Is increased activity or cognitive change responsible for improvement in Chronic Fatigue Syndrome?

The reliance on self-report measures makes it difficult to determine if behavior change or cognitive change is responsibile for the effectiveness of CBT with CFS. In a recent case study, an objective measure of physical activity (a step counter) was used in addition to self-report measures. Surprisingly, graded activity assignments actually resulted in overall physical activity actually decreasing 10.6% while the patient reported substantial improvement. The author suggests that improvement was associated with mood-enhancing, stress-reducing activities that were substituted for stress-exacerbating activities.

Friedberg, F. (2002). Does graded activity increase activity? A case study of chronic fatigue syndrome. Journal of Behavior Therapy & Experimental Psychiatry, 33, 203-215.

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