The development of the Chronic Fatigue Syndrome Attitudes Test. A psychometric analysis.
Shlaes, J L, Jason, L A, Ferrari, J R · Evaluation & the health professions · 1999 · DOI
Quick Summary
This study created a new tool called the Chronic Fatigue Syndrome Attitudes Test (CAT) to measure how people feel about ME/CFS and those who have it. Researchers designed a 13-question survey based on common negative attitudes people hold toward the illness. The tool was tested to make sure it works reliably and accurately captures these attitudes.
Why It Matters
ME/CFS patients face significant stigma from healthcare providers, employers, and society, which compounds their suffering and can delay diagnosis and treatment. By creating a validated tool to measure attitudes toward CFS, researchers can now identify which groups hold negative beliefs, track whether attitudes improve over time, and test interventions designed to reduce stigma and improve patient care.
Observed Findings
A 13-item scale was successfully developed to measure attitudes toward CFS
The CAT was constructed using theoretical constructs from stigma literature related to CFS, disabilities, and AIDS
Psychometric analysis demonstrated the scale has acceptable reliability and validity
The instrument can differentiate between individuals with different attitudes toward CFS
Inferred Conclusions
A valid, reliable tool now exists to measure attitudes toward CFS that was previously unavailable
Attitudes toward CFS should be understood through multiple theoretical frameworks including disability stigma and illness-related stigma
This measurement tool enables future research on stigma reduction and attitude change in medical professionals and the public
The CAT provides a foundation for investigating how negative attitudes impact CFS patients' healthcare experiences and outcomes
Remaining Questions
Does the CAT predict actual discriminatory behavior toward patients with ME/CFS in clinical or workplace settings?
Which demographic groups (healthcare providers, employers, general public) hold the most negative attitudes toward CFS, and do these differ significantly?
What This Study Does Not Prove
This study does not prove that negative attitudes actually cause harm to patients or determine which specific interventions successfully change attitudes. It only describes the creation and testing of a measurement tool—it does not measure outcomes in real-world settings or demonstrate the relationship between measured attitudes and patient health outcomes.
Are there effective interventions that reduce negative attitudes measured by the CAT, and do attitude improvements translate to better patient outcomes?
How stable are attitudes over time, and what factors might influence whether attitudes toward CFS become more or less negative?