Schmaling, Karen B, Fales, Jessica L, McPherson, Sterling · Journal of health psychology · 2020 · DOI
This study followed 68 people with chronic fatigue (some also with fibromyalgia) for 18 months to see how their loved ones' responses affected their health outcomes. The researchers found that when significant others responded negatively to fatigue and pain, patients experienced more pain, worse mental health, and worse fatigue symptoms over time. Interestingly, when loved ones were more helpful and comforting (solicitous), patients with more fibromyalgia tender points tended to have this response, and when loved ones helped distract patients, mental health was better.
Social support and how loved ones respond to illness significantly influence disease progression and mental health in ME/CFS. This research highlights that the quality of significant others' responses—whether they are supportive, dismissive, or unhelpfully solicitous—directly affects pain, fatigue, and psychological outcomes, suggesting that family-based interventions could be an important treatment consideration.
This study demonstrates correlation, not causation—we cannot conclude that negative responses cause worse outcomes, only that they are associated. The study does not establish whether certain responses are adaptive or maladaptive universally, as individual patient needs may vary. Additionally, the findings may not generalize to all ME/CFS populations or to patients in different cultural contexts.
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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