Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2005 Jul 27;90(10):1020–1024. doi: 10.1136/adc.2005.074583

Chronic fatigue syndrome and health control in adolescents and parents

E M van de Putte 1, R Engelbert 1, W Kuis 1, G Sinnema 1, J Kimpen 1, C Uiterwaal 1
PMCID: PMC1720106  PMID: 16049059

Abstract

Aims: 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.

Full Text

The Full Text of this article is available as a PDF (70.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bell D. S., Jordan K., Robinson M. Thirteen-year follow-up of children and adolescents with chronic fatigue syndrome. Pediatrics. 2001 May;107(5):994–998. doi: 10.1542/peds.107.5.994. [DOI] [PubMed] [Google Scholar]
  2. Brace M. J., Scott Smith M., McCauley E., Sherry D. D. Family reinforcement of illness behavior: a comparison of adolescents with chronic fatigue syndrome, juvenile arthritis, and healthy controls. J Dev Behav Pediatr. 2000 Oct;21(5):332–339. doi: 10.1097/00004703-200010000-00003. [DOI] [PubMed] [Google Scholar]
  3. Bültmann Ute, Kant Ijmert, Kasl Stanislav V., Beurskens Anna J. H. M., van den Brandt Piet A. Fatigue and psychological distress in the working population: psychometrics, prevalence, and correlates. J Psychosom Res. 2002 Jun;52(6):445–452. doi: 10.1016/s0022-3999(01)00228-8. [DOI] [PubMed] [Google Scholar]
  4. Chalder T., Goodman R., Wessely S., Hotopf M., Meltzer H. Epidemiology of chronic fatigue syndrome and self reported myalgic encephalomyelitis in 5-15 year olds: cross sectional study. BMJ. 2003 Sep 20;327(7416):654–655. doi: 10.1136/bmj.327.7416.654. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Chalder T., Tong J., Deary V. Family cognitive behaviour therapy for chronic fatigue syndrome: an uncontrolled study. Arch Dis Child. 2002 Feb;86(2):95–97. doi: 10.1136/adc.86.2.95. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Engström I. Family interaction and locus of control in children and adolescents with inflammatory bowel disease. J Am Acad Child Adolesc Psychiatry. 1991 Nov;30(6):913–920. doi: 10.1097/00004583-199111000-00008. [DOI] [PubMed] [Google Scholar]
  7. Fukuda K., Straus S. E., Hickie I., Sharpe M. C., Dobbins J. G., Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994 Dec 15;121(12):953–959. doi: 10.7326/0003-4819-121-12-199412150-00009. [DOI] [PubMed] [Google Scholar]
  8. Garralda E., Rangel L., Levin M., Roberts H., Ukoumunne O. Psychiatric adjustment in adolescents with a history of chronic fatigue syndrome. J Am Acad Child Adolesc Psychiatry. 1999 Dec;38(12):1515–1521. doi: 10.1097/00004583-199912000-00012. [DOI] [PubMed] [Google Scholar]
  9. Garralda M. Elena, Rangel Luiza. Impairment and coping in children and adolescents with chronic fatigue syndrome: a comparative study with other paediatric disorders. J Child Psychol Psychiatry. 2004 Mar;45(3):543–552. doi: 10.1111/j.1469-7610.2004.00244.x. [DOI] [PubMed] [Google Scholar]
  10. Haines L. C., Saidi G., Cooke R. W. I. Prevalence of severe fatigue in primary care. Arch Dis Child. 2005 Apr;90(4):367–368. doi: 10.1136/adc.2003.039917. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Heijmans M. J. Coping and adaptive outcome in chronic fatigue syndrome: importance of illness cognitions. J Psychosom Res. 1998 Jul;45(1):39–51. doi: 10.1016/s0022-3999(97)00265-1. [DOI] [PubMed] [Google Scholar]
  12. Helgeson V. S. Moderators of the relation between perceived control and adjustment to chronic illness. J Pers Soc Psychol. 1992 Oct;63(4):656–666. doi: 10.1037//0022-3514.63.4.656. [DOI] [PubMed] [Google Scholar]
  13. Jamison R. N., Lewis S., Burish T. G. Psychological impact of cancer on adolescents: self-image, locus of control, perception of illness and knowledge of cancer. J Chronic Dis. 1986;39(8):609–617. doi: 10.1016/0021-9681(86)90186-4. [DOI] [PubMed] [Google Scholar]
  14. Jones James F., Nisenbaum Rosane, Solomon Laura, Reyes Michele, Reeves William C. Chronic fatigue syndrome and other fatiguing illnesses in adolescents: a population-based study. J Adolesc Health. 2004 Jul;35(1):34–40. doi: 10.1016/j.jadohealth.2003.09.007. [DOI] [PubMed] [Google Scholar]
  15. Kellerman J., Zeltzer L., Ellenberg L., Dash J., Rigler D. Psychological effects of illness in adolescence. I. Anxiety, self-esteem, and perception of control. J Pediatr. 1980 Jul;97(1):126–131. doi: 10.1016/s0022-3476(80)80152-1. [DOI] [PubMed] [Google Scholar]
  16. Kennedy B. L., Lynch G. V., Schwab J. J. Assessment of locus of control in patients with anxiety and depressive disorders. J Clin Psychol. 1998 Jun;54(4):509–515. doi: 10.1002/(sici)1097-4679(199806)54:4<509::aid-jclp12>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  17. Newman Stanton, Steed Liz, Mulligan Kathleen. Self-management interventions for chronic illness. Lancet. 2004 Oct 23;364(9444):1523–1537. doi: 10.1016/S0140-6736(04)17277-2. [DOI] [PubMed] [Google Scholar]
  18. Ozolins Andrejs R., Stenström Ulf. Validation of health locus of control patterns in Swedish adolescents. Adolescence. 2003 Winter;38(152):651–657. [PubMed] [Google Scholar]
  19. Patel M. X., Smith D. G., Chalder T., Wessely S. Chronic fatigue syndrome in children: a cross sectional survey. Arch Dis Child. 2003 Oct;88(10):894–898. doi: 10.1136/adc.88.10.894. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Smith Mark S., Martin-Herz Susanne P., Womack William M., Marsigan Julie L. Comparative study of anxiety, depression, somatization, functional disability, and illness attribution in adolescents with chronic fatigue or migraine. Pediatrics. 2003 Apr;111(4 Pt 1):e376–e381. doi: 10.1542/peds.111.4.e376. [DOI] [PubMed] [Google Scholar]
  21. Smith Mark Scott. Adolescent chronic fatigue syndrome. Arch Pediatr Adolesc Med. 2004 Mar;158(3):207–208. doi: 10.1001/archpedi.158.3.207. [DOI] [PubMed] [Google Scholar]
  22. Stanton W. R., Nada Raja S., Langley J. Stability in the structure of health locus of control among adolescents. Br J Clin Psychol. 1995 May;34(Pt 2):279–287. doi: 10.1111/j.2044-8260.1995.tb01462.x. [DOI] [PubMed] [Google Scholar]
  23. Steptoe A., Wardle J. Locus of control and health behaviour revisited: a multivariate analysis of young adults from 18 countries. Br J Psychol. 2001 Nov;92(Pt 4):659–672. doi: 10.1348/000712601162400. [DOI] [PubMed] [Google Scholar]
  24. Stulemeijer Maja, de Jong Lieke W. A. M., Fiselier Theo J. W., Hoogveld Sigrid W. B., Bleijenberg Gijs. Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomised controlled trial. BMJ. 2004 Dec 7;330(7481):14–14. doi: 10.1136/bmj.38301.587106.63. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Vercoulen J. H., Swanink C. M., Fennis J. F., Galama J. M., van der Meer J. W., Bleijenberg G. Dimensional assessment of chronic fatigue syndrome. J Psychosom Res. 1994 Jul;38(5):383–392. doi: 10.1016/0022-3999(94)90099-x. [DOI] [PubMed] [Google Scholar]
  26. Viner R., Gregorowski A., Wine C., Bladen M., Fisher D., Miller M., El Neil S. Outpatient rehabilitative treatment of chronic fatigue syndrome (CFS/ME). Arch Dis Child. 2004 Jul;89(7):615–619. doi: 10.1136/adc.2003.035154. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Viner Russell, Hotopf Matthew. Childhood predictors of self reported chronic fatigue syndrome/myalgic encephalomyelitis in adults: national birth cohort study. BMJ. 2004 Oct 6;329(7472):941–941. doi: 10.1136/bmj.38258.507928.55. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Wallston K. A., Wallston B. S., DeVellis R. Development of the Multidimensional Health Locus of Control (MHLC) Scales. Health Educ Monogr. 1978 Spring;6(2):160–170. doi: 10.1177/109019817800600107. [DOI] [PubMed] [Google Scholar]
  29. White Peter D. Costs, correlates and consequences of fatigue in children and adults. Psychol Med. 2003 Feb;33(2):197–201. doi: 10.1017/s0033291702007249. [DOI] [PubMed] [Google Scholar]
  30. de Jong L. W., Prins J. B., Fiselier T. J., Weemaes C. M., Meijer-van den Bergh E. M., Bleijenberg G. Het chronische-vermoeidheidsyndroom bij jongeren. Ned Tijdschr Geneeskd. 1997 Aug 2;141(31):1513–1516. [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES