Zelfopoffering, onderwerping en pleasing bij vrouwen met CVS in vergelijking met vrouwen met reumatoïde artritis: een observationele studie

Abstract

Self-sacrifice, subjugation and approval-seeking in women with CFS in comparison to women with rheumatoid arthritis: an observational study CFS is a disorder with a multifactorial pathogenesis in which symptoms arise when precipitating factors combine with predisposing factors. An increasing body of research points to a dysfunction of the stress axis and finds evidence for a high prevalence of early childhood trauma, one of the most important vulnerability factors. Several pathways are conceivable through which early trauma may contribute to the vulnerability to or maintenance of the stress response and the symptoms. In this study, the authors used self-report questionnaires to identify maladaptive patterns that often stand out in clinical practice and may play both a predisposing and a maintaining role. These interpersonal patterns have often been adaptive in an early childhood context, but become harmful when they generalize and remain active in adult life. The authors investigated a group of 49 female CFS patients using 3 subscales of the Young Schema Questionnaire measuring the interpersonal styles of self-sacrifice, approval-seeking and subjugation. They included 45 women with a diagnosis of rheumatoid arthritis as a control group. The authors found significantly higher scores in the CFS group for the 3 variables, with a large effect size for each. The present findings have implications for the further research and treatment. These interpersonal patterns are usually very rigid and serve to protect self-esteem and sense of security. The standard treatment of graded exercise and a limited number of sessions of psychoeducation and cognitive behavioral therapy is often insufficient to allow recovery and prevent relapse. Further research is required to substantiate which is the most optimal treatment strategy to mitigate these patterns.