Heijmans, M, de Ridder, D · Journal of behavioral medicine · 1998 · DOI
This study looked at how people with ME/CFS and Addison's disease understand and think about their illnesses. Researchers found that ME/CFS patients and Addison's disease patients organize their illness experiences differently—what matters most to one group may not matter as much to the other. For ME/CFS patients, the key factors were how manageable the disease feels, how serious it is, whether they feel personally responsible, and whether they see external causes as responsible.
Understanding how ME/CFS patients perceive their illness—particularly beliefs about manageability, seriousness, personal responsibility, and external causation—is crucial for developing targeted interventions and patient education. These illness representations significantly influence health behaviors, treatment adherence, and psychological adjustment, making this study valuable for improving clinical care and patient outcomes.
This study does not establish causation or prove that specific illness representations directly cause better or worse health outcomes. The cross-sectional design cannot determine whether illness representations shape disease experiences or vice versa. The study also does not compare ME/CFS to other illnesses systematically or test interventions based on these representations.
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
Heijmans, M & de Ridder, D (1998). Assessing illness representations of chronic illness: explorations of their disease-specific nature.. Journal of behavioral medicine. https://doi.org/10.1023/a:1018788427100
BibTeX
@article{mecfsatlas-heijmans-1998-assessing-illness,
author = {Heijmans, M and de Ridder, D},
title = {Assessing illness representations of chronic illness: explorations of their disease-specific nature.},
journal = {Journal of behavioral medicine},
year = {1998},
doi = {10.1023/a:1018788427100},
note = {PubMed: 9836133},
url = {https://www.mecfsatlas.com/evidence/heijmans-1998-assessing-illness},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/heijmans-1998-assessing-illness
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