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

Jeroen J Roor*, Hans Knoop, Brechje Dandachi-FitzGerald, Maarten J.V. Peters, Gijs Bleijenberg, Rudolf W.H.M. Ponds

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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.

Original languageEnglish
Pages (from-to)188-196
Number of pages9
JournalApplied Neuropsychology-Adult
Issue number2
Early online date31 Oct 2018
Publication statusPublished - 3 Mar 2020


  • Chronic fatigue syndrome
  • Invalid performance
  • Feedback
  • Neuropsychological assessment
  • Underperformance

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