Butler, J A, Chalder, T, Wessely, S · Psychological medicine · 2001 · DOI
This study looked at how people with ME/CFS explain their symptoms—whether they believe physical causes are responsible versus other factors. Researchers found that patients with ME/CFS tend to blame physical causes for their symptoms more often than healthy controls do. Interestingly, family members living with ME/CFS patients also blamed physical causes for the patients' symptoms, but not for their own symptoms. The researchers suggest that how partners view the illness might affect how well patients recover.
Understanding how both patients and their families interpret ME/CFS symptoms could improve treatment approaches. If family beliefs about the illness influence patient recovery, then involving partners in psychologically-informed treatments might enhance outcomes. This study highlights that ME/CFS doesn't occur in isolation—the family environment and shared attributions about illness cause matter for patient wellbeing.
This cross-sectional design cannot establish causation: it does not prove that somatic attribution tendencies cause ME/CFS development, only that they are associated with it. The study also cannot determine whether attributions influence recovery outcomes without longitudinal follow-up data. Finally, self-reported attributions may not reflect actual beliefs or predict real clinical outcomes.
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
Butler, J A, Chalder, T, & Wessely, S (2001). Causal attributions for somatic sensations in patients with chronic fatigue syndrome and their partners.. Psychological medicine. https://doi.org/10.1017/s0033291799003001
BibTeX
@article{mecfsatlas-butler-2001-causal-attributions,
author = {Butler, J A and Chalder, T and Wessely, S},
title = {Causal attributions for somatic sensations in patients with chronic fatigue syndrome and their partners.},
journal = {Psychological medicine},
year = {2001},
doi = {10.1017/s0033291799003001},
note = {PubMed: 11200964},
url = {https://www.mecfsatlas.com/evidence/butler-2001-causal-attributions},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/butler-2001-causal-attributions
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