Operationalizing Substantial Reduction in Functioning Among Young Adults with Chronic Fatigue Syndrome

Kristen D. Gleason, Jamie Stoothoff, Damani McClellan, Stephanie McManimen, Taylor Thorpe, Ben Z. Katz, Leonard A. Jason*

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Purpose: Chronic fatigue syndrome and myalgic encephalomyelitis are fatiguing illnesses that often result in long-term impairment in daily functioning. In reviewing case definitions, Thrope et al. (Fatigue 4(3):175–188, 2016) noted that the vast majority of case definitions used to describe these illnesses list a “substantial reduction” in activities as a required feature for diagnosis. However, there is no consensus on how to best operationalize the criterion of substantial reduction. Method: The present study used a series of receiver operating curve (ROC) analyses to explore the use of the Medical Outcomes Study Short-Form-36 Health Survey (SF-36), designed by Ware and Shelbourne for operationalizing the substantial reduction criterion in a young adult population (18–29 years old). We compared the sensitivity and specificity of various cutoff scores for the SF-36 subscales and assessed their usefulness in discriminating between a group of young adults with a known diagnosis of chronic fatigue syndrome or myalgic encephalomyelitis (n = 98) versus those without that diagnosis (n = 272). Results: The four top performing subscales and their associated cutoffs were determined: Physical Functioning ≤ 80, General Health ≤ 47, Role Physical ≤ 25, and Social Functioning ≤ 50. Used in combination, these four cutoff scores were shown to reliably discriminate between the patients and controls in our sample of young adults. Conclusion: The implications of these findings for employing the substantial reduction criterion in both clinical and research settings are discussed.

Original languageEnglish (US)
Pages (from-to)448-455
Number of pages8
JournalInternational Journal of Behavioral Medicine
Volume25
Issue number4
DOIs
StatePublished - Aug 1 2018

Keywords

  • CFS case definitions
  • Chronic fatigue syndrome
  • Myalgic encephalomyelitis
  • Substantial reduction
  • Young adults

ASJC Scopus subject areas

  • Applied Psychology

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