Well-Being in Chronic Fatigue Syndrome: Relationship to Symptoms and Psychological Distress

There is growing recognition in psychology that wellness is more than the absence of disease and distress. Well-being has been defined in numerous ways. Two dominant models include Diener, Eunkook, Suh, Lucas & Smith’s (1999) Hedonic model of Subjective Well-Being (SWB) and Ryff’s (1989) Eudiamonic model of Psychological Well-Being (PWB). There has been insufficient research into positive mental processes and well-being in Chronic Fatigue Syndrome (CFS), in contrast to the abundance of research emphasising psychopathology and dysfunction. This study’s first aim was to examine PWB and SWB and their relationship to symptoms in individuals with CFS (N = 60). Participants completed self-report scales of PWB, SWB, fatigue, pain, anxiety and depression. The second aim was to compare PWB scores in a subgroup of the CFS sample (N = 42) to a matched non-clinical control group (N = 42). Correlations between scales of symptoms and well-being were found to be complex. Well-being dimensions were largely independent of physical symptoms (Pain intensity, Physical Fatigue, Reduced Activity and General Fatigue) but strongly related to psychological components of fatigue (Mental Fatigue and Reduced Motivation) and psychological distress (Depression and Anxiety). Multiple regression analyses indicated that five dimensions of well-being uniquely predicted symptomatology in CFS. Compared to the control group, the CFS group scored significantly lower on five of Ryff ‘s six PWB dimensions, with particularly marked deficits in Personal Growth, Environmental Mastery and Self-Acceptance. No significant difference was found between the CFS and control groups on the Autonomy subscale. This multi-dimensional assessment of well-being advances our understanding of CFS; it highlights the burden of CFS beyond symptoms, challenges the over emphasis on maladaptive cognitive and personality traits in previous research and offers several new treatment targets. Future research must investigate whether interventions targeting theses well-being deficits can boost the efficacy of symptom focused treatments, which currently produce unsatisfactory recovery rates in this client group.