An Empirical Verification of the Fennell Phases of CFS
ABSTRACT. The Fennell Phase Inventory is an instrument designed to measure the phases typically experienced by individuals with chronic fatigue syndrome. In a previous study, a three factor solution emerged. A cluster analysis was then conducted using the three mean scores for each individual, and four clusters emerged. These clusters matched the four phases predicted by Fennell. The Fennell Phase inventory appears to he a promising way of differentiating the phases that are experienced by individuals with CFS.
KEYWORD. Fennell Phase Inventory It is possible that chronic fatigue syndrome (CFS) is experienced differently by individuals depending upon the patient's particular illness phase. Fennell has proposed a fourphase model for understanding the phases individuals undergo when coping with CFS. According to Fennell, in Phase 1 of the CFS illness, the individual moves into a crisis mode after illness onset, wherein she or he experiences the traumatic aspects of a new illness. In Phase 2, the person with CFS continues to experience chaos and dissembling, followed by the eventual stabilization of the individual's symptoms. In Phase 3, the person with CFS moves into the resolution mode, as he or she works to accept the chronicity and ambiguity of this chronic illness and create meaning out of the illness experience. Finally, in Phase 4, the person with CFS achieves integration, wherein he or she is able to integrate the pre and postillness selfconcepts. Phase models might help researchers better deal with the mass of conflicting research studies in the field of chronic fatigue syndrome. If patients experience these phases in qualitatively different ways, their responses on standardized questionnaires could be dramatically different, depending upon the phase of their illness. If a researcher collapses the responses of patients in different phases, the findings might be obscured as the patients are experiencing fundamentally different processes. In a recent study, factor scores derived from a scale designed to assess these phases provided support for the Fennell model. Four hundred participants were recruited and a threefactor solution emerged yielding a Crisis score, a Stabilization score, and an Integration score for each individual. Scores on the Crisis Factor were significantly related to levels of fatigue and disability. The present study is an empirical investigation of this model using cluster analysis of the scores derived from the factor analysis in the previous study.
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Leonard A. Jason, Renee R. Taylor, Guy Fricano, and Jane A. Flalpert are affiliated with DePaul University.
Patricia A. Fennell is affiliated with Albany Health Management Associates, Inc.
Address correspondence to: Leonard A. Jason, PhD, Department of Psychology, DePaul University, 2219 N. Kenmore Avenue, Chicago, IL 60614. The authors appreciate the financial support provided by NIAID grant #A136295.
Journal of Chronic Fatigue Syndrome,