Implicit processing of symptom and illness-related information in chronic fatigue syndrome: a systematic review

Abstract

Background: Cognitive behavioural models propose that the way in which people with Chronic Fatigue Syndrome (CFS) process information, specifically how they attend to and interpret illness related information, may play an important role in symptom maintenance. This systematic review investigates whether people with CFS have implicit biases in how they process information. Methods: Electronic databases were searched using CFS and experimental methodology search terms. Twelve studies measured attention and interpretative bias for illness related information in CFS. Findings: The evidence for implicit biases was dependant on the methodology employed as well as the type and duration of the stimuli presented. There was preliminary evidence to suggest that people with CFS have illness related top down processing biases which affects how information is interpreted and attended to. Discussion: A clinical implication of these findings is that such processing biases may maintain negative illness beliefs and symptoms in people with CFS. This review highlights methodological issues in experimental design and makes recommendations for future research to forge a consistent approach in implicit processing research.