Effect of physician-recommended treatment on mental health practitioners' attributions for chronic fatigue syndrome

Objective: To evaluate whether differing treatment recommendations for chronic fatigue syndrome (CFS) by physicians influence attributions about CFS among mental health practitioners. Participants and Study Design: Ninety-three mental health practitioners (social work interns, clinical psychology trainees, licensed clinical social workers, and licensed clinical psychologists) were randomly assigned to 1 of 3 conditions. All groups read the same case study of a person diagnosed with CFS, with the only difference between groups being the type of treatment recommended by a physician. The treatment conditions included a drug trial (Ampligen) or 1 of 2 differing psychotherapy approaches, cognitive-behavior therapy with graded activity or cognitive coping skills therapy. Main Outcome Measures: Attributions regarding the illness, including impressions about its etiology, diagnostic accuracy, severity, prognosis, and the expected outcome of the proposed treatment; familiarity with CFS. Results: Participants in the 3 groups did not differ with respect to their prior familiarity with CFS. Participants who read the case study proposing treatment with Ampligen were more likely to report that the patient was correctly diagnosed and more likely to perceive the patient as disabled than those whose case study described cognitive-behavioral therapy with graded activity as the treatment. Conclusions: Results of this investigation support the hypothesis that physician recommendations for CFS treatment can influence subsequent attributions about a patient's illness among mental health practitioners.