Goals and Antigoals: Self-Regulation in Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS) is a debilitating illness with no cure, requiring patients to rely upon self-regulatory skills to manage their symptoms alongside their personal goals. This study investigated the role of self-regulation in symptom exacerbation, life activities and affective experience. Questionnaires were developed to assess self-regulatory behaviours relating to goals and antigoals guided by Carver and Scheier’s (1998) Control Systems Model (CSM). Consistent with Carver and Scheier, relatively independent factors representing each CSM component were identified; additionally, some components comprised multiple factors. Study 1 investigated CFS (n = 58) and healthy control (n = 111) group differences at each CSM component for goals and antigoals. The pattern of group differences differed between goal- and antigoal-related components, supporting the conceptualisation and measurement of goal and antigoal-related systems as separate constructs. Controlling for age and gender by individual matching, the CFS group (n = 44) reported undertaking more planning, encountering more problems, less control and more negative affect than the control participants (n = 44) in relation to goals; and more planning, more problems, less control, and higher negative affect ratings than the control group in relation to antigoals. Additionally, the matched CFS participants reported less goal confidence and a greater willingness to consider limited disengagement from their antigoal. Study 2 investigated whether trait optimism, pessimism or social support may account for the CSM differences identified in study 1. Lower optimism in the CFS group moderated the between-group differences in goal planning and control, but not goal-related negative affect or confidence; nor antigoal planning or flexibility. No differences in social support or pessimism were identified. Study 3 investigated the association between CSM components and the ability to maintain an active lifestyle. The CFS group worked fewer hours per week than the controls; however, this difference was unrelated to CSM components. Study 4 investigated the potential role of learned helplessness (LH) in limiting goal progress; homeostatic maintenance (HM) in limiting antigoal prevention; and the occurrence of goal-antigoal links (GAL) amongst the CFS participants. Consistent with the CSM, goal progress predicted positive affect, and impending antigoals predicted negative affect in both groups. Inconsistent with both CSM and the controls’ results, among CFS patients, poor goal progress also predicted negative affect. Dysregulation consistent with LH and HM in relation to goals and antigoals, respectively, were found within the CFS group but not the control group. There was no evidence of GAL within the CFS or control groups. Study 5 investigated differences in goal/antigoal-related affect in relation to LH and HM in CFS. Affect did not predict the cognitive aspects of the CSM relating to LH theory. Among CFS participants, depressive and anxious symptoms co-varied. Consistent with HM theory, greater psychological distress relating to antigoals was associated with more frequent contemplation and monitoring of the antigoal. Study 6 investigated predictors of goal- and antigoal-related distress, to test whether these were consistent with signs of LH and HM. In the CFS group, greater distress was associated with maladaptive illness perceptions of CFS as cyclical in nature consistent with HM processes, but there was no association between negative affect ratings and illness perceptions in relation to goals and LH. Optimism did not predict goal or antigoal-related distress. This thesis demonstrates the importance of controlling for age and gender to reduce spurious findings. It supports future experimentation with anxiety treatment for CFS patients focussing on homeostatic maintenance in relation to antigoals within the context of maladaptive illness cognitions associated with perception of CFS as cyclical in nature. Practical and theoretical implications of this research are discussed.