Chronic fatigue syndrome and the somatic expression of emotional distress: Applying the concept of illusory mental health to address the controversy

• Published in: Journal of clinical psychology Vol. 75; no. 1; pp. 116 - 131
• Main Authors: Bram, Anthony D., Gottschalk, Kiley A., Leeds, William M.
• Format: Journal Article
• Language: English
• Published: United States Wiley Periodicals Inc 01.01.2019
• Subjects: Adult; Chronic fatigue syndrome; chronic fatigue syndrome (CFS); Comorbidity; depression; Depression - epidemiology; Depression - physiopathology; Depressive Disorder - epidemiology; Depressive Disorder - physiopathology; Diagnostic Self Evaluation; Early Memory Index (EMI); Fatigue Syndrome, Chronic - epidemiology; Fatigue Syndrome, Chronic - physiopathology; Female; Humans; illusory mental health (IHM); Mental health; Middle Aged; Psychological Distress; Self Report; somatization; Somatoform Disorders - physiopathology; chronic fatigue syndrome (CFS); Early Memory Index (EMI); depression; illusory mental health (IHM); somatization
• ISSN: 0021-9762; 1097-4679
• DOI: 10.1002/jclp.22692

Objective The process of somatization in chronic fatigue syndrome (CFS) was investigated using the concept of illusory mental health (IMH). IMH involves self‐reporting low emotional distress alongside performance‐based assessment of distress. Method We studied IHM and physical symptoms in 175 women across four groups: (a) CFS plus depression; (b) CFS with no depression (CFS‐ND); (c) depressive disorder without CFS; and (d) healthy controls (HC). IMH was assessed using a self‐report measure plus the performance‐based Early Memory Index (EMI). Results CFS‐NDs were no more likely to have IMH compared with HCs. Among the CFS‐NDs, IMH was associated with more physical symptoms. For CFS‐NDs, EMI added meaningfully beyond self‐reported mental health in predicting physical symptoms. Conclusion Findings refute reducing CFS to somatization, but there is a subgroup of CFS whose lacking access to emotional distress is associated with heightened physical symptomatology.