Chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivities are controversial and poorly understood illnesses without clearly defined causes or well-established treatments. These closely related conditions, regarded by many clinicians as the most perplexing health care concerns of this era, are difficult to define, evaluate, and treat. Given the absence of knowledgeable health care and social service providers, individuals with these illnesses are often left without medical support or community resources. Because these enigmatic conditions are associated with both biologic and psychosocial factors, a clinically informed mind/body approach to assessment and treatment may best serve these patients. To address these issues, this book focuses on the authors' recently developed protocols for psychological and behavioral assessment, innovative treatment strategies, and a new form of cognitive-behavioral therapy.
Integrating case histories and current research findings, this book provides an important dialogue about the complexities of diagnosing these conditions and associated psychological issues. Finally, the authors outline the controversies regarding causal and perpetuating factors in these conditions, and review the numerous medical and alternative treatment approaches that have been advocated for these illnesses. This book is a useful and informative guide for clinicians who are now seeing these patients in their practices.
Included are numerous case studies, references, and resources, and six informal assessment instruments.
"This practitioner's guide covers, succinctly and still comprehensively, the cognitive-behavioral treatment of three debilitating controversial illnesses. It clearly describes the main aspects of these serious conditions and gives valuable multifaceted ways of possibly alleviating them. Remarkably well done!"
-Albert Ellis, PhD, Albert Ellis Institute, New York City
"This guide is 'must reading' for those with an interest in the neurobiopsychological aspects of these controversial illnesses, but medical practitioners and patients will reap a great deal also concerning the emotional evaluation of patients, helping patients to cope, and the development of a multidisciplinary approach to these problems. This is the most comprehensive review to date of these complicated and controversial disorders. I highly commend the authors for their work, and highly recommend [this book] to any individual who has an interest in CFS, FMS or MCS."
-Charles W. Lapp, MD, Director, Hunter-Hopkins Center, Charlotte, NC; Assistant Consulting Professor of Community and Family Medicine, Duke University Medical Center
"The book intelligently discusses both the medical and psychological aspects of this group of controversial and frustrating illnesses. It thoroughly reviews a wide spectrum of treatments, from mainstream to alternative. The sections on cognitive-behavioral therapy are practical, specific, and state-of-the-art. I highly recommend this book to practitioners who are trying to understand this group of illnesses, in order to help their affected patients."
-David C. Klonoff, MD, FACP, Clinical Professor of Medicine, University of California at San Francisco
"Chronic fatigue syndrome (CFS), fibromyalgia (FMS), and multiple chemical sensitivities (MCS) once thought to be merely forms of malingering or minor psychological disturbances are now recognized as severe disorders with biological, psychological, and social components that profoundly incapacitate millions of Americans. Taylor, Friedberg, and Jason have crafted a scientifically-based but thoroughly readable book that brings together all that is known about the etiology, assessment, and multifaceted treatment of these disorders. Through standard forms, case studies, and a host of other materials, practitioners will learn exactly how to assess these disorders and apply treatment components that fully embrace the biopsychosocial model and psychoneuroimmunology. Empirically-validated and alternative biological and psychological treatments are carefully described and assessed for utility. As a practitioner- or if you are a person or have a friend or relative with one of these disorders- this book is absolutely essential reading."
-Richard A. Winett, PhD, Heilig-Meyers Professor of Psychology, Director- Center for Research in Health Behavior, and Director of Clinical Training, Virginia Polytechnical Institute and State University
"This volume provides a clear, concise, and balanced overview of what we know and don't know about chronic fatigue syndrome and related disorders. [The authors] do an excellent job of melding empirical research and clinical wisdom. The case studies presented throughout the book nicely illustrate the authors' numerous valuable clinical insights. Taylor, Friedberg, and Jason's biopsychosocial approach holistically integrates material from diverse perspectives and points the way toward the types of comprehensive assessment, treatment, and education programs that are needed."
-David Glenwick, PhD, Professor of Psychology, Fordham University
Table of Contents:
Chapter 1: Introduction
Case Definitions, Associated Symptoms, and Prevalence
Chapter 2: Etiology and Perpetuating Factors
Chronic Fatigue Syndrome
Explanatory Models of Fibromyalgia
Explanatory Models of Multiple Chemical Sensitivities
Models Addressing Psychosocial Aspects of CFS, FMS and MCS
Biopsychosocial and Psychoneuroimmunological Models: A Unifying Approach to Understanding CFS, FMS, and MCS
Chapter 3: Diagnostic Issues
Differential Diagnoses: CFS, FMS, MCS Versus Primary Psychiatric Disorders
Case Examples- Pure-Type Conditions
Case Examples- CFS, FMS, MCS, and Comorbid Psychiatric Conditions
Chapter 4: Psychometric and Behavioral Assessment
Evaluation of Fatigue and Chronic Fatigue Syndrome
Evaluation of Disability and Quality of Life
Evaluating Psychosocial Phases of Illness and Coping
Evaluating Stigmatizing Attitudes
Assessing Psychiatric Comorbidity in CFS, FMS, and MCS
Evaluating Service Utilization in CFS, FMS, and MCS
Physical Activity Monitoring in CFS and FMS
Chapter 5: Pharmacological and Alternative Treatments
Alternative Medical Approaches
Patient Ratings of Treatment Efficacy
Chapter 6: Cognitive-Behavioral Treatment I
Case Study I: Illustrating the Integration of Envelope Theory with Cognitive Behavior Therapy
Identifying Goals and Reviewing Psychometric and Activity Data
The Treatment Process
Chapter 7: Cognitive-Behavioral Treatment II
The Interactive Symptom-Stress Model
Imaginal Desensitization in MCS
Pleasant Mood Induction
Cognitive Coping Skills
Case Example of CFS Treatment
Case Example of FMS Treatment
Case Example of MCS Treatment
Chapter 8: Summary and Future Directions
Appendix A: Chronic Fatigue Syndrome Self-Report Questionnaire
Appendix B: CFS Screening Questionnaire
Appendix C: Fatigue-Related Cognitions Scale
Appendix D: Fennell Phase Inventory
Appendix E: The Chronic Fatigue Syndrome Attitudes Test Questions
Appendix F: Behavioral Rating Scales
Appendix G: Resources for Individuals With CFS, FMS, and MCS
About the Authors
Renee R. Taylor, PhD, is a licensed clinical psychologist at DePaul University who currently serves as the Principal Investigator of a chronic fatigue syndrome (CFS) research and demonstration project. She has been working in the field of chronic fatigue syndrome research and intervention for over 8 years and has published over 30 articles on this subject.
Fred Friedberg, PhD, is a clinical assistant professor of psychiatry in the Division of Behavioral Medicine, Department of Psychiatry and Behavioral Sciences at the State University of New York at Stony Brook. Dr. Friedberg has authored two previous books on CFS and has written articles on CFS and fibromyalgia for a number of professional journals.
Leonard A. Jason, PhD, is a professor of psychology at DePaul University. He has written or edited 14 books, and published over 310 articles and 45 chapters on chronic fatigue syndrome; preventive school-based interventions; the prevention of alcohol, tobacco, and other drug abuse; media interventions; and program evaluation. He received the 1997 CSN ACTION Champion Award from the Chronic Fatigue Immune Dysfunction Syndrome Association of America. Dr. Jason has received grants from NIH to study the epidemiology and treatment of CFS.