E3 PreliminaryModerate confidencePEM not requiredMethods-PaperPeer-reviewedMachine draft
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The Beliefs about Emotions Scale: validity, reliability and sensitivity to change.
Rimes, Katharine A, Chalder, Trudie · Journal of psychosomatic research · 2010 · DOI
Quick Summary
Researchers created a new questionnaire called the Beliefs about Emotions Scale to measure how much people with ME/CFS tend to think negative emotions are unacceptable or shouldn't be expressed. They found that people with ME/CFS had much higher scores on this scale than healthy people, and that the scores improved after cognitive behavioral therapy (CBT), suggesting the scale can detect real changes in these unhelpful beliefs.
Why It Matters
This study provides a reliable measurement tool for assessing a psychological factor (unhelpful beliefs about emotions) that may be relevant to ME/CFS pathophysiology and treatment. Understanding whether and how these beliefs interact with ME/CFS symptoms could help identify patients who may benefit from therapies targeting emotion regulation, and could enable researchers to investigate whether emotional avoidance maintains symptoms.
Observed Findings
People with ME/CFS had significantly higher Beliefs about Emotions Scale scores than healthy controls.
The scale showed high internal consistency (Cronbach's α=0.91).
BES scores correlated most strongly with negative perfectionism (r=0.59) and also with dysfunctional attitudes, self-sacrifice, depression, anxiety, and fatigue measures.
Principal components analysis identified a single underlying factor.
BES scores decreased significantly in 22 individuals with CFS after receiving CBT.
Inferred Conclusions
Unhelpful beliefs about the unacceptability of negative emotions are more prevalent in people with ME/CFS than in healthy controls.
The Beliefs about Emotions Scale is a valid, reliable, and internally consistent measurement tool suitable for ME/CFS research.
These beliefs may be amenable to change through cognitive behavioral therapy.
Emotional avoidance beliefs may be a therapeutic target relevant to ME/CFS treatment.
Remaining Questions
Are unhelpful beliefs about emotions a cause, consequence, or maintaining factor in ME/CFS pathophysiology?
What This Study Does Not Prove
This study does not establish whether unhelpful beliefs about emotions cause ME/CFS, worsen outcomes, or maintain symptoms—it only shows an association. The small prospective CBT sample (n=22) with no control group does not prove that reducing these beliefs improves ME/CFS outcomes; improvements could reflect placebo effect, nonspecific therapeutic benefits, or natural recovery. The cross-sectional design cannot determine whether the beliefs precede or result from living with ME/CFS.
Tags
Symptom:Cognitive DysfunctionFatigue
Method Flag:PEM Not DefinedWeak Case DefinitionSmall SampleExploratory Only
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 →