Fiedler, N, Lange, G, Tiersky, L et al. · Journal of psychosomatic research · 2000 · DOI
This study looked at Gulf War veterans to understand why some developed chronic fatigue syndrome (CFS) while others stayed healthy. Researchers compared three groups: healthy veterans, veterans with CFS who also had other mental health conditions, and veterans with CFS alone. They found that personality traits, how people cope with stress, war-related exposures (like oil fires and pesticides), and life stress after the war were all connected to who developed CFS.
This study is important because it suggests that ME/CFS in veterans may result from multiple interacting factors—not just physical exposures, but also personality and coping style. Understanding these connections could help identify which veterans are at higher risk and inform more targeted interventions combining psychological and medical approaches.
This study cannot establish causation—it only shows associations between these factors and CFS. We cannot determine whether certain personality traits and coping styles caused CFS, resulted from having CFS, or were simply correlated with it. Additionally, findings from Gulf War veterans may not fully apply to ME/CFS patients from other populations.
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 →
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