exacerbates disease. Instead of relying solely on self-report
instruments the authors also used objectively measure physiological
processes.
Brain Behav Immun. 2012 Mar 6. [Epub ahead of print]
Stress management skills, neuroimmune processes and fatigue levels in
persons with chronic fatigue syndrome.
Lattie EG, Antoni MH, Fletcher MA, Penedo F, Czaja S, Lopez C, Perdomo
D, Sala A, Nair S, Fu SH, Klimas N.
Department of Psychology, University of Miami, FL, USA.
Abstract
OBJECTIVES:
Stressors and emotional distress responses impact chronic fatigue
syndrome (CFS) symptoms, including fatigue. Having better stress
management skills might mitigate fatigue by decreasing emotional
distress. Because CFS patients comprise a heterogeneous population, we
hypothesized that the role of stress management skills in decreasing
fatigue may be most pronounced in the subgroup manifesting the
greatest neuroimmune dysfunction.
METHODS:
In total, 117 individuals with CFS provided blood and saliva samples,
and self-report measures of emotional distress, perceived stress
management skills (PSMS), and fatigue. Plasma interleukin-1-beta
(IL-1=CE=B2, IL-2, IL-6, IL-10, and tumor necrosis factor-alpha (TNF-=CE=B1=
),
and diurnal salivary cortisol were analyzed.
We examined relations among PSMS, emotional distress, and fatigue in
CFS patients who did and did not evidence neuroimmune abnormalities.
RESULTS:
Having greater PSMS related to less fatigue (p=3D.019) and emotional
distress (p<.001), greater diurnal cortisol slope (p=3D.023) and lower
IL-2 levels (p=3D.043).
PSMS and emotional distress related to fatigue levels most strongly in
CFS patients in the top tercile of IL-6, and emotional distress
mediated the relationship between PSMS and fatigue most strongly in
patients with the greatest circulating levels of IL-6 and a greater
inflammatory (IL-6):anti-inflammatory (IL-10) cytokine ratio.
DISCUSSION:
CFS patients having greater PSMS show less emotional distress and
fatigue, and the influence of stress management skills on distress and
fatigue appear greatest among patients who have elevated IL-6 levels.
These findings support the need for research examining the impact of
stress management interventions in subgroups of CFS patients showing
neuroimmune dysfunction.
Copyright =C3=82=C2=A9 2012 Elsevier Inc. All rights reserved.
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