Cognitive behavioural models propose the way in which people with chronic fatigue syndrome (CFS) perceive and respond to symptoms and other illness-related information, contributes to the maintenance of fatigue and disability. Self-report studies exploring a number of these factors have proved fruitful. However, data regarding cognitions and behaviours that may occur at earlier, more implicit levels of processing is lacking. This thesis presents a series of experimental studies to investigate the manner in which people with CFS process information. The main work in this thesis is based on a large cross sectional cohort of people with CFS, compared to healthy controls; followed by a nested longitudinal study of the patients who underwent cognitive behavioural treatments for CFS, namely cognitive behavioural therapy (CBT) and graded exercise therapy (GET). Study 1: A systematic review of attention and interpretation biases found mixed evidence for information processing biases in CFS and highlights methodological issues in experimental design. Study 2: A published article addresses one of the key methodical issues highlighted in the review, the lack of illness-specific materials, by detailing a step-by-step process of comprehensive/robust stimuli development for experimental research. Study 3: A published quasi-experimental study indicates that, when using illness-specific materials, people with CFS (n=52) demonstrate attention and interpretation biases, compared to healthy individuals (n=51); which are associated with unhelpful responses to symptoms, but independent of comorbid mood disorder and attentional control deficits. Study 4: A replication study with a Dutch cohort of CFS participants (n=38) indicates that cognitive biases are a robust finding across cultures and CFS populations, and confirms that these biases are independent of attentional control. Study 5: A nested longitudinal study (n=26) found that, pre-existing attentional biases, as well as a high capacity to develop an attentional bias (i.e. attention malleability), predicts better functioning, but not fatigue post treatment for CFS. Pre-treatment interpretation biases do not appear to predict treatment outcomes in CFS. Study 6: A small follow-up up study (n=20) found that attentional control capacity significantly improves following treatment for CFS. Whilst attention and interpretation biases did not significantly change across this treated sample, the degree to which they changed was associated with more helpful cognitions and behaviours. By exploring the more implicit factors within the cognitive behavioural model of CFS, this body of experimental work has added another dimension to the CFS literature and contributes to a more comprehensive and nuanced understanding of information processing in CFS.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:762335 |
| Date | January 2017 |
| Creators | Hughes, Alicia Maria |
| Contributors | Moss-Morris, Rona ; Hirsch, Colette Rosanne |
| Publisher | King's College London (University of London) |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | https://kclpure.kcl.ac.uk/portal/en/theses/a-longitudinal-investigation-of-information-processing-biases-and-selfreported-cognitions-and-behaviours-in-chronic-fatigue-syndrome(cc5c9646-8a72-49bd-97b4-ba2df2bee0e1).html |
Page generated in 0.0014 seconds