Clark, James E, Davidson, Sean L, Maclachlan, Laura et al. · Fatigue : biomedicine, health & behavior · 2018 · DOI
This study looked at whether difficult childhood experiences are more common in people with ME/CFS. The researchers carefully separated people with ME/CFS who had never had depression from those who had. They found that childhood trauma was not actually more common in ME/CFS patients without depression compared to healthy people, suggesting previous studies may have been confused by patients who also had depression.
This study challenges the long-held belief that childhood trauma directly causes ME/CFS by demonstrating that the apparent link may be largely explained by depression. For patients, this suggests trauma history alone does not determine CFS development. For researchers, it highlights the critical importance of controlling for psychiatric comorbidity in aetiological studies to avoid misleading conclusions about CFS causation.
This study does not prove that childhood adversity plays no role in ME/CFS, only that it is not a direct causal factor independent of depression. The cross-sectional design cannot establish causation in any direction. Additionally, the small sample size limits generalisability, and excluding patients with depression may have removed important subgroups that warrant investigation.
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
Clark, James E, Davidson, Sean L, Maclachlan, Laura, Newton, Julia L, & Watson, Stuart (2018). Rethinking childhood adversity in chronic fatigue syndrome.. Fatigue : biomedicine, health & behavior. https://doi.org/10.1080/21641846.2018.1384095
BibTeX
@article{mecfsatlas-clark-2018-rethinking-childhood,
author = {Clark, James E and Davidson, Sean L and Maclachlan, Laura and Newton, Julia L and Watson, Stuart},
title = {Rethinking childhood adversity in chronic fatigue syndrome.},
journal = {Fatigue : biomedicine, health & behavior},
year = {2018},
doi = {10.1080/21641846.2018.1384095},
note = {PubMed: 29392095},
url = {https://www.mecfsatlas.com/evidence/clark-2018-rethinking-childhood},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/clark-2018-rethinking-childhood
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