title: An attention and interpretation bias for illness-specific information in chronic fatigue syndrome.
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.
  
  
  METHODS
  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.
authors.affiliation: Psychology Department,King's College London,Institute of Psychiatry, Psychology and Neuroscience,London,UK.
authors.forename: A M
authors.initials: AM
authors.lastname: Hughes
authors.affiliation: Department of Psychological Medicine,King's College London,London,UK.
authors.forename: T
authors.initials: T
authors.lastname: Chalder
authors.affiliation: Psychology Department,King's College London,Institute of Psychiatry, Psychology and Neuroscience,London,UK.
authors.forename: C R
authors.initials: CR
authors.lastname: Hirsch
authors.affiliation: Psychology Department,King's College London,Institute of Psychiatry, Psychology and Neuroscience,London,UK.
authors.forename: R
authors.initials: R
authors.lastname: Moss-Morris
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology*; D000070379:Attentional Bias / Q000502:physiology*; D015673:Fatigue Syndrome, Chronic / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013850:Thinking / Q000502:physiology*; D055815:Young Adult
keywords: Attentional bias; chronic fatigue syndrome; cognitive processing; interpretation bias