Puşuroğlu, Meltem, Topaloğlu, Mehmet Serhat, Hocaoğlu, Çiçek et al. · Turkish journal of physical medicine and rehabilitation · 2023 · DOI
This study looked at how fibromyalgia patients handle emotions and relationships compared to healthy people. Researchers found that fibromyalgia patients have more difficulty expressing their emotions, are more sensitive to rejection, and tend to have more anxious or avoidant attachment patterns in relationships. These emotional and relational differences may be connected to fibromyalgia symptoms.
Although this study examines fibromyalgia rather than ME/CFS specifically, the findings are relevant because both conditions share overlapping symptoms, psychosocial stressors, and poorly understood etiology. Understanding how chronic pain conditions relate to emotional regulation and attachment patterns may inform psychological interventions and help clinicians recognize comorbid emotional processing difficulties in ME/CFS patients.
This study does not establish whether emotional expression difficulties and attachment patterns cause fibromyalgia or result from it; the cross-sectional design prevents causal inference. It does not prove these psychological factors are primary drivers of fibromyalgia pathology, nor does it demonstrate generalizability to ME/CFS populations. The study cannot exclude reverse causation (e.g., chronic pain leading to emotional withdrawal).
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
Puşuroğlu, Meltem, Topaloğlu, Mehmet Serhat, Hocaoğlu, Çiçek, & Yıldırım, Murat (2023). Expressing emotions, rejection sensitivity, and attachment in patients with fibromyalgia.. Turkish journal of physical medicine and rehabilitation. https://doi.org/10.5606/tftrd.2023.11440
BibTeX
@article{mecfsatlas-puurolu-2023-expressing-emotions,
author = {Puşuroğlu, Meltem and Topaloğlu, Mehmet Serhat and Hocaoğlu, Çiçek and Yıldırım, Murat},
title = {Expressing emotions, rejection sensitivity, and attachment in patients with fibromyalgia.},
journal = {Turkish journal of physical medicine and rehabilitation},
year = {2023},
doi = {10.5606/tftrd.2023.11440},
note = {PubMed: 37674789},
url = {https://www.mecfsatlas.com/evidence/puurolu-2023-expressing-emotions},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/puurolu-2023-expressing-emotions
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