Preprint Understanding Psychological Distress in CFS/ME: The Roles of Functionality Appreciation, Body Appreciation, and Illness-Related Shame, 2026, Geller+

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Understanding Psychological Distress in CFS/ME: The Roles of Functionality Appreciation, Body Appreciation, and Illness-Related Shame

Geller, Shulamit; Levy, Sigal; Avitsur, Ronit

Background
Chronic fatigue syndrome/Myalgic encephalomyelitis (CFS/ME) is a debilitating chronic condition that often lacks overt physical signs yet is associated with substantial psychological distress. This study examined whether functionality appreciation and body appreciation help explain the association between CFS/ME and psychological distress, and whether illness-related shame further explains the link between fatigue severity and depression and anxiety within the CFS/ME group.

Methods
In a cross-sectional online survey, 248 adults participated, including 99 individuals with self-reported CFS/ME and 149 healthy peers. Participants completed measures of depression, anxiety, body appreciation, functionality appreciation, illness-related shame, and fatigue severity. Data were analyzed using descriptive statistics, independent-samples t tests, Pearson correlations, and serial mediation analyses (PROCESS Model 6).

Results
Compared with healthy peers, participants with CFS/ME reported significantly higher depression and anxiety and lower functionality appreciation and body appreciation. Serial mediation analyses indicated that the association between CFS/ME status and distress operated indirectly through lower functionality appreciation and lower body appreciation.

Within the CFS/ME group, greater fatigue severity was associated with higher distress, lower positive body image, and greater illness-related shame, and was indirectly linked to depression and anxiety through these variables.

Conclusions
Psychological distress in CFS/ME is associated not only with fatigue severity but also with how individuals experience and evaluate their bodies. Functionality appreciation and body appreciation may represent two interrelated facets of positive body image that help explain how symptom burden contributes to emotional vulnerability.

These findings highlight potential intervention targets aimed at strengthening appreciation of bodily functioning, fostering body acceptance, and reducing shame in people with CFS/ME.

Web | DOI | PDF | Research Square | Preprint
 
If one is wiped out by buying groceries and hates how frail and weak their body is, and is worried about possible worsening, is it useful to label this anxiety and depression?

For me the answer is clearly no. These are normal responses to the situation. The labels anxiety and depression suggest that these are "wrong" emotional responses, an error, and not a normal response.
 
I don't even want to waste my energy thinking about what on earth 'functionality appreciation and lower body appreciation' are and how they are 'measured'.

I would like the authors to tell us whether they would think this crap is appropriate for people with any other serious disbling chronic physical illness. No, on second thoughts, I just want them to go away and leave us alone.
 
The paper said:
yet is associated with substantial psychological distress
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It's not, though. This has held up very strongly over the years in so many studies. There are assessments that evaluate the various dimensions of functioning and it's actually the only thing that holds up despite immense suffering, so the entire premise of this study is a fabricated lied. Personally I think this is wrong in itself, but that's only because the point of studies like this is to influence health care for real people in real life and that makes it evil to do something like this.

Now of course if you build ideological models in which fatigue counts as psychological distress, well you might as well be studying the skull shapes of mannequins you moulded yourselves.
Within the CFS/ME group, greater fatigue severity was associated with higher distress, lower positive body image, and greater illness-related shame, and was indirectly linked to depression and anxiety through these variables.
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Uh, they literally just did that. How surprising. How traditional. How so overdone.
lower functionality appreciation
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Loss of functioning is literally one of the main criteria. The "mild" level of loss of functioning is a 50% loss, which is high enough to be a significant disability. People with low functioning consider themselves to be low functioning, framing this with some clownish "appreciation" nonsense doesn't change that.
These findings highlight potential intervention targets aimed at strengthening appreciation of bodily functioning, fostering body acceptance, and reducing shame in people with CFS/ME.
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Is it against the rules to say this is dumb? Not the people, the output, the claims and how they're built. This is just dumb. It's insulting in how dumb it is. The people putting out this garbage should be ashamed of themselves, but they seem to be so lacking in introspection that it's probably fanciful to expect that. Hey maybe they are mannequins, that would explain a lot, actually. Give me LLMs over this every single day. Seriously, LLMs are already far smarter than this and it's not even a fair comparison at this point.
 
yet is associated with substantial psychological distress​

I wonder why that might be. Couldn't possibly be that patients do in fact have a very serious and disabling unexplained physical disease that is being endlessly psycho-babblised and blamed on the patients' attitudes and 'psychology', that genuine productive research into it has been stonewalled for decades and that every attempt at reforming this bizarre disaster has been ruthlessly hijacked and perverted by the psycho-babblisers and moralistic thugs for their own ends, and the utterly appalling brutal consequences of all that on the lives of sick, vulnerable, innocent patients?

Real mystery, isn't it. :mad:
 
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