Vos-Vromans, D C W M, Huijnen, I P J, Rijnders, L J M et al. · Journal of psychosomatic research · 2016 · DOI
This study tested whether patients' expectations about treatment affect how well they recover from ME/CFS. Researchers gave 122 patients either cognitive behavioral therapy (CBT) or multidisciplinary rehabilitation treatment (MRT) and measured their expectations before starting. They found that for patients receiving MRT, having positive expectations was linked to better outcomes in fatigue and physical quality of life—but this connection was not found in the CBT group.
Understanding what drives treatment response in ME/CFS is critical because recovery outcomes vary widely. This research suggests that patient expectations may be a modifiable factor that clinicians can address to potentially improve results, particularly in rehabilitation-based approaches—offering a psychological lever for enhancing treatment effectiveness.
This study does not prove that increasing expectations alone will cure ME/CFS or that expectancy effects are the primary driver of improvement. The association between expectancy and outcome does not establish causation—it is possible that patients with better baseline capacity form higher expectations and recover better for other reasons. The findings are limited to the specific treatments studied and cannot be generalized to other therapeutic approaches.
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
Vos-Vromans, D C W M, Huijnen, I P J, Rijnders, L J M, Winkens, B, Knottnerus, J A, & Smeets, R J E M (2016). Treatment expectations influence the outcome of multidisciplinary rehabilitation treatment in patients with CFS.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2016.02.004
BibTeX
@article{mecfsatlas-vos-vromans-2016-treatment-expectations,
author = {Vos-Vromans, D C W M and Huijnen, I P J and Rijnders, L J M and Winkens, B and Knottnerus, J A and Smeets, R J E M},
title = {Treatment expectations influence the outcome of multidisciplinary rehabilitation treatment in patients with CFS.},
journal = {Journal of psychosomatic research},
year = {2016},
doi = {10.1016/j.jpsychores.2016.02.004},
note = {PubMed: 27020075},
url = {https://www.mecfsatlas.com/evidence/vos-vromans-2016-treatment-expectations},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/vos-vromans-2016-treatment-expectations
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