Interpretation bias modification (CBM-I) for fatigue in long term health conditions - A feasibility study

This study examined the acceptability of a new fatigue-focused Cognitive Bias Modification training for interpretations (CBM-I) for those with long term health conditions (LTC) and the feasibility of delivering a randomised controlled trial of fatigue-focused CBM-I compared to control training. Effects on fatigue-related interpretation bias, self-reported fatigue, depression and anxiety were also explored.

A two-armed (CBM-I or control) randomised controlled feasibility and acceptability trial. Participants with a LTC (cancer, multiple sclerosis, chronic fatigue syndrome or post-COVID condition) were randomly allocated to 12 online training sessions of CBM-I (N = 66) or a matched control condition (N = 65). Participants were assessed at baseline pre-randomisation (T0), and post-intervention (T1), two (T2) and four months post-randomisation (T3). Assessments included measures of acceptability, interpretation bias, self-reported fatigue and mood.

The results indicate that fatigue-focused CBM-I training appears acceptable to people with LTCs, shown by good rates of adherence (77% completing full dose) and acceptability scores. It appears feasible to recruit and retain participants through follow-up (70% retained at four months). There was a large effect size (g = 0.834, 95% CI [0.472,1.196]) in favour of the intervention on the purported mechanism of change (interpretation biases) and small effects on self-reported fatigue and depression but not anxiety.

The study suggests that CBM-I training is an easy to administer, relatively brief digital intervention which shows promise in reducing fatigue and associated symptoms in those with long term health conditions. A full-scale trial of CBM-I for fatigue LTCs is justified on the basis of the findings.