Perfectionism may be the problem behind chronic fatigue syndrome

Posted By News On December 14, 2014 - 7:08am

Perfectionism may be the issue in chronic fatigue and in other medical disturbances such as irritable bowel syndrome and fibromyalgia, according to a new paper.

Biopsychosocial hypotheses abou chronic fatigue syndrome (CFS) posit that personality and stress have predisposing and perpetuating roles in the persistent and unexplained fatigue that characterizes this functional somatic syndrome. Some studies indicate that many CFS patients are characterized by an achievement-oriented and perfectionist personality, and that such tendencies coupled with self-criticism drive these individuals to work beyond the point of exhaustion in a way that may initiate or perpetuate chronic fatigue.

Although research indicates that CFS patients use maladaptive coping strategies more than healthy controls, it is unknown whether this is true relative to other chronic illness groups.

This study examined perfectionism dimensions and maladaptive coping styles in CFS patients compared with healthy controls and two other chronic illness groups. Participants were drawn from a larger sample of community-dwelling adults from the USA or Canada (n = 980) who completed an anonymous online survey on personality and health after providing informed consent. Authors selected individuals who indicated on a medical checklist that included 13 different chronic health conditions that they had been diagnosed by a medical professional with CFS, irritable bowel syndrome (IBS), or fibromyalgia (FM)/arthritis for 3 subsamples.

The remaining participants were screened for the presence of other chronic diseases, leaving a final healthy sample of 564 subjects, which was divided into 6 random samples of comparable size to the illness groups, one of which was randomly chosen as the healthy control group.

Maladaptive perfectionism was significantly correlated with self-blame coping in both the CFS group and the healthy controls. The correlation between maladaptive perfectionism and behavioral disengagement coping was also significant for both group. However, these correlations did not differ significantly. Standards perfectionism was not significantly correlated with self-blame coping in the CFS group, but was negatively correlated in the healthy controls. The correlations with behavioral disengagement coping were negative in the CFS group and controls, but not significantly different. In the IBS group, maladaptive perfectionism was significantly correlated with each of the 4 maladaptive coping styles, whereas standards perfectionism negatively correlated with denial and behavioral disengagement.

In the FM/arthritis group, maladaptive perfectionism was significantly correlated with all but substance use coping while standards perfectionism was not significantly correlated with any of the coping strategies.

Overall, these findings suggests that maladaptive perfectionism promotes self-critical thoughts that fuel a tendency to cope with stress by becoming consumed with self-blame rather than taking constructive action, a tendency that may be pronounced in the context of CFS, and that contributes to the prolonged chronic stress and subsequent allostatic crash posited by previous studies. Furthermore, they provide evidence that cognitive behavioral interventions that target perfectionism may help enhance the coping capacities of people with CFS.

Citation: Sirois FM, Molnar DS. Perfectionism and Maladaptive Coping Styles in Patients with Chronic Fatigue Syndrome, Irritable Bowel Syndrome and Fibromyalgia/Arthritis and in Healthy Controls. Psychother Psychosom 2014;83:384-385

How ridiculous are these authors who decide to go by an "online survey" to reach their conclusions and refuse to look at the already proven science that has has been proven? Did "stress" and the way they "adapt" to it cause their chromosomal aberrations to be so skewered as just one proven aspect of the disease? Show me the science or stop wasting everyone's time with maladaptive conclusions.

shorter summary of this silly study: blame the victims.

You need to change the name of this blog to BS Codex. Why would you post this drivel?

Maybe it just seems like most CFS victims are achievement-oriented, because they're the ones who have to guts to challenge non-believers in the medical community and general public.

I thought we'd gotten past this ridiculous notion at the turn of the century!
This site has destroyed its credibility by publishing such an ignorant piece. Patients who read this drivel should not blame themselves in any way for their illness. Personality does not cause disease!

"the persistent and unexplained fatigue that characterizes this functional somatic syndrome."

I note that no author is willing to put his name on this drivel, and for good reason. It is *not* a functional syndrome, and it is also not a somatic syndrome. There are very real, identifiable, PHYSIOLOGICAL markers to this very real, NEUROIMMUNE DISORDER.

Did you know that back during the times of slavery, psychologists and psychiatrists created a "diagnosis" for slaves who tried to escape their masters, labelling such behavior as an illness? Did you know that a few decades ago, psychologists and psychologists were claiming that autism was created by "refrigerator moms". The "science" in this article is consistent with those earlier tragic efforts. Based on examples like this, we should all be contacting our elected representatives and urging them to decrease NIH funding for psychiatric and psychological disorders. This is a great example of how your tax money is being WASTED.

Imagine that your life depended on getting to the hospital, and you had exactly the amount of fuel necessary to get there, and not a single drop more. That's how a person with CFS lives. EVERY DROP COUNTS. Normal healthy people waste enough energy in a single hour to get a patient with CFS through an entire day. In fact, patients with CFS would be THRILLED to have the energy that most people can spend in an hour, to get them through a day. When your budget consists of an income of pennies, and yet your budget requires the expenditure of dollars, you learn to be a little bit perfectionist about how you spend your time and energy -- because that's what is necessary for your survival.

Very well put - & I'm writing from 40 years' experience of ME/CFS.
Even my husband doesn't understand this, & he has lived with me for most of that time. Nobody chooses to live like this, if it was within our power to change our lives then we would!

Putting aside methodological issues like self-selection bias and the context of questions being asked of patients, the title of this article is a massive misleading overreach. "Perfectionism may be the problem behind chronic fatigue syndrome", really, the fundamental problem behind a severe chronic illness with unknown etiology? Even according to the content of this article, CFS patients didn't stand out as being much different from healthy controls. With the lack of important differences, the argument now seems to be something along the lines of [maladaptive perfectionism promotes self-critical thoughts similarly in both CFS and healthy controls, but since we assume these problems are more relevant to CFS, then these results don't challenge our previous assumptions but are somehow even more especially specific and relevant to CFS]. The biopsychosocial waffle and the implications of the results are largely speculative in relation to "allostatic crash" and CBT treatment.

Patients are likely to say "once I achieved much more and was able to work much harder." To somebody with a bee in their bonnet and confirmation bias that sounds like "once I strove for perfection and worked too hard."

Don't forget now, doctors or a psychiatrists don't have to be smart: A level maths isn't necessary.


So I guess my documented Epstein-Barr Virus (EBV) in 1986 after visiting Lake Tahoe had nothing to do with my on-going illness...

And all the perfectionists in the world are doomed... Really? LOL

So much scientific information from small studies needs to be followed up and it is tripe like this that prevents the one million patients in the USA from getting the funding to do larger follow-up biological research studies that can lead to a marker, treatment and cure.

Stanford researchers just published a small study using ground-breaking technologies that show brain anomalies in ME/CFS patients that correlate with their fatigue and other symptoms. Once again, a larger study needs to be done to confirm their results. ME/CFS government research dollars are less than 1/3 of what is spent on male pattern baldness, $5 million to $16 million a year. As far as I know, no man's life has been completely ruined by baldness; it's just that those perfectionistic baldies can't bear to go without hair, the poor dears...

I just don't understand the motivation of people like this to deprecate the suffering of so many people. Celebrated author Laura Hillenbrand, who wrote Seabiscuit and Unbroken, both made into movies, describes her life in recent Washington Post and NY Times interviews. Do people think she's lying? Are all of us, 17 million world wide, 1 million in the USA alone, making it all up? Is that what you think? Why would so many people across the world make this up?

You probably thought people with stomach ulcers got them from stress--oops--until they discovered they are caused by bacteria. And that Multiple Sclerosis was psychological--oops--until they discovered that Myelin – the protective coating around nerve fibers in the central nervous system – was being destroyed in an immune attack in MS.

I've been ill for close to 3 decades now and children and young adults are being taken down day after day for what could be the rest of their lives. Show some compassion and support dramatic increases in funding for biological research into this devastating illness. It could strike someone close to you. Thank you.

Absolute NONSENSE. The author of this absurd study has no inkling of the horrors of this very physical disease. I'm disgusted.