Chronic fatigue in the community: ‘a question of attribution’

Thirty-eight subjects identified in a large community survey

were found to attribute their fatigue to ‘myalgic

encephalomyelitis’ (ME). They were matched randomly to two

other groups of subjects who attributed their fatigue to

either psychological or social factors. All three groups were

followed up 18 months later and were asked to complete a

series of questionnaires that examined fatigue, psychological

distress, number of symptoms, attributional style and levels

of disability. At onset the ‘ME’ group were found to be more

fatigued, had been tired for longer but were less

psychologically distressed than the other two groups. At

follow-up the ‘ME’ group were more handicapped in relation to

home, work, social and private leisure activities, even when

controlling for both duration of fatigue and fatigue at time

1, but were less psychologically distressed. The

relationships between psychological distress, specific illness

attributions, attributional style and their effect on the

experience of illness and its prognosis are discussed.

Attributing fatigue to social reasons appears to be most


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