Pedersen, Maria · Scandinavian journal of pain · 2019 · DOI
This review explains that ME/CFS and chronic pain conditions share important similarities—both involve protective body signals that were helpful in the short term but become problematic when they persist long-term. The authors suggest that our brain's tendency to anticipate and predict threats may play a role in keeping these conditions going, which helps explain why treatments focusing on stress relief and changing thought patterns can sometimes help patients improve.
This paper provides a conceptual framework helping ME/CFS patients understand how their fatigue and pain, while real biological symptoms, may be perpetuated by brain-based protective mechanisms. For researchers, it bridges neurobiology and behavioral science, potentially directing future investigation into predictive processing and treatment targets in ME/CFS.
This review does not establish that psychological factors cause ME/CFS, nor does it prove that cognitive behavior therapy is universally effective or appropriate for all patients. It presents a theoretical model rather than experimental evidence, and does not demonstrate causation between predictive brain processing and symptom persistence.
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 →
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Primary citation
Pedersen, Maria (2019). Chronic Fatigue Syndrome and chronic pain conditions - vitally protective systems gone wrong.. Scandinavian journal of pain. https://doi.org/10.1515/sjpain-2019-0072
BibTeX
@article{mecfsatlas-pedersen-2019-chronic-fatigue,
author = {Pedersen, Maria},
title = {Chronic Fatigue Syndrome and chronic pain conditions - vitally protective systems gone wrong.},
journal = {Scandinavian journal of pain},
year = {2019},
doi = {10.1515/sjpain-2019-0072},
note = {PubMed: 31256069},
url = {https://www.mecfsatlas.com/evidence/pedersen-2019-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/pedersen-2019-chronic-fatigue
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