Chronic fatigue syndrome: activity patterns and symptoms

Individuals with chronic fatigue syndrome (CFS) experience regular fatigue, pain, sleep disturbance, and many other symptoms. It is thought that patients with CFS respond to these symptoms with two activity patterns. The first is known as all-or-nothing behavior, in which individuals have interspersed bursts of intense activity with extended periods of rest. The second is known as activity limitation, in which individuals rest and limit activity.

In order to examine the relationship between activity patterns and patients’ symptoms/affect, researchers at the University of Manchester and the University of Southampton implemented a six-day experience sampling methodology study. They used smartphones to deliver alerts. Twenty-three patients with CFS were given an Android smartphone and alerted 10 times a day to respond to a survey. Each survey regarded items such as:

  • Patient activity management strategies
  • Affect
  • Symptoms

After analyzing the data with multilevel models, researchers found these results:

  • Positive affect was related to increased current activity limitation
  • Negative affect was related to increased current all-or-nothing behavior

Although the results at first seemed counterintuitive, it was suggested that these trends illustrate patient beliefs about the relationship between their symptoms and their use of activity management strategies. For example, patients may limit their activity because they believe resting is a beneficial strategy for coping with symptom severity and pain. Additionally, patients may increase their activity when they feel well, which may lead them to believe that worsening symptoms will follow, leading to an association between all-or-nothing behavior and negative affect.

Researchers concluded that both unhelpful activity patterns surface due to patient symptom experience and affect.

Want to learn more? Check out the full article!

Band, R., Barrowclough, C., Caldwell, K., Emsley, R., & Wearden, A. (2017).

Activity patterns in response to symptoms in patients being treated for chronic fatigue syndrome: An experience sampling methodology study.

Health Psychology, 36(3), 264.

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