Attentional bias towards health-threat information in chronic fatigue syndrome Ruihua Hou a , Rona Moss-Morris b, ⁎ , Brendan P. Bradley b , Robert Peveler a , Karin Mogg b a School of Medicine, University of Southampton, Southampton, United Kingdom b School of Psychology, University of Southampton, Southampton, United Kingdom Received 16 October 2007; received in revised form 11 March 2008; accepted 20 March 2008 Abstract Objective: To investigate whether individuals with chronic fatigue syndrome (CFS) show an attentional bias towards health- threat information. Methods: Attentional bias (AB) was assessed in individuals with CFS and healthy controls using a visual probe task which presented health-threat and neutral words and pictures for 500 ms. Self-report questionnaires were used to assess CFS symptoms, depression, anxiety, and social desirability. Results: Compared to a healthy control group, the CFS group showed an enhanced AB towards heath-threat stimuli relative to neutral stimuli. The AB was not influenced by the type of stimulus (pictures vs. words). Conclusion: The finding of an AB towards health-threat information in individuals with CFS is supportive of models of CFS which underlie cognitive behavior therapy. © 2008 Elsevier Inc. All rights reserved. Keywords: Attentional bias; Chronic fatigue syndrome; Health-threat stimuli; Visual probe task Introduction Chronic fatigue syndrome (CFS) is characterized by debilitating and unexplained fatigue lasting at least 6 months, associated with profound impairment in daily functioning [1]. Recent cognitive-behavioral models of CFS, which provide the basis for effective cognitive behavior therapy [2], suggest that individuals with CFS have specific underlying cognitions (e.g., negative illness beliefs and biased inter- pretations of symptoms) which are important in both the onset and perpetuation of CFS [3–6]. Most research into cognitive biases in CFS has relied on self-report measures. Consequently, the focus has been on the content of cognitions or beliefs rather than on processes which develop or maintain them. Processes such as an attentional bias (AB) to illness-related information may be particularly important in maintaining CFS because, if an individual selectively focuses attention on information related to potential health threats, this may amplify their subjective experience of ill- health out of their conscious awareness. Any situation or factor that may represent a danger to the health of people is defined as a health threat [7]. High levels of self-reported health worry and preoccupation with health threats are common in CFS [8]. However, the evidence that CFS is associated with a processing bias for health threat- related information is mixed and limited; for example, evidence has been found for a negative bias in the interpretation of ambiguous health threat-related informa- tion, but not an AB [9]. However, AB has so far only been assessed using a modified Stroop task which assesses the distracting effect of task-irrelevant threat information. The aim of this preliminary study was to investigate whether individuals with CFS show an AB for health-threat information using a visual probe task, which has been widely used to assess AB for threat information in other conditions, such as anxiety and chronic pain [10–12]. The task presents pairs of stimuli (e.g., a threat and neutral picture), and one item of each stimulus pair is replaced by a probe (e.g., an arrow). Reaction times (RTs) to probes provide a measure of Journal of Psychosomatic Research 65 (2008) 47 – 50 ⁎ Corresponding author. School of Psychology, University of South- ampton, Highfield, SO17 1BJ Southampton, United Kingdom. Tel.: +44 2380 597549. E-mail address: remm@soton.ac.uk (R. Moss-Morris). 0022-3999/08/$ – see front matter © 2008 Elsevier Inc. All rights reserved. doi:10.1016/j.jpsychores.2008.03.008