Do we know that HPA stuff is out of whack in ME/CFS when primary depression patients are excluded? I hear this but I don't have any studies to reference. I would like to know one way or the other. I do know that autonomic disturbance does cause ME/CFS patients to react poorly to stress of any kind. Since I can't read the full study (what is up with that? the CDC studies are usually free access?) I can't tell for sure, but since it specifically classified CFS as "neuropsychiatric" and and in the context of what the CDC has been saying lately and just the wording of "the individual's stress response"... I would expect her to mean emotional health and behavioral choices (as well as allostatic load). If you don't think so, that's good.