The Development of the DePaul Symptom Questionnaire: Original, Expanded, Brief, and Pediatric Versions

One of the key requirements of a reliable case definition is the use of standardized procedures for assessing symptoms. This article chronicles the development of the DePaul Symptom Questionnaire (DSQ) to assess symptoms of the major chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME) case definitions. The original questionnaire has been modified and expanded over time to more fully capture symptoms from various adult case definitions, and a brief as well as pediatric version have also been developed. The DSQ has demonstrated very good psychometric properties in terms of test-retest reliability and sensitivity/specificity, as well as construct, predictive, and discriminant validity. The DSQ allows for a clear characterization of a patient's illness and allows scientists and clinicians to improve diagnostic reliability and validity when employing case definitions of ME and CFS.

Validating a measure of myalgic encephalomyelitis/chronic fatigue syndrome symptomatology

OBJECTIVES

The present study sought to validate a comprehensive self-report measure of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) symptomatology to aid in clinical and research assessment.

METHOD

Exploratory factor analysis (EFA) was used to establish the underlying factor structure of the DePaul Symptom Questionnaire (DSQ) (Jason, Evans, et al., 2010) using a well-characterized sample of individuals (92.6% met the Fukuda et al. criteria (1994) and/or the Clinical Canadian Criteria (Carruthers et al., 2003)), and this structure was then tested on a less stringently recruited sample of individuals utilizing a confirmatory factor analysis (CFA). Convergent and discriminant validity of the DSQ were also examined utilizing alternative measures of symptomatology and functioning.

RESULTS

A 3-factor solution was found using EFA (Neuroendocrine, Autonomic & Immune Dysfunction; Neurological/Cognitive Dysfunction; Post-Exertional Malaise) and the fit of this factor structure was adequate for the second sample.

DISCUSSION

The DSQ is a valid measure of ME/CFS symptomatology. The emergent factors were consistent with previous literature on symptom clusters, and convergent and discriminant validity were established.

Small wins matter in advocacy movements: giving voice to patients

In this article, the various players are delineated in a story of a contested illness and patient advocacy, played out within the corridors of federal power. It is suggested that the mistreatment and negative attitudes that health care providers and others have towards those with chronic fatigue syndrome (CFS) is possibly due to the social construction of this illness as being a "Yuppie flu" disease. Institutional factors are identified that created these norms and attributions, as well as the multiple stakeholders and constituent groups invested in exerting pressure on policy makers to effect systemic change. This article also provides examples of how the field of Community Psychology, which is fundamentally committed to/based on listening to and giving voice to patients, is broadly relevant to patient activism communities. This approach focused, over time, on epidemiological studies, the name, the case definition, and ultimately the change in CFS leadership at the Centers for Disease Control and Prevention. Keys to this "small wins" approach were coalition building, use of "oppositional experts" (professionals in the scientific community who support patient advocacy goals) to challenge federal research, and taking advantage of developing events/shifts in power. Ultimately, this approach can result in significant scientific and policy gains, and changes in medical and public perception of an illness.