TY - JOUR
T1 - Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome
AU - Lattie, Emily G.
AU - Antoni, Michael H.
AU - Fletcher, Mary Ann
AU - Penedo, Frank
AU - Czaja, Sara
AU - Lopez, Corina
AU - Perdomo, Dolores
AU - Sala, Andreina
AU - Nair, Sankaran
AU - Fu, Shih Hua
AU - Klimas, Nancy
N1 - Funding Information:
This work was supported by a Grant from the National Institutes of Health to MHA ( 1R01 NS055672 ).
PY - 2012/8
Y1 - 2012/8
N2 - 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-1β, IL-2, IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α), 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.
AB - 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-1β, IL-2, IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α), 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.
KW - Chronic fatigue syndrome
KW - Immune dysfunction
KW - Stress management
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U2 - 10.1016/j.bbi.2012.02.008
DO - 10.1016/j.bbi.2012.02.008
M3 - Review article
C2 - 22417946
AN - SCOPUS:84863874496
VL - 26
SP - 849
EP - 858
JO - Brain, Behavior, and Immunity
JF - Brain, Behavior, and Immunity
SN - 0889-1591
IS - 6
ER -