title: Why did I get chronic fatigue syndrome? A qualitative interview study of causal attributions in women patients.
abstract: OBJECTIVE
  To explore causal attributions among women with chronic fatigue syndrome (CFS).
  
  
  METHODS
  Qualitative study where data from individual semi-structured interviews were analysed according to Malterud's systematic text condensation.
  
  
  METHODS
  Bergen, Norway.
  
  
  METHODS
  A purposeful sample of eight women aged 25-55, recruited among members of a self-help organization.
  
  
  METHODS
  Accounts of causal attribution for CFS among the informants, focusing on gender.
  
  
  RESULTS
  The participants agreed that their way of living could have increased the vulnerability of their resistance resources. Pressure they put upon themselves, workload burdens without subsequent relaxation, emotional conflicts, or preparing for assumed problem-solving were mentioned as gendered dimensions. They presented different explanations regarding potential triggers encountering their fragile immune systems, most often a virus infection. The participants thought women might have a weaker immune system than men, or that CFS was caused by a virus that women are more likely to catch. In their experience, their symptoms were activated when people put pressure on them, such that they might be nervous as to whether they could live up to the demands of their surroundings, and in the case of emotional strain related to family and work.
  
  
  CONCLUSIONS
  More studies are needed exploring hypotheses concerning the complex interplay between molecular predispositions and more or less gendered lifestyle issues in CFS. Doctors need to challenge their strong beliefs regarding medically unexplained conditions, where facts still remain unresolved. Recognizing this, the doctor may provide realistic support and advice, and contribute to the establishment of common ground for understanding and managing the condition.
authors.affiliation: Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Norway. mpkat@msn.com
authors.forename: Atle
authors.initials: A
authors.lastname: Soderlund
authors.forename: Kirsti
authors.initials: K
authors.lastname: Malterud
mesh_terms: D000328:Adult; D015673:Fatigue Syndrome, Chronic / Q000209:etiology* / Q000276:immunology / Q000523:psychology / Q000821:virology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008875:Middle Aged; D033262:Narration; D036301:Qualitative Research; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications; D016526:Workload