component (e. g. Reaction Time, Finger Tapping and Digit Symbol). CFS patients' performance improved over time (above practise) on word recognition, Stroop (colours), Reaction Time (Movement) and Digit Symbol. CFS patients were significantly more depressed/anxious than the control groups and scored higher on Middlesex Health Questionnaire (Psychiatric). Depression/anxiety did not diminish significantly by second testing. Differences on depression scores accounted for some of the differences in cognitive test performance, in particular Word Fluency and Stroop; however, significant differences remained after ANCOVA removed depression: significant differences remained on Logical Memory, Word Recognition, Digit Symbol, Finger Tapping and Reaction Time. It was concluded that CFS patients were slowed on psychornotor tasks and that this was only partly accountable by depression as suggested by depressed score. CFS patients performed slightly worse on some other tests possibly dependant upon the task demand. Digit Symbol, Reaction Time, and Finger Tapping seemed to be most sensitive to CFS. Brain damage was not necessarily indicated by the results: differences in psychornotor performance could be caused by difficulties in the transmission of instructions to the muscle or slowness in the nerves and muscles themselves. CFS patients' performance significantly improved on a number of tests over time, and did not significantly deteriorate on any test; therefore, the trend of CFS patients' test performance overall was to get better not worse over time.
4
Goudsmit, Ellen Marianne. "The psychological aspects and management of chronic fatigue syndrome." Thesis, Brunel University, 1996. http://bura.brunel.ac.uk/handle/2438/4283.
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Chronic fatigue syndrome (CFS) describes a condition characterised by severe fatigue of at least six months' duration. In this thesis, it is argued that the complexity of CFS with respect to other symptoms, the patients' response to their illness and the determinants of emotional distress, has yet to be fully recognised. This may have narrowed the focus of research and limited the range of treatments available. The first of the three studies investigated CFS from the patients' perspective. The findings challenge some of the generalisations concerning CFS, particularly those relating to the patients' attributions and their choice of coping strategies. They also suggest that the effects of the condition may have been underestimated and that certain influences on emotional distress may have been overlooked. The second study assessed a number of variables thought to be associated with emotional distress and psychological adjustment. The results show that uncertainty and lack of social support were significantly correlated with anxiety and depression while functional impairment was more closely linked to cognitive difficulties and other illness-related measures. The third study evaluated a management programme which acknowledges the complexity of CFS. After six months, significant differences between the treated patients and waiting-list controls were found for a number of variables, including fatigue, somatic symptoms, anxiety and perceived self-efficacy. However, many patients continued to record high levels of emotional distress, showing that the programme was not sufficient to deal with all the problems experienced.
5
Andrews, Karen Joyce. "The process of coping and self-management in the experience of recovering from chronic fatigue syndrome (CFS)." Thesis, Rhodes University, 2003. http://hdl.handle.net/10962/d1003132.
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A hermeneutical model of doing research is adopted to investigate the process of coping and self-management in the experience of recovering from Chronic Fatigue Syndrome (CFS). Three research participants who consider themselves as recovering or recovered from CFS were interviewed to obtain data for analysis. The findings are that once the participants cope with the uncertainty about the meaning of the onset of symptoms by defining themselves as ill in somatic terms, the participants use external social and treatment resources to cope with the onset of symptoms and being chronically ill with CFS. As a consequence of feeling stigmatised in relation to social and professional scepticism about initially being ill and subsequently, being chronically ill with CFS, the participants become uncertain about the meaning of having CFS. Coping shifts to using internal resources by adopting self-management practises. In this process, firstly, existing self-management shifts in such a way that the participants view themselves as recovering or recovered from CFS, and secondly, the participants come to the understanding that difficulties with self-management cause and maintain CFS. The findings are discussed to conclude that CFS may be a misdiagnosis of difficulties with self-management. CFS itself may not be an 'objective' disorder, but a constituent of social processes. Becoming diagnosed with CFS arises as a consequence of the search for meaning in relation to the lay and professional assumption that psychological illness does not constitute 'real' illness, operating at both the levels of popular society and the doctor-patient relationship. Difficulties with self-management rather than the diagnosis of CFS provide a more adequate understariding of the participants' illnesses.KMBT_363
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6
Paul, Lorna. "Aspects of voluntary motor performance in patients with Chronic Fatigue Syndrome." Thesis, Glasgow Caledonian University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298762.
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Rusch, Mary L. "Cognitive behavioural treatment of chronic fatigue syndrome: an in-depth case study." Thesis, Rhodes University, 2001. http://hdl.handle.net/10962/d1002555.
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Chronic Fatigue Syndrome (CFS) is a chronic disabling condition characterised by persistent physical and mental fatigue, and a variety of somatic, psychological and neurological symptoms. The aetiology of CFS is unknown and the cause of the illness remains controversial. Cognitive-behavioural therapy (CBT) is a non-pharmacological treatment approach that has been shown to be effective in treating patients with CFS. It is based on a model that hypothesises that certain maladaptive thoughts and dysfunctional beliefs may contribute to self-defeating behaviour that perpetuates symptoms and disability, and thereby impedes recovery. The main aim of this study was to critically examine the cognitive-behavioural approach of CFS outlined by Sharpe, Chalder, Palmer & Wessely (1997) by conducting three in-depth case studies. An additional aim was to present a full cognitive developmental case conceptualisation of CFS based on the theories of Leahy (1996) and Young (1994). This case study evaluated the effectiveness of a CBT treatment programme in a 48-year-old Caucasian woman diagnosed with CFS for three years. The treatment consisted of sixteen sessions of CBT and was evaluated both quantitatively and qualitatively. On the basis of this study, a set of core maladaptive schema in the area of disconnection and rejection was identified. In addition, it was found that specific compensatory schemas had developed to offset the core maladaptive schemas and that this compensatory strategy played an important role in maintaining the condition. The results also showed a significant decline in fatigue coupled with a moderate decline in functional disability and depression. A one-month follow-up interview revealed evidence of a substantial consolidation of therapeutic gains in that the improvements observed at the end of the treatment were sustained. Finally, the feasibility of incorporating a cognitive-developmental and/or schema-focused model into the standard CBT treatment model is discussed and the case study method as a research toll is evaluated in light of the findings.
8
Beaulieu, Marcia. "Stigma and legitimation in chronic fatigue syndrome : the role of social location." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp02/NQ44359.pdf.
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Barcroft, Rachel. "Chronic fatigue syndrome/myalgic encephalomyelitis and fibromyalgia : a social model of disability perspective." Thesis, Lancaster University, 2017. http://eprints.lancs.ac.uk/87165/.
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This thesis is composed firstly of a literature review focusing on the attitudes of health professionals towards chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and fibromyalgia. Secondly, a research paper explores the ways in which people living with CFS/ME have experienced psycho-emotional disablism. Finally, a critical appraisal discusses the process of conducting the research as well as its strengths and limitations. The literature review takes the form of a meta-synthesis regarding the attitudes of healthcare professionals towards CFS/ME and fibromyalgia. A meta-ethnographic approach was used with reciprocal translation producing the following themes: “Feeling hopeless and more hopeless”: psychological effects of lack of knowledge; “Your heart sinks when they come in the room”: stigma and stereotypes; and “I’m going to be with you through thick and thin”: management of the condition. The review highlights the difficulties faced by health professionals regarding the management and diagnosis of both conditions, as well as possible reasons for the negative attitudes held by some professionals. The research paper, which employed thematic analysis, explores the ways in which people living with CFS/ME have experienced psycho-emotional disablism. Three overarching themes were identified: “fighting to be heard”; “lack of legitimacy” and “feeling invisible”. Participants described the discrimination and stigma that they had encountered from many areas of society. Ideas for future research are proposed. The critical appraisal presents the author’s reflections on the research process as well as its strengths and limitations, and the five stages of the process are described as follows: choosing a thesis topic and designing the project; recruitment and research interviews; the interview process; analysis and writing up of the data; and the author’s reflections on the project.
10
Orr, Barry. "Psychological factors in social relationships and home functioning of patients with chronic fatigue syndrome." Thesis, University of Hull, 2008. http://hydra.hull.ac.uk/resources/hull:1679.
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Background: Emotional expressivity has received recent research attention in studying behavioural outcomes, in non-clinical samples and clinical samples alike. However, it has not been tested with chronic fatigue syndrome patients, to see if positive expressivity predicts better social relationships. Secondly, dysfunctional attitudes concerning attainment and achievement, and poor everyday routine, have been associated with poorer functioning in different clinical conditions, such as cancer and diabetes. These have not been examined in chronic fatigue syndrome, for whether they predict worse patient functioning in their home duties. This study primarily aims to explore these relationships. The relationship between attainment/achievement attitudes and routine in this patient group was also explored. Method: This explorative, cross sectional study measured 57 patients' levels of positive expressive behaviour, attainment and achievement attitudes, routine, and levels of social relationship functioning and home functioning via self-report measures. Levels of CFS symptoms and depressive symptoms were also controlled for in each question. Results: Hierarchical regressions indicated positive expressivity did not significantly predict worse or better relationships with friends. Increased positive expressivity did predict worse relationships with family members. Attainment and achievement attitudes did not predict better home functioning, but better routine did. No relationship was found between attitudes and routine. Depressive symptoms predicted greater variance than CFS symptoms in the regressions. Conclusions: Depression appears to be of importance in relationship and home functioning difficulties. Positive expressivity also appears to have a special role for CFS patients, reducing quality of family relationships. Increased routine may help patients to manage their home duties better, but attainment and achievement attitudes appear to make little difference. Such attitudes do not appear to influence routine. Implications of findings for present theory and clinical treatment for patients are discussed, with further research following these findings suggested.
11
Chan, Suet-mui Jessie, and 陳雪梅. "The psychosocial and physiological effects of Qigong exercise in integrative medicine : a study of Chinese patients with chronic fatigue syndrome-like illness." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206424.
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Mayer, Melissa Isabella. "The role of severe life stress, social support, and attachment in the onset of chronic fatigue syndrome." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0002/NQ41591.pdf.
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Kennedy, Alice Catriona. "Exploring the online social identities of people with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) : a discourse analysis approach." Thesis, University of Exeter, 2014. http://hdl.handle.net/10871/16296.
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People with CFS/ME suffer from physical symptoms and restriction in roles. Having a contested condition means facing scepticism, stigma and disbelief. Previous researcher-mediated studies found that people with CFS/ME excluded psychological explanations, to ward off negative stereotypes and to position themselves as genuinely ill. In this study I used social identity theory and discourse analysis methods to explore the identities exhibited by people with CFS/ME on an online forum. This study confirmed previous findings, namely that posters experienced biographical disruption owing to symptom severity and loss of roles and relationships. It also found that posters re-asserted limited self-efficacy to renegotiate their roles, to persuade family, friends and doctors that they were seriously ill and to position themselves as experts in CFS/ME. This raised the social status of the ingroup, people with CFS/ME. A new finding was that some posters considered psychological factors as exacerbating or causing CFS/ME.
14
Murray, Rebecca E. "A life lived differently : an exploration of how living with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) impacts upon people's identity." Thesis, University of Huddersfield, 2016. http://eprints.hud.ac.uk/id/eprint/31500/.
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Existing literature provides an insight into CFS/ME, but it is fractured, in that it does little to serve understanding, empathy or coping. Moreover the experiences of people with CFS/ME are under theorised. The literature demonstrates that issues of identity appear central to the lived experience of chronic illness, yet the mechanisms underpinning identity are not fully explored. Consequently there is little understanding of the crisis of identity in CFS/ME. Therefore, the aims and objectives of the current research endeavoured to examine identity within the context of the lived experience of CFS/ME. Drawing upon Wenger’s (1998) ‘Communities of Practice’ theory (CoP), the current research aimed to make transparent the mechanism of identity by exploring the lived experience of identity in chronic illness; specifically CFS/ME. It is argued throughout, that a millennia of meaning underpins the crisis of identity in CFS/ME and that CoP, whilst predominantly a social theory of learning, was re-conceptualised here to illuminate the crisis of identity in chronic illness. Data were gathered via a closed Facebook group; cfsid, which was created for the purpose of the current research. Participants (n. 37) contributed over time and in depth and in so doing revealed the complex foundation of their shifting identities. The data was analysed using a theoretical thematic analysis (Braun and Clarke, 2006). Aligned with CoP, the key findings indicate that the mechanism underpinning the crisis of identity in CFS/ME is the changing nature of participation. The history of CFS/ME is one defined by scepticism and as such the controversy surrounding CFS/ME interacted with the lived experience of the illness for participants. The lived experience of CFS/ME for participants was reliably defined by their inability to participate in either life or self. Lives and selves were unrecognisable, but all was not lost as acceptance and adjustment allowed participants to negotiate ways in which they could participate despite their CFS/ME. Participants’ experiences of participation emerged within the analysis as a journey to finding a new way to be in the world. On looking to the future, if people with CFS/ME are to be better supported and enabled within their lived experience of chronic illness, the burdening history of CFS/ME needs to be replaced by legitimacy, and the importance of the negotiation of participation in chronic illness needs to be illuminated further.
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Komulainen, Heidi, and Ulrika Sandström. "Kroniskt trötthetssyndrom : en diskursanalys av artiklar 1989-2006." Thesis, Stockholm University, Department of Social Work, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-6752.
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The purpose with this work is to describe the language that is built around the chronic fatigue syndrome (CFS) in Sweden. Our questions are: What does the professional field look like; who writes, about what and for which kind of readers? How do they describe the expressions and the upcoming of CFS? For which reasons can CFS be considered as a medical diagnosis/illness? How can CFS be understood from a social perspective? Our theoretical starting point is a social constructive theory and also Karin Johannisson's theory about medicalization and Foucault’s theory about power. We have from a literature-exposition of Swedish articles from 1989 to 2006, done a social constructive discourse analysis with help from Laclau & Mouffe's discourse theory, and Fairclough's model of social practices. In our textual analysis we found three dominating discourses: A medical discourse, a social/cultural discourse and a general/popular discourse. Our results showed that the dominating professional category is doctors and those who have medical direction within their work. In most cases they wrote articles that searched for medical explanations of CFS and their common factor was that they looked at CFS as an illness. The articles that had a social constructive, anthropological, idea historical or religious perspective to CFS was in a minority and they often defined the phenomenon as an expression of different kind of public elements and were often critical to medicalization.
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Hart, M. J. Alexandra. "Action in Chronic Fatigue Syndrome: an Enactive Psycho-phenomenological and Semiotic Analysis of Thirty New Zealand Women's Experiences of Suffering and Recovery." Thesis, University of Canterbury. Social and Political Sciences, 2010. http://hdl.handle.net/10092/5294.
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This research into Chronic Fatigue Syndrome (CFS) presents the results of 60 first-person psycho-phenomenological interviews with 30 New Zealand women. The participants were recruited from the Canterbury and Wellington regions, 10 had recovered. Taking a non-dual, non-reductive embodied approach, the phenomenological data was analysed semiotically, using a graph-theoretical cluster analysis to elucidate the large number of resulting categories, and interpreted through the enactive approach to cognitive science.
The initial result of the analysis is a comprehensive exploration of the experience of CFS which develops subject-specific categories of experience and explores the relation of the illness to universal categories of experience, including self, ‘energy’, action, and being-able-to-do.
Transformations of the self surrounding being-able-to-do and not-being-able-to-do were shown to elucidate the illness process.
It is proposed that the concept ‘energy’ in the participants’ discourse is equivalent to the Mahayana Buddhist concept of ‘contact’. This characterises CFS as a breakdown of contact. Narrative content from the recovered interviewees reflects a reestablishment of contact.
The hypothesis that CFS is a disorder of action is investigated in detail.
A general model for the phenomenology and functional architecture of action is proposed. This model is a recursive loop involving felt meaning, contact, action, and perception and appears to be phenomenologically supported.
It is proposed that the CFS illness process is a dynamical decompensation of the subject’s action loop caused by a breakdown in the process of contact.
On this basis, a new interpretation of neurological findings in relation to CFS becomes possible. A neurological phenomenon that correlates with the illness and involves a brain region that has a similar structure to the action model’s recursive loop is identified in previous research results and compared with the action model and the results of this research. This correspondence may identify the brain regions involved in the illness process, which may provide an objective diagnostic test for the condition and approaches to treatment.
The implications of this model for cognitive science and CFS should be investigated through neurophenomenological research since the model stands to shed considerable light on the nature of consciousness, contact and agency.
Phenomenologically based treatments are proposed, along with suggestions for future research on CFS. The research may clarify the diagnostic criteria for CFS and guide management and treatment programmes, particularly multidimensional and interdisciplinary approaches.
Category theory is proposed as a foundation for a mathematisation of phenomenology.
17
Åsbring, Pia. "Osäkra "sjukdomar" - dilemman och möjligheter : kvinnliga "patienters" och läkares erfarenheter av kroniskt trötthetssyndrom och fibromyalgi /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-603-0/.
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Morgan, Leona. "Chroniese moegheidsindroom : 'n ekosistemiese perspektief." Diss., 1996. http://hdl.handle.net/10500/17513.
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Hierdie studie is 'n kwalitatiewe ekosistemiese ondersoek van die fenomeen Chroniese Moegheidsindroom (CMS) . Die paradigmaverskuiwing vanaf die Cartesiaans-Newtoniaanse epistemologie na die kubernetiese epistemologie, het 'n aantal belangrike implikasies vir die bestudering en konseptualisering van CMS, soos uiteengesit in hierdie studie.
'n Bespreking van die konseptualisering en behandeling van CMS
vanuit die tradisionele, reduksionistiese navorsing word verskaf.
Die aannames van twee-orde kubernetika en sosiale konstruksionisme,
is bespreek en toegepas op die beskrywing van twee sisteme waarin
CMS voorkom. Die navorsingsmetodologie van die studie is gegenereer
op grand van die genoemde teoretiese aannames. Die implikasies van die toepassing van die ekosistemiese epistemologie vir die konseptualisering van CMS word uitgewys. Die herkonseptualisering van CMS as 'n transisieproses word bespreek en riglyne vir verdere navorsing en psigoterapie word aangedui. Die huidige studie bied 'n beskrywing van die unieke betekenisse en oplossings wat gesinne genereer tydens die veranderings wat CMS vergesel.The present study is a qualitative ecosystemic exploration of the phenomenon known as chronic fatigue syndrome (CFS). The paradigm shift from the Newtonian epistemology to the epistemology of cybernetics, has important implication for research and the conceptualisation of CFS, as indicated in the study. The traditional, reductionist conceptualisation of CFS in research and treatment methods, is discussed. The suppositions of second order cybernetics and social constructionism, are discussed and applied in the description of two systems where CFS occurs. The research methodology of the present study is generated from the theoretical suppositions. Die implications of the use of the ecosystemic epistemology for the conceptualisation of CFS are indicated. The re-conceptualisation of CFS as a transition process is discussed and guidelines are given for future research and psychotherapy. The present study is a description of the unique meanings and solutions that the families generated during the changes that accompany CFS.
Psychology
M.A. (Kliniese Sielkunde)
19
Sleigh, Kenna Marie. "Relations between illness perceptions, coping, social support, and outcomes in the Chronic Fatigue Syndrome." Thesis, 2004. http://hdl.handle.net/2429/16151.
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Chronic fatigue syndrome (CFS) is a disorder of unknown etiology characterized by
fatigue, flu-like symptoms, and neurocognitive complaints. Due to the severe impairment
associated with the illness patients are often unable to work and must rely on disability income.
Few patients recover spontaneously although a sizeable proportion has reported improvement.
Since no definitive treatment is available for CFS, it is essential to identify effective ways for
patients to adjust to the illness.
The purpose of the study was to describe how patients adapt to CFS. A sample of 100
patients diagnosed medically with CFS and meeting the Centers for Disease Control and
Prevention (CDC) case definition were recruited primarily from the practices of two hospital-based
internists. The respondents were screened for psychiatric conditions and completed a
battery of questionnaires at four time points over a 21-month period. Guided by Leventhal's self-regulatory
model, multiple regression analyses and ANOVA were utilized to assess the relations
between respondents' illness representations, self-management strategies (coping and social
support), perceived efficacy of self-management, and outcomes including functioning,
psychological distress, and health care utilization.
Analyses revealed pessimistic illness representations and coping characterized by
catastrophizing, focusing on symptoms, avoidance, and venting predicted unfavorable outcomes.
On the other hand, optimistic perceptions and coping by accommodating to the illness, approach
strategies, and social support predicted favorable outcomes. Moreover, in addition to the direct
associations between illness representations and outcomes, representations were also related to
coping. Pessimistic representations predicted maladaptive coping (strategies that predicted
unfavorable outcomes) and optimistic perceptions predicted adaptive coping (strategies that
predicted favorable outcomes). Coping frequency was a better predictor of outcomes than
perceptions of coping efficacy save for physical functioning. To examine change, analyses of differences within and between groups were conducted.
When the sample was stratified into short (ill four years) and long illness duration groups (ill
four years or more) the long duration group reported fewer health care visits. As a whole the
respondents experienced little change in outcomes over a 21-month period but stratification
demonstrated that the short illness duration group evidenced a small but statistically significant
improvement in physical functioning while the long illness duration group reported less vitality.
Coping and social support efficacy decreased over time although for the most part the frequency
of self-management behaviors was quite stable. The implications of the study results for the
management of CFS and future research were discussed.Medicine, Faculty of
Medicine, Department of
Experimental Medicine, Division of
Graduate
20
Orlando, Rebekah. "Gimp Anthropology: Non-Apparent Disabilities and Navigating the Social." Thesis, 2012. http://hdl.handle.net/1911/64712.
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Individuals with non-apparent, physical disabilities face unique social challenges from those that are encountered by the more visibly disabled. The absence of visible cues indicating physical impairment causes ambiguity in social situations, leaving the sufferer vulnerable to moral judgments and social sanctions when they are unable to embody and perform to cultural norms. This dynamic generates a closeted status that the individual must learn to navigate. Using Eve Sedgwick's "The Epistemology of the Closet," this paper deploys auto-ethnography, traditional ethnographic techniques, and literature reviews to illuminate a third space of functioning between the outwardly 'healthy' and the visibly disabled.
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Steiner, Jennifer Leah. "Assessing the Efficacy of Acceptance and Commitment Therapy in Reducing Schema-enmeshment in Fibromyalgia Syndrome." Thesis, 2014. http://hdl.handle.net/1805/4984.
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Indiana University-Purdue University Indianapolis (IUPUI)The presence of a chronic pain condition can have a profound impact on one’s self-concept. Some individuals may have had to make major lifestyle changes. As a result, some people may start to define themselves in terms of their pain, such that their self-schema and pain-schemas become intertwined in a process termed schema-enmeshment. It is thought that schema-enmeshment is related to psychological distress making it a prime target for intervention. Little research has been conducted on interventions to reduce schema-enmeshment. Acceptance-based interventions may be especially appropriate in reducing schema-enmeshment or the connection between self and illness symptoms as these interventions tend to emphasize learning to live with pain and other symptoms and to work toward important life goals rather than continually fighting against the condition and allowing it to control their life. This study is a randomized trial comparing Acceptance and Commitment Therapy (ACT) to education about pain management in a sample of women with Fibromyalgia Syndrome (FMS). The primary aim of this study was to assess the efficacy of ACT in reducing schema-enmeshment between self and pain, as well as enmeshment between self and other symptoms and FMS as a whole. In addition, this study also explored the role of pain acceptance, specifically activity engagement as a mediator of the relationship between treatment group membership and changes in schema-enmeshment. The data was analyzed as an intent-to-treat analysis using the “last measure carried forward” method. Results indicated that the ACT group reported statistically significant differences in self schema-enmeshment with FMS, fatigue, and cognitive symptoms, but not with pain, following the intervention, compared to the educational control group. In each of these cases, the ACT group experienced greater reductions in schema-enmeshment compared to the education group. Interestingly, no statistically significant differences were observed for schema-enmeshment with pain. Statistically significant group differences were also observed for acceptance of pain following the intervention. Finally, a mediational model in which changes in activity engagement (a form of pain acceptance) served as the mediator of the relationship between treatment group and changes in schema-enmeshment with FMS was tested. The model was tested using a bootstrapping method, and results revealed a trend toward a significant indirect effect of changes in activity engagement leading to changes in schema-enmeshment with FMS. Taken together, the results of this study indicate that ACT may be a promising intervention for targeting maladaptive beliefs about the self in relation to illness, especially schema-enmeshment of self with illness and illness symptoms. Additionally, there is evidence that ACT may target key constructs such as activity engagement, which may be related to other cognitive and behavioral changes. Future directions for research and clinical practice related to ACT as an intervention for FMS are discussed in depth.