Psychological and demographic factors associated with fatigue and social adjustment in young people with severe chronic fatigue syndrome/myalgic encephalomyelitis: a preliminary mixed-methods study.

Observed Findings

• Stronger fear-avoidance beliefs at baseline predicted higher fatigue approximately 5 months later.
• Female gender was associated with lower work/school attendance at baseline and follow-up, but not with fatigue severity or social adjustment.
• Participants who had accessed treatment reported lower work/school attendance at both timepoints.
• Fear-avoidance beliefs showed significant multivariate association with worse social adjustment at follow-up.
• Qualitative data indicated severe ME/CFS negatively impacted multiple aspects of young people's lives including education, relationships, and identity.

Inferred Conclusions

• Fear-avoidance beliefs appear to be a modifiable psychological factor associated with fatigue and poor social adjustment in young people with severe ME/CFS.
• Cognitive-behavioural interventions targeting fearful beliefs about activity warrant further investigation as a potential treatment approach.
• Gender differences in work/school attendance may reflect differential illness severity, access to accommodations, or other social factors requiring further exploration.
• Severe ME/CFS in young people requires consideration of psychological, social, and educational impacts beyond symptom management alone.

Remaining Questions