Ray, C, Phillips, L, Weir, W R · The British journal of clinical psychology · 1993 · DOI
Many people with ME/CFS report problems with attention and concentration in daily life. This study compared ME/CFS patients with healthy people using questionnaires about attention problems and computer-based attention tests. Patients reported significantly more attention difficulties than controls, though standard attention tests didn't show clear differences. Interestingly, patients were slower at processing tasks like reading words and naming colors, suggesting their thinking speed may be affected rather than their ability to focus.
This study provides early evidence that cognitive complaints in ME/CFS may involve slowed processing speed rather than simple attention deficits, which has implications for how cognitive symptoms are understood and managed. It highlights an important gap between what patients experience and what standard cognitive tests measure, validating patient reports of 'brain fog' while pointing toward specific mechanisms that deserve further investigation.
This study does not establish the cause of cognitive difficulties in ME/CFS, only that they exist. The small sample size and cross-sectional design mean findings cannot be generalized to all ME/CFS populations or used to determine whether cognitive symptoms change over time. It also cannot determine whether slowed processing is primary to ME/CFS or secondary to fatigue and other symptoms.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Ray, C, Phillips, L, & Weir, W R (1993). Quality of attention in chronic fatigue syndrome: subjective reports of everyday attention and cognitive difficulty, and performance on tasks of focused attention.. The British journal of clinical psychology. https://doi.org/10.1111/j.2044-8260.1993.tb01068.x
BibTeX
@article{mecfsatlas-ray-1993-quality-attention,
author = {Ray, C and Phillips, L and Weir, W R},
title = {Quality of attention in chronic fatigue syndrome: subjective reports of everyday attention and cognitive difficulty, and performance on tasks of focused attention.},
journal = {The British journal of clinical psychology},
year = {1993},
doi = {10.1111/j.2044-8260.1993.tb01068.x},
note = {PubMed: 8251968},
url = {https://www.mecfsatlas.com/evidence/ray-1993-quality-attention},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/ray-1993-quality-attention
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