Exhaustion disorder is complex and difficult to measure. People’s experiences cannot always be captured through limited tests, as demonstrated in a recent doctoral thesis by Andreas Nelson, researcher at Karlstad University.
– These are complex processes. Cognitive functions, such as memory and attention, are difficult to measure, just like exhaustion. There are so many factors involved. My thesis specifically examines the subjective experiences of cognitive dysfunction, says Andreas Nelson.
His research findings show that there was no correlation between self-reported cognitive difficulties in everyday life and the results of cognitive tests. This was also observed among healthy individuals.
– I have focused on self-report and the subjective experience, which is important since clinical diagnoses are often based on these perceptions, says Andreas Nelson.
The weak correlation between cognitive test results and self-report questionnaires does not appear to be explained by any unique characteristic of the patient group. Rather, it is more likely that the issue lies in the methodology, for example, that the tests simply do not capture the specific problems that the individuals are experiencing. Another possibility is that individuals with exhaustion disorder are able to make more of an effort during the limited time it takes to complete a test, and thereby compensate for their difficulties so that they do not appear in the results.
– What is measured during a brief memory test differs significantly from the cognitive demands of everyday life.
Together with his colleagues, Andreas Nelson has explored the subject from different perspectives, using different methods: questionnaires, cognitive tests and brain imaging. They also conducted qualitative interviews with people who have undergone treatment for exhaustion disorder.
The interviews provided a more nuanced picture, based on the participants’ own words, of the cognitive difficulties they had actually experienced, as well as what had been helpful during the recovery process.
– The findings reveal a fairly complex picture, where, for example, the degree of self-reported cognitive difficulties appears to be linked to mental well-being, but not necessarily to performance on cognitive tests, says Andreas Nelson.
– It has been very interesting to explore these issues in such depth. In the end, I hope that the research will contribute to improving the lives of those affected by these difficulties, he says.
Andreas Nelson completed his PhD at Karlstad University on 29 April 2025 with his doctoral thesis "Self-reported cognition in Exhaustion Disorder: From brain to experience".
