A new experimental study published in Scientific Reports explores how expectations around fatigue impact how motivated people with primary biliary cholangitis (PBC) feel to push through mentally demanding activities.
Fatigue is one of the most common symptoms of PBC, and is a major burden on quality of life. None of the available treatments for PBC appear to alleviate fatigue, and in some instances, it may persist even after liver transplantation. Fatigue is known to cause depressive symptoms in people with PBC and leads to avoiding tasks and activities that may be fatigue-inducing.
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For the study, researchers recruited 46 people with PBC, the majority of whom were women. Participants were randomly assigned to one of two groups. Before being asked to complete a demanding cognitive task, one group received instructions that the task would increase fatigue (negative instructions), while the other was told the task would reduce fatigue (positive instructions).
Across both groups, feelings of fatigue and the urge to stop doing the task increased over time. But the results showed key differences between the groups in motivation to complete the tasks. Those given negative instructions reported a significantly greater urge to quit the task over time compared to those in the positive instruction group. Importantly, reported levels of fatigue during the task did not differ between groups.
Researchers say that these findings suggest that verbal suggestions of how a task or symptom is framed can influence how willing people may be to persist through fatigue, even if their sense of tiredness doesn’t change.
For individuals with PBC, this could be especially important, as they may be prone to avoid tasks in anticipation of fatigue, leading to isolation and decreased quality of life.
The authors note important limitations, including the overwhelmingly female participant pool and the small sample size. Additionally, the experiment involved short tasks in an experimental setting, so implications for everyday activities, work and long-term tasks are not yet known.
Still, the researchers say the study could be helpful for clinicians in how they speak to patients with PBC about fatigue and motivation.
“In clinical practice, careful communication that fosters realistic expectations and encourages cognitive activity may help patients to reduce avoidance behavior and to maintain an appropriate level of activity,” they concluded.
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