Feedback on underperformance in patients with Chronic Fatigue Syndrome: The impact on subsequent neuropsychological test performance

Appl Neuropsychol Adult. 2020 Mar-Apr;27(2):188-196. doi: 10.1080/23279095.2018.1519509. Epub 2018 Oct 31.


Performance Validity Tests (PVTs) are used to measure the credibility of neuropsychological test results. Until now, however, a minimal amount is known about the effects of feedback upon noncredible results (i.e., underperformance) on subsequent neuropsychological test performance. The purpose of this study was to investigate the effects of feedback on underperformance in Chronic Fatigue Syndrome (CFS) patients. A subset of these patients received feedback on Amsterdam Short-Term Memory (ASTM) failure (i.e., feedback [FB] group). After matching, the final sample consisted of two comparable groups (i.e., FB and No FB; both n = 33). At baseline and follow-up assessment, the patients completed the ASTM and two measurements of information processing speed (Complex Reaction Time [CRT] and Symbol Digit Test [SDT]). Results indicated that the patients in the FB group improved significantly on the CRT, compared to the No FB group. Although not significant, a comparable trend-like effect was observed for the SDT. Independent of the feedback intervention there was a substantial improvement on ASTM performance at re-administration. A limited feedback intervention upon underperformance in CFS patients may result in improvement on information processing speed performance. This implies that such an intervention might be clinically relevant, since it maximizes the potential of examining the patients' actual level of cognitive abilities.

Keywords: Chronic fatigue syndrome; Feedback; Invalid performance; Neuropsychological assessment; Underperformance.

MeSH terms

  • Adult
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / etiology
  • Cognitive Dysfunction / physiopathology*
  • Fatigue Syndrome, Chronic / complications
  • Fatigue Syndrome, Chronic / physiopathology*
  • Feedback, Psychological*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • Task Performance and Analysis*