Review Understanding mental fatigue and its detection: a comparative analysis of assessments and tools, 2023, Kunasegaran

Free fulltext:
https://peerj.com/articles/15744/

Kunasegaran K, Ismail AMH, Ramasamy S, Gnanou JV, Caszo BA, Chen PL. 2023. Understanding mental fatigue and its detection: a comparative analysis of assessments and tools. PeerJ 11:e15744 https://doi.org/10.7717/peerj.15744



Abstract


Mental fatigue has shown to be one of the root causes of decreased productivity and overall cognitive performance, by decreasing an individual’s ability to inhibit responses, process information and concentrate.

The effects of mental fatigue have led to occupational errors and motorway accidents.

Early detection of mental fatigue can prevent the escalation of symptoms that may lead to chronic fatigue syndrome and other disorders.

To date, in clinical settings, the assessment of mental fatigue and stress is done through self-reported questionnaires.

The validity of these questionnaires is questionable, as they are highly subjective measurement tools and are not immune to response biases.

This review examines the wider presence of mental fatigue in the general population and critically compares its various detection techniques (i.e., self-reporting questionnaires, heart rate variability, salivary cortisol levels, electroencephalogram, and saccadic eye movements).

The ability of these detection tools to assess inhibition responses (which are sensitive enough to be manifested in a fatigue state) is specifically evaluated for a reliable marker in identifying mentally fatigued individuals.

In laboratory settings, antisaccade tasks have been long used to assess inhibitory control and this technique can potentially serve as the most promising assessment tool to objectively detect mental fatigue.

However, more studies need to be conducted in the future to validate and correlate this assessment with other existing measures of mental fatigue detection.

This review is intended for, but not limited to, mental health professionals, digital health scientists, vision researchers, and behavioral scientists.

 

TO me the generic phrase 'mental' fatigue rather than cognitive or other more specific terms (including sensory effects) is an indicator of this being another rabbit hole (and the usual mixing up the migrainey almost inability to see from sensory bombardment/overdoing it with 'brain fog' or 'not thinking well' and 'mental health' as a generic) - and yes those two often combine e.g. with light, computer, TV and thinking whilst having tried to have a conversion or noise and often cognitive fatigue comes from having done something physical previously (PEM) or the required bits at the time (sitting up) but they also occur separately. I don't unerstand how someone thinks they can advise or develop a mdoel if they are going to simplify the 'finding out what it is' part and aren't seeking to be stringent on methods to exclude the different parts when they are measuring.

What I don't understand is that cognitive pyschology has been studying mental fatigue much more effectively for decades - one specific context being e.g. air traffic control (so they know when breaks are needed and look at 'load' etc for safety), but also things relating to driving and more than likely other occupations.

The ME/CFS literature is starting to have techniques like those of Workwell, Bateman-Horne and PhysiosforME etc looking at what measures reliabiy indicate debility and exhaustion and patterns.

Why isn't it required that said literature is combined when the 'medicine version' bounds in calling it a 'new area' and wants to begin from scratch with ideology often in place of what is almost certainly good methodology on which things can be built for specific conditions to be tested well.

My heart sinks at the usual 'we've developed a questionnaire' but even worse when they don't even think that they should be using such existing techniques to at least check whether said questionnaires have internal validity - if they do have to use the excuse of 'questionnaires can be done by GPs' etc.

 

This is really poor on stress too, as it is relevant. I don't know why I'm surprised but they've just done a few lines saying 'sometimes increased stress can reduce fatigue' but then descend only into their cliched narrow definition of it.

Even in the consumer behaviour literature they are able to define things like 'flow' and 'involvement' and to understand that these aren't 'stress' but enjoyable states that can be brought about by things which might increase e.g. time pressure to add a bit of focus on a crossword but also relates to other aspects of the environment and importantly to how long someone is doing somehing cumulatively - because it isn't about the 'emotional' as they wish to short-cut the link regarding things like cortisol as if it doesn't relate to the body starting to wane and get tired but is some 'mental alert' that cascades the other way, which is of course tosh. Otherwise 'involvement' and 'flow' wouldn't work. Someone can be in those zones but getting fatigued, which basically blows their nonsense 'hypothesis that they think is fact and not even just a hypothesis' out of the water. The neck ache from a video-gamer isn't because their CNS has red-flagged.

I don't understand why this discipline wants to rabbit-hole itself into a thick red herring so much. On the science. And I know medicine loves its making up nonsense myths to pretend what it wants to do for one reason has a lovely little 'storytelling' pretending to be science-based with the punchline of 'but what the patient claims isn't actually what is happenning' (when that is exactly the observation e.g. science) such as when those who have PA get told 'your 3month injection doesn't wear off until 3mnths some patients claim they feel more tired at other points but that can't be the case and is other things/their mind'. Which of course we know from research going on with guidelines there now was always untrue. Is that what this discipline wants its 'use' to be? Fairy tale writing? Even when it could join the party and pick up where the knowledge is and start doing some real stuff?

And tiredness will affect physical function, but its also vice versa so that whole paradigm is over-simplified again to the 'brain rules all' - which whether someone is reading in context of 'mental' alone or not isn't corrrect so shouldn't be being short-cut that way.

Heck it could even understand its magic cortisol and CNS reaction stuff better if it wasn't mixing up all the different inputs and orders of them and might finally get somewhere with the illnesses it actually might own but have done little for due to lack of precision and curiosity.

I know this might be some sort of summarising document trying to speak down to other professionals but come on, there is a difference between not burying into intricate detail and choosing complex words and missing the models so you misrepresent by doing over-simplified pictures as your aim, whether they are factually right or not. I'd assume and they should that everyone reading it should have done a science to a certain level at school where they had to do diagrams with more arrows and ifs and buts that then old simplified 'fight-flight amygdala alarm' soo why does it get reduced at this point.