The effects of cognitive behavioral therapy for postcancer fatigue on perceived cognitive disabilities and neuropsychological test performance

Martine M Goedendorp, Hans Knoop, Marieke F M Gielissen, Constans A H H V M Verhagen, Gijs Bleijenberg

Research output: Contribution to JournalArticleAcademicpeer-review


CONTEXT: After successful cancer treatment, a substantial number of survivors continue to experience fatigue and related concentration and memory problems. Severe fatigue after cancer treatment can be treated effectively with cognitive behavioral therapy (CBT), but it is unclear whether CBT has an effect on cognitive functioning.

OBJECTIVES: We hypothesized that patients would report less cognitive disability after treatment with CBT for cancer-related fatigue. CBT was not expected to affect neuropsychological test performance, as it has been shown that fatigue is not associated with test performance.

METHODS: Data were used from a randomized controlled trial in which 98 severely fatigued cancer survivors, treated at least one year previously, were assessed at baseline (T1) and six months post-baseline (T2). Patients were randomly assigned to receive CBT (n = 50) or to a waiting list (WL) control condition (n = 48). Self-reported cognitive disability was assessed by the Concentration subscale of the Checklist Individual Strength and the Alertness Behavior subscale of the Sickness Impact Profile. Neuropsychological test performance was measured by the symbol digit modalities task and two reaction time tasks.

RESULTS: Patients who received CBT for post-cancer fatigue reported significantly less cognitive disability compared with those in the WL group. CBT also was associated with a clinically relevant reduction in concentration problems (CBT, 32% vs. WL, 2%). There were no significant differences in neuropsychological test performance between the CBT and WL groups.

CONCLUSION: CBT for post-cancer fatigue has already been shown to be an effective therapy. The present study demonstrates that CBT also may lead to a decrease in perceived cognitive disability.

Original languageEnglish
Pages (from-to)35-44
Number of pages10
JournalJournal of Pain and Symptom Management
Issue number1
Publication statusPublished - Jan 2014
Externally publishedYes


  • Adult
  • Attention
  • Cognition Disorders/etiology
  • Cognitive Behavioral Therapy
  • Fatigue/etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasms/complications
  • Neuropsychological Tests
  • Self Report
  • Survivors/psychology
  • Treatment Outcome


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