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Dr. Chiou & Perception of Fatigue
Dr. Chiou & Perception of Fatigue
Dr. Kathy S. Chiou is an assistant professor in the Department of Psychology and an affiliate faculty at the Center for Brain, Biology and Behavior. Her doctoral training in clinical psychology with an emphasis in neuropsychology was completed at the Pennsylvania State University, with a year of clinical internship also in neuropsychology done at the University of Florida Health Science Center. She then completed a postdoctoral fellowship in the Traumatic Brain Injury research lab at Kessler Foundation.
Dr. Chiou's research is guided by translational themes that range from the investigation of basic mechanisms that underlie performance/behavior to the development of tools, protocols, and interventions for clinical application. In particular, Dr. Chiou is interested in how processes of self-awareness and metacognition (the online ability to “think about thinking”) are affected by brain injury. These research questions (and others) are investigated in the lab using a combination of methodologies including traditional cognitive assessment, as well as structural and functional magnetic resonance imaging (MRI).
When Dr. Chiou is not in the lab, you're likely to find her: on a couch somewhere (reading), on one of the trails in town (biking or running), or on a mountain somewhere (backpacking or snowboarding).
(source)(source)Awareness of Subjective Fatigue
Awareness of Subjective Fatigue
In one of her studies (cited to the right), Dr. Chiou compared patients with Traumatic Brain Injuries (TBI) and a healthy comparison group. She asked them to complete several scales, such as the Modified Fatigue Impact Scale described below, in which participants described how often they had been fatigued in the past month. She also asked for an 'informant report', in which someone who knew the participant well provided their ratings of the participant's functioning over the same time period. The difference between these two reports -- the participants' own ratings of themselves, and those from the person who knew them well -- became the discrepancy score.
The graph to the right depicts the average discrepancy score of patients with TBI. The three categories (physical, cognitive, and psychosocial) are based on participants reports of fatigue when doing physical, cognitive, or psychosocial tasks. (You'll read more about this scale in the section below.)
In your own words, what does this mean for TBI patients' ability to identify their own physical, cognitive, and psychosocial fatigue?
Figure 1. Average and standard deviation of fatigue awareness. Awareness is quantified by the absolute discrepancy score; higher scores indicate poorer awareness (greater discrepancy between self- and informant ratings) and smaller scores indicate better awareness (smaller discrepancy between self- and informant ratings).
Chiou, K. S., Chiaravalloti, N. D., Wylie, G. R., DeLuca, J., & Genova, H. M. (2016). Awareness of subjective fatigue after moderate to severe traumatic brain injury. Journal of Head Trauma Rehabilitation, 31(3), E60-E68.
Fatigue Perception & Depression
Fatigue Perception & Depression
When we talk about sensation and perception, we usually think about senses like sight, smell, or touch. In the study mentioned above, Dr. Chiou explored patients' perceptions of fatigue and found a potential relationship between perceived fatigue, brain injury, and depression.
By examining the the illustration below, you can see how this experience of repeated mis-perception could lead to depression. Thinking about your own life as a student, how could you help your classmates (with or without TBI) correctly identify their fatigue and not blame themselves?
Identifying Feelings
Identifying Feelings
As part of her study with TBI patients, Dr. Chiou asked them to complete the Modified Fatigue Impact Scale (MFIS, mentioned above) and a depression inventory (the Patient Health Questionnaire-9, PHQ-9). In the spreadsheet linked to the right, we have presented both scales so you can take them yourself. We won't ask you to report your scores, just reflect on your feelings about the measures themselves.
To take the surveys: Open the spreadsheet in a new window, and go to File > Make a Copy. This will let you save a version of the file to your own Drive, so you can edit it without anyone seeing your score.
What are some differences between the two scales? What are some similarities? How do you know what you're feeling when two experiences can be so similar?
Sensation is Complicated!
Sensation is Complicated!
Wikipedia has a helpful article about interoception, also known as our sense of our body’s internal state (e.g., the ability to sense fatigue). You can read about what interoception is, as well as research exploring the relationship between interoception and mental health.
Does anything described in this article sound like something you've experienced? How can you use this information to be self-aware and experience better mental health?
-alternately-
Can you think of any interoceptive misperceptions that might explain something from psychology that you're interested in?
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