- Jul 2018
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europepmc.org europepmc.org
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On 2014 Feb 27, Tom Kindlon commented:
The validity of the measure of self-critical perfectionism employed in this study is questionable for patients with a chronic, disabling, invisible illness
This paper used the self-critical perfectionism (SCP) subscale of the Depressive Experiences Questionnaire (DEQ). The authors describe such perfectionism as "maladaptive perfectionism".
This may be true for some people with primarily psychological disorders, such as those from whom the DEQ was designed (1), but I question it is true for chronic fatigue syndrome (CFS).
Here are the five items that load most strongly on the self-criticism subscale of the DEQ (1):
There is a considerable difference between how I am now and how I would like to be.
I often feel guilty.
The way I feel about myself frequently varies: There are times when I feel extremely good about myself and other times when I see only the bad in me and feel like a total failure.
Often, I feel I have disappointed others.
I often find that I don't live up to my own standards or ideals.
Unless somebody actually wants to have a disabling condition, which would be an abnormal response, patients with CFS would generally agree with item #1 and the more fatigue and pain they had, the stronger their agreement with it would be.
To a lesser extent, it seems feasible that quite a lot patients with CFS might agree with items 4 & 5 without it necessarily representing maladaptive perfectionism. CFS is a fluctuating and disabling condition so people may say they will do something but don't manage to do it which could disappoint others. Also, their output at home or in the workplace may be lower than previously which might disappoint employers, family members, etc. (2). The invisible nature of the condition can mean that other people can expect quite a lot from somebody. Similarly, with item five, individuals with CFS may not be able to live up to their own pre-illness standards in various ways, for reasons relating to their illness. For example, as mentioned, the symptoms of CFS could can cause financial pressures (not being able to work or work as much) which can impair one's ability to live up to one's standards or ideals in various ways. Impairments from CFS could also more directly impair one's ability to maintain one's home, involve oneself in family life, and indeed most activities one might be involved in.
It would have been more interesting if the investigators had used patients with another disabling illness such as multiple sclerosis or rheumatoid arthritis as a control group to attempt to control for such issues.
References:
Depressive Experiences Questionnaire: http://www.mentalhealthce.com/courses/contentHD/secHD15.html
Reynolds KJ, Vernon SD, Bouchery E, Reeves WC. The economic impact of chronic fatigue syndrome. Cost Eff Resour Alloc. 2004 Jun 21;2(1):4.
This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.
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- Feb 2018
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europepmc.org europepmc.org
-
On 2014 Feb 27, Tom Kindlon commented:
The validity of the measure of self-critical perfectionism employed in this study is questionable for patients with a chronic, disabling, invisible illness
This paper used the self-critical perfectionism (SCP) subscale of the Depressive Experiences Questionnaire (DEQ). The authors describe such perfectionism as "maladaptive perfectionism".
This may be true for some people with primarily psychological disorders, such as those from whom the DEQ was designed (1), but I question it is true for chronic fatigue syndrome (CFS).
Here are the five items that load most strongly on the self-criticism subscale of the DEQ (1):
There is a considerable difference between how I am now and how I would like to be.
I often feel guilty.
The way I feel about myself frequently varies: There are times when I feel extremely good about myself and other times when I see only the bad in me and feel like a total failure.
Often, I feel I have disappointed others.
I often find that I don't live up to my own standards or ideals.
Unless somebody actually wants to have a disabling condition, which would be an abnormal response, patients with CFS would generally agree with item #1 and the more fatigue and pain they had, the stronger their agreement with it would be.
To a lesser extent, it seems feasible that quite a lot patients with CFS might agree with items 4 & 5 without it necessarily representing maladaptive perfectionism. CFS is a fluctuating and disabling condition so people may say they will do something but don't manage to do it which could disappoint others. Also, their output at home or in the workplace may be lower than previously which might disappoint employers, family members, etc. (2). The invisible nature of the condition can mean that other people can expect quite a lot from somebody. Similarly, with item five, individuals with CFS may not be able to live up to their own pre-illness standards in various ways, for reasons relating to their illness. For example, as mentioned, the symptoms of CFS could can cause financial pressures (not being able to work or work as much) which can impair one's ability to live up to one's standards or ideals in various ways. Impairments from CFS could also more directly impair one's ability to maintain one's home, involve oneself in family life, and indeed most activities one might be involved in.
It would have been more interesting if the investigators had used patients with another disabling illness such as multiple sclerosis or rheumatoid arthritis as a control group to attempt to control for such issues.
References:
Depressive Experiences Questionnaire: http://www.mentalhealthce.com/courses/contentHD/secHD15.html
Reynolds KJ, Vernon SD, Bouchery E, Reeves WC. The economic impact of chronic fatigue syndrome. Cost Eff Resour Alloc. 2004 Jun 21;2(1):4.
This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.
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