Objectives
Stressors and emotional distress responses impact chronic fati
gue syndrome (CFS) symptoms, includin
g fati
gue. Havin
g better stress mana
gement skills mi
ght miti
gate fati
gue by decreasin
g emotional distress. Because CFS patients comprise a hetero
geneous population, we hypothesized that the role of stress mana
gement skills in decreasin
g fati
gue may be most pronounced in the sub
group manifestin
g 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¦Â, IL-2, IL-6, IL-10, and tumor necrosis factor-alpha (TNF-¦Á), 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 = .019) and emotional distress (p < .001), greater diurnal cortisol slope (p = .023) and lower IL-2 levels (p = .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.