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looking words are used to describe this variability: anisotropy and heterogeneity. If the hydraulic conductivity of an aquifer is anisotropic, then you would obtain a different value if you measured it in one direction than you would if you measured it in another. In most sedimentary and volcanic aquifers, by far the most important manifestation of anisotropy in K values relates to the stark contrast between horizontal hydraulic conductivity (Kh; i.e. K measured parallel to bedding), and

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disorder occurring since their CFS diagnosis, 667% of those without psychiatric comorbidity had MRI abnormalities versus only 222% with psychiatric comorbidity The CFS without psychiatric diagnosis group had the highest frequency of lesions, and these lesions were most often found in the frontal lobes Several investigators have also argued for the presence of important subgroups of patients including the presence versus absence of a premorbid psychiatric condition and gradual versus sudden onset of the illness (DeLuca et al, 1997) Johnson, DeLuca, and Natelson (1999) also suggest that there might be two groups of CFS patients, one with sudden onset, nonpsychiatric, and serious cognitive impairments, and the other with slow onset, psychiatric comorbidity, and mild cognitive impairment However, in a community-based sample, higher frequency of symptoms was not associated with a greater number of psychiatric diagnoses (Jason, Taylor, Kennedy, Jordan, et al.

, 2001), but sudden onset of illness was associated with psychiatric comorbidity (Jason, Taylor, Kennedy, Song, et al, 2000) In addition, when patients with and without a premorbid psychiatric diagnosis were compared, there were no signi cant differences on sociodemographic variables, measures of fatigue and symptom severity, disability, stress, and coping (Jason, Taylor, Kennedy, Song, et al, 2001) Possible differences between these ndings and those of DeLuca and associates (1997) may be attributed to different ways in which the participants were recruited In the Jason, Taylor, Kennedy, Jordan, et al (2001); Jason, Taylor, Kennedy, Song, et al (2000); and Jason, Taylor, Kennedy, Song, et al (2001) studies, participants with CFS were recruited using randomized, community-based telephone sampling In the DeLuca et al (1997) study, participants with CFS were self-referred based on media reports about a CFS treatment center and also recruited by physician referral.

Patients diagnosed with CFS and bromyalgia have been found to be substantially more disabled than patients with either condition alone (Bombardier & Buchwald, 1996) Jason, Taylor, Kennedy, Song, et al (2001) also found that those with CFS and comorbid FM compared to those with only CFS had increased symptoms and functional impairment Jason, Taylor, and Kennedy (2000) found in a community sample of individuals with CFS that 156% also had FM, 406% had multiple chemical sensitivities (MCS), and 315% had FM and MCS, whereas only 406% had pure CFS Future studies should subclassify patients according to whether they are pure types or have FM and or MCS It is possible that CFS is experienced differently by individuals depending on the particular illness phase Fennell (1995) has proposed a four-phase model for understanding.

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