Friedberg, Fred, Adamowicz, Jenna L, Bruckenthal, Patricia et al. · Journal of translational medicine · 2023 · DOI
This study tracked 128 ME/CFS patients over six months to see how daily pleasant and unpleasant events related to whether their illness got better, stayed the same, or got worse. Patients who worsened experienced more intense unpleasant events and had fewer pleasant events over time, while those who improved showed the opposite pattern. The findings suggest that the balance between daily hassles and uplifts may play a role in how ME/CFS progresses.
Understanding the relationship between daily life events and disease trajectory could inform behavioral interventions for ME/CFS, offering patients and clinicians potentially modifiable targets beyond symptom management alone. This addresses the significant gap in knowing what factors influence clinical worsening versus improvement in ME/CFS.
This study does not prove that hassles cause worsening or that increasing uplifts will improve ME/CFS outcomes—the relationship may be bidirectional or driven by unmeasured factors. The observational design cannot establish causation, and the homogeneous sample limits generalizability to diverse ME/CFS populations. Additionally, it does not determine which types of uplifts or hassles are most therapeutic or harmful.
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
Friedberg, Fred, Adamowicz, Jenna L, Bruckenthal, Patricia, Milazzo, Maria, Ramjan, Sameera, Zhang, Xiaoyue, et al. (2023). Uplifts and hassles are related to worsening in chronic fatigue syndrome: a prospective study.. Journal of translational medicine. https://doi.org/10.1186/s12967-023-04412-z
BibTeX
@article{mecfsatlas-friedberg-2023-uplifts-hassles,
author = {Friedberg, Fred and Adamowicz, Jenna L and Bruckenthal, Patricia and Milazzo, Maria and Ramjan, Sameera and Zhang, Xiaoyue and Yang, Jie},
title = {Uplifts and hassles are related to worsening in chronic fatigue syndrome: a prospective study.},
journal = {Journal of translational medicine},
year = {2023},
doi = {10.1186/s12967-023-04412-z},
note = {PubMed: 37598161},
url = {https://www.mecfsatlas.com/evidence/friedberg-2023-uplifts-hassles},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/friedberg-2023-uplifts-hassles
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