Schmaling, Karen B, Fales, Jessica L, McPherson, Sterling · Journal of health psychology · 2020 · DOI
This study followed 68 people with chronic fatigue (some also with fibromyalgia) for 18 months to see how their loved ones' responses affected their health outcomes. The researchers found that when significant others responded negatively to fatigue and pain, patients experienced more pain, worse mental health, and worse fatigue symptoms over time. Interestingly, when loved ones were more helpful and comforting (solicitous), patients with more fibromyalgia tender points tended to have this response, and when loved ones helped distract patients, mental health was better.
Social support and how loved ones respond to illness significantly influence disease progression and mental health in ME/CFS. This research highlights that the quality of significant others' responses—whether they are supportive, dismissive, or unhelpfully solicitous—directly affects pain, fatigue, and psychological outcomes, suggesting that family-based interventions could be an important treatment consideration.
This study demonstrates correlation, not causation—we cannot conclude that negative responses cause worse outcomes, only that they are associated. The study does not establish whether certain responses are adaptive or maladaptive universally, as individual patient needs may vary. Additionally, the findings may not generalize to all ME/CFS populations or to patients in different 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
Schmaling, Karen B, Fales, Jessica L, & McPherson, Sterling (2020). Longitudinal outcomes associated with significant other responses to chronic fatigue and pain.. Journal of health psychology. https://doi.org/10.1177/1359105317731824
BibTeX
@article{mecfsatlas-schmaling-2020-longitudinal-outcomes,
author = {Schmaling, Karen B and Fales, Jessica L and McPherson, Sterling},
title = {Longitudinal outcomes associated with significant other responses to chronic fatigue and pain.},
journal = {Journal of health psychology},
year = {2020},
doi = {10.1177/1359105317731824},
note = {PubMed: 28925285},
url = {https://www.mecfsatlas.com/evidence/schmaling-2020-longitudinal-outcomes},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/schmaling-2020-longitudinal-outcomes
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