Attentional and interpretive bias towards illness-related information in chronic fatigue syndrome

[Dolphin]

When I was failing to find the full text for this I found this from a phd dissertation that could be of interest:

Attentional Bias and Physical Symptom Reporting

2015

Sarah Scott

Results
Chronic Fatigue Syndrome
There is very limited evidence for an attentional bias towards body relevant information in individuals with CFS according to the findings of the reviewed studies. Although this has been explored using a range of paradigms (exogenous cueing task, emotional Stroop task and dot-probe task), attentional bias has only been observed in one study using the dot-probe task with an SOA of 500ms in CFS patients compared to healthy controls. Hou, Moss-Morris, Bradley, Peveler, and Mogg (2008) found that CFS participants were faster to respond when the threat stimulus and probe were in the same position relative to when these were in different positions; this implies that the threatening information had a facilitating effect. The effect was not influenced by mode of presentation and was unrelated to anxiety, depression and psychomotor speed. In contrast, Hou et al. (2014) did not find evidence of an attentional bias to health threat information on a dot-probe task with the same stimuli when participants with CFS with poor executive control were excluded. Thus, the attentional bias effect appeared to be dependent reflect poor executive attention in the CFS participants; however, there was no comparison with non-CFS participants with poor executive attention, making it difficult to draw firm conclusions. No effects at an SOA of 1250ms were found.

A larger study by the same authors was able to detect more detailed subgroup results (Hou et al., 2014). Using the same stimuli, they found people with CFS had an attentional bias towards health-threatening words, but not for threatening pictures presented for both 500 and 1,250 ms (Hou et al., 2014), indicating attentional biases continue to occur at later stages of processing. There were no significant correlations between attentional bias scores and anxiety or depression. Hou et al. (2014) also measured attention processes using the Attention Network Task (Fan, McCandliss, Sommer, Raz, & Posner, 2002), an objective measure of the altering network, orientation of attention, and executive attentional control. There were no group differences in alerting or orientating of attention; however, people with CFS had impaired executive attentional control (p = .01) compared to healthy participants, which was associated with increased attentional bias for threat words (p < .001) but not pictures (F < 1.)

I didn't find the underlying bit being highlighted in the current review or at least not very clearly.

Rona Moss-Morris was an author on both papers including being the corresponding author on the review.

I see that Esther12 has already made this point in a subsequent post:
http://forums.phoenixrising.me/inde...nic-fatigue-syndrome.45325/page-2#post-738255

 

[Dolphin]

One unpublished study employed a visual-probe task (Papitsch, 2005). The CFS group was dichotomized into those with and without comorbid depression and compared to a healthy control group. Papitsch (2005) used five sets of 12 words relating to fatigue, illness, depression, positive control, and neutral words, presented for 500 ms. Papitsch (2005) found no significant differences between groups in response to fatigue or depression words but a significant effect in relation to illness stimuli (p < .05), with depressed CFS patients responding slower to illness stimuli whereas healthy controls responding quicker (p < .01). Planned contrasts also found CFS participants with concurrent depression had an attentional bias for depression-related information when compared to non-depressed CFS participants (p < .05). These effects were not controlled for anxiety despite the depressed CFS group reporting significantly higher anxiety than the non-depressed CFS group (p < .005) and healthy controls (p < .001). These findings These findings should be treated with caution as this unpublished study was underpowered and had poor quality rating compared to the published studies in this review.

Is the underlined bit the opposite of what one would expect if CFS patients were overly focused on the illness words?

 

[Dolphin]

Martin and Alexeeva (2010) used an online lexical decision task to measure interpretive bias after inducing a neutral or ruminative state. The lexical decision task required participants to quickly identify whether a string of letters (target) that appeared on screen was a word or non-word, whilst they listened to homophones with illness, depression, or neutral interpretations. The study found there was a trend for CFS participants to be slower than controls to identify whether the text was a word or nonword (p = .055) and neutral homophones produced significantly faster reaction times than illness and social threat homophones (p < .001). However, there was no significant interaction between groups (CFS and healthy controls), homophones, and the target (p = .680) regardless of induction.

Is the underlined bit the opposite of what one would expect if CFS patients were overly focused on the illness words? Admittedly it looks like the control group had a similar response.

 

[Dolphin]

Thus, cognitive biases in CFS may represent a specific cognitive strategy developed to avoid further injury and disability.

If this is true, it is not necessarily maladaptive.

 

[Dolphin]

Seems reasonable:

Some studies reported mean illness durations over 11 years; thus, cognitive biases may reflect the chronicity of their illness generally rather than a unique CFS effect.

 

[Dolphin]

Potentially, once this basic research is carried out, this knowledge could be translated into novel clinical interventions, for example cognitive bias modification training (see Hertel & Mathews, 2011) or attentional control functioning (see Siegle, Ghinassi, & Thase, 2007) to be used alongside existing treatments.

I don't like the sound of these therapies,especially the first one..

 

[Barry53]

On the plus side, they're starting to sound quite insane now. There's a sort of demented, euphoric mania about the tone of this. I have visions of them, gathered in the BPS bunker while the forces of reason converge on them, churning out paper for all they're worth and cackling to themselves. I think they know their goose is cooked and they're totally losing the plot.

A sort of twaddle factory.

 

[Dolphin]

There are various questionable claims made about CFS in general in this paper, coming from the perspective of the CBT school of thought. No biological findings are mentioned or contradictory findings are mentioned.

 

[Barry53]

Therefore, of course,



This is a common feature of their claims and reasoning: they pass straight from possible to definite, without having to go through that messy evidence based proof step in between.

They have been doing it since I can remember, and are only getting worse.

••••••••••••••••••



But apparently not in doing psychiatric research into CFS.

This is not unlike some of the archaeological/historical quasi-investigative TV programmes you see. Uncover tentative evidence that might just possibly be true, and then proceed along the lines of "Now that we know such-and-such to be the case we can now establish ... blah ...".

 

[Wolfiness]

Cognitive processes have a role to play in the cognitive behavioural model of CFS.

My Little Pony has a role to play in the My Little Pony universe. FFS. The circular argument is circular. All they're doing is anatomising their own fallacy.

 

[Cheshire]

Well, this study is soooo wonderfull that they replicated it with a Dutch (why am I not surprided?) cohort:

Cross-Cultural Study of Information Processing Biases in Chronic Fatigue Syndrome: Comparison of Dutch and UK Chronic Fatigue Patients

• Alicia M. Hughes
• Colette R. Hirsch
• Stephanie Nikolaus
• Trudie Chalder
• Hans Knoop
• Rona Moss-Morris
  
  
  

  Abstract
  Purpose
  This study aims to replicate a UK study, with a Dutch sample to explore whether attention and interpretation biases and general attentional control deficits in chronic fatigue syndrome (CFS) are similar across populations and cultures.
  
  Method
  Thirty eight Dutch CFS participants were compared to 52 CFS and 51 healthy participants recruited from the UK. Participants completed self-report measures of symptoms, functioning, and mood, as well as three experimental tasks (i) visual-probe task measuring attentional bias to illness (somatic symptoms and disability) versus neutral words, (ii) interpretive bias task measuring positive versus somatic interpretations of ambiguous information, and (iii) the Attention Network Test measuring general attentional control.
  
  Results
  Compared to controls, Dutch and UK participants with CFS showed a significant attentional bias for illness-related words and were significantly more likely to interpret ambiguous information in a somatic way. These effects were not moderated by attentional control. There were no significant differences between the Dutch and UK CFS groups on attentional bias, interpretation bias, or attentional control scores.
  
  Conclusion
  This study replicated the main findings of the UK study, with a Dutch CFS population, indicating that across these two cultures, people with CFS demonstrate biases in how somatic information is attended to and interpreted. These illness-specific biases appear to be unrelated to general attentional control deficits.

  https://link.springer.com/article/10.1007/s12529-017-9682-z

Still no sick control group...

 

[sarah darwins]

@Dolphin - I don't know how you manage to wade through so much bullshit without completely losing your mind, but thank you for doing it so the rest of us don't have to. You're a star.

 

[Kati]

This is another attempt to discredit patients.

 

[A.B.]

This is another attempt to discredit patients.

They would like to tell a narrative of purely subjective symptoms, where the patient has a cognitive bias towards illness.

 

[leela]

Where's the study on *their* cognitive biases? Hmm?