title: Chronic fatigue syndrome and health control in adolescents and parents.
abstract: OBJECTIVE
  To explore the locus of health control in adolescents with chronic fatigue syndrome (CFS) and their parents in comparison with healthy adolescents and their parents.
  
  
  METHODS
  In this cross-sectional study 32 adolescents with CFS were compared with 167 healthy controls and their respective parents. The Multidimensional Health Locus of Control (MHLC) questionnaire was applied to all participants.
  
  
  RESULTS
  There was significantly less internal health control in adolescents with CFS than in healthy controls. An increase of internal health control of one standard deviation was associated with a 61% reduced risk for CFS (OR = 0.39, 95% CI 0.25 to 0.61). Internal health control of the parents was also protective (OR fathers: 0.57 (95% CI 0.38 to 0.87); OR mothers: 0.74 (95% CI 0.50 to 1.09)). The external loci of health control were higher in adolescents with CFS and in their parents. Increased levels of fatigue (56%) were found in the mothers of the adolescents with CFS, in contrast with the fathers who reported a normal percentage of 13.
  
  
  CONCLUSIONS
  In comparison with healthy adolescents, adolescents with CFS and their parents show less internal health control. They attribute their health more to external factors, such as chance and physicians. This outcome is of relevance for treatment strategies such as cognitive behaviour therapy, for which health behaviour is the main focus.
authors.affiliation: Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center, Utrecht, Netherlands. e.vandeputte@wkz.azu.nl
authors.forename: E M
authors.initials: EM
authors.lastname: van de Putte
authors.forename: R H H
authors.initials: RH
authors.lastname: Engelbert
authors.forename: W
authors.initials: W
authors.lastname: Kuis
authors.forename: G
authors.initials: G
authors.lastname: Sinnema
authors.forename: J L L
authors.initials: JL
authors.lastname: Kimpen
authors.forename: C S P M
authors.initials: CS
authors.lastname: Uiterwaal
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D015444:Exercise; D005190:Family; D005220:Fathers; D015673:Fatigue Syndrome, Chronic / Q000150:complications / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D007389:Internal-External Control; D016014:Linear Models; D008297:Male; D009035:Mothers; D016487:Parenting; D012917:Social Adjustment