Ray, C, Jefferies, S, Weir, W R · Psychological medicine · 1995 · DOI
This study looked at how different ways of coping with ME/CFS affected patients' symptoms and daily functioning. Researchers found that trying to stay active was linked to better functioning, while accepting the illness as permanent was linked to more disability. Giving up or withdrawing from activities was connected to both worse disability and emotional problems like depression or anxiety.
This research highlights that coping approaches significantly influence ME/CFS outcomes beyond fatigue alone. Understanding which coping strategies lead to better functional outcomes helps patients and clinicians identify approaches that may preserve independence and emotional wellbeing, while recognizing that certain coping patterns may worsen disability or mental health.
This study does not prove that coping strategies cause changes in ME/CFS symptoms—it only shows associations. The cross-sectional design means we cannot determine whether certain coping styles lead to worse outcomes, or whether worsening symptoms cause people to adopt less helpful coping strategies. Individual circumstances vary greatly, and findings may not apply equally to all patients.
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
Ray, C, Jefferies, S, & Weir, W R (1995). Coping with chronic fatigue syndrome: illness responses and their relationship with fatigue, functional impairment and emotional status.. Psychological medicine. https://doi.org/10.1017/s0033291700037429
BibTeX
@article{mecfsatlas-ray-1995-coping-chronic,
author = {Ray, C and Jefferies, S and Weir, W R},
title = {Coping with chronic fatigue syndrome: illness responses and their relationship with fatigue, functional impairment and emotional status.},
journal = {Psychological medicine},
year = {1995},
doi = {10.1017/s0033291700037429},
note = {PubMed: 8588012},
url = {https://www.mecfsatlas.com/evidence/ray-1995-coping-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/ray-1995-coping-chronic
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