Romano, Joan M, Jensen, Mark P, Schmaling, Karen B et al. · Journal of behavioral medicine · 2009 · DOI
This study looked at how the responses of family members and close partners affect people with chronic fatigue. Researchers found that when significant others were supportive or 'solicitous' (caring and attentive), patients tended to show more illness-related behaviors. Interestingly, when significant others responded negatively, patients reported higher levels of depression. The findings suggest that social interactions and family dynamics may play a role in how chronic fatigue affects daily functioning.
Social and family responses to illness behaviors may significantly influence disability outcomes and depression in ME/CFS patients. Understanding these dyadic interactions opens potential avenues for behavioral interventions that involve family members or significant others, which could complement medical treatment and improve both physical and mental health outcomes.
This study does not establish whether solicitous responses cause increased illness behavior or vice versa (the direction of causality remains unclear). It also does not prove that modifying significant other responses will directly improve patient outcomes, as the cross-sectional design only demonstrates associations, not causal mechanisms. Additionally, the findings may not generalize to all ME/CFS populations or cultural contexts.
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
Romano, Joan M, Jensen, Mark P, Schmaling, Karen B, Hops, Hyman, & Buchwald, Dedra S (2009). Illness behaviors in patients with unexplained chronic fatigue are associated with significant other responses.. Journal of behavioral medicine. https://doi.org/10.1007/s10865-009-9234-3
BibTeX
@article{mecfsatlas-romano-2009-illness-behaviors,
author = {Romano, Joan M and Jensen, Mark P and Schmaling, Karen B and Hops, Hyman and Buchwald, Dedra S},
title = {Illness behaviors in patients with unexplained chronic fatigue are associated with significant other responses.},
journal = {Journal of behavioral medicine},
year = {2009},
doi = {10.1007/s10865-009-9234-3},
note = {PubMed: 19915971},
url = {https://www.mecfsatlas.com/evidence/romano-2009-illness-behaviors},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/romano-2009-illness-behaviors
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