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Behav Res Ther. 2014 Jan;52:9-16. doi: 10.1016/j.brat.2013.10.005. Epub 2013 Oct 24.

Attention processes in chronic fatigue syndrome: attentional bias for health-related threat and the role of attentional control.

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Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
Health Psychology Section, Psychology Department, Institute of Psychiatry, King's College London, London Bridge, London SE1 9RT, United Kingdom. Electronic address:
Psychology, University of Southampton, Southampton, United Kingdom.
University of Southampton, Primary Medical Care, Aldermoor Health Centre, Southampton, United Kingdom.


Cognitive behavioural models of chronic fatigue syndrome (CFS) propose that attention processes, specifically, enhanced selective attention to health-threat related cues, may play an important role in symptom maintenance. The current study investigated attentional bias towards health-threat stimuli in CFS. It also examined whether individuals with CFS have impaired executive attention, and whether this was related to attentional bias. 27 participants with CFS and 35 healthy controls completed a Visual Probe Task measuring attentional bias, and an Attention Network Test measuring executive attention, alerting and orienting. Participants also completed self-report measures of CFS and mood symptoms. Compared to the control group, the CFS group showed greater attentional bias for health-threat words than pictures; and the CFS group was significantly impaired in executive attention. Furthermore, CFS individuals with poor executive attention showed greater attentional bias to health-threat related words, compared not only to controls but also to CFS individuals with good executive attention. Thus, this study revealed a significant relationship between attentional bias and executive attention in CFS: attentional bias to threat was primarily evident in those with impaired executive attention control. Taking account of individual differences in executive attention control in current intervention models may be beneficial for CFS.


ANOVA; ANT; Attention Network Test; Attentional bias; CDC; CFS; Centre for Disease Control; Chronic fatigue syndrome; Executive attention control; HADS; Hospital Anxiety and Depression Scale; RT; SPSS; Statistical Package for Social Sciences; VPT; Visual Probe Task; analysis of variance; chronic fatigue syndrome; reaction time

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