Targeting thinking bias regarding fatigue with Cognitive Bias Modification in renal patients

Background: Renal patients with fatigue frequently show attentional bias and self-identity bias which affect individuals’ focus of attention and self-representation. The present pilot study explores the effectiveness of CBM in reducing attentional bias and self-identity bias regarding fatigue and related behavioral outcomes. Methods: The design of the present study was a single case ABA series design (N=22). After a 7 or 14 days baseline phase, there was a 2-week treatment and 3-weeks follow-up phase with the IAT, VPT and CBSQ as outcome measures. Results: CBM reduced attentional bias (d=0.56) and self-identity bias (d=0.81) from baseline to post-test. Individuals did not report lower avoidance behavior and all-or-nothing behavior after the intervention. Higher bias at baseline increased the CBM treatment effect. Only for self-identity bias, effects were maintained for three weeks follow-up. CBM responders showed similar levels of avoidance behavior and all-or-nothing behavior as non-responders. Conclusion: The present study provides the first preliminary evidence suggesting the effectiveness of CBM targeting attentional bias and self-identity bias related to fatigue. Although this study presents a valuable starting point regarding a novel CBM intervention targeting fatigue, due to insufficient statistical power, future research with an adequate powered sample is needed.