Self-investigation in adolescent chronic fatigue syndrome: narrative changes and health improvement.
OBJECTIVE
A small-scale intervention study into narrative self-investigation in adolescent chronic fatigue syndrome (CFS).


METHODS
The self-confrontation method (SCM) is an instrument to assess and change personal life stories. Forty-two adolescents diagnosed with CFS were included and randomly assigned to either 6 or 12 sessions with the SCM. Twenty-five healthy adolescents were assigned to 6 sessions. Outcome was measured directly after the self-investigation procedure at 4 months. Follow-up measurements were made 10 months later. The Checklist Individual Strength and the Child Health Questionnaire were used to measure changes in fatigue, physical and psychosocial functioning.


RESULTS
Self-investigation resulted in significant changes in participants' narratives. Moreover, after self-investigation there was a significant improvement in fatigue, physical and psychosocial functioning for the adolescents with CFS. The patients who completed 12 sessions improved most. At follow-up, the positive effects were maintained.


CONCLUSIONS
Self-investigation enables a move beyond the symptoms of CFS in an individualized, patient centered way. Narrative transformation seems to contribute to improved physical and psychosocial outcome in adolescent CFS.


CONCLUSIONS
The SCM allows adolescents to discover (for themselves) factors that might cause or perpetuate their fatigue. The results suggest that self-investigation is a useful instrument in the management of adolescent CFS.
van Geelen
Stefan M
SM
Division of Pediatric Psychology, University Medical Center Utrecht, Utrecht, The Netherlands. S.M.vanGeelen@umcutrecht.nl
Fuchs
Coralie E
CE
Sinnema
Gerben
G
van de Putte
Elise M
EM
van Geel
Rolf
R
Hermans
Hubert J M
HJ
Kuis
Wietse
W
D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior; D000704:Analysis of Variance; D015673:Fatigue Syndrome, Chronic / Q000523:psychology* / Q000628:therapy; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D033262:Narration; D009426:Netherlands; D011594:Psychometrics; D012647:Self-Assessment; D013315:Stress, Psychological; D011795:Surveys and Questionnaires