title: Telephone-administered versus live group cognitive behavioral stress management for adults with CFS.
abstract: Chronic fatigue syndrome (CFS) symptoms have been shown to be exacerbated by stress and ameliorated by group-based psychosocial interventions such as cognitive behavioral stress management (CBSM). Still, patients may have difficulty attending face-to-face groups. This study compared the effects of a telephone-delivered (T-CBSM) vs a live (L-CBSM) group on perceived stress and symptomology in adults with CFS.
  
  
  
  Intervention data from 100 patients with CFS (mean age 50years; 90% female) participating in T-CBSM (N=56) or L-CBSM (N=44) in previously conducted randomized clinical trials were obtained. Perceived Stress Scale (PSS) and the Centers for Disease Control and Prevention symptom checklist scores were compared with repeated measures analyses of variance in adjusted and unadjusted analyses.
  
  
  
  Participants across groups showed no differences in most demographic and illness variables at study entry and had similar session attendance. Both conditions showed significant reductions in PSS scores, with L-CBSM showing a large effect (partial ε2=0.16) and T-CBSM a medium effect (partial ε2=0.095). For CFS symptom frequency and severity scores, L-CBSM reported large effect size improvements (partial ε2=0.19-0.23), while T-CBSM showed no significant changes over time.
  
  
  
  Two different formats for delivering group-based CBSM-live and telephone-showed reductions in perceived stress among patients with CFS. However, only the live format was associated with physical symptom improvements, with specific effects on post-exertional malaise, chills, fever, and restful sleep. The added value of the live group format is discussed, along with implications for future technology-facilitated group interventions in this population.
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, FL, USA; Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA. Electronic address: dhall7@mgh.harvard.edu.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Hall
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, FL, USA; Center for Behavioral Intervention Technologies (CBITs), Northwestern University, Chicago, IL, USA.
authors.forename: Emily G
authors.initials: EG
authors.lastname: Lattie
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, FL, USA.
authors.forename: Sara F
authors.initials: SF
authors.lastname: Milrad
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Czaja
authors.affiliation: Institute for Neuro Immune Medicine, Nova Southeastern University, Davie, FL, USA.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Fletcher
authors.affiliation: Institute for Neuro Immune Medicine, Nova Southeastern University, Davie, FL, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Klimas
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, USA.
authors.forename: Dolores
authors.initials: D
authors.lastname: Perdomo
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, FL, USA; Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Antoni
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001143:Arousal; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015673:Fatigue Syndrome, Chronic / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology*; D013689:Telephone
keywords: CFS; Cognitive behavioral stress management; Perceived stress; Post-exertional malaise; Symptoms; Telehealth