Ali, Sheila, Matcham, Faith, Irving, Katherine et al. · Journal of psychosomatic research · 2017 · DOI
This study compared how people with ME/CFS and people with autoimmune rheumatic diseases (like rheumatoid arthritis) experience fatigue and cope with their symptoms. The researchers found that people with ME/CFS were more fatigued, had worse sleep, and were more likely to avoid activities and struggle with accepting their illness, while people with rheumatic diseases were more likely to worry about damage to their bodies. This suggests that fatigue in these different conditions may need different treatment approaches.
Understanding how ME/CFS differs from other fatiguing conditions in terms of psychological responses and coping patterns is crucial for developing targeted treatments. This study provides evidence that avoidance and lack of acceptance may be particularly important factors in ME/CFS fatigue, potentially informing psychological intervention design specifically suited to ME/CFS rather than applying strategies from rheumatic disease treatment.
This cross-sectional design cannot establish causality—it cannot prove whether lack of acceptance and avoidance cause worse ME/CFS fatigue or result from it. The study also does not measure post-exertional malaise (PEM), a hallmark ME/CFS symptom, so it cannot determine whether avoidance patterns in ME/CFS relate specifically to PEM-triggered symptom exacerbation. Differences in psychosocial profiles may reflect differences in disease biology rather than differences in psychological processes.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Ali, Sheila, Matcham, Faith, Irving, Katherine, & Chalder, Trudie (2017). Fatigue and psychosocial variables in autoimmune rheumatic disease and chronic fatigue syndrome: A cross-sectional comparison.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2016.11.002
BibTeX
@article{mecfsatlas-ali-2017-fatigue-psychosocial,
author = {Ali, Sheila and Matcham, Faith and Irving, Katherine and Chalder, Trudie},
title = {Fatigue and psychosocial variables in autoimmune rheumatic disease and chronic fatigue syndrome: A cross-sectional comparison.},
journal = {Journal of psychosomatic research},
year = {2017},
doi = {10.1016/j.jpsychores.2016.11.002},
note = {PubMed: 27998507},
url = {https://www.mecfsatlas.com/evidence/ali-2017-fatigue-psychosocial},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/ali-2017-fatigue-psychosocial
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