OBJECTIVE: This study examines social processes that construct
the course of chronic illness. Specifically, it identifies and
describes mechanisms that constitute the process of role
constriction in employment for individuals with chronic
METHOD: Sixty-six persons meeting the Centers for
Disease Control case definition of chronic fatigue syndrome
(CFS) participated in a longitudinal study involving three
waves of data collection over 3 years. Qualitative and
quantitative methods were combined in the research, which
included face- to-face semistructured interviews, telephone
interviews, and self- report questionnaires. Materials
presented in this study are drawn principally from the Year 1
face-to-face and telephone interviews.
RESULTS: When patterns
of symptoms and of the illness course in CFS intersect with
work requirements, they impede performance and place ill
individuals at risk for job loss. Persons with CFS devise and
implement specific strategies to resist role constriction and
remain in the work force.
CONCLUSIONS: Role constriction is a
social process of marginalization in chronic illness. Opposing
forces of marginalization and resistance define the social
course in chronic illness and suggest that chronicity can be
thought of as a marginalized position in social space.