Stefan Kempke's research while affiliated with KU Leuven and other places

Publications (30)

Article
Objective: Hypothalamic-pituitary-adrenal (HPA) axis dysfunction may play a role in fibromyalgia (FM) pathogenesis, but remains understudied in this disorder. Furthermore, early childhood adversities (ECA) are common in FM, but whether they moderate stress reactivity is unknown. Hence, we investigated cortisol and subjective responses to acute psy...
Article
Objective Although the precise mechanisms are not yet understood, previous studies have suggested that chronic fatigue syndrome (CFS) is associated with hypothalamic-pituitary-adrenal (HPA) axis dysregulation and trauma in early childhood. Consistent with findings suggesting that early life stress-induced DNA methylation changes may underlie dysreg...
Article
The 22q11.2 deletion syndrome (22q11.2DS) is a microdeletion syndrome with high phenotypic variability, including somatic disorders like congenital heart disease and psychiatric disorders such as schizophrenia, anxiety disorders, and mood disorders. Clinical observations suggest that many patients with 22q11.2DS suffer from severe fatigue. However,...
Article
Patients with somatoform disorder (SFD) are characterized by the presence of chronic physical complaints that are not fully explained by a general medical condition or another mental disorder. Insecure attachment patterns are common in this patient group, which are often associated with interpersonal difficulties. In the present study, the mediatio...
Chapter
Chronic fatigue syndrome (CFS) is a highly invalidating condition characterized by severe and prolonged fatigue. Clinicians and researchers have long theorized a connection between perfectionism and chronic fatigue. This chapter provides an overview of research examining the role of perfectionism in CFS. Along with a brief description of the concep...
Article
Objective: Previous studies have suggested that self-critical perfectionism (SCP) may play a role in the development and maintenance of Chronic Fatigue Syndrome (CFS). In this study we investigated whether SCP is related to a hypofunction of the hypothalamic-pituitary-adrenal (HPA) axis, which has been shown to be a key factor in the pathophysiolo...
Article
There is a paucity of studies that have investigated the assumption that early childhood trauma is associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction in Chronic Fatigue Syndrome (CFS). The current study is the first to simultaneously investigate relationships among early childhood trauma, cortisol activity, and cortisol stress re...
Article
The theoretical relevance and clinical usefulness of a neurobiologically based .,stress adaptation model" for medically .,unexplained" chronic fatigue and pain are discussed, based upon recent literature on this subject. It becomes increasingly clear that this model may facilitate adequate diagnostic delineation, defy dualistic etio-pathogenetic th...
Article
Background: A symptom cluster consisting of ‘medically-unexplained’ chronic fatigue, effort intolerance and widespread pain is a complex and still poorly understood condition. Purpose: To demonstrate the theoretical and clinical value of a biopsychosocially-oriented ‘stress-adaptation’ model for this multi-symptom illness. Methods: Clinical observa...
Article
This paper describes the rationale and treatment principles of a mother-infant unit for severely depressed mothers and their infants in Flanders (Belgium). The unit integrates systemic, psychodynamic, and cognitive behavioral treatment approaches, and aims at improvements on three levels: (1) improving mood and interpersonal relationships in depres...
Article
Background: Self-critical perfectionistic personality features have been shown to influence the onset and perpetuation of pain symptoms. However, no study to date has investigated whether these personality features are associated with treatment response in chronic pain. Methods: Using a naturalistic pre-post design, the present study examined th...
Article
Although some studies have found high rates of early childhood trauma in Chronic Fatigue Syndrome (CFS), the role of early trauma in this condition remains controversial. This study examined the prevalence of early childhood trauma and its impact on daily fatigue and pain levels over a 14-day period in a sample of 90 carefully screened CFS patients...
Article
Full-text available
Background It is not yet clear whether chronic fatigue syndrome (CFS) is associated with elevated levels of personality disorders. Purpose This study aims to determine the prevalence of DSM-IV axis II personality disorders among patients with CFS. Methods We examined the prevalence of personality disorders in a sample of 92 female CFS patients and...
Article
Background: Research suggests that the personality factor of self-critical or maladaptive perfectionism may be implicated in chronic fatigue syndrome (CFS). However, it is not clear whether self-critical perfectionism (SCP) also predicts daily symptoms in CFS. Method In the present study we investigated whether SCP predicted fatigue and pain over...
Article
Full-text available
There is a need for effective brief interventions in chronic pain patients, and the identification of mechanisms of change. In the present study, we tested the effectiveness of MPEP (Multidisciplinary Pain Education Program), a very brief, four-session cognitive-behaviorally based psycho-educational intervention for chronic pain using a pre-and pos...
Article
Patients with chronic fatigue syndrome (CFS) often experience depression which may negatively affect prognosis and treatment outcome. Research has shown that depression in CFS is associated with maladaptive or self-critical perfectionism. However, currently, little is known about factors that may explain this relationship, but studies in nonclinica...
Article
Chronic Fatigue Syndrome (CFS) is a highly disabling disorder that is part of a broader spectrum of chronic pain and fatigue disorders. Although the etiology and pathogenesis of CFS largely remain unclear, there is increasing evidence that CFS shares important pathophysiological disturbances with mood disorders in terms of disturbances in the stres...
Article
In the current study, we investigated whether the distinction between adaptive (i.e. high personal standards) and maladaptive (i.e. concern over mistakes and doubt about actions) perfectionism that has been found in the literature, is also valid in patients with chronic fatigue syndrome (CFS). We hypothesized that maladaptive, but not adaptive, per...
Article
Full-text available
Inflated responsibility is increasingly regarded a pathogenetic mechanism in obsessive-compulsive disorder (OCD). In seeming contrast, there is mounting evidence that latent aggression is also elevated in OCD. Building upon psychodynamic theories that an altruistic façade including exaggerated concerns for others is partly a defense against latent...
Article
Chronic fatigue syndrome and/or fibromyalgia (CFS/FM) consists of highly overlapping, medically unexplained symptoms, including long-lasting fatigue, effort intolerance, cognitive dysfunction, and widespread pain and tenderness. CFS/FM often seems to be triggered by infections and physical trauma, but depression, sleep disturbances, and personality...
Article
Little is known about factors predicting treatment outcome in chronic fatigue syndrome (CFS). Based on Vercoulen et al.'s (1998) cognitive-behavioral model of perpetuating factors in CFS, the predictive value of the following patient characteristics were examined in a sample of 178 CFS patients who followed a multi-component treatment program: (1)...
Article
This prospective longitudinal study investigated the role of the personality dimensions of dependency and self-criticism in the course of depressive symptoms in a sample of inpatient severely postpartum depressed mothers (n = 55). Depressive symptoms and personality were measured during hospitalization and on average 3 1/2 years later. In line with...
Article
Aim of the present study was to compare chronic fatigue syndrome (CFS) patients, attending 2 "ideologically" contrasting clinics for CFS, on various patient and illness characteristics. Fifty-nine CFS patients of each clinic, located in Leuven and Brussels (Belgium), participated. Patients did not differ with regard to age, levels of fatigue, psych...
Article
Research into the role of stress in psychiatric disorders faces major challenges. However, over the last few decades there has been considerable progress in this area as a result of methodological, technological and conceptual developments. The advent of recursive and non-linear models and research into the neurobiology of stress have made importan...
Article
Full-text available
Chronic fatigue syndrome (CFS) is a debilitating condition characterized by serious medically unexplained mental and physical fatigue. The high prevalence and both direct and indirect health costs of CFS patients represent a huge problem for contemporary health care. Moreover, the prognosis of CFS, even when treated, is often poor. In this paper, w...
Article
This paper provides an overview of the growing convergence among psychodynamic and cognitive-behavioral approaches of Obsessive-Compulsive Disorder (OCD). From a traditional psychoanalytic point of view, OCD is mainly conceptualized in terms of a constant conflict between feelings of love and hate. More recent psychodynamic theories of OCD, such as...

Citations

... Hormones regulating dysfunctional responses of the HPA-axis to chronic stress have been implied in the etiology of most disorders that can be subsumed under the construct of MSD [53][54][55][56]. In addition, the role of leptin and its influence on the HPA-axis and its role with painful disorders have been investigated. ...
... Child maltreatment included sexual abuse, physical abuse, neglect, exposure to intimate partner violence during pregnancy, and emotional abuse. Notably, most studies were performed on a clinical population (n = 7), including patients with borderline personality disorder (Martín-Blanco et al., 2014;Perroud et al., 2011), major depressive disorder (Bustamante et al., 2016;Farrell et al., 2018;Perroud et al., 2011), bulimia nervosa (Steiger et al., 2013), or chronic fatigue syndrome (Vangeel et al., 2015;Vangeel et al., 2018), while other researchers (n = 4) investigated a non-clinical population (Cicchetti & Handley, 2017;McGowan et al., 2009;Radtke et al., 2011;Romens et al., 2015). Most studies used a cross-sectional research design based on retrospective measures with an exposed and a control group (Bustamante et al., 2016;Cicchetti & Handley, 2017;Farrell et al., 2018;McGowan et al., 2009;Perroud et al., 2011;Romens et al., 2015;Steiger et al., 2013;Vangeel et al., 2015;Vangeel et al., 2018). ...
... That same year, Vergaelen et al. [12] published a study that showed an inversely proportional relationship between the level of fatigue in adults with DS 22q11.2 and their quality of life, especially in the psychological aspects and in their environment. In addition, the authors observed that patients' level of activity decreased and, as a result, so did the quality of their social relationships. ...
... Furthermore, if alexithymia mediates the relationship between maladaptive emotion regulation and depressive symptoms is currently unknown. Alexithymia has been previously shown to be a significant mediating factor between many psychological phenomena in adult populations, such as childhood trauma and non-suicidal self-injury (Paivio & McCulloch, 2004), experiences of sexual abuse and psychological distress (Hébert, Boisjoli, Blais & Oussaïd, 2018) and avoidant attachment and interpersonal problems (Koelen, Eurelings-Bontekoe & Kempke, 2016). However, as previously stated, the mediating role of early-life alexithymia between adverse psychological phenomena in children remains little understood. ...
... The PCWBS is also piloting a 6-week self-compassion course due to evidence of perfectionism/high achievers being more vulnerable to developing CFS/ME. 59 Consistent with this, individuals participating in the "Recovering from COVID" course showed signs of high expectations and high levels of selfcriticism. Anecdotally, this appeared to have a direct link to individuals finding it hard to pace activity management despite having the practical knowledge and information. ...
... For this reason, acceptance and commitment therapy has been used [33,35] to reduce perfectionism and the associated symptoms. Previous studies have shown that there is an association between perfectionism and stress, poor mental health, reductions in functioning, and the frequency/intensity of pain and fatigue [36][37][38]. Particularly, perfectionism is associated with reductions in health functioning in women with fibromyalgia [37], mediated by behavioral disengagement processes, denial, and self-blame [29,30]. ...
... The name given to a disease may be experienced as stigmatizing by the patients suffering from it. It is conviction of the authors that this is the case of the disease called by the purely descriptive name "Chronic Fatigue Syndrome" (CFS), particularly since this disease is commonly contributed to poor "stress-adaptation" [1] which is alleged to cause and "somatoform disturbances" [2] of psycho-psychological nature [3]. In Belgium, a multidisciplinary "care-net" was created to assists patients [4] based on the psycho-social treatment principle, in spite of the fact that an audit by the Belgian Federal Agency for Healthcare [5] had concluded that the effectiveness of this therapy is minimal, and not worth the cost [6,7]. ...
... Findings suggest that CPP, fibromyalgia, chronic fatigue syndrome, and asthma are adrenocortical hyporesponsiveness. Several investigated case-control studies have demonstrated that patients with fibromyalgia more often report traumatic childhood experiences such as negligence, maltreatment, or abuse as compared to medically ill or healthy controls (Van Houdenhove et al., 2013). CFS/FM patients (Low & Schweinhardt, 2012) report a history of accumulating psychosocial stress from early childhood. ...
... Still, the question remains as to how socio-emotional vulnerability influences mental health in youth. As such, the biological stress system has received abundant scientific attention (Faravelli et al., 2012;Heim, Newport, Mletzko, Miller, & Nemeroff, 2008;Kempke et al., 2015;McGowan, 2013;Pariante & Lightman, 2008;Raymond, Marin, Juster, & Lupien, 2019). Indeed, one hypothesis is that when faced with adverse life events, children and adolescents presenting increased socio-emotional vulnerability might react by secreting increased cortisol levels (i.e. an important stress hormone in humans) which might contribute to psychiatric symptoms through dysregulation of various cognitive processes (for reviews, see Raymond, Marin, Majeur, & Lupien, 2018;Soliemanifar, Soleymanifar, & Afrisham, 2018). ...
... While descriptive content is tailored to UCPPS, the protocol synthesizes [69] evidence-based CBT strategies into 4 modules targeting core transdiagnostic vulnerability factors [70][71][72][73] reflecting a rigid cognitive style expressed as discrete perceptual biases [74]. These include (a) a tendency toward self-immersive, abstract, and repetitive negative thought (RNT) [70] manifested in (b) the inclination to overestimate the probability of negative events (threat expectancy bias) [75][76][77][78]; (c) the tendency to inflate their costs or consequences when they occur (threat interpretative bias) [79][80][81]; (d) extreme negative self-schemas [82] (i.e., dysfunctional misconceptions or core beliefs like perfectionism [83][84][85]); and (e) a rigid, non-discriminative coping style characterized by an overreliance on control-oriented, problem-focused strategies deployed regardless of situational demands (e.g., controllability) [86][87][88][89][90]. Technical components include "real time" self-monitoring to generate a functional analysis of symptoms, their triggers, and responses across multiple domains (cognitive, emotional, somatic, behavioral), diaphragmatic breathing to reduce arousal and enhance personal control, worry control (e.g., evidence-based logic, decatastrophizing) to correct maladaptive information processing style, flexible problem solving, and relapse prevention skills to maintain gains after treatment discontinuation. MC-CBT content is introduced sequentially and reinforced through the provision of a workbook [91] with home exercises designed to facilitate skills acquisition. ...