Kempke, Stefan, Luyten, Patrick, Mayes, Linda C et al. · Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2016 · DOI
This study looked at whether people with ME/CFS who tend to be hard on themselves and set unrealistically high standards (self-critical perfectionism) have a different stress response than others. Researchers gave 41 women with ME/CFS a stressful test and measured their cortisol (a stress hormone) levels. They found that those with higher self-critical perfectionism felt more stressed mentally, but their bodies produced less cortisol in response—suggesting their stress system isn't working as well as it should.
Understanding the relationship between personality traits and neurobiological stress response dysfunction helps explain why some ME/CFS patients have more severe symptoms. This finding suggests that psychological interventions targeting perfectionism might help restore more appropriate stress system functioning, potentially improving symptoms.
This study does not prove that self-critical perfectionism causes ME/CFS or HPA axis dysfunction—it only shows an association. The cross-sectional design means we cannot determine the direction of causality: perfectionism might contribute to illness, or the illness experience might reinforce perfectionist thinking. Results are limited to women and may not apply to men with ME/CFS.
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
Kempke, Stefan, Luyten, Patrick, Mayes, Linda C, Van Houdenhove, Boudewijn, & Claes, Stephan (2016). Self-critical perfectionism predicts lower cortisol response to experimental stress in patients with chronic fatigue syndrome.. Health psychology : official journal of the Division of Health Psychology, American Psychological Association. https://doi.org/10.1037/hea0000299
BibTeX
@article{mecfsatlas-kempke-2016-self-critical,
author = {Kempke, Stefan and Luyten, Patrick and Mayes, Linda C and Van Houdenhove, Boudewijn and Claes, Stephan},
title = {Self-critical perfectionism predicts lower cortisol response to experimental stress in patients with chronic fatigue syndrome.},
journal = {Health psychology : official journal of the Division of Health Psychology, American Psychological Association},
year = {2016},
doi = {10.1037/hea0000299},
note = {PubMed: 26690635},
url = {https://www.mecfsatlas.com/evidence/kempke-2016-self-critical},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/kempke-2016-self-critical
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