The Content of Gilbert’s Regulation Theory focused on the Threat System in Chronic Fatigue Syndrome in the Netherlands: A factor analysis

Abstract

Chronic fatigue syndrome (CFS) is characterized by the persistent presence of fatigue and other symptoms. Gilbert's theory contains three interactive components called Soothers, Threats, and Drives. The threat system is responsible for recognizing dangers and preparing the body for the respective threats. Since threats can worsen illnesses, this study focuses on possible threats that occur in CFS. The aim is to determine threat factors based on 40 in previous studies examined threat items and to analyze whether the factors vary with education levels and symptom severity. A questionnaire with 40 threat items and a symptom severity questionnaire was published. A total of 612 CFS (11%), Fibromyalgia (FM) participants (72%), CFS and FM participants (17%) completed this questionnaire (aged 18 to 81 or older). To provide a meaningful factor analysis, Fibromyalgia participants were added to the sample. 95% of the participants identified as female and 93%, were Dutch origin participants. The factor analysis revealed a three-factor solution with factor 1 'negative emotions and cognitions', factor 2 'weather changes', and factor 3 'physical demands'. The level of education was not associated with different perceptions of the threats, but high symptom severity is associated with the increased perception of the threat factors. The results represent the different perceptions of individual threat factors in CFS/FM and the successful filtering and clustering of all threat items which may exacerbate the symptoms of CFS/FM. In future, the threat factors can be targeted and limited with interventions, possibly with the Soother component of Gilbert's theory.