Tummers, Marcia, Knoop, Hans, van Dam, Arno et al. · Journal of psychosomatic research · 2013 · DOI
This study looked at which ME/CFS patients benefit most from a self-guided treatment that focuses on changing thoughts and behaviors related to fatigue. Researchers found that younger patients, those without significant depression, and those who don't tend to avoid activities responded better to this treatment. Patients with severe depression or who are older may need different or additional types of help.
This study provides clinically actionable information about which ME/CFS patients are most likely to benefit from self-guided cognitive-behavioral interventions. Identifying treatment moderators can improve patient selection and outcomes, while also highlighting that patients with significant depression may need integrated or alternative treatment approaches.
This study does not prove that age, depression, or avoidance cause poor treatment response—only that these factors are associated with differential outcomes. The results are specific to guided self-instruction and may not generalize to other ME/CFS treatments. The study also does not establish whether depression should be treated before, during, or instead of guided self-instruction.
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
Tummers, Marcia, Knoop, Hans, van Dam, Arno, & Bleijenberg, Gijs (2013). Moderators of the treatment response to guided self-instruction for chronic fatigue syndrome.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2013.01.007
BibTeX
@article{mecfsatlas-tummers-2013-moderators-treatment,
author = {Tummers, Marcia and Knoop, Hans and van Dam, Arno and Bleijenberg, Gijs},
title = {Moderators of the treatment response to guided self-instruction for chronic fatigue syndrome.},
journal = {Journal of psychosomatic research},
year = {2013},
doi = {10.1016/j.jpsychores.2013.01.007},
note = {PubMed: 23597323},
url = {https://www.mecfsatlas.com/evidence/tummers-2013-moderators-treatment},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/tummers-2013-moderators-treatment
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