van Middendorp, H, Geenen, R, Kuis, W et al. · Pediatrics · 2001 · DOI
This study looked at how 36 teenage girls with ME/CFS were coping emotionally and psychologically. The researchers found that most girls had experienced problems before getting sick, but they generally maintained healthy self-esteem and social skills despite their illness. However, the girls struggled with activities typical for teenagers, like sports and dating, and many kept their emotions bottled up rather than expressing them openly.
Understanding the psychological adjustment and coping strategies of adolescents with ME/CFS is crucial for developing age-appropriate rehabilitation and mental health support. This study identifies both strengths (resilience, optimism) and vulnerabilities (low perceived competence in peer activities, emotional internalization) that can inform personalized psychosocial interventions. The finding that optimistic coping may paradoxically maintain illness by encouraging overexertion has important implications for pacing and activity management education.
This study does not establish whether premorbid psychological or physical problems cause ME/CFS, only that they are common in this population—without a healthy control group, the baseline prevalence is unknown. The cross-sectional design cannot determine whether observed psychosocial patterns are causes, consequences, or correlates of the illness. The study cannot prove that optimistic coping strategies actually maintain the syndrome, only that such patterns are observed.
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
van Middendorp, H, Geenen, R, Kuis, W, Heijnen, C J, & Sinnema, G (2001). Psychological adjustment of adolescent girls with chronic fatigue syndrome.. Pediatrics. https://doi.org/10.1542/peds.107.3.e35
BibTeX
@article{mecfsatlas-van-middendorp-2001-psychological-adjustment,
author = {van Middendorp, H and Geenen, R and Kuis, W and Heijnen, C J and Sinnema, G},
title = {Psychological adjustment of adolescent girls with chronic fatigue syndrome.},
journal = {Pediatrics},
year = {2001},
doi = {10.1542/peds.107.3.e35},
note = {PubMed: 11230616},
url = {https://www.mecfsatlas.com/evidence/van-middendorp-2001-psychological-adjustment},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/van-middendorp-2001-psychological-adjustment
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