Hambrook, David, Oldershaw, Anna, Rimes, Katharine et al. · The British journal of clinical psychology · 2011 · DOI
This study looked at how people with ME/CFS and anorexia nervosa process emotions differently compared to healthy people. Researchers found that both patient groups had more difficulty tolerating emotional distress, tended to suppress their own needs for others, and held more negative beliefs about experiencing and expressing emotions. These emotional processing difficulties may play a role in how these illnesses develop and persist.
Understanding that ME/CFS patients, like those with AN, may struggle with emotional processing provides important context for why psychological interventions are being studied in ME/CFS. This research suggests that addressing emotional regulation difficulties could be a valuable complement to physical symptom management and validates patient experiences of emotional complexity in this illness.
This study cannot establish whether emotional processing difficulties cause ME/CFS or result from it—the cross-sectional design only shows associations. The study does not prove that psychological treatment targeting emotions will be effective in ME/CFS, nor does it address whether emotional processing difficulties are primary or secondary to the disease process. The findings do not determine whether these emotional patterns are universal in ME/CFS or characterize only a subset of patients.
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
Hambrook, David, Oldershaw, Anna, Rimes, Katharine, Schmidt, Ulrike, Tchanturia, Kate, Treasure, Janet, et al. (2011). Emotional expression, self-silencing, and distress tolerance in anorexia nervosa and chronic fatigue syndrome.. The British journal of clinical psychology. https://doi.org/10.1348/014466510X519215
BibTeX
@article{mecfsatlas-hambrook-2011-emotional-expression,
author = {Hambrook, David and Oldershaw, Anna and Rimes, Katharine and Schmidt, Ulrike and Tchanturia, Kate and Treasure, Janet and Richards, Selwyn and Chalder, Trudie},
title = {Emotional expression, self-silencing, and distress tolerance in anorexia nervosa and chronic fatigue syndrome.},
journal = {The British journal of clinical psychology},
year = {2011},
doi = {10.1348/014466510X519215},
note = {PubMed: 21810109},
url = {https://www.mecfsatlas.com/evidence/hambrook-2011-emotional-expression},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/hambrook-2011-emotional-expression
Contribute
Private, reviewed by a human. Not a public comment thread.