Hughes, Alicia M, Hirsch, Colette R, Nikolaus, Stephanie et al. · International journal of behavioral medicine · 2018 · DOI
This study looked at how people with ME/CFS pay attention to and interpret information related to illness and symptoms. Researchers in the Netherlands and UK tested whether people with ME/CFS tend to notice illness-related words more quickly and interpret unclear situations in ways related to their symptoms. They found that people with ME/CFS did show these patterns, and importantly, these patterns were similar in both countries, suggesting this is a consistent feature of the condition rather than a cultural difference.
Understanding whether cognitive biases in ME/CFS are universal across cultures helps researchers determine if these are core features of the condition or influenced by social and cultural factors. If these biases are consistently present, they may represent important targets for cognitive-behavioral interventions or help explain how the condition maintains itself.
This study does not prove that attentional and interpretation biases cause ME/CFS or are the primary driver of symptoms. The cross-sectional design means we cannot determine whether these biases develop as a result of having the condition or contribute to its development. This study also only included Dutch and UK populations, so the findings may not apply to all cultures worldwide.
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
Hughes, Alicia M, Hirsch, Colette R, Nikolaus, Stephanie, Chalder, Trudie, Knoop, Hans, & Moss-Morris, Rona (2018). Cross-Cultural Study of Information Processing Biases in Chronic Fatigue Syndrome: Comparison of Dutch and UK Chronic Fatigue Patients.. International journal of behavioral medicine. https://doi.org/10.1007/s12529-017-9682-z
BibTeX
@article{mecfsatlas-hughes-2018-cross-cultural,
author = {Hughes, Alicia M and Hirsch, Colette R and Nikolaus, Stephanie and Chalder, Trudie and Knoop, Hans and Moss-Morris, Rona},
title = {Cross-Cultural Study of Information Processing Biases in Chronic Fatigue Syndrome: Comparison of Dutch and UK Chronic Fatigue Patients.},
journal = {International journal of behavioral medicine},
year = {2018},
doi = {10.1007/s12529-017-9682-z},
note = {PubMed: 28836119},
url = {https://www.mecfsatlas.com/evidence/hughes-2018-cross-cultural},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/hughes-2018-cross-cultural
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