Moulton, Calum D, Jordan, Cheryl, Hayee, Bu'Hussain et al. · Inflammatory bowel diseases · 2024 · DOI
This study looked at people with inflammatory bowel disease (IBD) who experience fatigue and found that two behavior patterns predict worsening tiredness over time: all-or-nothing behavior (doing a lot of activity followed by needing extended rest) and catastrophic thinking (expecting the worst outcomes). These findings suggest that how patients think and behave may play an important role in their fatigue levels.
While this study focuses on IBD, the identified behavioral patterns—all-or-nothing activity cycling and catastrophic thinking—are also commonly observed in ME/CFS patients. Understanding how these behaviors contribute to fatigue progression could inform behavioral interventions and help explain why some fatigue persists even when inflammation is controlled. The findings support investigating similar mechanisms in ME/CFS cohorts.
This study does not prove that all-or-nothing behavior and catastrophic thinking cause fatigue; it only shows they predict worsening fatigue over time (correlation, not causation). The study is specific to IBD and findings may not directly transfer to ME/CFS or other fatigue conditions. It does not determine whether modifying these behaviors would reduce fatigue or whether treating the underlying inflammation independently affects these psychological patterns.
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 →
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