Perfectionism Increases Symptoms of Chronic Fatigue

Perfectionism can be a highly adaptive trait, helping people focus attention on goal achievement and personal accomplishments. However, self-critical perfectionism (SCP) can lead to negative outcomes. People who are highly critical of themselves and strive endlessly to reach high standards may be overcome with feelings of guilt and shame when they do not. They may feel worthless when they fall short of perfection and can experience negative mood states, including depression.

For people with chronic fatigue (CFS), the ability to persist toward a goal may be compromised by the fatigue and pain that accompanies the illness. But those with SCP may disregard their physical limitations and pursue their aspirations to the point of exhaustion. This persistence or “all or nothing” attitude is common with perfectionism, but may actually increase the symptoms of CFS. For instance, when people push themselves too hard, they may then be forced to stop entirely, which could cause them to see themselves as failures. The negative self-image can exacerbate pain and fatigue, and also increase depression in some people.

Although this theory has been loosely established in previous research, it has yet to be fully explored. In an effort to do this, Stefan Kempke of the Department of Psychology at the University of Leuven in Belgium recently conducted a study of 90 participants with CFS. The participants recorded their moods, pain, and fatigue over a 14-day period.

Kempke reviewed this data and found that in contrast to other evidence, the fatigue of the participants fluctuated quite significantly during the 14-day study period. However, the pain levels remained relatively stable. Kempke also found that those with high SCP experienced more fatigue and pain than those with low levels of SCP. Even when Kempke accounted for depression, SCP was still a strong predictor of pain and fatigue in the participants.

Kempke believes that perhaps those with SCP are unable to be inactive, and that they feel useless or worthless when they are not actively doing something or pursuing a goal. Although this is not always a bad thing, this inability to limit activity can exacerbate the symptoms of fatigue and pain. “Hence, treatment of CFS should target SCP and related cognitive behavioral factors in patients with self-critical features,” said Kempke.

Kempke, S., et al. (2013). Self-Critical Perfectionism and its Relationship to Fatigue and Pain in the Daily Flow of Life in Patients with Chronic Fatigue Syndrome. Psychological Medicine 43.5 (2013): 995-1002. ProQuest. Web. 23 May 2013.

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  • joe


    June 4th, 2013 at 3:53 AM

    Because some people are so busy trying to do everything perfectly they are constantly wearing themselves out!

  • Paul DB

    Paul DB

    June 10th, 2013 at 4:49 PM

    Speaking as an SCP person with CFS,I’d say Kempke is truly on to something! The description of the theory is almost autobiographical (for me, that is). Ouch, on the one hand, but kudos to him on the other!

  • Kerbox


    June 28th, 2013 at 7:05 PM

    Whatever the thinker the thinks, the prover proves. Just more pseudoscience and conjecture for this horrific and clearly biomedical condition.

    The fact is there is no consistent personality trait for people who develop this condition, hits anyone from any walk of life.

    It is easy to confuse this kind of behaviour with the simple fact that people with this condition are endlessly struggling to achieve anything and watching their life go by them.

    I can easily relate to what this article is saying through my own years of ME/CFS, I have taken up many subjects and activities to try and keep myself busy with high motivation only to ‘burn out’. The fact remains I was trying to function on about a 20-30% capacity to any normal person, with severe cognitive deficiencies, because of a real physical illness.

    Finding psychological traits with this condition is like shooting fish in a barrel, but it is just nit picking at the wreckage after the storm and what has any of it done to advance improvement in the condition for decades?

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