Cognitive and behavioural responses to symptoms in adolescents with Chronic Fatigue Syndrome (CFS): A Case Control Study nested within a cohort

Maria Loades, Katharine Rimes, Kate Lievesley, Sheila Ali, Trudie Chalder

Research output: Contribution to journalArticlepeer-review

16 Citations (SciVal)
103 Downloads (Pure)


Background: What adolescents think about symptoms and what they do in response could contribute to fatigue maintenance. We compared the cognitive and behavioural responses of adolescents and their parents with chronic fatigue syndrome (CFS; N = 121) and asthma (N = 27) and explored the predictive value of these variables on fatigue and functioning in CFS. Method: Consecutively referred adolescents with CFS were recruited. Questionnaires, completed by adolescents and parents, assessed fatigue, functioning, mood and cognitive and behavioural responses to symptoms. Age-matched adolescents with asthma completed the same questionnaires. Adolescents with CFS completed questionnaires again approximately 3 months later. Results: Adolescents with CFS scored higher on all unhelpful cognitive and behavioural subscales than adolescents with asthma. Parents’ cognitions about their child’s symptoms were associated with adolescent’s own cognitions. Unhelpful cognitive and behavioural responses, particularly, damage beliefs, predicted subsequent fatigue in CFS, and all-or-nothing behaviour, catastrophising and damage beliefs predicted subsequent physical functioning. Conclusion: Unhelpful cognitive and behavioural responses to symptoms appear to be particularly prominent in adolescents with CFS. There is some consistency but not a perfect match between cognitive and behavioural responses to symptoms reported by adolescents and their parents. These responses could be contributing to fatigue maintenance and disability.
Original languageEnglish
Pages (from-to)564-579
Number of pages16
JournalClinical Child Psychology and Psychiatry
Issue number3
Early online date15 Mar 2019
Publication statusPublished - 1 Jul 2019


  • Parents
  • all-or-nothing
  • catastrophising
  • cognitive behavioural therapy
  • damage beliefs
  • psychosocial functioning

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Psychology
  • Psychiatry and Mental health


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