Evaluating Neuropsychological Impairment in Chronic Fatigue Syndrome

Department of Medical Psychology, Radboud University Nijmegen, Nymegen, Gelderland, Netherlands
Journal of Clinical and Experimental Neuropsychology (Impact Factor: 2.08). 05/1998; 20(2):144-56. DOI: 10.1076/jcen.
Source: PubMed


This study was designed to provide an estimate of the prevalence of neuropsychological impairment in chronic fatigue syndrome (CFS), to evaluate the concordance between impairment found on standardized tests and self-reported neuropsychological problems, and to study the relationship between neuropsychological functioning and fatigue severity and psychological processes. We adopted an individual approach to determine neuropsychological impairment as contrasted with the group-comparisons approach used in previous studies. Also, correction for premorbid functioning and confounders was done on an individual basis. The results show that a minority of participants were impaired in neuropsychological functioning. There was no relationship between neuropsychological impairment on standardized tests and self-reported memory and concentration problems. Neuropsychological functioning was not related to fatigue or depression. Slowed speed of information processing and motor speed were related to low levels of physical activity.

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    • "A number of studies have focussed on cognitive processes involved in CFS. Research has found an association between the self‐reported tendency to focus on symptoms and illness‐related impairment (Ray, Jefferies, & Weir, 1995, 1997; Vercoulen et al., 1998) in patients with CFS. In addition, an interpretative bias for processing somatic information (Moss‐Morris & Petrie, 2003), high levels of self‐reported health‐related worry and preoccupation with health threats (Aggarwal, McBeth, Zakrzewska, Lunt, & *Correspondence to: Marcantonio M. "
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    ABSTRACT: Chronic fatigue syndrome (CFS), which is characterized by fatigue and flu-like symptoms that are not alleviated by rest, is a poorly understood condition and an often controversial diagnosis. Earlier research has indicated that general metacognitions are associated with the severity of symptoms in patients with CFS. In the current study, we aimed to determine whether specific metacognitive factors are implicated in CFS. Using the metacognitive profiling interview template we investigated the following: (1) whether patients held positive or negative metacognitions about conceptual processes; (2) what their goals with respect to engaging in these processes were; and (3) what indicated that it was appropriate to stop. We also examined attention focus when experiencing CFS symptoms, and its advantages and disadvantages. Results showed that patients endorsed positive and negative metacognitions pertaining to conceptual processes. The goals of engaging in these processes were to identify the cause of, and devise strategies to cope with, symptoms. Patients were either unable to identify a stop signal for conceptual processing or identified an improvement in fatigue-related symptoms as representing the stop signal. Finally, patients reported that their attention focus when experiencing symptoms included distraction and monitoring of symptoms. Advantages to these strategies included symptom management, whereas disadvantages included an escalation of negative affect. The present findings provide preliminary evidence that specific metacognitive factors may be involved in CFS. Copyright © 2011 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Metacognitive profiling that may aid assessment and conceptualisation of psychological distress in CFS.
    Full-text · Article · Nov 2012 · Clinical Psychology & Psychotherapy
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    • "We did not identify a mechanism by which low visual information-processing speed and attention increased the risk of fatigue. In patients with CFS [26], the relationship between fatigue and deficits of visual information-processing speed and attention in accordance with symbol digit modalities test [35-37] and task A on TMT [37,38] have been shown. In a functional magnetic resonance imaging study, the lateral prefrontal and parietal cortices were activated during both tasks A and B on TMT [39]. "
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    ABSTRACT: Fatigue is a common complaint among elementary and junior high school students, and is known to be associated with reduced academic performance. Recently, we demonstrated that fatigue was correlated with decreased cognitive function in these students. However, no studies have identified cognitive predictors of fatigue. Therefore, we attempted to determine independent cognitive predictors of fatigue in these students. We performed a prospective cohort study. One hundred and forty-two elementary and junior high school students without fatigue participated. They completed a variety of paper-and-pencil tests, including list learning and list recall tests, kana pick-out test, semantic fluency test, figure copying test, digit span forward test, and symbol digit modalities test. The participants also completed computerized cognitive tests (tasks A to E on the modified advanced trail making test). These cognitive tests were used to evaluate motor- and information-processing speed, immediate and delayed memory function, auditory and visual attention, divided and switching attention, retrieval of learned material, and spatial construction. One year after the tests, a questionnaire about fatigue (Japanese version of the Chalder Fatigue Scale) was administered to all the participants. After the follow-up period, we confirmed 40 cases of fatigue among 118 students. In multivariate logistic regression analyses adjusted for grades and gender, poorer performance on visual information-processing speed and attention tasks was associated with increased risk of fatigue. Reduced visual information-processing speed and poor attention are independent predictors of fatigue in elementary and junior high school students.
    Full-text · Article · Jun 2011 · Behavioral and Brain Functions
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    • ". Research studies have suggested that reductions in fatigue following a graded exercise therapy treatment program may be a consequence of a decrease in symptom focus rather than an increase in physical fitness [15] and that improvements in CFS symptoms following a course of cognitive–behavioral therapy (CBT) are related to changes in negative beliefs about the consequence of exercise and activity [16]. Other research studies have also demonstrated that CFS patients have biases toward health-related threat stimuli [17] and somatic information [18], display a tendency to focus on symptoms and illness-related impairment [19] [20] [21], and present with high levels of preoccupation about health threats [22]. In addition, despite subjective reports of deficits in cognitive functioning, the lines of evidence for objective differences are inconsistent [23] [24]. "
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    ABSTRACT: Chronic fatigue syndrome (CFS) describes a condition that is primarily characterized by fatigue and flu-like symptoms that are not alleviated by rest. This study investigated the relationship among metacognitions, negative emotions, and symptom severity in CFS. A total of 96 patients who had received a diagnosis of CFS according to the Oxford Criteria completed a battery of self-report measures that consisted of the Depression Anxiety Stress Scales, the 30-Item Metacognitions Questionnaire, the Chalder Fatigue Questionnaire (CFQ), and the RAND 36-Item Short-Form Health Survey-Physical Functioning. Correlation analyses showed that negative emotions and metacognitions were positively correlated with measures of symptom severity and that metacognitions were a better predictor of symptom severity than anxiety and depression. Hierarchical regression analyses indicated that (1) lack of cognitive confidence predicted both mental and physical factors of the CFQ and physical functioning independently of negative emotions and (2) beliefs about the need to control thoughts predicted the mental factor of the CFQ independently of negative emotions and lack of cognitive confidence. The data support the potential application of the metacognitive model of psychological disorder to understanding CFS.
    Full-text · Article · Apr 2011 · Journal of Psychosomatic Research
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