Cognitive Impact of Fatigue in Forensic Neuropsychology Context

• Published in: Psychological injury and law Vol. 11; no. 2; pp. 108 - 119
• Main Authors: Schultz, Izabela Z., Sepehry, Amir A., Greer, Sarah C.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2018; Springer Nature B.V
• Subjects: Assessors; Attribution; Behavioral Science and Psychology; Brain research; Causality; Clinical Psychology; Cognitive functioning; Comorbidity; Confusion; Fatigue; Law and Psychology; Medical diagnosis; Medical prognosis; Neuropsychological assessment; Neuropsychology; Psychology; Research methodology; Search engines; Traumatic brain injury; Validity; Neuroimaging; Fatigue; Neuroscience; Forensic; Neuropsychology; Brain fog
• ISSN: 1938-971X; 1938-9728
• DOI: 10.1007/s12207-018-9324-z

Physical and mental fatigue are common factors affecting function and recovery in litigated injuries and illnesses. Despite the high prevalence of fatigue-related symptoms and anticipated impact on cognitive functioning, forensic neuropsychological assessments are often challenged by the following approaches to the evaluation of fatigue: (1) confusing physical and mental fatigue; (2) referencing fatigue as a factor in existence but disregarding its specific cognitive impact; (3) over-attribution of all identified problems to fatigue; and (4) neglecting the impact of fatigue on effort in testing. In the context of a wide range of idiosyncratic approaches applied by neuropsychologists with respect to the significance of fatigue factors and the role of the assessor in accounting for them, there is a risk of confusion. Yet, impairments caused by fatigue can be disabling and resistant to treatment, and even more so when the treatment is based on incorrect diagnostic, causality, and prognostic assumptions. The current review will focus on integrating the available empirical evidence from neuroscience and neuropsychology regarding our current understanding of the cognitive impact of fatigue. Our critical review will emphasize the implications of the accumulating new evidence for forensic assessment determinations regarding causality, diagnosis, and impact on function, as well as prognosis and treatment. To this end, electronic search engines including PubMed, PsycINFO, and Google Scholar (up to January 2018) have been screened and reviewed both for the neuroscience and neuropsychological literature related to mental fatigue.