Lattie, Emily G, Antoni, Michael H, Fletcher, Mary Ann et al. · Brain, behavior, and immunity · 2012 · DOI
This study looked at whether people with ME/CFS who are better at managing stress have lower fatigue levels. Researchers measured stress management skills, emotional distress, fatigue, and inflammation markers in the blood and saliva of 117 people with ME/CFS. They found that people with better stress management skills reported less fatigue and emotional distress, and this benefit was especially strong in people who had higher levels of a specific inflammatory marker called IL-6.
This study identifies a potential mechanism—emotional distress and inflammatory markers—through which stress management might reduce fatigue in certain ME/CFS patients. The finding that benefits are strongest in patients with specific immune abnormalities supports a precision medicine approach, suggesting tailored stress management interventions could be designed for the ME/CFS subgroups most likely to benefit.
This study does not prove that stress management interventions will reduce fatigue or that emotional distress causes fatigue—it only shows correlations observed at one point in time. The cross-sectional design cannot establish causality or determine whether stress management skills lead to lower IL-6 levels or whether other factors underlie both improved stress management and lower inflammation. The study cannot rule out that fatigue itself causes worse stress management skills or emotional distress.
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
Lattie, Emily G, Antoni, Michael H, Fletcher, Mary Ann, Penedo, Frank, Czaja, Sara, Lopez, Corina, et al. (2012). Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome.. Brain, behavior, and immunity. https://doi.org/10.1016/j.bbi.2012.02.008
BibTeX
@article{mecfsatlas-lattie-2012-stress-management,
author = {Lattie, Emily G and Antoni, Michael H and Fletcher, Mary Ann and Penedo, Frank and Czaja, Sara and Lopez, Corina and Perdomo, Dolores and Sala, Andreina and Nair, Sankaran and Fu, Shih Hua and Klimas, Nancy},
title = {Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome.},
journal = {Brain, behavior, and immunity},
year = {2012},
doi = {10.1016/j.bbi.2012.02.008},
note = {PubMed: 22417946},
url = {https://www.mecfsatlas.com/evidence/lattie-2012-stress-management},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/lattie-2012-stress-management
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