Cognitive Behavioral Stress Management for Chronic Fatigue Syndrome

慢性疲劳综合症的认知行为压力管理

• 批准号: 7125318
• 负责人: MICHAEL Howard ANTONI
• 金额: $ 34.32万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-05 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7125318
• 关键词: chronic fatigue syndrome; clinical research; conditioning; cortisol; cytokine; experimental designs; fatigue; health; stress; stress management; telemedicine

DESCRIPTION (provided by applicant): This is a 4-year study that uses a 10-week telephone based cognitive behavioral stress management intervention (T-CBSM) to illuminate neuroimmune mechanisms underlying the effects of stress and stress management on physical health status and immune regulation in individuals with chronic fatigue syndrome (CFS) relative to participants receiving a health promotion telephone (T-HP) intervention. CFS is characterized by physical symptoms which bring about severe limitations in lifestyle behaviors and vocational activities. Associated symptoms include debilitating fatigue, low grade fever, lymph node pain and tenderness, cognitive difficulties, and mood changes. There is growing evidence that CFS patients may also show abnormalities in HPA axis functioning and on several indices of immune functioning. Chronic stress is also associated with a flattened diurnal secretion pattern for cortisol. An inability to maintain regulation in the HPA axis may contribute to the pathophysiology of CFS via diminished control of pro-inflammatory cytokines and associated physical symptoms related to chronic immune activation and inflammation. Given the debilitating nature of CFS, we propose to deliver the T-CBSM intervention through a telecommunications system (i.e. Telecare) designed to enhance access to formal and informal care for a population that may have difficulty accessing traditional psychotherapeutic settings. In our prior work with individuals with CFS, we have shown that individuals in a structured group CBSM intervention report significantly improved quality of life, perceived stress, fatigue, memory, muscle pain, and post-exertional malaise compared to individuals in the control condition. The Telecare system has been successful in delivering a supportive intervention for older caregivers of dementia patients. This study is novel in expanding our prior work to individuals with CFS who have reported difficulty participating in structured groups due to physical burden. The study design is a 2 X 3 randomized experimental design with group (T-CBSM, n=60 vs. T-HP, n=60) as the between-group factor, and time (Pre-intervention, Post-intervention and 6 month follow-up) as the within-group factor. Our primary objective is to evaluate the extent to which a T-CBSM intervention Aimed at building skills in anxiety reduction, distress tolerance, stressor appraisals, and adaptive coping strategies may improve physical health status and immune regulation in CFS by modulating neuroimmune interactions.

描述（由申请人提供）：这是一项为期4年的研究，使用为期10周的基于电话的认知行为压力管理干预（T-CBSM），以阐明慢性疲劳综合征（CFS）个体相对于接受健康促进电话（T-HP）干预的参与者的压力和压力管理对身体健康状况和免疫调节影响的神经免疫机制。CFS的特征是身体症状，这些症状导致生活方式行为和职业活动的严重限制。相关的症状包括衰弱性疲劳、低热、淋巴结疼痛和压痛、认知困难和情绪变化。越来越多的证据表明，CFS患者也可能表现出HPA轴功能和免疫功能的几个指标异常。慢性压力也与皮质醇的扁平日分泌模式有关。不能维持HPA轴的调节可能通过减少对促炎细胞因子的控制以及与慢性免疫激活和炎症相关的相关身体症状而导致CFS的病理生理学。鉴于CFS的衰弱性质，我们建议通过电信系统（即电信系统）提供T-CBSM干预措施，旨在为可能难以进入传统心理治疗环境的人群提供正式和非正式护理。在我们之前对CFS患者的研究中，我们已经表明，与对照组相比，结构化组CBSM干预报告中的个体显着改善了生活质量，感知压力，疲劳，记忆力，肌肉疼痛和运动后不适。老年护理系统成功地为老年痴呆症患者的老年护理者提供了支持性干预。这项研究是新颖的扩展我们以前的工作与CFS的个人谁报告难以参与结构化的群体，由于身体负担。研究设计为2 × 3随机实验设计，组（T-CBSM，n=60 vs. T-HP，n=60）为组间因素，时间（干预前、干预后和6个月随访）为组内因素。我们的主要目的是评估T-CBSM干预旨在建立减少焦虑，痛苦耐受，压力源评估和适应性应对策略的技能，通过调节神经免疫相互作用，可以改善CFS的身体健康状况和免疫调节。