Antoni, M H, Brickman, A, Lutgendorf, S et al. · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 1994 · DOI
This study looked at how thoughts, feelings, and coping strategies affect how sick ME/CFS patients feel and function day-to-day. Researchers found that negative thinking patterns and avoidance-based coping (like denial) were linked to worse symptoms and lower quality of life, while active problem-solving strategies did not improve outcomes. These relationships held true whether or not patients also had depression.
Understanding psychological factors that worsen ME/CFS burden may inform interventions beyond treating physical symptoms alone. This work suggests that cognitive and behavioral approaches targeting negative thinking patterns and avoidance strategies could potentially reduce disability and functional impairment in ME/CFS patients.
This cross-sectional design cannot establish causation—it remains unclear whether negative thoughts and avoidance coping cause worse illness burden, or whether greater illness burden leads to negative thinking and avoidance. The study also does not address whether changing cognitive appraisals or coping strategies would actually improve outcomes, nor does it clarify the biological basis of ME/CFS itself.
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
Antoni, M H, Brickman, A, Lutgendorf, S, Klimas, N, Imia-Fins, A, Ironson, G, et al. (1994). Psychosocial correlates of illness burden in chronic fatigue syndrome.. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. https://doi.org/10.1093/clinids/18.supplement_1.s73
BibTeX
@article{mecfsatlas-antoni-1994-psychosocial-correlates,
author = {Antoni, M H and Brickman, A and Lutgendorf, S and Klimas, N and Imia-Fins, A and Ironson, G and Quillian, R and Miguez, M J and van Riel, F and Morgan, R},
title = {Psychosocial correlates of illness burden in chronic fatigue syndrome.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
year = {1994},
doi = {10.1093/clinids/18.supplement_1.s73},
note = {PubMed: 8148457},
url = {https://www.mecfsatlas.com/evidence/antoni-1994-psychosocial-correlates},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/antoni-1994-psychosocial-correlates
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