{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T20:46:28Z","timestamp":1782938788595,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Chronic fatigue syndrome\/myalgic encephalomyelitis (CFS\/ME) is a debilitating condition characterized by persistent fatigue, impaired functioning, and substantial societal burden. Although cognitive behavioral therapy (CBT) is commonly used for CFS\/ME, the effective components and delivery formats remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched MEDLINE, Embase, PsyclNFO, Web of Science, the Cochrane Library, and major English and Chinese databases from inception to January 15, 2025, without language restrictions. Ultimately, a frequentist network meta\u2010analysis (NMA) and component network meta\u2010analysis (cNMA) of 16 randomized controlled trials were conducted to assess the associations between CBT components, delivery formats, and patient\u2010important outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At the treatment level, guided self\u2010help CBT (mean difference [MD], \u22126.89; 95% CI, \u22129.56 to \u22124.22; moderate certainty) and individual CBT (MD, \u22124.81; 95% CI, \u22126.98 to \u22122.65; moderate certainty) probably reduced fatigue when measured immediately after treatment. At the component level, goal setting (incremental mean difference [iMD], \u22128.83; 95% CI, \u221216.92 to \u22120.74), third\u2010wave components (iMD, \u22126.02; 95% CI, \u221211.33 to \u22120.72), and cognitive restructuring (iMD, \u22124.41; 95% CI, \u22128.83 to 0.01) were associated with reduced fatigue when measured immediately after treatment. Psychoeducation was potentially counterproductive (iMD, 5.23; 95% CI, 0.64 to 9.82). At the end of follow\u2010up, cognitive restructuring was associated with reduced fatigue and depression, and improved physical function; goal setting was also associated with improved physical function. The combination of goal setting, third\u2010wave components, and cognitive restructuring delivered via guided self\u2010help may be an efficacious component\u2010based intervention relative to the nonspecific treatment component (iMD, \u221216.33; 95% CI, \u221226.68 to \u22125.99).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The effective CBT combination probably involves goal setting, third\u2010wave components, and cognitive restructuring delivered via guided self\u2010help, while psychoeducation may be detrimental. Future studies should prospectively examine core CBT components and their interactions, as well as incorporate measures of dose and intensity to guide more personalized and scalable interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>CRD420251018083<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71513","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:11:48Z","timestamp":1780290708000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Components and Delivery Formats of Cognitive Behavioral Therapy for Chronic Fatigue Syndrome\/Myalgic Encephalomyelitis: A Systematic Review and Component Network Meta\u2010Analysis"],"prefix":"10.1002","volume":"16","author":[{"given":"Shoujian","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Tuina Shuguang Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Tuina Shuguang Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sitong","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Tuina Shuguang Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiukui","family":"Hao","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Qing","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Dental Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Department of Health Research Methods, Evidence and Impact McMaster University  Hamilton Canada"},{"name":"CEBIM (Center for Evidence\u2010Based Integrative Medicine) Guang'anmen Hospital China Academy of Chinese Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingjun","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Tuina Shuguang Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"},{"name":"Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Tuina Shuguang 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