(MRC DTP) Acute stress reactivity and partner support in Chronic Fatigue Syndrome: Does the quality of support moderate biological and psychosocial reactivity to an acute laboratory stressor?

Chronic Fatigue Syndrome (CFS) is a distressing and debilitating illness affecting 0.2-0.4% of the UK population. It is associated with increased use of health care, work hours lost, and need for informal care from spouses or parents (Collin et al., 2011). Multiple biological and psychosocial factors are thought to influence the onset, course and severity of CFS. Patients with CFS frequently report that acute stressors play a role in triggering, or worsening, their symptomatology. While there is evidence for stress system (HPA axis) dysregulation, less is known about how this relates to fatigue symptoms on an individual basis (Powell et al. 2015). To date, little research has examined whether subjective and objective (biological) responses to acute stressors are altered in CFS, and how these responses relate to each other.

Partner support has been shown to reduce both biological and subjective acute stress reactivity in healthy populations (Ditzen et al., 2007), and it is possible that partner support may reduce acute stress reactivity for CFS patients. Furthermore, characteristics of the relationship, such as partner Expressed Emotion, attachment style and quality of support, may moderate the effectiveness of the support provided (Meuwly et al., 2012).

The aim of this PhD would be to 1) assess acute stress reactivity in a laboratory setting in patients with CFS, 2) assess whether partner support during preparation for a stressful task alters subjective and biological reactivity, and 3) assess whether EE, attachment style, and quality of support moderate this effect. Our proposed protocol has been extensively and successfully tested in a pilot study involving college students. We believe that the results of this study will provide valuable insight into the relationship between CFS symptoms and altered psychosocial and biological responses to acute stress. This in turn, may inform future interventions for patients with CFS and their families.

The programme of research would equip the student with skills in: systematic reviewing; administering the Trier Social Stress Test (TSST: Kirschbaum et al, 1993), including cortisol assays; interviewing and coding relationship variables (EE, attachment); advanced data analysis using multi-level modelling.

http://www.manchester.ac.uk/research/alison.wearden