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An attention and interpretation bias for illness-specific information in chronic fatigue syndrome

Published online by Cambridge University Press:  29 November 2016

A. M. Hughes ,
T. Chalder ,
C. R. Hirsch  and
R. Moss-Morris
A. M. Hughes
Affiliation:
Psychology Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
T. Chalder
Affiliation:
Department of Psychological Medicine, King's College London, London, UK
C. R. Hirsch
Affiliation:
Psychology Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
R. Moss-Morris*
Affiliation:
Psychology Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
*
*Address for correspondence: R. Moss-Morris, Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th Floor Bermondsey Wing, Guy's Hospital Campus, London Bridge, London SE1 9RT, UK. (Email: Rona.moss-morris@kcl.ac.uk)
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Abstract

Background

Studies have shown that specific cognitions and behaviours play a role in maintaining chronic fatigue syndrome (CFS). However, little research has investigated illness-specific cognitive processing in CFS. This study investigated whether CFS participants had an attentional bias for CFS-related stimuli and a tendency to interpret ambiguous information in a somatic way. It also determined whether cognitive processing biases were associated with co-morbidity, attentional control or self-reported unhelpful cognitions and behaviours.

Method

A total of 52 CFS and 51 healthy participants completed self-report measures of symptoms, disability, mood, cognitions and behaviours. Participants also completed three experimental tasks, two designed specifically to tap into CFS salient cognitions: (i) visual-probe task measuring attentional bias to illness (somatic symptoms and disability) v. neutral words; (ii) interpretive bias task measuring positive v. somatic interpretations of ambiguous information; and (iii) the Attention Network Test measuring general attentional control.

Results

Compared with controls, CFS participants showed a significant attentional bias for fatigue-related words and were significantly more likely to interpret ambiguous information in a somatic way, controlling for depression and anxiety. CFS participants had significantly poorer attentional control than healthy individuals. Attention and interpretation biases were associated with fear/avoidance beliefs. Somatic interpretations were also associated with all-or-nothing behaviour and catastrophizing.

Conclusions

People with CFS have illness-specific biases which may play a part in maintaining symptoms by reinforcing unhelpful illness beliefs and behaviours. Enhancing adaptive processing, such as positive interpretation biases and more flexible attention allocation, may provide beneficial intervention targets.

Keywords

Attentional biaschronic fatigue syndromecognitive processinginterpretation bias
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 5 , April 2017 , pp. 853 - 865
Copyright
Copyright © Cambridge University Press 2016 

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Footnotes

† Joint last authors.

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