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The Psychology of Fatigue
Fatigue can have a major impact on an individual’s performance and

wellbeing, yet is poorly understood, even within the scientific com-
munity. There is no developed theory of its origins or functions, and
different types of fatigue (mental, physical, sleepiness) are routinely
confused. The widespread interpretation of fatigue as a negative
consequence of work may be true only for externally imposed goals;
meaningful or self-initiated work is rarely tiring and often invigorat-
ing. In the first book dedicated to the systematic treatment of fatigue
for over sixty years, Robert Hockey examines its many aspects – social
history, neuroscience, energetics, exercise physiology, sleep and clini-
cal implications – and develops a new motivational control theory, in
which fatigue is treated as an emotion having a fundamental adaptive
role in the management of goals. He then uses this new perspective to
explore the role of fatigue in relation to individual motivation, work-
ing life and wellbeing.
r o b e r t h o c k e y is Emeritus Professor of Human Factors and

Cognitive Engineering in the Department of Psychology at Sheffield
University. His research on human attention and performance, work-
load, stress and fatigue has emphasized the adaptive nature of human
regulatory activity in task performance, and he has acted as a con-
sultant in the maritime, rail, nuclear and space industries. He has
published over 170 research articles and edited or written five books,
including Stress and Fatigue in Human Performance (1983).
The Psychology of Fatigue
Work, Effort and Control
Robert Hockey
University of Sheffield
CA MBR IDGE U N I V ER SIT Y PR ESS
Cambridge, New York, Melbourne, Madrid, Cape Town,
Singapore, São Paulo, Delhi, Mexico City
Cambridge University Press
The Edinburgh Building, Cambridge CB2 8RU, UK
Published in the United States of America by Cambridge University Press,

New York
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Information on this title: www.cambridge.org/9780521762656
© Robert Hockey 2013
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and to the provisions of relevant collective licensing agreements,
no reproduction of any part may take place without the written
permission of Cambridge University Press.
First published 2013
Printed and bound in the United Kingdom by the MPG Books Group
A catalogue record for this publication is available from the British Library
Library of Congress Cataloguing in Publication data

Hockey, Robert.
The psychology of fatigue : work, effort and control / Robert Hockey.
pages cm
Includes bibliographical references.
ISBN 978-0-521-76265-6 (hardback)
1. Fatigue. I. Title.
BF482.H63 2013
152.1′886–dc23
2012048497
ISBN 978-0-521-76265-6 Hardback
Cambridge University Press has no responsibility for the persistence or

accuracy of URLs for external or third-party internet websites referred to in
this publication, and does not guarantee that any content on such websites is,
or will remain, accurate or appropriate.
To the memory of my teachers, colleagues and
friends:
D. Roy Davies, Donald Broadbent, Peter Hamilton
and Bert Mulder
Contents
List of figures page xi

List of tables xii
Preface xiii
1 The problem of fatigue 1

Background 1
Rationale and focus of the book: the adaptive role of fatigue 4
The failure of classical fatigue theory 6
Limitations of the energy account of fatigue 7
Fatigue is not (just) a negative state 8
A motivational perspective 10
Defining the field: what is fatigue? 11
A working definition 13
Fatigue and related feelings 15
The conceptual status of fatigue 18
Some questions for a scientific theory of fatigue 21
Plan of the book 23
2 Changing experiences of fatigue: the

social-historical context 25
Background 25
Roots of the energy metaphor of fatigue 26
The pre-modern experience of work and fatigue 29
Fatigue, idleness and volition 32
Work as a benign experience 34
The loss of control over work 35
Work and fatigue in the post-industrial period 37
The intensification of work 38
Changes in leisure and recreation 39
A demands-control analysis of changes in the experience of work 40
The link between fatigue and energy 43
The medicalization of fatigue 45
Fatigue as a subject for scientific study 47
Summary 50
3 The work–fatigue hypothesis 51

Background 51
The golden age of fatigue research 54
vii
viii Contents
The early research agenda 54

The work curve 56
Early research on the work decrement 58
Is fatigue general or specific? 62
Recovery from fatigue: effects of rest and change 63
After-effects of fatigue 66
Vigilance and sustained attention 67
What causes the vigilance decrement? 69
Habituation and executive control 71
The sensitive task 72
Work intensity, effort and executive control 73
Workload, capacity and resources 73
Effort and executive control 74
A reappraisal of the work curve 77
Rapid onset of decrement 77
Interruptions of control: blocks, gaps and lapses 80
Three sources of performance decrement 82
Summary 85
4 Stress, coping and fatigue 86

Background 86
Stress, homeostasis and allostatic load 86
The response to stress 88
Adaptive physiological systems 89
Psychological stress and coping 91
Fatigue and the costs of coping 92
Task performance under stress 93
Early research on stress and performance 94
The modal stress pattern 95
Theoretical perspectives on stress and fatigue 96
Distraction and arousal 96
Limitations of general arousal 97
Stress and emotion as distractors 99
Emotional states and feelings 100
Specific emotions and general feelings 101
The adaptive value of feelings 101
Fatigue as an emotion 102
Summary 105
5 Effort, strain and fatigue 107

Background 107
A systems perspective on performance decrement 107
Assessing the costs of task management: effectiveness
and efficiency 108
Goal competition in task performance 109
Varieties of goal: have to, want to and need to 110
The vulnerability of task goals 112
Protection of performance under stress: effort, strain and fatigue 113
Indirect effects of stressors on performance 115
Secondary task decrements 115
Strategy changes 116
Contents ix
Psychophysiological activation 118

Fatigue after-effects 120
Strain and fatigue at work 123
Work strain 123
Laboratory versus real-life stress 126
Modes of work management 127
Fatigue and recovery from stress 130
Summary 131
6 A motivation control theory of fatigue 132

Background 132
Goals in motivation control 134
Outline of the theory 135
Elements of the fatigue state 135
The interruption function of fatigue 136
A control systems implementation 139
The compensatory control model 140
Revising the model 141
Control model description 143
Where is fatigue located in the control model? 145
Evidence from neuroscience 146
Goal maintenance and monitoring 147
Effort regulation 149
Goal interruption 151
Relation between effort and interruption 152
Summary 154
7 Extensions and limitations: energy, physical work

and sleep 155
Background 155
Brain energy 155
Energy use by the brain 156
Energy metabolism in brain and body 157
Does brain energy have a role in mental work
and fatigue? 160
Physical work and exercise 164
Peripheral and central fatigue in exercise 165
The central governor hypothesis 167
Effects of physical exercise on cognition 172
Sleep and fatigue 173
Models of sleep and alertness 174
Compensatory control in sleep deprivation 175
The energy hypothesis of sleep 176
Local brain sleep as a basis for fatigue? 177
Elements of an integrated fatigue framework? 178
Summary 179
8 The psychopathology of fatigue 180

Background 180
Prevalence of persistent fatigue 181
Chronic fatigue syndrome (CFS) 183
x Contents
The clinical context of chronic fatigue 183

What causes CFS? 184
Effort and motivational control in CFS 185
Fatigue in chronic medical conditions 187
Cancer 188
Multiple sclerosis 188
Parkinson’s disease 189
Persistent fatigue from work stress 190
Work conditions, extended hours and shift work 190
The need for recovery from work 192
Emotional demands and burnout 193
A motivation control analysis of persistent fatigue 195
Carry-over effects of coping failures 196
A proposed model: the effort–fatigue disengagement spiral 197
Physiological implications of CFS 201
Summary 203
9 An agenda for fatigue: research and application 205

Background 205
Tests of the motivation control theory 206
The work–fatigue relationship 207
Cost–benefit analysis 208
Short-term recovery from fatigue 208
Contributions from neuroscience 209
Brain energy 210
Physical and mental fatigue 211
Persistent fatigue and CFS 214
Some practical considerations 216
Summary 218
References 219
Name index 258
Subject index 268
Figures
1.1 Changes in frequency of fatigue

publications 1890–2000 page 3
3.1 Arai’s (1912) data, showing time taken for mental
arithmetic problems over four 12-hour days 61
3.2 Data of Bills and McTeer (1932), showing the number of
three-letter sequences completed during successive
odd minutes, separated by sequences with different
numbers of letters in common 66
3.3 Data from Morgan (1926), showing rapid decrement
in cancellation and addition 79
3.4 Three phases of the work decrement function 84
4.1 The two axes of the stress response 90
6.1 Motivational control model of executive control, effort
and fatigue 144
7.1 Main elements of the central governor model: after
St Clair Gibson and Noakes (2004) 168
7.2 Effect of exercise load on cognitive vigilance performance
(d′). Full lines = increasing phase of the load cycle; broken
lines = decreasing phase 171
8.1 The strain disengagement spiral. Unresolved stress
from a sustained strain response to excessive demands
leads to prolonged fatigue. This increases the need for
effort the following day, with resultant further incremental
effects on stress, fatigue and effort. For simplicity, only two
cycles of the spiral are shown, with increasing strain
indicated by the use of + and ++ modifiers. When the
compensatory limit is reached, the high effort strategy
is abandoned in favour of one of disengagement 198
xi
Tables
1.1 Possible patterns of the fatigue response to work tasks page 15

2.1 Summary of changes in working life between
1750 and 1880 41
5.1 Modes of work management 128
xii
Preface
When I decided to write this book I became aware of an obvious but

previously dormant fact: that, for as long as I can recall, my intellec-
tual life has been dominated by fatigue. My undergraduate dissertation
was on vigilance, under the guidance of D. Roy Davies; my PhD was
on attention and stress in prolonged tasks, under the supervision of
Donald Broadbent; and my later work, while ostensibly on stress, was
always ultimately about the causes of work decrement. Even when I did
some research on short-term memory (as it was known at the time) I
somehow managed to think of memory work as something that could
go wrong if you stuck at it for too long. By the mid 1980s, inspired by
Danny Kahneman’s wonderful book on attention and effort, it seemed
to me that the ideas of fatigue and energy mobilization could provide
a way of integrating problems of performance decrement, stress, effort
and arousal, and those associated with the core body of work on human
information processing, and I developed a cognitive energetic theory
with Peter Hamilton that emphasized these interactions.
Then my interest in fatigue took a personal as well as an intellectual
direction. On moving to a new job in Sheffield in 1985 I developed a
condition related to chronic fatigue, which lasted for six years. In addi-
tion to the obvious problems it caused me, I found the state intriguing
because, oddly, its main impact was on my motivation and capacity
for cognitive work – not simply the demands associated with the read-
ing, writing and serious thinking of academic life, but also reading the
newspaper and keeping track of the plot during films and plays – while
I was still able to run and cycle, even taking part in marathons and long
cycling holidays, and carrying out garden building projects in our new
home.
This (admittedly, unscientific sample of one) led me to think that
there may be different kinds of fatigue, or at least that feelings of fatigue
may have different origins, which may not necessarily lead to the same
outcomes. It also made me aware of the implausibility of fatigue being
caused by a loss of energy; if that were the case why was it just my
xiii
xiv Preface
mental life that was impaired, while my body seemed relatively free to
get on with its normal activities? My early rambling thoughts on these
issues were tried out while cycling through the Yorkshire Dales with my
brother, Ken Hockey, and our mutual friend, Harry French. They lis-
tened patiently and asked interesting questions while I worked my way
through ideas about possible similarities and differences between men-
tal and physical fatigue – though I don’t think they were wholeheartedly
convinced that the weariness we all felt on the ride might be in the head
and not the legs after all!
My reading of the early work on fatigue, starting with Bartley and
Chute’s (1947) comprehensive review, and extending to Bartlett, Bills,
Thorndike and others, suggested that my earlier enthusiasm with
energy explanations of fatigue and performance decrement needed a
rethink. Fatigue appeared to be less about energy than about personal
motivation and interest. Specifically, fatigue seemed to reflect conflicts
in the control of motivational choices – an unwillingness to continue
with an activity that was unrewarding, rather than an inability to com-
plete one that was too demanding – ideas that appear to have got lost as
the problem of fatigue drifted from the theoretical landscape (at least
as far as experimental psychology was concerned). I talked about these
ideas with various colleagues, but most of all with Theo Meijman, with
whom I had many discussions. Theo and I even planned to write a
review paper and, possibly, a book on the problem, but I suppose we
were both too busy at the time, and maybe too tired to take it on! But
those who are familiar with Theo’s thinking on fatigue will recognize
its contribution to the core ideas underlying the theory presented in
this monograph. I also acknowledge the formative influences of my
mentors, Roy Davies and Donald Broadbent, and the invaluable expe-
rience of working (and playing) with the many wonderful colleagues
I have had the privilege to know. Foremost amongst these are Tony
Gaillard, Peter Hamilton and Bert Mulder, with all of whom I have
spent many stimulating hours over many years. But I am also grate-
ful for the guiding influences and stimulating ideas of John Duncan,
Marion Frankenhaeuser, Peter Hancock, Danny Kahneman, Raja
Parasuraman, Mike Posner, Pat Rabbitt and Wolfgang Schönpflug,
as well as the thoughts and comments at various stages of numerous
colleagues and graduate students, including Torbjörn Åkerstedt, Nik
Chmiel, Peter Clough, Kevin Connolly, Gareth Conway, Fiona Earle,
Renata Manoussos, Dietrich Manzey, John Maule, Ben Mulder, Peter
Nickel, Adam Roberts, Jürgen Sauer, Nick Shryane, Andy Tattersall,
Hans Veltman, Dave Wastell and Marion Wiethoff.
Preface xv
Some of the research for this book was carried out with the support of
an Emeritus Fellowship award from the Leverhulme Trust. I am grate-
ful to them for this funding, which enabled me to employ Lorna Bleach
and Felicity Stout to help with research on historical and etymological
material. I thank them both for their valuable contributions, and Lorna
for her further help with the compilation of references. The details of
the text were influenced by the comments of Lorna and Felicity, and
also by Nick Shryane, who also helped me with the technical side of
formatting figures and tables so that they stay put, and the mysteries of
the outline mode in Word.
Finally, I give special thanks to my wife, Jenny Hockey – seasoned
campaigner, author and editor of many books on anthropology and
sociology – for her regular monitoring of my efforts, and for advice,
pointers, insights and constant encouragement, and for generously
making allowances for my occasional inevitable shortcomings in the
other activities that constitute shared family life.
1 The problem of fatigue
Background
Fatigue is a pervasive influence on human life, experienced by everyone
on a regular basis. It may be felt as a low mood (tiredness, weariness,
lethargy) or unfocused mental state (distraction, frustration, discom-
fort), or as an unpleasant bodily state, including headaches, tension,
and vague pains in muscles and joints. It is also implicated in everyday
disturbances of mood and quality of life, and, in more intense cases, can
be felt as physical exhaustion, a total incapacity for any exertion, a pro-
found lack of motivation, or depression. In terms of cognitive activities,
fatigue is associated with problems of completing – or even starting –
tasks, particularly where there is a requirement to sustain high levels
of effort over long periods. In addition, fatigue (along with headache
and colds) is among the most frequently reported health complaints
in primary care clinics in Western countries, a feature of almost all ill-
nesses, and a common after-effect of surgical intervention. Yet, fatigue
remains a puzzle. How is it that we can feel tired when we do not appear
to have done very much? How is it that we appear to be able to recover
so quickly under some conditions, but not others? What is going on
when weariness following a hard day at work can be banished by going
for a run or a session at the gym? Why do some kinds of activity make us
feel tired, while others, equally or even more demanding, do not? Just
what is fatigue about, and how does it come to play such a significant
part in mental life? Does it have an adaptive function, or is it simply an
end state of the failure of the normal process of energy management?
Or is it something else altogether?
Fatigue in the modern world is widely regarded as a major problem
for health and wellbeing. Endemic tiredness is recognized not only in
practical areas of life such as work and driving, but also in everyday
experience. General practices are beset with patients reporting being
‘tired all the time’, and there is increasing clinical recognition of the
related condition of chronic fatigue. Yet, despite the widespread general
1
interest in fatigue, and the plethora of popular books on the subject –

an Amazon search on mental energy and fatigue conducted in early
2009 generated over 500 such books – the topic is poorly understood.
This is true even within the scientific community, where it has been
surprisingly neglected in terms of systematic scientific investigation.
Following the stimulation of interest in human work and fatigue dur-
ing the late nineteenth century, there was a proliferation of research
on the topic, reaching its peak during the 1930s. The period between
1900 and 1940 was characterized by a wealth of detailed empirical
studies, widespread theoretical interest, and a concern with applica-
tion of knowledge to both educational and industrial practice. Since
that time, fatigue has gradually receded from the scientific landscape,
so much so that it now rarely appears even in the index of modern
textbooks of cognitive psychology or even work psychology, and not at
all in recent monographs and major reviews on attention and perform-
ance (Logan, 2004; Pashler, 1997; Pashler, Johnson & Ruthruff, 2001;
Styles, 2006).
This trend is illustrated in Figure 1.1, which summarizes the results
of a search on PsycARTICLES for journal articles that included the
word ‘fatigue’ in the title, published during successive ten-year peri-
ods. The pattern is somewhat obscured by the fact that the number of
academic periodicals (in all fields) has increased by a factor of several
hundred during this period, from around 100 at the beginning of the
twentieth century to a current total of somewhere between 20,000 and
50,000, depending on definitional criteria.1 I could not find the rele-
vant data for psychology and mental health, but have assumed that the
growth rates are similar to those in other disciplines, as estimated by
Mabe and Amin (2001), and shown here on a logarithmic scale. Figure
1.1 also indicates the very high values for fatigue publications over the
two most recent decades. In fact, little of this dramatic upturn refers to
the traditional laboratory research on work and fatigue that is the core
of this monograph. Instead, it reflects the renewed interest over the past
20 years or so in research in two areas of practical significance. One
is a concern for the effects of fatigue in the form of sleep deprivation,
especially in military and transport applications. The other, a much
stronger influence, is the proliferation of research on fatigue as a clin-
ical problem within medical and neurological contexts. Such a resur-
gence of interest is welcome, and is likely to provide a valuable focus for
fatigue research from many different directions: not only clinical, but
These numbers are estimated from various sources, all based on Ulrich’s Periodicals
1
Directory.
Background 3
300 100,000
2458
250 864
Number of fatigue publications
10,000
Total number of journals

200
150 1,000
100
100
50
0 10
80
90
00
10
20
30
40
50
60
70
80
90
00
18
18
19
19
19
19
19
19
19
19
19
19
20
Year
Figure 1.1 Changes in frequency of fatigue publications 1890–2000
cognitive, physical, sleep, stress and neuroscience. Even so, if an adjust-

ment is made for publication opportunities, current publication rates of
articles on fatigue are no more than around a tenth of the peak levels
achieved during the 1930s and 1940s.
Of course, the tailing-off of interest in fatigue is not, in itself, note-
worthy. Science is as much prone to fashion as any other aspect of human
experience, and other topics take their turn in the limelight. Research
on vigilance and monitoring, another topic within the attention and per-
formance genre, emerged during the 1950s, and flourished during the
second half of the twentieth century. The parent discipline of attention
had an early peak, along with fatigue, in the 1920s and 1930s, before
fading from view until its revival during the 1960s at the heart of the new
cognitive psychology. What is strange in the case of fatigue is not that it
has declined in intensity but that the problem appears to have been more
or less abandoned (at least by experimental psychologists), and before it
had been even partially solved. Instead, fatigue is now predominantly a
topic for medical research, with a focus on its role not only in chronic
fatigue but also in a wide range of other chronic illnesses. Even today,
there is no widely accepted view of what fatigue is, no mature theory
of its origins and function, and little understanding of the relationship
between the several different types of fatigue (mental, physical, sleepi-
ness) that are routinely confused in the scientific literature.
Rationale and focus of the book: the adaptive

role of fatigue
The present monograph is the first dedicated to the scientific treat-
ment of the topic of fatigue for more than 60 years, since Bartley
and Chute’s (1947) comprehensive review. Since then, publications
on fatigue have been confined to edited symposia (Ackerman, 2011;
Floyd & Welford, 1953), collections of chapters (DeLuca, 2005;
Hancock & Desmond, 2001; Hockey, 1983; Matthews, Desmond,
Hancock & Neubauer, 2012; Simonson, 1971; Simonson & Weiser,
1976), and individual chapters in textbooks or more general collec-
tions (Craig & Cooper, 1992; Hockey, 1986, 2011; Holding, 1983;
Matthews, Davies, Westerman & Stammers, 2000). While many of
these have usefully updated the literature and provided new ideas
and insights, they have been necessarily eclectic, and have gener-
ally had little lasting impact on our understanding of what fatigue is:
what causes it; what its function is (if any); what brain processes are
implicated; and so on. Some of these sources also deal with the rela-
tionship between fatigue and stress, as a package of closely related
issues, and it will be clear that the present book also makes no sharp
distinctions between the two. Rather, they are considered to be dif-
ferent facets of the same adaptive process, in which the process and
feeling of fatigue refer to the complex pattern of changes that follow
a sustained attempt to maintain task goals under threat from envi-
ronmental or task stressors. The book offers a reinterpretation of the
nature of the experience of fatigue, starting with an analysis of its
historical and social context. It proposes a new theory, based on the
idea that such experience is a natural, adaptive feature of mental life.
While fatigue is regarded as a major problem for present-day society,
this was not always the case. So how did it get to be this way? And
what can we do to help reduce its impact on everyday wellbeing and
chronic ill-health?
The motivation for this monograph was to provide a new perspective
on the nature of fatigue. At its core is the hypothesis that the experience
of fatigue serves an adaptive signal function for the effective control
of actions and human motivation. I argue that, rather than interfer-
ing with our ability to carry out tasks by wearing down our energy or
resources, fatigue makes us aware of the opportunity costs of current
activities, and of the attraction of neglected needs and alternative goals.
This is a long-held perspective that has become lost from scientific
view. For example, the influential Italian physiologist Angelo Mosso
said of fatigue, that:
Rationale and focus of the book 5
what at first sight might appear an imperfection of our body, is on the contrary
one of its most marvellous perfections. The fatigue increasing more rapidly
than the amount of work done saves us from the injury which lesser sensibility
would involve for the organism. (Mosso, 1906, p. 156)
Such insights are also evident in the writings of Edward Thorndike, one
of the most significant experimental psychologists of the early twenti-
eth century. Thorndike (1900) rejected the idea of fatigue as a state of
reduced effectiveness, likening it more to a state of mental discomfort
or aversion to mental activity. He argued that:
feelings of fatigue, such as they were, were not measures of mental inability
… we can feel mentally fatigued without being so, that the feelings described
above serve as a sign to us to stop working long before our actual ability to
work has suffered any important decrease which an experimenting psycholo-
gist could measure and use as a warning to us. (p. 481)
A similar perspective was offered by Bartley and Chute (1947) in their
comprehensive review of the problem. They interpreted the emergence
of a feeling of fatigue within an individual as part of the transaction
between the performer and the environment, representing a change
of orientation from acceptance and engagement to one of discomfort,
resistance and aversion to continuing with the present activity. The
conflict between present and desired goals demands (or at least invites)
a reappraisal of priorities.
While the approach and content of the present book are inevitably led
by my personal research interests over the past 25 years or so, they are
informed by an extensive literature. My goal in writing this book is to
provide a broad context for understanding the meaning and function of
fatigue, through the use of a wide range of sources: empirical and the-
oretical; experimental and clinical; modern and historical. I believe that
a better understanding of the problem of fatigue will have benefits not
only for psychological theory, but also for managing fatigue on a prac-
tical level: within work design, everyday wellbeing and mental health.
It will be clear from a quick leaf through the pages of this book that
its primary focus is on the experimental psychology of mental or cogni-
tive fatigue. Yet, the title suggests a concern with the unqualified topic
of fatigue in general. This more inclusive term was chosen deliberately
to reflect a desire to reconnect the various facets of the problem that
have become dissociated over the past 100 years or so. These include
not only fatigue from mental activity, but also issues related to sleep dis-
turbances and physical work. My strategy, in basing the book on mental
fatigue, is to emphasize the centrality of the cognitive and subjective
experience of fatigue, in understanding not only mental fatigue itself
but also the impact of sleep deprivation and physical work on mental
processes. This is not to say that all fatigue is mental fatigue: that there
is no need to look beyond a general explanation; on the contrary, it is
clear that fatigue from sleep disturbances is associated with specific
needs and brain mechanisms, while physical fatigue involves muscular
and metabolic demands far in excess of those met in cognitive tasks.
However, I argue that, while the various forms of fatigue appear to have
distinctive aetiologies, contexts and forms of expression, the develop-
ment and management of mental fatigue underlies or plays a major part
in all of them. A comprehensive review of the literature in these differ-
ent specialist areas is not a practical goal for a monograph of this kind.
Instead, I make reference to physical fatigue and sleepiness whenever it
is appropriate to do so throughout, and attempt in Chapter 7 to sum-
marize the major issues relating to these alternative manifestations of
the fatigue problem, and to consider how they may be integrated into a
general framework.
Another deliberate focus of the book is on short-term (transient)
effects of fatigue – the state experienced under conditions of acute task
demands or stress, but that normally recedes when more favourable
conditions prevail – rather than on enduring problems of health and
wellbeing such as chronic fatigue. Inevitably, a systematic treatment of
chronic fatigue is beyond the scope of this book. However, I again try
to address relevant issues throughout, and, in Chapter 8, review the
core issues on persistent fatigue of different origins, including work and
problems of chronic ill-health. I also put forward a tentative dynamic
model to show how pathologies of fatigue may occur through a failure to
manage the response to stress and short-term motivational conflicts.
The failure of classical fatigue theory

Despite over 100 years of research and scientific thinking about fatigue,
we still have no well-developed theory of how the process works or what
its function might be. A recurring theme throughout the book is that
there have been two major obstacles to our understanding. The first is
the irresistible tendency to think of fatigue in terms of the exhaustion
of energy (feeling spent, worn out, exhausted, batteries running down).
A second problem has been the near-universal tendency to consider
fatigue as a negative state, and as an inevitable consequence of work.
Both of these assumptions are considered in this section and found to be
flawed. The alternative view, proposed in this book, argues that fatigue
has an adaptive function, serving the management of motivation.
Limitations of the energy account of fatigue

The most serious failure of traditional fatigue theory has been its
assumption that it is caused by a loss of energy, caused by the activ-
ity of carrying out (too much) work. This is not surprising, given the
widespread influence of ideas on energy conservation and transform-
ation on nineteenth-century thought (Rabinbach, 1990). The tendency
to think about fatigue in terms of energy failure can be seen to have its
origins during the Industrial Revolution, in the growing awareness of
the role of energy in the work of machines, and as the limiting factor
in production. Within a short time, as Anson Rabinbach (1990) shows
in his analysis of the social history of fatigue, the work→energy depletion
framework was being applied not only to the work of machines, but also
to that of humans, and further extended to include mental activity as
well as the more directly comparable physical work. The idea had an
immediate and major impact on both the scientific literature and every-
day language, which began to use the terms fatigue and energy together
in relation to human activity from around 1870. It was a short step
from this to ‘explain’ the problem of fatigue – the failure to continue to
produce output – as the result of a loss of energy. The feelings of weari-
ness during and after periods of demanding work appeared to make
sense within this new way of thinking about the body. I shall discuss
the derivation of these ideas in Chapter 2, and argue that the roots of
the link between work, energy and fatigue are to be found in the dra-
matic changes in working life during the second half of the nineteenth
century.
Energy-based explanations are ubiquitous within psychological
theorizing on motivation, personality and cognitive psychology, often
taking the form of drives or resources, though they probably had their
greatest impact through Freud’s psychodynamic model, which posited
‘psychic energy’ as the basic driving force of mental life (Strachey,
1953). Reinforced by followers such as Jung, Adler and Klein, such
views had a major influence on cultural thought during the first half of
the twentieth century, and led to the widespread acceptance of mental
energy as the prime mover of motivation and action, and lack of energy
as the reason why things were not (or could not be) done. The late
nineteenth-century energy view of fatigue has been highly resistant
to change, even in the face of the growth of psychology as a science
and the emergence of new understanding of brain and body mecha-
nisms. While (up to a point) an energy explanation can be made to
work for physical exercise, it has not stood the test of time as a way of
understanding patterns of decrement in mental work. Of course, at

the most basic level, energy transformations are the basis of all neural
events and all behaviour. But this does not mean that it is necessarily
appropriate for high level explanations of behavioural change. It is pos-
sible (though still not confirmed) that the brain uses up more glucose
and oxygen to carry out more demanding tasks than simpler ones, but
the difference appears to be very small, and there are never signs of
anything approaching a state of a depletion of energy reserves (Gibson,
2007; Raichle & Mintun, 2006).
Despite the lack of any convincing role for energy variations in behav-
iour, we talk freely about psychological energy (or vigour, or vitality) as
a primary agent of action in many areas of mental life: for example,
motivation (Ryan & Deci, 2008), work engagement (Shirom, 2003),
self-control (Baumeister, Vohs & Tice, 2007), or mood (Matthews,
2011; Thayer, 1989). What we refer to as ‘mental energy’ seems to be a
convincing characteristic of people, readily understood as a feeling of
liveliness and active enthusiasm for the pursuit of goals. Yet, there is no
evidence that healthy, highly energetic individuals differ from others in
terms of actual brain energy (Lieberman, 2006). If mental energy is not
a function of differences in physical energy, what is it? The continued
use of the energy metaphor makes it difficult to consider other explana-
tions for what lies behind such a state.
Fatigue is not (just) a negative state

A second, related, reason for the failure of the fatigue construct to
attain scientific maturity is its narrow interpretation as an unwanted
by-product of (physical and mental) work. This is a natural conse-
quence of identifying human transactions with the environment with
the work done by industrial machines, and the exhaustion of energy in
the execution of that work. However, the ensuing emphasis on fatigue
as a negative state associated with the depletion of energy has not been
as useful an idea as was initially assumed. I would go further and argue
that such views have impeded progress towards a genuine theory of
fatigue. Examination of archival material in Chapter 2 suggests that
fatigue may have been experienced quite differently in the pre-modern
era (before the full impact of industrialization). I shall argue that the
widespread use of energy and fatigue terms in everyday language dates
from the increasing shift to factory-based work over the second half of
the nineteenth century; before that time, as Rabinbach (1990) argues,
there is little to indicate that fatigue was experienced as a generally
negative state. I will argue that the same principle applies today, even
though the environmental and cultural context of working life has

changed considerably; work is not always experienced as tiring.
As others have commented (notably, Bartley & Chute, 1947), the
energy depletion perspective has almost certainly been a source of
distraction in the search for an understanding of fatigue. Fatigue has
always been associated with work, specifically with the depletion of
energy through excessive work (what I refer to as the work–fatigue
hypothesis). Such a view has long been considered an inadequate
account of the varied phenomena of fatigue. Bartley and Chute
(1947) concluded categorically that, even for physical work, unless
extreme, fatigue represented not an inability to do work, but rather a
lack of desire: an ‘attempt to retreat or escape from a situation’ (p. 53).
I examine the relationship between work and fatigue in Chapters 3,
4 and 5, in relation to stress and coping strategies, and try to deter-
mine the boundary conditions for the assumed causal nature of the
work–fatigue relationship. At one level, work may represent simply
the physical and mental load on the body and brain defined by the
energy requirement of the activities carried out. It becomes clear that
this is not a good predictor of fatigue and its consequences, except in
the case of extreme physical work. Instead, the evidence shows that
it matters how activities are understood by the performer: whether
they are externally driven (tasks) or self-selected (leisure); or, if they
are tasks, whether they allow a high level of control (discretion in how
and when they are carried out). As has long been known (Thorndike,
1900), when activities are self-initiated (and sustained by personal
goals) mental work is not generally perceived as tiring, and may even
have the opposite effect: that of energizing the performer, as in the
experience of ‘flow’ described by Czikszentmihalyi (1977, 1990;
Demerouti, 2006).
Holding (1983) identified the core effect of being fatigued as an aver-
sion to further activities that demanded high levels of effort. It is impor-
tant to acknowledge at the outset the explicit link between fatigue and
effort. Effort is assumed to act as a precursor to fatigue, which then
triggers control activity that serves to reduce effort. In many contexts,
where the time course of feelings is not well defined, the two may be
almost interchangeable; phenomenologically, needing to make more
and more effort is functionally equivalent to becoming more and more
tired. Bartley and Chute (1947) argued that fatigue (or effort?) may
be considered both a warning of the need to escape and a marker of
the distress felt when this action is not carried out. They emphasized
the importance of the ‘stance’ or ‘attitude’ an individual takes to the
task: whether it is desired by the performer, or not; whether it leads to
engagement or resistance. This reinterpretation of the nature of the

experience of fatigue has been largely forgotten, or at least overlooked
in modern treatments of the problem, though it is rekindled by recent
work that shows the value of considering effort in terms of its cost for
behavioural direction and decision-making (Boksem & Tops, 2008;
Kool, McGuire, Rosen & Botvinick, 2010; Kurzban, Duckworth, Kable
& Myers, in press).
A motivational perspective
In contrast to the prevailing view of fatigue as a failure of energy, the
approach taken in this volume is to regard fatigue as primarily affect-
ing the selection and control of goals. As with all organisms, humans
are in a state of constant dilemma between the choice of maintaining
current goals and behavioural directions and switching to new ones
whenever they offer greater potential benefits. A more general motiv-
ational context is the conflict between the need to exploit established
sources of reward and explore the environment for new opportunities.
This is a well-established principle in evolutionary biology (e.g., Tooby
& Cosmides, 2005), where, for example, foraging behaviour is shown
to accurately reflect changing utilities of available food sources; ani-
mals decide almost optimally whether to stay or to shift. In human
behaviour such ideas are less well developed, though they are implicitly
understood in theories of motivation and cognitive control (Dreisbach,
2006). In Chapter 4, I outline the case for considering fatigue as an
emotion, with the adaptive function of maintaining this motivational
balance. Interruptions of current behaviour allow alternative options
for the control of behaviour to be entertained. By interrupting ongoing
activity, fatigue provokes a reappraisal of the benefits and costs of cur-
rent goals, and allows alternatives to compete for access to motivational
control. As I shall discuss in Chapter 5, goals need to be protected from
such intrusion only when they rely heavily on top-down executive con-
trol. Specifically in the context of work and fatigue, the act of carrying
out work is assumed to be fatiguing only when it takes the form of a
task, a goal that is driven by external or internal targets, whether for
someone else or for oneself. Fatigue develops if the performer is moti-
vated to maintain the task goal in the face of a desire to stop or change
to something else, and needs to employ a high level of effort to do so.
Over a century ago Thorndike (1900) interpreted the development of
fatigue as the problem of doing the right thing, rather than doing too
much. The same point was being made by Cattell (1941), who argued for
a strong guiding role of purpose (or goal) in preventing fatigue-related
Defining the field 11
decrement: ‘There is no fatigue as long as a purpose itself is not fatigued’

(p. 624). The broader view of Bartley (1943) was that: ‘The basis of
fatigue is conflict and frustration. One of the first significant outcomes
of conflict is a sense of discomfort, danger or failure’ (p. 161). And the
idea of fatigue as a result of conflict of goals is reiterated in Bartley
and Chute’s (1947) volume; they concluded that fatigue was a result of
conflict between competing behavioural tendencies: between doing and
not doing; between doing one thing and doing another; between doing
one thing for a long time or switching to something else.
The idea that the resolution of conflict is an effective basis for the
control of action is a familiar one (Berlyne, 1960; Botvinick, Braver,
Barch, Carter & Cohen, 2001; Norman & Shallice, 1986), with cogni-
tive control acting to select and promote goals, maintain selected goals,
and prevent disruption by competing goals. Adaptive goal-directed
behaviour requires the monitoring of current actions and outcomes,
and making appropriate modifications in relation to costs and benefits
of different activities. As I have already stated, fatigue is interpreted
here as an adaptive state, supporting the effective overall (system-wide)
management of goals. In this conceptualization, the subjective experi-
ence of fatigue arises through conflict between current and competing
goals or action tendencies. In effect, the feeling of fatigue is assumed to
have a signal value for motivational control, providing a mechanism for
resolving conflicts between current goals and other possible or desired
course of actions. This approach is developed within the rest of the
book by considering the boundary conditions for the experience and
impact of fatigue, especially in relation to work and the performance
of tasks. However, the focus is necessarily broader than fatigue itself,
since fatigue is but one aspect of the complex set of control systems that
manage goal activity in the service of motivational requirements. Thus,
the book is also about effort, stress, coping and motivation.
Defining the field: what is fatigue?

How can we define fatigue? What are the psychological criteria for
it? What does it do? These questions have recurred throughout the
history of the problem, and we are still unable to provide definitive
answers. There are three persisting problems in addressing the ques-
tion of definition. One is the widespread assumption that it is prima-
rily about decrement; for example, Simonson (1971) identifies fatigue
with ‘all processes resulting in a decrement of capacities’. The second
is that, while fatigue may be recognized as being about not only dec-
rement, but also subjective experience or even physiological changes,
different researchers have routinely given different weight to these vari-

ous aspects, emphasizing one to the near exclusion of others. The third
is that the term appears to have quite different institutionalized mean-
ings across different scientific groups: the medical profession thinks of
fatigue as a debilitating consequence of a wide range of diseases and
systemic conditions; neurophysiologists focus on the loss of motor con-
trol leading to reduced muscular strength; exercise physiologists talk
of fatigue as a limiting factor in physical performance and endurance;
and sleep researchers regard it as a condition brought on by impaired
sleep quality or duration. And how do psychologists think of fatigue?
Throughout its history, there has been a tendency towards overgener-
alization; in the words of one prominent early researcher:
Fatigue is a comprehensive term which in its widest application embraces all
those immediate and temporary changes, whether of a functional or organic
character, which take place within an organism or any of its constituent parts
as a direct result of its own exertions, and which tend to interfere with or
inhibit the organism’s further activities. (Ash, 1914, p. 1)
On such a basis, it would appear difficult not to study fatigue, whatever
one’s research focus, as long as the organism does something! The prob-
lem has also been one of circularity; fatigue was often assumed simply
because of the nature of the testing conditions, or the ways in which
behaviour was assessed. In a frequently cited report to the Industrial
Fatigue Board, the Australian industrial psychologist Bernard Muscio
(1921) concluded that it was not possible to define what fatigue was
independently of the tests used to measure it, and recommended that the
term be avoided altogether. He was certainly correct in criticizing the
circularity of reasoning that pervaded psychological research at that
time – and not only in work on fatigue – though his conclusions are
unduly pessimistic.
Ideally, what is needed is to show a correspondence between an
acknowledged state of fatigue and various consequences of that state.
In early research effects were typically expected as a reduction of scores
on specific tests, but these tests were also often used to define what
was meant by the state itself (or the characteristic expression of it): ‘a
condition caused by activity in which the capacity for repeating the
activity that caused it is diminished’ (Muscio, 1921, p. 35). Muscio
argued that there needed to be an independent measurement of the
fatigue state, such as a set of physiological changes. This is what the
early fatigue researchers had anticipated they would find in simple mus-
cular or metabolic measures of energy loss, though they were uniformly
unsuccessful. In fact, circularity of this kind is still frequently found
in journal articles, again concerning not only fatigue, but also stress,
arousal, effort, and many other motivational constructs. These all have
in common the difficulty of finding any unequivocal bodily indicators
of what are broad, complex states. I would argue that, while Muscio’s
analysis reflects a realistic appraisal of the state of the art at the time,
his inference is flawed. How is fatigue different in this respect from
other psychological states that rely on introspective reports as the pri-
mary evidence for their occurrence? What about effort? Anxiety? Pain?
In some cases, there may be the possibility of measuring concomi-
tant physiological changes, but these are not completely reliable, nor
uniquely attributable to changes in the relevant state. The essence of
fatigue (as of effort, anxiety and pain) is not its physiology or its effect
on performance, but its undeniable subjective quality; the feeling of
mental tiredness is one that is universally recognized and understood.
A working definition
It is, however, necessary to be clear about what we do mean by fatigue:
what it is and what it is not. For this purpose, a good starting point is
provided by the criteria suggested by Bartlett, in the Floyd and Welford
(1953) symposium on fatigue:
Fatigue is a term used to cover all those determinable changes in the expres-
sion of an activity that can be traced to the continuing exercise of that activity
under its normal operational conditions, and that can shown to lead, either
immediately or after delay, to deterioration in the expression of that activity,
or, more simply, to results within that activity that are not wanted. (Bartlett,
1953, p. 1)
Bartlett’s definition has a number of features that are worth emphasiz-
ing. First, fatigue is identified as a process – a growing problem associ-
ated with continued activity of a task. This remains the core definition of
fatigue effects in task performance, especially when a person has been
carrying out a highly demanding task or dealing with stressful events.
Second, like Bartley and Chute (1947), Bartlett is careful not to iden-
tify effects of fatigue with decrement per se. He suggested that ‘feeling
tired’ (with its associated signs of physical discomfort) may, in fact, rep-
resent a somewhat late stage in the fatigue process, ‘when a good many
unwanted effects have already invaded performance’, and identified
three phases in the development of fatigue with repeated work, before
any discernible overall reduction in work output or speed occurred:
(1) loss of timing and control of successive task elements; (2) loss of
organization, or adjustments in the way the task is being managed; and,
finally, (3) feelings of fatigue and physical discomfort. Although per-

formance decrements are generally regarded as the gold standard of
fatigue research, as I show in Chapter 3 they are by no means routinely
observed. In Chapters 4 and 5 I argue that this is because performance
may be protected by the use of effortful strategies that help maintain
task goals, especially when individuals are highly motivated (Hockey,
1997). However, the act of performance protection under increasing
effort is expected to result in the emergence of the end state identi-
fied by Bartlett’s definition, a delayed effect of fatigue on performance.
Although he assumes a gradual breakdown of performance, the devel-
opment of fatigue may also have an impact on post-task activities, what
I refer to as the fatigue after-effect. In addition to a gradual reduction
in commitment to the continuing task, fatigue inculcates a preference
for low effort strategies in the period following a demanding or stressful
work session. Following its clarification by Broadbent (1979), Cohen
(1980) and Holding (1983), this type of effect has become increasingly
studied and identified as a more typical consequence of fatigue, par-
ticularly in realistic work situations, or when participants are highly
motivated to perform well on primary tasks (Hockey & Earle, 2006; van
der Linden, 2011).
I shall retain the essence of Bartlett’s criteria to define the range
of phenomena to be explained, with the addition of an index of the
costs of effort. The use of compensatory effort to account for the dis-
crepancy between fatigue and impairment was understood by many
early researchers (e.g., Bitterman, 1944; Freeman, 1931; Ryan, 1944;
Thorndike, 1900) and provides a valuable reference point for interpret-
ing fatigue states; an absence of impairment, when it is accompanied by
higher levels of effort and tiredness, is an indicator of the increased dif-
ficulty of maintaining task goals, a defining feature of what is meant by
fatigue. The feeling of fatigue may be regarded as a direct result of the
use of increased effort to maintain task goals and protect performance
during periods of demanding work. In some conditions effort has to be
increased much more to prevent major impairment in the task (what I
refer to as the strain state). Putting this all together (Table 1.1) it is clear
that the patterning of fatigue may take three general forms: acceptance
of interruption and its consequences; normal (manageable) resistance
to interruption; and a state of strain, where extended resistance (and
sustained effort) develops into an aversive state. Note that performance
decrement and fatigue feelings are not considered to co-occur in the
‘pure’ states, though most responses to tasks involve a mixture of the
two. Under strain, high effort may not be enough to sustain task fidelity
and both effects may be observed.
Table 1.1 Possible patterns of the fatigue response to work tasks
Performance After-
Fatigue mode Subjective state decrement effects
Acceptance minor (transient) fatigue yes no

Resistance increasing effort and fatigue no yes
Strain sustained high effort and fatigue slight yes
Fatigue and related feelings

Fatigue appears to be a rather distinctive state, and, in later chap-
ters, I develop the idea of fatigue having the core properties of a
basic emotion, with attendant implications for goal management and
behavioural expression. However, it appears to act as a highly gen-
eralized background emotion, with figural detail being provided by
other more specific states, such as the anger and distress of young
children (Tomkins, 1963). Because of this it has conceptual and phe-
nomenological overlaps with many other motivational and emotional
experiences: notably boredom, depression and anxiety. Fatigue is also
functionally related to the experience of effort, and is a natural out-
come of the stress response, as well as being a commonly reported
symptom of many illness states. These associations with other feelings
sometimes make it difficult to identify fatigue as the key factor in par-
ticular situations, and may influence the kind of explanation of behav-
iour that seems appropriate. In other cases it serves to remind us that
states such as fatigue are nearly always more complex than typically
assumed. Nevertheless, there is a need for clarity about the relation of
fatigue to these other feelings.
Boredom. The link with boredom is particularly strong, and has
been a source of ambiguity since the 1930s. Myers (1937) differenti-
ated between mental fatigue and boredom, though recognized that
they may have similar effects on performance. Specifically, he defined
boredom as ‘the outcome of a failure to find interests which can main-
tain spontaneous or voluntary attention’ (p. 298), while fatigue was ‘a
general impotence to concentrate attention and to act purposefully,
intelligently and creatively’ (p. 299). Myers’ main distinction, then, is
that boredom is a failure to attend to a specific source of information,
while fatigue is a more general failure of concentration. Based on an
extensive programme of work, Barmack (1937) argued that boredom
developed in task situations under low intrinsic motivation, and was

a state of conflict between remaining in the situation and wanting to
get away from it. This conflict was partially resolved by the onset of a
state of detachment or sleep-like withdrawal, associated with reduced
sympathetic activity. Stated in this way, boredom looks remarkably
like fatigue, as I have defined it here. Berman (1939) preferred to
think of boredom as satiation, a general response to continued stimu-
lation of all kinds, but without the need to invoke a mental state. Both
boredom and satiation are clearly related to fatigue, though without
the sense of task striving; the most basic of the three is satiation, since
it can occur in the absence of a task, while boredom may be thought
of as fatigue without the effort to remain actively engaged with task
goals.
Welford (1968) considered the relation between fatigue and boredom
in terms of the arousal-information processing theories of the day. The
construct of general arousal became very popular in applied experi-
mental psychology during the 1960s as a framework for accounting
for effects of stressors on performance, through its supposed ‘inverted
U’ relationship with performance (e.g., Broadbent, 1963). In relation
to human performance, such views assumed that general arousal was
dependent on the level of information in task events, and that there was
an optimal level of arousal for effective performance. Welford suggested
that fatigue occurred as a consequence of information overload (too
high a level of arousal), and considered decrements under fatigue to be
caused by the consequent increase in ‘neural noise’ under the sustained
stimulation of demanding tasks. This seems counter-intuitive, since a
state of ‘over-arousal’ is usually taken to mean one of stress or panic,
rather than the more familiar understanding of fatigue as an inhibited,
withdrawn or inactive condition. However, he did not consider the pos-
sibility put forward later in this book of the one state leading to the
other, through active inhibition. By contrast, boredom was assumed
to be caused by underload, too low a level of arousal, brought about
by inadequate environmental stimulation; although task events attract
attention they do not contain enough information to maintain active
engagement.
Despite this distinction, Welford nevertheless recognized that fatigue
and boredom were not always easy to separate empirically, and that
both may occur in a prolonged task situation (where, for example, parts
of the task are highly demanding while overall throughput of informa-
tion is low). There are some contextual differences between fatigue and
boredom; O’Hanlon (1981) has suggested that boredom is a response
specific to situations that are highly repetitive or monotonous, not
standard features of the typical fatigue-inducing task. One possibility

is that fatigue and boredom represent subjective responses to different
features of the task situation. In their analysis of the characteristics of
the fatigue process, Bartley and Chute (1947) argued that the aversive
feelings experienced under boredom were a response to the monotony
of the environment, whereas fatigue had its origins in the individual’s
perceived inadequacy to manage the task. Overall, however, these two
feeling states are very close together, and I would argue that boredom
may be a component of the broader fatigue process. In this case, the
monotony of the task environment may be considered a special (or lim-
iting) case of the demanding work situation associated with fatigue. In
both paradigms, individuals are required to remain in the task situa-
tion imposed from outside, and, in both cases, they are motivated to
change the environment or task, or to break out of the situation and do
something else.
Anxiety and depression. A second potential source of confusion is
the frequent association observed between fatigue and other nega-
tive mood states, such as anxiety and depression. Such feelings have
long been recognized as occurring together in what were categorized
as ‘nervous disorders’ in eighteenth-century England (Porter, 2001;
Sicherman, 1977; Wessely, 1991), and are regularly found as a cluster
of symptoms in mood disturbances. In modern analyses of mood, the
relationship between them can be interpreted in a number of ways.
Standard circumplex models (e.g., Russell, 1980) typically illustrate
a two-dimensional solution for the underlying structure of feelings,
based on factor analyses of the correlations between mood reports.
This identifies mood terms varying in terms of valence or hedonic tone
(negative to positive) and intensity or arousal (low to high). In this kind
of analysis, feelings such as fatigued, anxious and depressed (the ‘nega-
tive mood’ cluster) are grouped together as negative valence, in con-
trast to positive mood terms such as energetic, contented and elated.
The intensity dimension serves to distinguish active or aroused states
(energetic, anxious, elated) from less active ones (fatigued, depressed,
contented).
An alternative methodology involves rotating the axes of the fac-
tor analytic solution to give dimensions based on the diagonals of
the standard solution. The best-known of these models (Watson &
Tellegen, 1985; Watson, Wiese, Vaidya & Tellegen, 1999) refers to
these new dimensions by the somewhat confusing labels of positive
affect (PA) and negative affect (NA), both ranging from low to high.
High PA includes feelings such as enthusiastic, elated and energetic,
and low PA feelings of depressed state and fatigue; high NA refers to
a state of active distress, including feeling anxious and angry; and low
NA to feelings such as calm and contented. Finally, a modification of
the rotated model (Thayer, 1989) expresses moods in terms of two
patterns of arousal: energetic arousal and tense arousal. These can be
seen to be broadly equivalent to PA and NA, but with less emotional
content. While the two kinds of solution are statistically equivalent,
the PA/NA structure of affect has been of greater value for measur-
ing response to stress or task demands (Hockey, Maule, Clough &
Bdzola, 2000; Warr, 1990). Watson et al. (1999) have shown that they
are also highly correlated with the ‘big two’ personality dimensions,
extraversion and neuroticism, and correspond in affective terms to
the two fundamental motivational systems associated with goal pur-
suit/approach and withdrawal/avoidance behaviour. I will say more
about this in Chapter 4 in relation to the metacognitive role of feelings
in goal management.
It makes sense on other grounds to distinguish anxiety and fatigue,
as they clearly represent different mechanisms and subjective states.
However, they are bound together as components of the response to
stress and high demands. In a number of studies, while we have found
it useful to distinguish fatigue (low energetic arousal or low PA) from
anxiety (high tense arousal or high NA) as separate indicators of strain,
they often occur in combination as the classic strain pattern associated
with an effortful response to demanding work (Hockey, Payne & Rick,
1996). In the compensatory control model (Hockey, 1997) anxiety is
identified with the response to a perceived threat from the environment.
It will always occur in task situations when demands are unexpectedly
hard to manage. Anxiety is also the typical precursor of fatigue in such
situations, but only when sustained effort is recruited to meet these
demands.
The conceptual status of fatigue

Following the early enthusiasm for research on fatigue, a general scep-
ticism developed, expressing concern that fatigue was an unnecessary
concept. This was articulated most forcibly by Muscio (1921), who
argued that there was no way of defining fatigue independently of
the measurements made to identify it. These problems have not been
resolved and, even today, considerable confusion remains about its con-
ceptual status. Does fatigue have a real explanatory value? Does it help
us to understand the different patterns of behaviour observed under
various work conditions? Does it relate to some real physical entity such
The conceptual status of fatigue 19
as a brain process or bodily condition? Or does it simply add an unneces-

sary layer of description to the empirical relationships that we observe
between independent and dependent variables? Of course, these are
questions that can be (and have been) asked of almost all explanatory
concepts in psychology. Part of the problem is that researchers often
use conceptual terms loosely, or may be unclear about how they mean
them to be understood.
Such issues were treated formally in an influential paper by
MacCorquodale and Meehl (1948), mainly addressed to the confu-
sion over the meaning of explanatory terms between the competing
dominant behaviourist theories of the time (those of Hull, Tolman
and Skinner). MacCorquodale and Meehl distinguished between two
kinds of theoretical uses of unobserved variables that mediate between
or link stimuli/inputs and responses/outputs: hypothetical constructs
and intervening variables. Intervening variables are abstract concepts
employed to summarize the observed relationships in a way that aids
meaning (for example, through their association with everyday lan-
guage), though they are not presumed to have any physical reality. By
contrast, hypothetical constructs are assumed to have an underlying
basis in physical processes. They have properties and implications
that have not necessarily been directly observed, and therefore have
a stronger role in theory development, helping to generate hypotheses
about hitherto untested relationships, and improving its predictive
power.
One problem is that, depending on the context, the same term may
be used either as an intervening variable or as a hypothetical construct.
Consider learning as an example. It cannot be observed directly, though
we believe that it corresponds to some physical activity (changes in
neuronal structures) that underlies observed increments in knowledge
and skill. Used in this way learning has the status of a hypothetical
construct. However, in some uses, it may have the status only of an
intervening variable. Suppose we observed an unexpected improve-
ment in the performance on a well-practised motor skill between two
task sessions, and ‘explained’ this as being due to learning having taken
place. Here, learning is being used as an intervening variable; it adds
nothing to the understanding of the observed relationship. It is also
misleading, since we have not ruled out other potential causes of skill
improvement in the second session, such as changes in motivational
factors, effort, or demand characteristics of the task. This may seem
a trivial example, since we can recognize the attribution of learning in
the latter case as one of slipshod methodology; we need to control for
these other competing hypotheses before we can support learning as

the ‘real’ cause. However, the difference is not always clear-cut and may
be a matter of degree. In the case of learning we may be fairly sure of
our physical ground, but what of fatigue, or of goal, energy and effort?
Soames-Job and Dalziel (2001) were unequivocal in their definition of
fatigue as a hypothetical construct, based on an underlying energy limi-
tation of some kind:
Fatigue refers to the state of an organism’s muscles or viscera, or central ner-
vous system, in which prior physical activity and/or mental processing, in the
absence of sufficient rest, results in insufficient cellular capacity or system-wide
energy to maintain the original level of activity and/or processing by using nor-
mal resources. (p. 469)
This is the traditional view of fatigue, and one that I will argue against
in later chapters, though it clearly imbues the idea of fatigue with some
substance. More importantly, at this stage, is the question of whether
a case may be made for considering fatigue as an intervening vari-
able only. After all, it is most typically used as a ready explanation for
performance on a task falling off over time: a convenient label for the
observed relationship between a set of conditions and an outcome. It
is also sometimes used to refer to the experimental condition of an
independent variable (the ‘fatigue’ condition), pre-empting its role as
an explanatory variable in the understanding of the observed empir-
ical relationship. Because of these tendencies, Muscio (1921) cannot
be strongly criticized for dismissing fatigue – in many cases, the term
appeared to do no more than this – even though his argument could
have been applied equally to many psychological concepts at that time.
In other situations, however, and with the growth of empirical evi-
dence, it is clear that fatigue implies a more elaborate central process.
In this form, time on task is but one of the ways of inducing fatigue,
and an observed decrement but one of its possible manifestations.
Fatigue may also be induced by stressors and high effort, and reduced
by control opportunities. It may be measured not only as subjective
tiredness, but also as interruptions of response timing or after-effects
of resistance to further effort. Here, fatigue is the conceptual anchor
that is needed to draw together the various separate effects. Rather
than have independent explanations for each we may propose a general
theory that goes beyond the observable data of specific manipulations;
it can account for apparently incompatible findings, and simplifies the
explanatory framework. As with more widely accepted constructs,
such as memory, metabolism or multiple sclerosis, or emotions such as
anxiety and anger, a theory that makes use of a hypothetical construct
Some questions for a scientific theory of fatigue 21
has to show that it can go beyond the empirical relationships observed

in experiments, and carries with it a duty to predict new cause–effect
patterns. On the view proposed here, I would argue that the manifes-
tations of fatigue are (at least in principle) observable as components
of a brain state. In the second half of the book, I will provide evidence
for such a claim.
The key point here is to recognize that the subjective feeling of fatigue
is the primary marker of the state (as is true also for anxiety, pain, hun-
ger and other states), rather than performance decrement. The failure
to find the holy grail of an objective test of fatigue is irrelevant, since it
has been driven by the misguided search for evidence of a draining of
central energy, leading inexorably to a waning of output or behavioural
intensity. As Bartley (1943) points out:
(the) subject’s report of fatigue is its sine qua non. One is not tired till he knows
it. Prior to this one is only impaired, the realization of which becomes a com-
ponent of the resulting total fatigue-syndrome. Fatigue is the desire to quit
a given activity and turn to something else, arising out of the discomfort or
impairment involved in pursuing the task, or in the relative failure in doing so
for any reason; or it is the feeling of aversion toward instituting a given activ-
ity owing to the anticipated discomfort or relative inability in performing it.
(p. 161)
However, I believe that fatigue is a more complex process than both
impairment and the emergent feeling. Rather, it has subtle effects on
performance even at the earliest stage of task engagement, before both
of these are evident. I shall develop this idea throughout the book. In
Chapter 4 I put forward an argument for treating fatigue as having a
basis in emotion, like anxiety and depression. As with both of these,
fatigue is both a process and a state. As with all emotions (Izard, 2009;
Nesse, 1990) the process (fatigue, anxiety, depression) is triggered by
an automatic response to significant environmental events, leading to a
set of changes designed to resolve the problem. However, an extended
or unresolved process may lead to the distinctive end state experienced
as fatigued, anxious or depressed.
Some questions for a scientific theory of fatigue

In deciding upon the approach and contents of this book, I have had to
consider what issues a modern treatment of fatigue should address. To
a certain extent this will, inevitably, reflect my own interests and biases.
However, I have tried to be as broad and impartial as possible in my
choice of topics. The following is a set of issues that I believe are central
to the process of developing a scientific theory of fatigue. I have not

tried to justify them here; rather, they may be seen as general postulates
for the theory I develop later in the book.
(1) Function of fatigue. Does fatigue have a function or purpose, for
example in terms of regulating bodily or mental events? What is it
for? What does it do? Early researchers considered fatigue not as
an end point of an energy transformation process, but as a warn-
ing or indicator of the need to stop now, before irreparable dam-
age occurs. This makes sense within an evolutionary framework.
I explore the view that fatigue may be considered, like anxiety, to
have an adaptive function, serving to protect the organism from
over-commitment to specific goals, in the service of a balanced
motivational strategy. By acting as a signal for rest or change it
allows a reappraisal of competing needs and their values.
(2) Task performance. The core empirical work on fatigue has been con-
cerned with its role in task performance; with its assumed relation-
ship with work and sustained attention and high workload. Such
effects are known to be moderated by work conditions such as con-
trol and effort, though these have not been included in most theor-
ies of performance decrement. In general, a theory of fatigue will
need to be able to account for the variability of performance under
a wide range of tasks and conditions.
(3) Stress and effort. The effects of fatigue are intimately bound up with
the response to stress, and to the use of sustained effort as a con-
trol strategy. These effects may explain the after-effects of fatigue
and be the origin of longer-lasting problems of fatigue. A theory
of fatigue will need to be consistent with what is known about the
stress response.
(4) Task goals, personal goals and control. One of the building blocks of
my approach is that fatigue is a way of preventing rigidity of goal
maintenance. This is assumed to be a problem only for work that
is imposed or understood as a task. For personal goals or interests
(with high control or intrinsic motivation) fatigue does not appear to
be a problem. The role of control is therefore central to the dynam-
ics of the fatigue process.
(5) Brain mechanisms of fatigue and effort. Are there identifiable brain
processes that relate to the phenomena of fatigue and to the effort–
fatigue relationship? I make the case that a strain on executive func-
tioning is the core problem; are there mechanisms that reflect this?
And can we say anything about possible neurochemical factors that
may support these?
Plan of the book 23
(6) Energy. The traditional link between work, energy and fatigue is
one of the starting points for the book. While it now seems unlikely
that fatigue is caused by marked changes in glucose metabolism in
either brain or body, the possibility of more subtle influences needs
to be considered. Energy transactions are also implicated in the
related problems of sleep and physical work, raising further ques-
tions of how feelings of fatigue and effort are related to changes in
energy.
(7) Varieties of fatigue. A long-running question is whether fatigue is
one thing or many; whether mental fatigue, physical fatigue and
sleepiness are the same thing, or whether they represent quite dif-
ferent processes. At this stage the evidence is not sufficient to draw
unequivocal conclusions, though some commonality is likely. A
theory will need to be clear about where it draws its boundaries.
(8) Malfunctions of fatigue. While the normal mechanisms of fatigue
impose brief disruptions on behaviour and early recovery, fatigue
may sometimes persist for an evening or a few days; sometimes for
weeks or months. A major question is whether this persistent or
chronic fatigue is the same process without its recovery phase, or
whether it is something different, with some of the same feelings.
While this is not an issue that a theory of normal fatigue needs to
be overly concerned about, an all-embracing perspective should be
able to at least consider such issues.
(9) Centrality of mental fatigue. Whatever the outcome of arguments
about the plurality of fatigue states, mental fatigue is hypothe-
sized as being, at least, a final common path. It reflects a subject-
ive assessment of whether some activity needs to be stopped (or
changed), and may also have a primary role in their management:
when sleep must be resisted or yielded to; when physical endurance
can no longer be tolerated.
Plan of the book

Following this introduction, Chapter 2 adopts a historical perspective
to consider changes in the meaning and impact of fatigue, both as an
everyday term and in its scientific usage. In Chapters 3, 4 and 5, I
examine the core human performance issues of the work–fatigue rela-
tionship in the context of sustained work, workload, vigilance, stress
and coping. This leads in Chapter 6 to development of the motivational
control theory of fatigue, which combines approaches from control
theory with emerging knowledge about brain mechanisms of executive
function and effort. In Chapters 7 and 8, I consider constraints placed

on this approach by evidence from related fields, concerned with brain
energy, physical work and sleep (Chapter 7) and pathological states
such as chronic fatigue (Chapter 8). Finally, in Chapter 9, I suggest a
broad agenda for research on fatigue and its application to real-world
problems.
2 Changing experiences of fatigue: the
social-historical context
Background
Our present-day understanding of fatigue as a property of our mental
life is usually framed in terms of a depletion of energy resources from
work (or overwork); but it may not always have been so. The Oxford
English Dictionary (OED) defines fatigue as ‘weariness resulting from
bodily or mental exertion’. We say that we feel ‘tired’ or ‘weary’; or, if
the feeling is stronger, ‘worn out’, ‘drained’ or ‘exhausted’; we complain
of overwork and lack of energy. What is the origin of these expressions?
And what do they say about what we understand our state to be when
we use them? I argue in this chapter that such ideas evolved out of the
changing experiences of work during the Industrial Revolution, in par-
ticular, the erosion of much of the control over work that was evident
in pre-modern times. By the end of the nineteenth century, fatigue had
changed from a generally benign (and rarely complained of) natural
state to the negative condition we recognize today.
This chapter examines a number of themes relating to changes in the
meaning of fatigue and of working life: the language and use of the term
‘fatigue’ and its synonyms; the moral code attached to tiredness, most
explicitly during the medieval period, but still a pervasive influence well
into the nineteenth century, and observable even today; transitions in
the attribution of fatigue, from willpower to exhaustion; and the formal
acceptance of fatigue as a problem state, with medical recognition. What
is clear is that fatigue had a widespread influence on the everyday lives
of the pre-modern period, varying from spiritual sloth to bodily tired-
ness; from the sleepiness and acceptance of toil of the rural labourer to
the wariness of any physical activity in intellectuals and the aristocracy;
from the casual working style of eighteenth-century craftsmen to the
introduction of clock-time to the working day. The chapter also traces
the ontogeny of the energy metaphor in late nineteenth-century sci-
ence, and its role in the medicalization of fatigue.
25
26 Changing experiences of fatigue
As part of the book’s brief to take a fresh look at the whole topic
of fatigue, the chapter examines the social history of the feeling of
tiredness – its changing meanings and implications – from medi-
eval and pre-modern periods up to the establishment of the modern
post-industrialization lifestyle. Evidence on the feelings and experi-
ence of fatigue may be found in a number of archival sources: dic-
tionaries, diaries, literature, poetry, essays, sermons and speeches,
letters, newspapers, reports, mass observation surveys, and so on. Of
course, such sources of evidence are clearly not as strong as we would
wish, or normally expect, for the development of a scientific argument.
Nevertheless, I believe that they offer valuable insights into the evo-
lution of our understanding of the experience of fatigue. A second
limitation of this exercise is that, while some of the evidence comes
from other cultures, my focus will inevitably be on changes within the
UK. This is primarily dictated by the relative ease of accessibility of
materials, as well as the obvious advantages of working in one’s own
language when interpreting such material. However, I am confident
that the broad arguments and conclusions are applicable to our under-
standing of the changed experience of fatigue across (at least Western)
society in general. Part of this conviction stems from the fact that simi-
lar changes have occurred in society throughout Europe and North
America, including the impact of religious routines and changes in
working practice. It is also recognized that the major driving force for
change, in both work and the experience of tiredness – the Industrial
Revolution – while occurring somewhat earlier in the UK, affected
all Western civilizations dramatically during the nineteenth century.
Landes (1969) shows how the different pattern of these changes across
different European states reflects local priorities, needs and resources,
though the impact of the factory system on working life remained
broadly the same.
Roots of the energy metaphor of fatigue

Over the period of its increasing adoption by society, the energy explan-
ation for feelings of fatigue was regarded as having a firm basis in
the mechanics of the body, and new physiological theories generally
appeared to support that view (Rabinbach, 1990). But this explana-
tory framework – as in all cases where everyday language based on
other kinds of knowledge is used to reflect on our subjective experi-
ence (Lakoff & Johnson, 1980) – is a metaphor. The human body was
not actually one of the new industrial machines; it just seemed to have
some of the same characteristics under certain operating conditions.
And even if the underlying machinery of the body did appear to work
like that of a steam engine, this mechanical process is not directly avail-
able to our feelings or experience. Furthermore, as we shall see in later
chapters, effects of doing work are not always experienced as a problem
of energy depletion, and energy is not actually depleted by work – rarely
even seriously challenged. As Lakoff and Johnson have argued, poorly
understood experiences become prime targets for metaphor, and this
has been true of fatigue for many centuries. Occasionally, metaphors
become perceived as physical reality, and this is what has happened in
the case of energy and fatigue; we now think of both the body and the
mind-brain as energy transforming systems, exchanging work outputs
for an inevitable energy cost. Of course, such transactions are an inev-
itable and essential part of the physics of behaviour, but they may not
be the most appropriate way of understanding problems of behavioural
control.
Expressions for the feelings associated with fatigue have been around
for a very long time, and have not always invoked the idea of failing
energy. Some of the fatigue expressions we think of as derived from
nineteenth-century energy ideas are in fact much older, based on the
root metaphor of the machine; the arrival of the scientifically grounded
theory of energy conservation served to draw them all together within
language and popular culture. The Oxford English Dictionary (OED)
shows that ‘weary’ dates from the ninth century, ‘tired’ from the fif-
teenth, and ‘fatigated’ (an early form of fatigued) from the sixteenth.
These are all basic expressions of affective state (as with anxious, mis-
erable, angry or happy): words that have evolved to describe the feeling
directly. However, reports of fatigue often make use of ontological met-
aphors (where feelings are represented by some concrete entity). The
dominant modern metaphor for fatigue is recognizably that of a loss
of energy: a limited store of fuel that is being used up; a battery run-
ning down. These derive from the root metaphor of the body-mind as a
machine. In addition to providing a carrier for the meaning for fatigue,
the machine metaphor underlies the way we think about many aspects
of bodily state, including motivation (wheels set in motion, springs of
action); performance (like a well-oiled machine, everything on track)
and illness (mental breakdown, burned out). In the case of fatigue, the
machine metaphor emphasizes the need for a supply of energy for its
operation. Certainly, earlier expressions hint at energy-like processes,
but these derive from other root metaphors. While the term ‘energy’
was used in the seventeenth century, it referred only to the force of
expression (in language or writing). For example, the OED gives ‘spent’
as first being used in print in 1559, ‘exhausted’ in 1656 and ‘used up’
in 1839. These seem related to energy, and may now be regarded as

having moved on to be associated with energy as a more specific lim-
ited resource, but the OED shows that they derived originally from the
sense of limited resources or supplies. A further group of expressions all
come from the metaphor of physical deterioration with continued use:
‘drooping’ (1553), ‘sagging’ (1599) and ‘worn out’ (1750), and these
too may be considered to have been incorporated into the later energy
metaphor.
Direct links between fatigue and energy appear quite late in the his-
tory of feelings. As Rabinbach (1990) shows, the origins of the modern
machine energy metaphor are in the proliferation of nineteenth-century
machines, based on steam (and, later, batteries and dynamos). The
OED indicates that ‘run out of steam’ and ‘grind to a halt’ entered
the language of fatigue in the 1890s, and ‘out of energy’ in the early
1900s. The use of ‘drained’ to refer to the ‘human battery’ dates from
around 1860; ‘charged’ and ‘recharged’ human batteries are not dis-
cussed until around 1910. The use of ‘energetic’ for human activity
(the opposite of fatigued) dates from the 1880s, and ‘mental energy’
(in relation to human behaviour) from 1901. The point I want to make
here is that the relevance of these machine energy expressions in the
language of fatigue is not simply that they have influenced the way we
talk about fatigue; rather, as Lakoff and Johnson (1980) have argued,
they have shaped our understanding of its meaning. I would argue
that, happening as it did at the same time as the modernization of work
practice in the late nineteenth century, the spread of ideas about energy
encouraged people to think of their response to work (and to the other
demands of life) as a part of the new understanding of machines and
living things. Unlike earlier metaphors, energy provided the subjective
experience of fatigue with a convincing explanation and meaning; it
resolved much of the ambiguity of an indistinct human state, which,
as we shall see, has never been fully understood. The new principle
of energy conservation meant that fatigue could now be explained as
a result of running down of the supply of whatever fuel the body (or
mind) used. I believe this is why it has become such a dominant way of
understanding, and talking about, tiredness. As we shall see later, the
energy-depletion explanation of fatigue, in effect, medicalized what
had previously been understood as a natural result of interaction with
environmental events; fatigue had become the dominant symptom of
the strain of coping with the modern, more complex and demanding,
world.
As discussed in Chapter 1, even during the period of the earliest sys-
tematic research on the psychology of fatigue (e.g., Thorndike, 1900)
it was clear that fatigue was not an inevitable consequence of work;

under the right conditions, the battery may not run down at all, or
may even get recharged! Rather, it is a common outcome only of the
class of activities that may be considered as tasks: externally driven
behaviour that we would rather not be engaged in. As was well under-
stood at that time, negative fatigue feelings were not commonly expe-
rienced when people carried out work that was personally meaningful
or interesting, or when they were engaged in other, equally demand-
ing but self-initiated, activities, such as hobbies and leisure pursuits.
Such issues are central to our understanding of fatigue and its role in
behaviour, and will be examined in detail in the next few chapters. For
the moment, they simply raise questions about why such an under-
standing has been lost over the last century of research on fatigue and
performance.
The pre-modern experience of work and fatigue

It is only during the past two centuries that fatigue has come to have
the generally negative connotation it has today. Before that time, tired-
ness – the core experience of fatigue – appears to have been perceived as
a natural part of life, and certainly not something to complain about, or
a cause for concern. In some contexts this is still true today of course;
we often refer to a ‘pleasant’ tiredness after a long walk or a game of
tennis, or even following one of those rare productive days of academic
writing, where the words appear to flow through the keys. In fact, the
meaning of tiredness appears to have changed since the pre-modern
period. While the use of words to describe feelings of fatigue date from
the fifteenth century or so, their widespread use in everyday language,
as we saw earlier, appears to date only from the large-scale regulariza-
tion of work and medicalization of the problem during the second half
of the nineteenth century. The agricultural labourer of the seventeenth
century would certainly have got tired from working all day, but there
is no evidence that it would have been a topic of conversation, or per-
ceived as an aversive state. As with the feeling of sleepiness towards the
end of the day, it was understood as a natural part of the flow of daily
life. In its more formal status as a recognized medical problem, fatigue
did not even exist before around 1870. However, by 1900, as Rabinbach
points out, it was established as the disease of the modern age, exempli-
fied by Beard’s (1869) description of neurasthenia as a state of nervous
exhaustion. For most of the post-industrial period up to the present day
fatigue has continued to be perceived as a major problem for society.
How did this change occur?
While much has been written about related, but arguably more dra-
matic, states, such as madness, depression, anxiety and melancholy,
social historians have had little to say about fatigue, or its cognate psy-
chological states: tiredness, weariness, idleness. With the notable excep-
tion of Thomas’ (1999) comprehensive anthology, even the much larger
topic of work, the accepted primal cause of fatigue, has received little
attention. Thomas remarks that part of the reason for this seems to be
the reluctance of normal working people to write about their experi-
ences of work, even in their autobiographies! Burnett (1974) assembled
an anthology of extracts of 27 diaries and autobiographies of ordin-
ary working people (labourers, domestic servants and skilled workers).
While the book contains many interesting descriptions of the details of
working practice, little mention is made of the demands of the working
environment, or of feelings in response to these demands, and almost
no mention of fatigue. Typically, in these accounts, the period spent
doing work is presented as a backdrop to more rewarding aspects of life,
such as family activities, social gatherings and recreation. However,
Burnett’s book does contain a number of observations from the middle
to late nineteenth century of how much harder work had become with
mechanization (for example, in the textile industry), with the monotony
of rigid work schedules, the time pressure induced by the increasing
speed of machines, and the strain from work (and pay) being driven
entirely by factory production targets.
In examining the social historical context for the personal under-
standing of fatigue, it is not clear how far we should go back to provide
a baseline or reference pattern to compare with the modern perspective.
Certainly, of course, we need to consider the periods before, during and
after the Industrial Revolution, where the greatest changes occurred,
both in work and in society in general. The Industrial Revolution is
usually agreed to have taken hold in England by the middle of the eight-
eenth century (around 1770) and to be more or less completed by the
end of the nineteenth century. However, this is an over-simple picture
of a more complex set of changes, with an early trickle phase based on
sporadic inventions for use in textile manufacturing, and (later) iron
and coal production, and a second phase (from around 1850) driven
by the development of technology for the large-scale use of steam and
electrical power in industrial engines, ships and railways. From the
point of view of the experience of fatigue, the impact of the Industrial
Revolution was felt most strongly in changes relating to the manage-
ment and legislation of work, such as the regulation of working hours
and rest periods, and factors such as the shift from rural to urban liv-
ing. Whatever the time scale of these various changes, it is clear that
they had a major effect on people’s lives, and especially on their percep-
tion of work and its consequences. However, they occurred over a very
long period (three or four generations), and it is likely that everyday
life was only marginally affected during the early phases; the historian
Eric Hobsbawm (1962) has pointed out that the Industrial Revolution
did not have a major impact on working life until the 1830s or 1840s.
It seems highly likely that the period of transformation of the indus-
trial landscape between the late eighteenth century and late nineteenth
century is the major factor underlying our changing experience of work
and fatigue. Hobsbawm argued that work was valued for its own sake,
even by labourers, during the pre-industrial era, but that this was lost
when labour became a commodity later in the nineteenth century.
However, we also need to be able to establish a baseline for assessing
the impact of the Industrial Revolution, by considering earlier influ-
ences, such as those from medieval religious constraints on idleness,
and Enlightenment influences on the relationship between mind and
body.
In his influential social history of work, energy and fatigue, The human
motor, Rabinbach (1990) examines the ways in which modern think-
ing and working life have been influenced by the nineteenth-century
adoption of the living machine metaphor for the body. He regarded
the notion of fatigue as the direct result of work as an inevitable con-
sequence of the embracing of modernity by the Western world. This
modern experience of fatigue as a negative, even aversive, state – a kind
of pain associated with the depletion of bodily or mental energy – has
become the norm, and is essentially the way we understand it today.
However, Rabinbach argues that such experiences may have been less
common in earlier times. He points to a long-standing perception of
fatigue as a natural part of life: a benign acceptance of the demands
and feelings associated with work, as of being sleepy towards the end
of the day:
The association of fatigue with pain, and especially with the depletion of bodily
or mental forces, contrasts sharply with a much older, more benign perception
of fatigue as the necessary accompaniment of work. (p. 39)
This interpretation hypothesizes a major shift in the meaning and per-
ception of fatigue. Yet, the change may not be as clear-cut as he sug-
gests; analysis of medieval and early modern sources reveals a more
complex picture of the social history of fatigue, with evidence of both
benign and harmful experiences at all times. Rabinbach (1990, pp.
25–26) also alludes to a second kind of shift in meaning, concerning
the motivational basis for a reluctance to continue working. Modern
conceptions of fatigue generally attribute this to a lack of energy or

capacity: a failure of the individual’s ability to meet the demands of the
task. However, for a very long period, stretching from medieval times
to well into the nineteenth century – and still evident today – a fail-
ure to do work was considered an act of will: a free choice to be idle,
unconstrained by external factors, and a failure of the moral obligation
to be industrious. Such issues underscore the ambiguity inherent in
our understanding of fatigue, and the failure of scientific psychology to
come to terms with the problem. I deal with this idea next.
Fatigue, idleness and volition

When someone does not carry out the work set for them, or if they
show a reluctance to do so, there are two possible ways in which we
might account for their actions, and these have different consequences
for how we evaluate them. We expect to be able to more or less excuse
them for not completing a piece of work if they are tired (and unable to
summon sufficient resources or energy reserves), but how do we know
that they are really tired? Just because they say so? What if, instead,
they are simply lazy or idle? In fact, the two ideas have long been con-
founded, and there exists a much older tradition where all displays of
tiredness, weariness and exhaustion were subject to moral criticism.
This has its origins in the highly spiritualized language of the medieval
monastery, where the working life was hard and highly controlled. This
was understood and formalized in the culture of the early Christian
model of acedia (equivalent to idleness or sloth), one of the seven deadly
sins (Wenzel, 1960). Acedia gave rise to frequent feelings of resistance
in monks, and was perceived by the church as a constant threat to the
capacity for doing ‘noble work’, leading to the neglect of duty or failure
of diligence. The monk experienced withdrawal, apathy and weariness
of pursuing goals, but also guilt for not being able to overcome these
feelings. During the fourteenth century, attitudes towards sloth and
idleness were readily transferred from the monasteries to the general
population, and widely understood as a threat to the disciplined use of
time. Work was recommended as the best therapy for idleness, and, well
into the sixteenth century, any signs of the various characteristics of
sloth – idleness, negligence, weariness, slowness to ‘do good’, heaviness
of thought – were subject to severe moral admonition.
How do these ideas about acedia or sloth relate to modern concep-
tions of fatigue? Although the underlying premise of the sin of sloth in
the medieval context is a moral one, these early writings also refer to
its negative effects on motivation, action, ability and willpower. Even at
the end of the Industrial Revolution, Revilliod’s (1880) medical trea-

tise, while clearly anchored in the new psychological and physiological
studies into fatigue, nevertheless echoed the medieval moral position,
suggesting that fatigue may take the form of laziness: ‘The head is
weighty, the spirit becomes lazy, thought, memory and the will all lan-
guish, and the apathy that results seizes control of the body’s legislative
and executive power’ (p. 13). In effect, Revilliod’s uncertainty recog-
nizes what we, even today, acknowledge as a persisting dualism, that
two separate causal attributions underlie a failure to continue working:
a depletion of (bodily) resources or a lack of (mental) willpower. Both
interpretations exist in our everyday awareness of the motivation under-
lying reported fatigue, leading us either to understand or to criticize:
is someone not able to do what we ask of them, or simply unwilling?
Are they really tired or just lazy? In the modern psychological context,
Kuhl (1987) has argued that ‘good intentions’ are not enough to ensure
completion of a goal; the decision to do something has to be followed
by a volitional act. A different view, from the extensive research on ‘ego
depletion’ (Baumeister et al., 2007) suggests that the two motivational
failures may be one and the same thing. Baumeister and his colleagues
argue that ‘willpower’ is determined by the availability of glucose and
can be impaired by activities that demand self-control, which deplete
this resource (though the evidence is far from conclusive; e.g., Hagger,
Wood, Stiff & Chatzisarantis, 2010).
One complication in all this is that there is also a tradition for regard-
ing idleness as not necessarily such a bad thing. During the eighteenth
century, many writers (including Samuel Johnson1) even argued that it
is a natural condition of human behaviour, representing a baseline state
of rest: a free-running state where goals are free to come and go – even
followed – but not necessarily maintained. During the period of the
Enlightenment, idleness was highly valued by both intellectuals and
the aristocracy, not as an end in itself but as a way of avoiding harm-
ful physical activity, which would ‘weaken the spirit’ (Saint-Amand &
Gage, 2011). For eighteenth-century intellectuals, idleness was consid-
ered as the active pursuit of leisure and rest in order to purify the mind,
essential for the work of the muse, and to provide the conditions for
effective creativity. Furthermore, this (positively valenced) idleness was
distinguished from laziness, associated with the avoidance of duties.
While the two are synonyms in most Western languages, laziness was
regarded as a core weakness of the soul, and remains (for some) a cause
for moral condemnation. The ‘wilful’ act of maintaining a goal in the
Johnson (1758).
1
face of a natural desire to be at rest (or idle) requires effort, and effort
will always lead to fatigue if not managed. Whether this is because effort
makes use of limited energy resources or because the pursuit of one goal
necessarily prevents access to others is a central concern of this book. In
fact, as I shall argue in later chapters, both kinds of motivational con-
struct (bodily constraints and will, representing energy management
and executive control) may be required for a theory of fatigue.
Work as a benign experience

A second change in the meaning of fatigue proposed by Rabinbach
(1990) is a core shift in our understanding of what it means to be tired;
what its implications are for our wellbeing and future activity. He
argues that, at an earlier (pre-industrial) time, fatigue was generally
perceived to be a natural response to work (and life, for that matter),
rather than the ‘spent batteries’ of our present era. While Rabinbach is
not specific on this, such a view does not mean that fatigue was never a
negative state, or that work was always considered pleasant. Rather, this
perception of work as benign (in the sense of not being experienced as
necessarily oppressive or harmful) may be considered as the default pos-
ition for this period. There are, of course, plenty of counter-examples.
During the sixteenth and seventeenth centuries, contemporary writings
show that the term ‘fatigue’ (and its precursor ‘fatigation’) referred to a
range of experiences, including the familiar bodily and mental exhaus-
tion from everyday physical and mental work to the extensive demands
and exertions of warfare and travel. Such negative experiences were
associated with the kinds of things that are familiar today: hard work,
long hours of study and prolonged physical demands on the body.
Central to all these was the experience of tiredness or weariness of
bodily activity, mental dullness, and a loss of interest in and engage-
ment with outside events. There was widespread recognition in the
sixteenth century of the dangers of too much work or study, amongst
lawyers, scholars and monks, made explicit in the quasi-medical texts
of the seventeenth century, such as that of Robert Burton.2 However,
these earlier definitions and usages do not imply a specific loss of energy
or failing capacity for action. While acknowledging the vulnerability of
the human body, they refer to fatigue from labour or toil (work) not as
unpleasant feelings, but in terms of their consequences for mental life:
loss of interest, apathy or melancholy.
Burton (1621).
2
The loss of control over work

All these patterns are, of course, identifiable in modern work psych-
ology accounts of the link between work characteristics and tired-
ness, such as Karasek and Theorell’s (1990) demands-control-support
(DCS) model. High demands, coupled with low control (and low sup-
port), typically produce a state of strain, including fatigue and anxiety,
while high levels of control and support may compensate for any effects
of high demands. I would argue that work in the pre-modern period
was characterized, for the most part, by a relatively high degree of what
I have referred to as control: a sense of self-determination or autonomy
in how, when and what work is carried out. Whatever the historical con-
text, such differences between work conditions have always existed; and
strain has always been likely in situations where work is oppressive and
over-constrained (lacking control). A good example of an early con-
straint was the introduction in major centres across Europe during the
late fourteenth century of mechanical clocks to mark the working day.
Le Goff (1980, pp. 43–52) points out how control of work activities for
urban vineyard workers then fell into the hands of those who owned
the clocks; this was in sharp contrast to work time being shaped by the
natural rhythms of daylight, supplemented by the familiar routines of
monasteries and church bells. Under clock conditions, tiredness would
increase not only with longer working hours, but with the perception
of reduced choice and power over work schedules. However, these early
clocks were neither robust nor reliable, and had little practical influence
on working life. Only when Huygens’ improved pendulum clocks began
to be employed towards the end of the seventeenth century did this pat-
tern begin to re-emerge. In rural areas, work still followed the natural
diurnal and seasonal rhythms until well into the nineteenth century.
As Thomas (1999) illustrates in his anthology of writing on work
themes, the relation between work and life has changed dramatically
since that time. In the post-industrial age, extending up to the present
day, work acts as a prime driver of social and family life, determining
when people are occupied, when they are free; when they go to bed
and get up; when to see their parents, partner or children. In short,
work gives structure to life. By contrast, the pre-modern era could be
considered as one in which life gave structure to work. Fixed hours
were very rare, jobs taking as long as they took – no more, no less – and
work was fitted to the nature of the task. Put simply, work was done
when it needed to be done. Milkmaids had to get up early to milk cows,
but did not need to milk them again until the evening; in between,
they were basically free to carry out other jobs at their discretion.
Shepherds were highly constrained by the urgent needs of lambing

and shearing at fixed times of the year, but could otherwise manage
their work as they preferred. In the absence of artificial lighting, work
was carried out during the hours of daylight, which meant that there
was much more of it during the summer than the winter. Referring to
the impact of the Industrial Revolution, the historian E. P. Thompson
(1963) observed that pre-industrial working life was characterized by
a natural ‘task-oriented’ rhythm, in contrast to the imposed arbitrary
‘time-oriented’ nature of nineteenth-century factory work.
During the eighteenth century, most work was agricultural work,
and most of this was seasonal. Thomas observes that, while hours were
long during the summer months, the work was not intensive, and inter-
rupted by frequent breaks and refreshment. For craftsmen, work and
leisure were necessarily integrated by having workshop and home in the
same building. They worked at their own pace, either alone or in small
groups, and took breaks whenever they wished. Thomas adds that even
field labourers, farm workers and navvies (labourers who worked on
the canals and railways) had no experience of ‘slave-gang pressure’. In
addition, people lived and worked in the same community, and rarely
moved away from it, so that they saw their work activities as an inte-
grated part of this broader life. Of course, we cannot have any direct
evidence of how people perceived tiredness from work, but there is little
evidence of fatigue being a generally negative experience under these
conditions. In Anna Karenina, Tolstoy has the gentleman farmer Levin
discovering the joys of mowing while working with his labourers. At
first, he finds it very hard, in contrast to the peasants, who move effort-
lessly through the meadows with their scythes while he labours and
sweats; but he eventually adapts to the rhythm of the work, so that ‘The
scythe seemed to mow of itself’.
All of this is, of course, a highly simplified summary of working life
in the pre-modern era. And the fact that work may not have been gen-
erally perceived as a threat to wellbeing does not mean that life was
necessarily easier during this period. Pre-modern existence was very
difficult in many ways, including a low level of basic living conditions:
housing, nutrition, health. In Britain, the standard of living (and loss
of control) was further severely affected during the early eighteenth
century by the government’s act of ‘enclosure’, which prevented villag-
ers from continuing their traditional free access to common lands for
raising livestock and growing food. Furthermore, my analysis of the
changing comprehension of fatigue during this period does not imply
that it was a rare experience at that time. Our general understanding
from historians is that eighteenth-century rural families were physically
exhausted for much of the time, from the much higher level of manual
work demands. The central point I want to make is specifically about
the work–fatigue relationship. It is that, compared to the post-industrial
period, tiredness was less directly perceived to be caused by the act of
working per se. To frame this in a modern statistical context; if we had
equivalent data from the two periods, and were able to carry out a mul-
tiple regression of reported levels of fatigue onto the two predictors,
work demands and control, we would expect to find a smaller multiple
R 2 value for the pre-modern data set. This does not mean that average
levels of fatigue were lower at the earlier time, but that the combined
variation in demands and control accounted for less of the variance
in fatigue experiences (while other factors, such as living conditions,
accounted for much more). And, as we have already seen, it is not dif-
ficult to find examples of work being unpleasant and causing distress,
even within rural activities. But these can, in the main, be found in
situations where the work was particularly hard and long, and the con-
straints on the worker unusually severe.
Such configurations of demands and control have always occurred,
and may vary with circumstances (weather, degree of urgency, sever-
ity of employer), even within the same type of work and same period
of history. They anticipate the normative conditions of working life in
the modern period, following the Industrial Revolution. I look at this in
the next section, examining the impact of changes in the conditions of
work, from the relatively unstructured set of demands I have sketched
out, for the most part carried out as an integral part of the worker’s life,
to being driven by external demands, under the tyranny of factories,
clocks and artificial lighting.
Work and fatigue in the post-industrial period

The greatest changes to working life in the modern era are associated
with the Industrial Revolution (beginning, in the UK, around the mid-
dle of the eighteenth century). While working conditions were clearly
hard in the pre-industrial era, historical accounts indicate that workers
had considerable control over what they did, how and when they did
it, and the breaks they took from working. However, by the middle of
the nineteenth century this had changed dramatically for many people.
Rabinbach (1990) argues that the first objective indications of a shift
in the perception of fatigue are found in the medical literature of the
1870s, when it is formally recognized as a disease of overwork, and a
sign that the body (and mind) have a limited capacity for responding to
the demands of modern working life.
The intensification of work

A reasonable interpretation of the conclusions of historians (e.g.,
Hopkins, 1982; Voth, 2001; Wohl, 1983) is that work intensified during
the period of industrialization, while the level of control that employ-
ees had over their work fell. The acceleration of mechanization and
factory-based manufacturing has been assumed to result in not only
an increase in work demands, but also a simultaneous eroding of the
sense of involvement and ownership that many people were familiar
with. The pre-modern experience of work was one of self-management;
within cottage industries, workers set their own pace and took on only
as much work as they felt comfortable with, or met their current eco-
nomic needs. The new factory work did not allow this; to justify the
heavy investment in new plant, work had to be externally managed,
driven by the continuous running of steam engines and weaving looms.
There was also a shift in the way in which work was compensated, from
a piece rate system (where workers were paid a fixed amount for each
unit they produced) to payment by the day (or hour). McIvor (1987)
claims that (most) nineteenth-century industrialists considered labour
only as a ‘commodity’, and assumed that the same high level of work
could be maintained over 12-hour shifts. It would be surprising if such
changes were not major influences in the transformation of the work–
fatigue relationship. It has been shown that the harder work required
of people was not even rewarded by better living conditions; Feinstein
(1998) analysed changes in both earnings and other economic factors
over the period 1770–1870 and found no sign of a real increase in the
standard of living.
How much harder was work during this period? The most object-
ive measure of increased demand is, of course, the time committed to
work, in terms of both work hours and holidays. The best evidence on
working hours comes from Voth’s (2001) interesting analyses, based
on the reports of witnesses to crimes, who, as a part of their testimony,
were obliged (under oath) to indicate whether they were at work or not
at the time of the incident. Voth used these observations to compile
detailed estimates of the amount of time spent at work, comparing the
years around 1760, when industrialization was beginning in some areas
of the UK, to those around 1830, when it was in full flow. He found that
work consumed 33 per cent of the waking day in 1760, rising to 46 per
cent in 1830 (or from 34 to 56 per cent if travel to work is included): in
terms of working hours, the annual figure increased from around 2,500
hours in 1760 to 3,600 hours in 1830. In fact, this appears to be the
peak for annual working hours, and, as result of a gradual shortening
of the working day in highly mechanized industries (from around 16

hours in 1830, to 11 or 12 by 1870), the annual level towards the end
of the century had fallen to roughly the 1760 figure. It appears that the
changes in the early part of the nineteenth century were caused mainly
by a reduction in the number of days (Sundays and the holy days of
the church calendar) allowed for rest and leisure. In the early eight-
eenth century these were numerous, and in many places also included
Mondays, which became a traditional rest (or absentee) day for craft
workers during the seventeenth century; the day was widely referred
to as ‘St Monday’ in recognition of its role as an honorary saint’s day.
(This tradition existed also in France and Germany, as St Lundi and
Blaue Montag.) In addition to Sundays and Mondays, the 1760 data
included 53 holy days, and only around 208 working days in all. In
contrast, by 1830, holy days had been cut to seven, and only Sundays
were earmarked for rest during the week, giving 306 days of work. This
pattern of a reduction in free days remained in place throughout the
century, even though the length of the working day has fallen steadily,
to the present level (in the UK) of around 1,600 hours annually. Of
course, other countries have different standard working hours, but all
have fallen significantly over the last century.
Changes in leisure and recreation

The reduction of rest days was not the only loss of free time. Cunningham
(1980) states that the official attitude towards leisure during the second
half of the nineteenth century was that workers would waste time if
they had more holidays: that inactivity (idleness) was not only unpro-
ductive but also ‘harmful to the human spirit’. There was, nevertheless,
recognition by middle-class reformers of the need to provide leisure
opportunities, such as public parks, libraries and galleries, though their
primary function was not one of relaxation or entertainment, but of
recreation: repairing (restoring) workers’ bodies and minds to enable
them to resume effective work. Free time away from the working envir-
onment was deemed necessary, but only for renewal of depleted energy:
the restoration and ‘improvement’ of the body and mind for work.
This functional view of leisure was widely advocated by scientists of
the period. Writing in the most widely read science magazine of the
late nineteenth century, the evolutionary biologist George Romanes
exclaimed that:
Recreation is nothing more than ‘re-creation’, the forming ‘a-new’ and a
‘re-novation’ of the vital energies; leisure time and appropriate employment
serve to repair organic machinery which has been impaired by the excess of
work. (Romanes, 1879, p. 773)
In the pre-modern period, what we now think of as ‘leisure’ was based
on local traditions, games and fairs, as well as drinking and periods of
idleness – what some of us may now refer to as ‘chilling’. The term leis-
ure was not widely used until the 1860s or so, when it changed from
being part of the natural cycle of work and non-work to defining the
time that people were not at work. These early practices were effect-
ively destroyed by the removal of holy days and the breaking up of rural
groups with urbanization, and replaced by more formal, institutional
activities. The worthy recreation activities of the 1870s were eventually
supplemented by activities such as music halls, train excursions, motor
trips and organized sport. However, these transitions took place over a
long period and required considerable adjustment, during which time
many of the familiar sources of pleasure were no longer available.
A demands-control analysis of changes in the experience of work

It is clear that the period from before the onset of the Industrial
Revolution to its (more or less) completion in the UK (I shall take this
as being from 1750 to 1880) represents a major cultural disturbance,
changing both the way that work was carried out and the relation of
workers to their jobs. I want to argue that these changes carry the main
responsibility for the shift in our everyday perception of fatigue, from
that of a natural state associated with a broad range of activities to one
of a negative experience caused primarily by oppressive work.
I have attempted in Table 2.1 to summarize the main changes over
this period in the experience of work, discussed over the preceding
pages, using concepts borrowed from the two most influential work
stress theories: the demands-control-support (DCS) theory of Karasek
and Theorell (1990) and Siegrist’s (1996) effort-reward imbalance
(ERI). As I have already mentioned, the DCS model identifies the pri-
mary problem of work strain as having high demands coupled with low
control. The ERI model differs in focusing on strain being associated
with a low reward from work in response to a high level of effort or
commitment. I do not propose to compare these two models here. As I
argue in Chapter 5, while they emphasize different features of the work
environment, they in fact have much in common. For the moment,
I assume that effort is broadly equivalent to demands (or at least the
response to demands); reward clearly refers to both pay and intrinsic
rewards of satisfying work and, as such, has much in common with the
Table 2.1 Summary of changes in working life between 1750 and 1880
Aspect of work Pre-modern (1750) Post-industrial (1870)
Context rural, agrarian urban, factory

Demands high high
Effort high high
Total working hours moderate moderate
Work shift hours/times variable long/fixed
Work rate variable very high
Resources (control/support) high low
Rewards high low
Units of production task oriented time oriented
Work structure integrated piecemeal
Work flow self managed externally paced
Work breaks self managed short/fixed
Leisure amusement, informal organized, formal
way I have discussed control (in the sense of intrinsic motivation and
satisfaction from work well done). Formal tests of both models show
that high levels of resources or rewards are able to compensate for high
demands or effort, and markedly reduce their impact on wellbeing and
health, including both the subjective experience and negative impact
of fatigue (Ganster & Fusilier, 1989; Karasek & Theorell, 1990; Van
Vegchel, de Jonge, Bosma & Schaufeli, 2005).
I have taken an eclectic approach in the (necessarily informal) analy-
sis of changes in work experiences between early and later phases of the
Industrial Revolution, adopting the central variables from both models.
The ERI analysis is represented by separate assessments of effort and
reward, while, for simplicity, I have classified control and support under
one heading as ‘resources’. These are often hard to separate in natural
work contexts, and Bakker and Demerouti (2007) argue that resources,
in fact, provide a better fit to the data, as well as making more sense
theoretically. In their alternative job demands-resources (JD-R) frame-
work, a high level of resources is associated with both a lower risk of
strain and ill-health and higher levels of work motivation and engage-
ment. I will, nevertheless, sometimes refer to resources simply as con-
trol, since I take this to be the core feature of work management options
that reduce the likelihood of fatigue.
Table 2.1 classifies features of the work environment, as far as pos-
sible, in terms of their impact on the key constructs of the two work
stress theories: demands, effort, resources (control and support) and
rewards. Context refers to the broad features of the domestic and

working environment, and reflects the shift from a rural/agrarian soci-
ety, where most work was carried out in the fields or in small work-
shops, to the urban/factory life of the later period. Demands reflect
not only total and shift working hours, and required work rate (time
pressure), but the influence of machine pacing and the intensity of
required work. As we have seen, total hours were probably about the
same in the two periods, though hours of work per se have, in any
case, not always been found to be a problem for health and wellbeing.
This has been found only for jobs demanding highly repetitive work
or continuous attention demands (Sparks, Cooper, Fried & Shirom,
1997) or when long hours are obligatory or not adequately rewarded
(Van der Hulst & Geurts, 2001). The main difference in the nature of
paid work between the pre-modern and post-industrial period was in
the rate of required activity. Work rate was generally increased by the
introduction of shifts, as work became increasingly time-structured
and driven by machine-pacing; working hours also became less flex-
ible, another indicator of reduced control. Most of the significant
changes I can discern reflect changes in resources and rewards: units
of production, structure and flow of work, breaks and intrinsic value
of work activity. All these are reduced or changed for the worse in
the post-industrial period. I have also included the changes in leis-
ure. In addition to being greatly reduced in total available time, the
shift from a natural, informal set of activities to an imposed and more
structured ‘programme’ may also suggest a reduced level of resources
and rewards, at least during the transition period of the mid to late
1800s.
In terms of the DCS and ERI models, the overall picture is of a shift
from a work environment of high resources and rewards to one of low
resources and rewards. While demands and required effort may gen-
erally have increased over this period (in terms of required work rate
and the need for standard shift hours) this may not be a critical factor,
since the overall demand for work effort was high in absolute terms dur-
ing both periods. The overall conclusion is that the experience of work
changed during the Industrial Revolution, primarily in terms of a loss
of the perception of the control that people had over their activities. The
relationship of work to fatigue changed with it, from work and tiredness
being an integral part of everyday life to their being seen as the product
of a new imposed regime. What I have meant to imply by my infor-
mal analysis is, however, merely a shift of emphasis; all combinations
of demands and control have existed at all times in history. However,
the dramatic changes in working practice during this period have, I
The link between fatigue and energy 43
suggest, shifted the nature of the relationship between the experience

of work and fatigue.
It appears that the benign/natural status that I have attributed to the
experience of fatigue is at odds with the tendency in modern working
life to try to stretch the capacity of human beings – to work for longer
periods, and to a more rigid set of demands, to produce more, to work
more quickly, to work for longer without breaks, to work on smaller and
less meaningful units, and so on. Once the natural braking function of
fatigue is overridden by society’s needs, fatigue becomes the aversive
state we are familiar with.
The link between fatigue and energy

As discussed earlier, the energy metaphor for understanding human
work has been around in a concrete form for only 120 years or so. It was
driven, ultimately, by the overwhelming impact on society (and work,
in particular) of the rapid spread of energy transforming machines dur-
ing the Industrial Revolution, and the identification of the scientific
basis for the work (and limitations) of machines. However, the use of
the term energy in connection with human activity dates back at least
to the Enlightenment, reflecting the newly emerging conceptions of the
mechanical nature of living organisms by Descartes and others, notably
late seventeenth-century philosophers such as Borelli and Perrault (Des
Chene, 2005). The literature of the time refers to labour or toil (work)
as being fatiguing, without implying any specific mechanism (such as
energy loss), though writers sometimes referred to a ‘loss of spirits’.
The term spirit referred to the (God-given) life force of living creatures,
and is the nearest match to energy in pre-modern discourse on fatigue.
Such ideas may, in any case, be seen as precursors of later concep-
tions of energy, in that they provided a motive force for behaviour, and
an explanation for activity failures based on bodily constraints – terms
such as exhaustion, and fatigue itself, both come from this period –
though they did not include the idea of energy as a limited resource.
This more specific adoption of energy as a functional link between
bodies and machines (and the relationship between energy and work)
emerged with the development of industrial machinery and the asso-
ciated new understanding of energy in science during the nineteenth
century. Rabinbach (1990) referred to this new way of conceptualizing
human activity as ‘the human motor’, a term coined by Amar (1921)
to describe new methodologies for studying human work through the
measurement of movement. The idea that human activities could be
understood in terms of energy transactions was originally applied to
physical work, but very quickly extended to account for fatigue from
mental work. The energy metaphor had an immediate and major
impact on both the scientific literature and everyday language. The
terms fatigue and energy became directly associated with human activ-
ity from around 1860, particularly within physiology, psychology and
clinical medicine, and can be assumed to be a part of everyday language
by around 1870. Before the advent of the energy perspective, failures to
complete work duties were attributed either to a problem of volition –
a reluctance or unwillingness to start a task or to continue it – or to a
non-specific feeling of lethargy or apathy.
The metaphor of energy through which the correspondence of machine
and body was achieved derived from the discovery of the energy con-
servation law. In the middle of the century, building on a considerable
body of earlier work, Hermann von Helmholtz published two of the
most influential scientific books of the period,3 on energy conservation
and transformation. In both books, Helmholtz argued that energy is
not lost during the movement of a muscle, but transformed into another
form. His general theory of the conservation of energy proposed that
mechanics, heat, light, electricity and magnetism could all be treated
as alternative aspects of a single force (energy in modern terms). This
idea of energy conservation was readily appreciated as a way of under-
standing the factors that determined the relationship between the work
of machines and the amount of energy they used. Helmholtz’s law of
energy conservation applied not only to the physics of nature and indus-
trial machines, but also to the human motor: the working of the human
body and its muscles. He considered all matter, inorganic and organic,
to be subject to the same thermodynamic laws. In terms of its movement
and activity, the human body was considered fundamentally identical
to the thermodynamic engine, so could be measured and studied using
the same methods. These ideas were enthusiastically adopted during
the latter part of the nineteenth century, and applied increasingly to the
study and explanation of human work.
A further effect of the adoption of the machine analogy within the
sphere of human activity was to raise the possibility that human bod-
ies were also dependent on the management of energy to be able to
operate effectively. Rabinbach (1990) points out that, between 1870
and 1880, such issues were discussed regularly in scientific magazines
(such as the influential Popular Science Monthly, dating from 1872),
in particular debating the question of whether the human machine
was subject to the same constraints as physical (or animal) machines.
von Helmholtz (1854 and 1889).

3
The medicalization of fatigue 45
Force and energy dominated not only the industrial field, but also
that of physiology and the newly emerging science of psychology, as is
evident from the widespread psychological research on neurasthenia,
moral and physical exhaustion, and mental fatigue. The phenomenon
of fatigue was identified as a severe limitation in human engagement
with work, and – more specifically – a weakness of the body in com-
parison with the idealized efficiency of the engine. We can assume
that, over a period, these ideas permeated the everyday language,
not only of scientists and industrialists, but of the broader working
population.
Of course, we are unable to determine exactly when this happened,
but probably not earlier than the 1870s, when the experience of the
excessive demands of factory working conditions had become well
established, and the technical language of work and energy was in
place. Hopkins (1982) argues that, apart from the intensive activity of
the textiles mills in the north of England and a few other places, most
areas of the UK were relatively unaffected by the factory system until
after 1850, while the OED shows that the first appearance of energy
metaphors in published sources referring to fatigue appeared around
1900. A best guess is that the explicit association of fatigue with energy
loss happened over only a single generation, between 1870 and 1900.
The different experience of work with new machines and new work
environments is accounted for through this new understanding; chil-
dren growing up witnessing the effects of the new regimes on their
parents and grandparents now had a mechanism and a vocabulary that
made it easy to discuss and explain them.
The widespread adoption of the energy metaphor for mental work
led to the explicit assumption that energy was required for both brain
work and muscular work, and that the two kinds of activity had mutu-
ally debilitating effects. The first formal description of a fatigue ‘dis-
ease’ (neurasthenia, discussed below) was regarded as a chronic loss
of mental energy resulting from a failure to cope with the (physical
and mental) demands of the modern world (Rabinbach, 1990, p. 153),
while Binet and Henri (1898) identified the rapidly growing demands
for study and intellectual work as the cause of the endemic physical
weariness and lethargy amongst French schoolchildren.
The medicalization of fatigue

Rabinbach (1990) tells us that fatigue was ‘discovered’ around 1875.
What he means by this is that only at this time did it become recog-
nized formally as a problem state – a disorder of overwork worthy of
study – and part of the medical literature. Not that the problem was
new; seventeenth-century medical texts had long recognized the prob-
lem of overwork, and advocated relief from both exhaustion and mel-
ancholy (Porter, 2001). Melancholy (or melancholia) was one of the
most common diseases of sixteenth- and seventeenth-century Europe.
Although it was not exclusively a problem of fatigue – in modern terms,
a combination of fatigue and depression: a state of apathy, lassitude and
‘weakness of spirit’ – melancholy was a recognized disorder of failing to
respond effectively to life’s demands.
One of the strongest influences on the acceptance of fatigue as a
medical condition in the late industrial period was the identification
of ‘neurasthenia’ as the illness of modernity by the American psych-
iatrist George Miller Beard. Beard (1869) argued that the condition
was caused by an ‘over-taxing of the nerves’, making them less respon-
sive to new demands. He saw neurasthenia as the body’s expression
of its struggle with the demands of modernity, specifically as exempli-
fied by the American experience of having to deal with the most rapid
change any society had known to that date – the product of hard work,
striving for success, and upward mobility – though such a profile is,
in fact, consistent with nineteenth-century changes in most Western
societies. Beard’s claim that neurasthenia was a modern disease may
also be questioned; for example, Porter (2001), Wessely (1991) and
others have argued that it has a readily traceable lineage back to the
sixteenth-century diagnosis of melancholy.
Clearly, there were strong similarities between the fatigue diseases
of the Enlightenment and those of the industrial age, though there
appear to be differences of emphasis; neurasthenia may be considered
more strongly related to fatigue, and melancholy to depression. Early
nineteenth-century writers characterized neurasthenia (or melan-
choly) as being the result of mental work, rather than general manual
toil, in recognition of the tendency for it to occur more in intellec-
tuals. However, while the medical literature of the 1870s similarly
reflected the concern with widespread reports of fatigue, overwork
and exhaustion, it now framed them within the scientific context of
energy and nervous depletion (e.g., Bainbridge, 1919). Fatigue symp-
toms were interpreted as the result of the body’s resistance to the
increasingly restrictive demands of modernity and the central mech-
anism in the exhaustion of the body’s resources, not only from work,
but from life in general. Such an idea has continued into modern-day
diagnoses, through the rubric of stress (characterized more broadly
as a breakdown of the body’s defences), through to chronic fatigue
syndrome (CFS).
The main point about the ‘modern’ diagnosis, with its focus on energy
loss and nervous exhaustion, was that it provided a credible mechanism
for the problem. By the beginning of the twentieth century medics all
over Europe and America were warning of the dangers of over-exertion
from mental or physical activity of any kind; it would consume a per-
son’s energy and leave them with a nervous system unable to respond
to new demands. Both the medical and popular literature talked of the
dangers of ‘wasting nervous reserves’ and ‘taxing nervous resources’
and a new journal (The Journal of Nervous Exhaustion) was launched to
publish medical papers on the problem. The French psychiatrist Pierre
Janet (and later Carl Jung) preferred the term ‘psychasthenia’, in order
to focus on the mental state rather than its presumed underlying ori-
gins; for Janet, it represented a failure of attention control and concen-
tration (executive function in modern terms). Despite all this, following
its peak of success in the period from 1880 to 1920, neurasthenia has
now been more or less abandoned, primarily because it was found to be
too general and of little diagnostic value, though it is still used in Russia
and parts of Asia, where it is considered primarily a physical disorder,
while psychasthenia remains part of the MMPI self-report inventory.
The idea has had a lasting influence, however, in highlighting the real-
ity of fatigue as a pathological condition, and provided the impetus for
the modern clinical concern with chronic fatigue. It also indicates the
possible long-term consequences of failure to manage the demands of
modern life. This sounds very much like the way we now think of the
more general problem of stress, and the link between demands, fatigue
and stress is, I believe, at the heart of current dilemmas and uncer-
tainty about the status of fatigue as a clinical problem (e.g., Afari &
Buchwald, 2003; Lewis & Wessely, 1992; Pearce, 2006). I shall address
these issues directly in Chapter 8.
Fatigue as a subject for scientific study

The factors that led to the recognition of fatigue as a medical condition
also gave rise to its status as a subject worthy of scientific study. The
common reports of fatigue problems associated with the conditions of
work in factories during the second half of the nineteenth century led
to a recognition of the work–fatigue problem, and to the emergence of
a Europe-wide ‘science of work’ during the late nineteenth century.
Its main aim was to understand the limitations of the body’s response
to physical and mental demands, and to apply this knowledge to the
design of industrial work. Fatigue at work was the subject not only of
public interest, but also of scientific research, international symposia,
and national committees on best work practice. Major members of

this group included: in Germany, Zuntz, Kraepelin, Ebbinghaus and
Munsterberg (later, also in the United States); in France, Marey, Amar,
Imbert and Binet; in Belgium, Solvay and Ioteyko; in Italy, Mosso; in
the UK, Myers and Vernon; and, in the United States, Cattell, Taylor,
Lee and Goldmark.
The experimental study of fatigue was also part of the first serious
research programme in psychology in Wilhelm Wundt’s laboratory,
where the principle of conservation of energy had a central place in
theorizing about work, effort and attention. Wundt’s student Emil
Kraepelin provided the strongest early influences on the direction of
fatigue research within experimental psychology. His research on men-
tal work (Kraepelin, 1902) demonstrated how simple laboratory tasks
could be used to study decrements in work output (the ‘curve of work’)
and showed how rest pauses during work were able to diminish these
effects. These ideas are the starting point for an assessment of decre-
ment in Chapter 3. Kraepelin believed that fatigue, which represented
the falling energy of the body and mind in carrying out work, could
be measured only by overt performance. He also provided the starting
point for arguments about definitions of fatigue over the next 20–30
years by insisting on a distinction between fatigue (emüdung) and sub-
jective manifestations of tiredness (müdigkeit); he regarded the latter as a
mere by-product of the energy depletion occurring under ‘real’ fatigue.
Munsterberg (1913) criticized Kraepelin’s approach as failing to rec-
ognize the complex nature of fatigue, arguing that subjective reactions
were important to both the patterning of performance and the onset of
fatigue; fatigue could not usefully be equated with work performance
alone. Ioteyko (1919), too, believed that the subjective feeling of fatigue
could not be ignored, and that it was an early warning (or safeguard)
against the over-expenditure of limited energy.
The period around the turn of the twentieth century produced a
remarkable number of important monographs on fatigue and work,
among them: Amar, 1921; Binet and Henri, 1898; Goldmark and
Brandeis, 1912; Ioteyko, 1919; Kraepelin, 1897; Lee, 1918; Mosso,
1906; Munsterberg, 1913; Myers, 1921; Thorndike, 1914; and Vernon,
1921. These had widespread influence and helped establish the agenda
for a truly scientific approach to the problem on a number of fronts:
not just within academic psychology and physiology, but also indus-
trial psychology and work design. The search for efficient production
was a major concern in the early twentieth century, and reformers like
Goldmark and Ioteyko identified the management of fatigue in over-
worked employees as the key to solving this problem. One of the earliest
and most influential attempts to apply newly acquired knowledge about

fatigue to factories was Taylor’s scientific management approach
(Taylor, 1911). This had productivity as its main goal, through optimiz-
ing and standardizing procedures to reduce inefficiency of movements.
The idea of using careful measurement and planning of work, including
the forced imposition of rests, had considerable benefits to output, often
increasing it by a factor of four or five. However, implementation within
factories was often driven by the promise of greatly enhanced speed
of production, and not always supported by sensitive management of
employees’ needs and limitations. The approach was widely criticized,
among others, by Goldmark and Brandeis (1912), Munsterberg (1913)
and Ioteyko (1919), as ignoring the need for work to be meaningful
for employees, and of individual differences in energy deployment and
capacity for effort.
The concern with fatigue in the early 1900s was initially about
worker health and wellbeing, but Derickson (1994) argues that the
work reform movement was ultimately effective not because it showed
that factory work schedules were inhumane, but because it was able to
demonstrate impaired productivity. The new work-energy perspective
was that effort could overcome work demands but only up to a limit,
until energy becomes exhausted. It was increasingly recognized that
length of the working day was not the only variable that determined
greater output; in particular, it depended on how efficient work was.
Overwork was widely recognized (e.g., Goldmark & Brandeis, 1912;
Munsterberg, 1913) as being caused not only by long working days but
also by the high speed, machine-driven nature of factory work. Muscio
(1920) argued that fatigue was a product of both the length of work and
the demanding (fast, unvarying) pace of work, which was inconsistent
with the ‘natural rhythm of work’ for different workers. Goldmark and
Brandeis’s (1912) book, which reviewed the evidence on work hours,
shift work, increased speed of work from the introduction of scientific
management, and other changes, concluded that reduced output was
inevitable when work was too long and too demanding.
Such issues were highlighted by the industrial needs of the First
World War, leading to the setting up of dedicated national bodies to
examine the impact of fatigue on production, notably the Health of
Munitions Workers Committee (later the Industrial Fatigue Research
Board, IFRB, then the Industrial Health Research Board, IHRB) in
the UK, and the US Committee for Industrial Fatigue. The IFRB brief
was ‘To consider and investigate the relationship of the hours of labour
and of other conditions of employment, including methods of work, to
the production of fatigue, having regard both to industrial efficiency
and to the preservation of health amongst the workers’. On the basis of

an extensive research programme (see Vernon, 1921), they confirmed
the view that work was more efficient when working weeks were shorter
than the 70–80 hours typical of the period: serious errors fell dramat-
ically, while output remained unchanged. Such programmes contrib-
uted significantly to the establishment of industrial psychology as a
specialism in many countries over the next decade. They also seemed
to provide support for what I shall refer to as the work–fatigue hypoth-
esis – the widely accepted fatigue view that prolonged periods of work
invariably lead to reduced output and inefficiency. I examine this in
detail in the next chapter.
Summary
Chapter 2 has examined the historical context of fatigue, and high-
lighted the key roles played by ideas about energy and changes in
work patterns brought about by the Industrial Revolution. The idea of
fatigue being a negative experience brought on by work does not appear
to be a common feature of pre-modern life, but is fully established by
the late nineteenth century. The association of fatigue with a loss of
energy is traceable to technological developments and the growth of
energy-based metaphors over the period. An informal analysis indi-
cates that the main change in work during the Industrial Revolution
was in terms of a reduction in controllability.
3 The work–fatigue hypothesis
Background
This chapter takes a new look at an old question: the failure of concen-
tration. Why does performance tend to become less effective if a task is
continued for a long time? Since its origins in the late nineteenth cen-
tury, what I shall refer to as the work–fatigue hypothesis – that fatigue
(and performance decrement) is a direct consequence of doing work –
has been assumed more or less without question in mainstream theory
and practice. The performance decrement is a ubiquitous characteristic
of the effects of sustained attention, or prolonged work of any kind, and
has long been regarded as the defining feature of the effects of fatigue
on performance and – for many theorists – its primary objective marker.
In practice, while decrements may be observed at different times in
the work period, depending on variations in goal orientation and effort
(e.g., Ackerman & Kanfer, 2009; Davis, 1946; Thorndike, 1912), cumu-
lative time at work is widely used as a proxy indicator of fatigue as an
independent variable; fatigue is often assumed to be induced simply
by virtue of requiring people to work at a task without rest for a sus-
tained period. Yet, as I pointed out in Chapter 1, and as emphasized by
Bartley (1943), it is the feeling of fatigue itself, rather than the observa-
tion of performance impairment, that should be regarded as the defin-
ing feature. Certainly, the facts about performance decrement are not
as clear-cut as the above caricature suggests; whether performers feel
tired or not, sustained attention does not always lead to performance
decrement. Under what conditions does sustained, or demanding, work
lead to a reduced level of performance, or to feelings of fatigue? And
when does it not?
The chapter examines evidence on the work–fatigue hypothesis over
the last 100 years or so, from the ‘golden age’ of fatigue during the late
nineteenth and early twentieth centuries to more recent developments in
vigilance and workload. My intention is not to provide a comprehensive
51
review; there is little value in this, since the material has been covered
effectively on many previous occasions (e.g., Broadbent, 1971; Gopher
& Donchin, 1986; Hockey, 1986; Koelega, 1996; Parasuraman, 1986;
Warm, 1984; Wickens, 2008). Rather, my goal is to draw out the pos-
sibilities and limitations of the work–fatigue hypothesis, and show
how it may be better understood as part of a broader motivational
framework for considering the patterning of performance variation.
This is necessary to impose some order on a rather unruly set of data.
While time-based decrements are common, they are by no means rou-
tinely observed; sometimes they evade detection even under the most
demanding conditions; conversely, they may be observed in situations
where demands appear to be very low. Sometimes feelings of fatigue
accompany impairment; often they do not. The same lack of consist-
ency applies to the physiological response to work. The most common
finding is that sympathetic activation is higher when work is carried out
effectively, and lower when performance shows a decrement (Hockey,
1997), though increased activation may accompany decrements under
some conditions. Furthermore, as Thorndike repeatedly argued (e.g.,
Thorndike, 1914), decrements may sometimes be attributable to the low
intrinsic attractiveness of the task itself, which discourages performers
to persist with their engagement with it, rather than the difficulty of
meeting its demands, or the effects of distraction from competing men-
tal or environmental events.
As suggested by the set of dates of the above reviews on sustained
attention, there has been little major academic activity on performance
decrement in recent years. The topic is rarely addressed directly within
modern mainstream psychology, and recent reviews of the broader
topic of attention and performance (e.g., Logan, 2004; Pashler et al.,
2001; Styles, 2006) make no specific mention of sustained work, fatigue
or performance breakdown. This may be partly because the problem is
perceived as dated (or even solved!). Certainly, it is often seen as a ves-
tige of a more rigid framework of channels, bottlenecks, limited capacity
and general resources. More likely, it has simply not been identified as
a central concern for the new cognitive neuroscience approach to atten-
tion, which emphasizes computational processes, neural architecture
and brain mapping. One of the aims of this book is to show that fatigue
and the management of performance remain a relevant and legitimate
concern for the modern approach, and this will be developed over the
next few chapters. Within this framework, performance on a set task
is considered but one feature of the adaptive transactions of goal man-
agement, in which the costs of maintaining effective task responses,
Background 53
shifting costs and benefits of alternative behavioural directions, and

strategies for goal priorities are part of the process.
For the moment, a brief review is necessary to establish what we do
know about the nature of the work decrement. The main aim of this
chapter is to summarize the disparate set of findings on performance
decrement within a single theoretical framework. While early research
was concerned primarily with the problem of time at work – the need to
sustain effective work over a prolonged period – other factors are also
likely to be relevant.
Intensity of work. Does the extent of the decrement depend on how
intense or demanding the work is? The time at work theme was revived
and invigorated during the 1950s with the rise of the vigilance para-
digm, following Norman Mackworth’s (1948) demonstration of severe
decrement in a task that appeared to make relatively few demands on
the operator. Conversely, research on workload, also developed dur-
ing the 1950s, has shown that tasks making greater demands are more
likely to produce performance breakdown (Wickens, 1984).
Variety of work. Does it matter what kind of work is being carried out,
and whether it is unchanging or varying? Robinson and Bills (1926)
argued that homogeneity of task elements was the primary cause of
the time on task effect, and the value of varied work has long been
recognized in industrial psychology, though this insight has not been
explored fully by more recent research on task performance.
Meaning of work. Does it matter whether the work has meaning or
interest for the performer, as claimed in the first chapter of this book?
This certainly fits with our personal experience, and Thorndike and
others (e.g., Bartley & Chute, 1947) argued that neither feelings of
fatigue nor a performance decrement occurred when the performer’s
activity had strong personal meaning. This is a very important idea for
both the theory and practice of fatigue. But, again, it does not appear to
have been systematically explored or developed by modern approaches
to the problem, except in the extreme case of maximum meaning and
engagement identified by Czikszentmihalyi (1977) as the flow state.
Stress. Finally, in order to identify a decrement with fatigue from
work, we need to ask what other conditions can also cause such a
change. For example, performance is highly susceptible to disruption
by uncontrollable stress or emotional states, though such decrements
may not always occur (Hockey, 1997; Teichner, 1966). What determines
whether performance goals are maintained under stress? It is likely that
fatigue may be an inevitable consequence of combating the distrac-
tion associated with these conditions (Cameron, 1973; Hockey, 1979;
Schönpflug, 1983), but is this directly related to whether performance

suffers or not?
I shall consider issues relating to the first three of these questions
within this chapter; the relation between stress, fatigue and perform-
ance is treated separately in Chapters 4 and 5.
The golden age of fatigue research

Such uncertainties as these did not overly concern early theorizing
about fatigue and work performance. Following the explosion of inter-
est in work and fatigue during the late nineteenth century, fatigue
became a prominent topic in the new science of experimental psych-
ology. Articles appeared during the early 1890s in issues of newly estab-
lished psychology journals in Germany, Britain, France and the United
States. Oddly, while the most prominent psychology text of the era,
William James’ Principles of psychology (James, 1890), discusses limita-
tions of effort and ‘the will’, the topic of fatigue is not addressed spe-
cifically. Nevertheless, by 1900 it had become part of the core agenda
of psychology. Major reviews of the period (Arai, 1912; Phillips, 1920;
Thorndike, 1914) attest to the surprisingly extensive body of work
that had accumulated over the previous 20 years or so, dealing with
many emerging aspects of the fatigue problem: effects of time at work,
transfer between different kinds of work, other factors that influenced
productivity, performance under effects of drugs, distraction from
environmental events, and effects of mental work on physiological proc-
esses, such as pulse rate, breathing and muscular strength.
The early research agenda

Fatigue researchers in the early years of the nineteenth century were
interested in two general kinds of question concerning the effects of
work on fatigue. The first was the time course of fatigue: how did per-
formance (and feelings) change as a result of continuous time spent on
a task? The second concerned the generality of the fatigue state gener-
ated by continuous work; were effects specific to the activity that had
produced them, or did they transfer to other kinds of work?
Because of the emphasis on studying ‘pure’ mental fatigue, laboratory
tests were designed to minimize the demands for physical effort, while
maximizing demands for mental effort, and usually involved some form
of mental arithmetic or computation. Two general approaches developed
(Starch & Ash, 1917), both designed to assess decrements in perform-
ance with continuous work on a task (what I shall refer to throughout
as the loading task). The most common method was to measure dec-
rement from performance on the loading task itself. Robinson (1923)
and Bills (1937) refer to this as the continuous work method, and I will
also use that term in this context. The second approach was to infer
decrements from changes in the performance of a separate task, admin-
istered both before and after (and sometimes during) the work period.
Robinson called this the testing method, but the term is ambiguous and
too general for modern discussions. Bills referred to it as the interpol
ation method, which is clearer, but I shall use the term probe method.
Not only is this more in keeping with modern usage (e.g., Posner &
Boies, 1971; Sternberg, 1966), but it also reflects more directly the pur-
pose of the test, which is to find out about changes in underlying per-
formance of the loading task.
The continuous work approach was highly suited to laboratory test-
ing, where the homogeneity of work across successive time periods
could be assured. However, in real-life work situations, such as schools
and factories, such conditions did not apply and the probe method was
typically preferred. Vernon (1921) argued the need for a standard test
for use in comparing fatigue across different industrial settings: ‘a test
which can be easily applied, in the course of a few minutes, to any
industrial worker at any time in the course of his working day, and
afford a quantitative measure of his state of fatigue’ (p. 4). This was a
common plea at the time, based on the assumption that fatigue was a
simple underlying state, directly determined by energy and time; for
reasons that I hope will become clear, this was a forlorn hope, and no
such test was ever developed. Probe tests were also necessary for the
study of effects of other sources of variations in mental efficiency, such
as drugs, sleep deprivation and time of day. Robinson (1923) pointed
out that the probe test can only serve as a marker of impairment of
work if it is closely related in terms of task requirements to those of the
loading task itself. In this sense, the probe task was considered a kind of
surrogate for the actual work performance being fatigued, so that any
decrement in underlying function was detectable as a drop in perform-
ance on the probe.
A complicating issue in all of this is the specificity of the impairment.
As noted earlier, this was a second major question for early theorists. Was
fatigue general or specific? Robinson’s argument assumes that fatigue
is specific to the kinds of operations that have to be sustained. Many
early studies assumed an all-or-none effect of fatigue transfer between
loading task and probe, with little rationale for the selection of the two
tasks. The implied dichotomy has to be seen in retrospect as incapable
of systematic testing, since, in practice, it was not possible to isolate the
mental functions of different activities, or to assess the extent to which

two tasks depended on the same function. Thorndike (1914) argued that
the real question was not whether transfer was specific or general, but
‘How much does continued work at any one or any combination of tasks
diminish efficiency for any other task?’. In any case, the use of probe
tests varying in systematic ways from the loading task provided the basis
for tests of the factors underlying the transfer of fatigue.
The work curve

The major impetus for empirical work on the time course of fatigue was
the extensive programme of research carried out during the early part
of the twentieth century on what was known as ‘the curve of work’ (or
work curve). The idea was developed and initiated by Emil Kraepelin
(Kraepelin, 1902) and executed by his group in Heidelberg. It gener-
ated a great deal of research activity, not only in Germany, but also in
the United States, Britain, and other emerging centres of experimental
psychology, since it appeared to offer a way of mathematically defin-
ing the progress of fatigue over the course of a work activity. Although
such a goal soon proved unrealistic, it nevertheless, by emphasizing
changes in performance as a function of time on task, laid down one
of the major foundations for research on human performance over the
next century. The work curve was the major research paradigm of its
day. It was widely accepted that performance output fell with continued
time spent at work. Because of the desire to establish a scientific study
of fatigue, there was a strong drive to be able to define the form of this
decrement function and to derive its time course. Much of the work
carried out during the first 20 years of the twentieth century was char-
acterized by ‘heroic’ studies, with testing often carried out for many
hours a day over weeks or months. Since it was difficult to obtain vol-
unteers for such studies – or because of researchers’ distrust in any but
their own motivation to stay the course – these were usually conducted
on the researchers themselves. Many early studies of continuous work
were concerned with fatigue in muscular contractions, making use of
Mosso’s (1906) newly developed ergograph, which allowed repeated
muscular contractions (for example, finger flexions) to be recorded as
a series of deflections on a pen recording. These generally revealed a
rapid reduction in the size of contractions, effectively to zero within a
few minutes. I will not discuss these further here, though their findings
were broadly similar to those on mental tasks.
Research on the role of fatigue in the work curve was complicated
by the inclusion of a bewildering array of factors, hypothesized by
Kraepelin as necessary for the systematic explanation of the changes

observed in continuous performance over time. These included (in add-
ition to fatigue): practice, warm-up (anregung), adaptation (gewohnung),
and various kinds of localized ‘spurt’: initial spurt, end spurt, spurts
after fatigue (ermudungsantriebe) and spurts after disturbance (storungs
antriebe). In fact, while such a scheme now seems over-deterministic (at
least in the absence of adequate data), it actually addresses a genuine
problem: that all behavioural sequences have multiple causes; later in
this chapter I will revive the essence of the approach to try to bring
together the evidence about decrement. Certainly, some factors have
stood the test of time; practice, of course, caused performance to get
better over the early part of a task, though mainly for tasks that were not
well learned to begin with; we still think of warm-up effects whenever
we observe improvements in performance over the first few trials of a
task as the task set becomes established, for both mental and physical
work, particularly when the task is well-learned; end spurt accounted
for the improvement often found towards the end of a session, when
the end-point is known or can be predicted and is another phenomenon
familiar to later researchers (e.g., Bergum & Lehr, 1963). Other kinds
of spurt are merely descriptive of unexpected improvements, although
initial spurt is more interesting. It refers to a short-lived high level of per-
formance at the beginning of the task, which cannot be maintained. In
fact, this was by no means common in work curves (Thorndike, 1912)
and its meaning may be more straightforward; rather than representing
an unrealistic level of aspiration on the part of the performer, the ini-
tial spurt may simply reflect the rapid onset of fatigue itself. (There is
considerable evidence of such effects, in both the work curve literature
and later research on continuous performance, discussed later in the
chapter.) Adaptation, having a role of what appears to be simply a more
long-lasting warm-up, may seem the least convincing of the set, though,
as discussed later, it too may be considered to have a role in the analysis
of decrement patterns.
The main problem with the work curve factors was not that there
were so many, nor that they were not necessarily relevant to the observed
pattern of work performance, but that they were rarely controlled for
directly by experimental design. For example, practice may be more or
less removed from the equation by extensive training, while warm-up
effects may similarly be minimized by initial practice during the test
sessions. Instead, they were usually invoked in an ex post facto way to
‘explain’ what may well have been natural fluctuations in performance.
As Thorndike (1912) complained, Kraepelin and his followers ‘seem
to regard each drop-rise sequence in the curve of work as a deficiency
caused by fatigue or disturbance, which stimulates a gain in efficiency

as a result of an ermudungsantrieb (spurt after fatigue) or storungsan
trieb (spurt after disturbance)’ (p. 175, author’s italics added). Despite
the complications introduced by the work curve factors, the assessment
of fatigue effects was still deemed possible. Kraepelin expected that,
under the influence of practice, warm-up and adaptation, continuous
work performance would usually improve steadily, despite the growing
tendency to be dragged down by fatigue. But there came a point where
the curve stopped rising and started to fall. At this point, fatigue was
assumed to have taken over. An obvious problem with this, of course,
apart from the implicit assumption of non-overlapping processes, is
that it almost certainly underestimates the influence of fatigue, since it
denies any such effects when performance is improving (for example,
fatigue may slow down practice) and makes it impossible to separate
fatigue from other overlapping processes.
Early research on the work decrement

Early fatigue researchers fully expected to find large decrements in
work performance with continued time at the task. In practice, how-
ever, they were generally disappointed, with few clear-cut results con-
sistent with the prevalent idea of energy being relentlessly drained by
the act of work. The general expectation was (and generally still is)
that performance would start out well (assuming that the task has been
well learned), but fall away within the first half hour or so, settling
at a new lower level. The details of the decrement – when it begins,
how far it falls, when it levels out – may depend on specific task and
environmental differences, but the general form was agreed. The evi-
dence is mixed, with both clear examples of decrement and more or
less flat performance functions. Usually, some kind of decrement was
found, though effects were typically small, of the order of 5–10 per cent
of the initial level. In this section I briefly review the extensive litera-
ture on time-dependent decrements – both the pioneering early work
on performance decrement and later research on vigilance and work-
load – with the goal of trying to understand the general principles that
underlie decrement: whether performance of a task will be maintained
over a long period of work or suffer impairment. I shall not review the
evidence on subjective fatigue, since this generally all points in one dir-
ection, increasing with time on task (Ackerman & Kanfer, 2009). What
is interesting is that performance does not normally follow this same
pattern of response to task demands.
The first systematic attempt to measure the work curve appears to

have been carried out by Oehrn (1889; cited by Arai, 1912), as part of
Kraepelin’s work curve programme, though it did not provide convin-
cing support for the work decrement. While performance on a range
of mental tasks (such as search, proofreading, and memory and add-
ition) varied over a period of two hours’ continuous work, there was
no clear evidence of overall decrement. Instead, performance generally
improved before falling off. The lack of a clear decrement with time at
work was also found by Thorndike (1912), based on the task of adding
ten-digit columns over two-hour periods. Thorndike argued that the
observed increase of 6 per cent in time taken was typical for studies of
the work curve.
An intrinsic limitation of some (though by no means all) of the early
studies was a lack of attention to methodological rigour, which often
made conclusions unreliable or misleading. Amongst these, the major
problem was a failure to take account of the effect of practice or learn-
ing. This is to some extent understandable, since most tasks used were
assumed to be familiar and already well learned (calculations, memor-
izing, proofreading, etc.), though we now know that even apparently
simple tasks continue to show marked practice effects over many ses-
sions within a test environment. This means that, in the typical absence
of extended practice (ideally to an asymptote of no further improve-
ment), the work curve would often show improvement before falling
later in the session. This probably explains the pattern of performance
observed in Oehrn’s (1889) study, and the work of Kraepelin’s group in
general; there were many such others (see review by Phillips, 1920). A
failure to ensure adequate practice was, in some ways, surprising since
its contribution to performance was widely acknowledged, and prac-
tice was included explicitly in Kraepelin’s taxonomy of factors affect-
ing the work curve. On the other hand, this was not always seen to be
a major impediment because of the assumption that practice effects
could be removed by the use of simple arithmetic within the perform-
ance function.
This criticism does not apply to all early studies, a number of which
have retained their validity in the face of modern critical analysis. As
I mentioned earlier, some studies designed to quantify the work curve
were heroic in their scope and application. The most impressive of these
was carried out by Tsuru Arai (1912), as part of her doctoral work at
Columbia, using the continuous work method. As was common for
such studies (possibly because no one else could be persuaded to do
it), Arai carried out the experiment with herself as the sole participant.
(This is the only serious criticism that may be made of her research,
though it was normal practice at the time, and still is in areas such as
psychophysics. In addition to allowing the study to be completed with-
out problems of participant attrition, it allowed her much better control
over the maintenance of task goals, compliance with instructions, and
so on. Such researchers were highly conscientious and their motives
never questioned.) Arai also made every effort to minimize contamin-
ation from learning effects by including an extended period of practice
on similar problems before the testing sessions started. It is worth look-
ing at what she did in some detail.
Arai’s self-imposed task involved carrying out a series of staggeringly
difficult four by four multiplication problems (such as 2,645 × 5,784
= ?), over four days of unbroken 12-hour periods, starting at 1100 h
and finishing at 2300 h, with breakfast before and a light supper after-
wards. As will readily be appreciated, these were extremely difficult
problems to complete, typically taking around ten to 15 minutes each.
An interesting aside, given what seems to me our quite limited mod-
ern competency in mental arithmetic – I suspect that most of us would
find it difficult to complete even one such problem – is that Arai found
the calculations too easy if she left the multiplicands exposed while she
solved them. This was the method she had adopted during her extensive
period of practice, but she switched to a more demanding procedure for
the later practice sessions and test proper. This was to cover up each
problem after memorizing it, and do the calculation while holding the
problem in working memory, a considerable load on executive control.
A summary of her main results is shown in Figure 3.1. In plotting
this I have used Arai’s (1912) original tabulated data (pp. 38–39) for the
time taken to solve each problem (a total of 67 on each of four successive
days), rather than making use of Thorndike’s (1914) graphed version,
since that averages performance over blocks of problems. As is com-
mon at the time, the solution times included an adjustment for errors
(of 10 s per wrong digit). This is, of course, quite arbitrary, but makes
no appreciable difference to the form and magnitude of the work curve.
The data show clear evidence for a time-dependent work decrement in
her performance. The time taken to solve problems roughly doubled
over the course of each of the 12-hour days, with complete recovery
after each night’s sleep.
Despite Arai’s concern to eliminate practice effects, the data clearly
show a small general improvement over the four days (as is common
in many modern studies on extended work), though the decrement is
nevertheless evident within each day’s work. However, her findings are
subject to confounding from another source that few early researchers
25 day 1 day 2 day 3 day 4
20
Time per problem (min)
15
10
0
Successive problems (1–67) over four 12-hr days
Figure 3.1 Arai’s (1912) data, showing time taken for mental
arithmetic problems over four 12-hour days
were aware of: the time of day effect. Sometimes, this led to improve-
ments later in the day, leading to surprise that a whole day’s school-
work had not impaired performance on demanding mental tests (Ellis
& Shipe, 1903), or that performance got better before it got worse. A
Russian study (Sikorski, 1879), probably the first to make use of the
probe method, found that dictation tests were even performed bet-
ter at the end of the school day than at the beginning. In fact, results
comparing different points in the working or school day were gener-
ally inconsistent. Thorndike (1900) found no evidence of a difference
between early and late tests in schoolchildren, which he took as support-
ing evidence for his firm stance that decrements with continued work
were either very small or non-existent. Ebbinghaus (1897) and Winch
(1911) did report decrements later in the day, while others (Gates, 1916;
Hollingworth, 1914; Marsh, 1906) found different patterns of decre-
ments for cognitive tasks and motor tasks. It was not that effects of time
of day were completely unknown, but they were attributed to environ-
mental factors such as temperature changes and eating patterns, rather
than to what we now know to be an underlying rhythmic modulation of
the neural processes underlying mental and physical activity.
A similar variability in performance over the day was evident in
factory work, and typically attributed to local factory conditions and
work practices (Vernon, 1921). A later review by Freeman and Hovland
(1934) identified multiple examples of all possible patterns of perform-

ance change, for different types of task and situations, while a review
by Smith (1941) concluded that there was little overall evidence of dec-
rements in output over the working day. Wyatt and Langdon (1932)
found considerable evidence for decrement in work outputs for both
high-speed tasks and slow, monotonous activities. Vernon’s (1921) ana-
lysis of industrial performance concluded that there was widespread
evidence of marked decrements in manual work output over the day,
but only for work that was well practised. In addition, many studies
showed evidence of end-spurt, with normal levels of output during the
last work period replacing earlier periods of reduced effectiveness. This
highlights a major problem for all continuous work studies, as relevant
now as then. If performance can be resurrected when the end of the task
is in sight, the earlier evidence of impairment cannot be unequivocally
attributed to a progressive fatigue effect. As has often been pointed out
(e.g., Brehm & Self, 1989; Spencer, 1927; Wright, 2008) it is unlikely
that individuals are working at near-maximum effort throughout, and
rest pauses are an intrinsic part of work strategies; Kalsbeek (1968)
refers to the ‘willing to spend’ capacity as the effective limit of effort
use in sequential choice reaction tasks. Instead, motivational factors
are necessarily involved in managing the supply of effort to meet what
performers believe they can achieve. The time of day effect represents a
second problem for continuous work research. It is now clear that most
cognitive functions are more effective later in the day (Hockey, 1986),
which may mask any putative work-fatigue effect, while some activities
(notably those involving memory) are more effective at earlier times
(Hockey, 1986), which would artificially enhance any measurement of
decrement. Both factors complicate the study of continuous work, even
today. Any changes during the course of the work may be due to the
cumulative suppression effects on performance from work already car-
ried out. But they may also be the result of intrinsic variation in work
effectiveness associated with the planned management of effort and
biphasic effects of time of day.
Is fatigue general or specific?

The plethora of research on the work curve in the first quarter of the
last century made it clear that the decrement with time at work was not
a straightforward phenomenon. Sometimes, large effects were found,
sometimes there was hardly any loss over time; mostly, decrements
were very small. What is interesting is how variable the decrement was;
why were such differences observed? The question is likely to be related
to the second major issue of concern for early researchers: the general-
ity of the fatigue effect. The underlying assumption was that work had
a general effect of running down the body’s limited energy supply. The
strong form of the energy depletion theory clearly hypothesizes that
fatigue is a general impairment, reducing the effectiveness of all men-
tal work (as Kraepelin believed), and could be cured only by a period
of rest. The ameliorative effects of rest were commonly reported in
the early research (reviewed by Arai, 1912), though these are difficult
to interpret because of frequent confounding with practice and order
effects. An alternative form of the argument implicated energy deple-
tion in mechanisms responsible for specific functions, in which case
fatigue was assumed to be specific to the particular activities exercised
in the loading task. Kraepelin (1902) argued ‘Fatigue through mental
work is, so far as we know a general fatigue … Only the difficulty and not
the kind of mental work is significant for the general extent of fatigue’
(p. 479). If fatigue was, indeed, general, any observed decrement would
be found to transfer readily to performance on a second task, whereas a
specific form of fatigue would be resistant to transfer to any but a closely
similar activity. A second consequence of this concerns recovery from
fatigue, as tested by comparison of performance before and after a new
task. A general fatigue effect would predict no recovery from a change
of task, while a specific effect would predict some level of recovery. An
interesting question is how recovery from a change of task compares
with that from rest.
Recovery from fatigue: effects of rest and change

Probably the earliest study on this question, by Bettman (1892; cited in
Arai, 1912, p. 9), found no difference in the degree of impairment on an
arithmetic test after fatigue induced by either mental work (on a similar
loading task) or physical work (hard walking). Ellis and Shipe (1903)
similarly found no clear differences in recovery (from several hours’ men-
tal work) between various transfer tasks. Weygandt (1897; cited in Arai,
1912) did find that a change of task reduced the decrement compared to
repeating a task, but only with a change to an easier task. Such results
were taken as supporting the idea of a general fatigue state, although
they were criticized by Arai (1912) as being unreliable because of the
influence of practice effects. Arai, herself, extended her study of mental
multiplication, discussed earlier, and found that problems took longer
to solve after she had translated a complex essay into Japanese (her first
language) than after having previously rested. Chapman (1917) found
clear evidence of (partial) recovery from repeated brief (30 s) periods of
additions from both rest and a change of task (to that of cancellation),
though the effect was greater for rest than for change. In addition, the
effect of change was found only for a switch from additions to cancel-
lation, but not the reverse. A similar finding was obtained by Vickery
(1931), based on longer (5 min) task periods; while there was partial
recovery from a demanding equations completion task from a switch
to cancellations, there was no advantage for the switch in the opposite
direction. In both cases (as with Weygandt’s earlier study), decrements
from continued work on a task may be reduced by a switch of task, but
only to one that is less demanding. Although there are few examples
of this asymmetry of transfer in the literature, such findings imply two
separate consequences of the impact of continuous work; the need for a
change of task goal, and the need to reduce executive activity.
A more systematic test of the specific fatigue hypothesis was provided
by studies that manipulated the degree of similarity between loading
task and probe. Seashore (1904) had suggested that transfer may depend
not simply on whether the two tasks were the same or different, but on
the degree of overlap between their mental functions. This applied also
to the failure to find decrement in many studies. Dodge (1917) argued
that most of the tasks used in such experiments involved such a diver-
sity of mental functions that little time was spent doing exactly the
same thing continuously. The first systematic attack on the generality
of fatigue was carried out by the two dominant fatigue researchers of
the period, Edward Robinson and Arthur Bills. Robinson (1926) sug-
gested no less than seven principles that might explain differences in
the size of work decrements, of which two central principles may be
distilled: the familiarity or repetitiveness of task elements, and competi-
tion between task and non-task responses. This analysis was developed
further by Robinson and Bills (1926) as a two-factor theory of the work
decrement. They argued that homogeneity of task events (or lack of var-
iety) was the key factor, with decrement occurring most strongly when
a loading task had little variety in the successive units of work. The
principle of homogeneity applied to both the work decrement and the
degree of transfer to other tasks. So, fatigue was more likely to develop
within a highly repetitive loading task, resulting in both a perform-
ance decrement and increased decrement in subsequent tasks of the
same type. In contrast, tasks that include a variety of features appeared
not to suffer at all, and showed little or no transfer to other tasks. The
second factor was competition between task responses, which appeared
to operate in the opposite direction. Tasks that involved selection from
a large set of responses were more prone to decrements than ones that
made lower such demands.
The homogeneity hypothesis is consistent with many of the findings

in the literature, including Thorndike’s oft-reported negative findings
(Robinson & Bills, 1926). Robinson (1934) argued that Thorndike’s
scepticism was driven by the kind of tasks he used, which not only
included quite varied material, but emphasized accuracy of work and
provided considerable feedback on errors. Bills (1937) concluded that
decrements were generally associated with tasks having high levels of
homogeneity, but also greater continuity (faster events rates with no
breaks). This latter point is important. In contrast to varied or low
event rate tasks, fast event rate tasks have been identified (Broadbent,
1971; Mackworth, 1969; Posner, 1978) as being susceptible to an
habituation-type effect from repeated stimulation of the same neural
pathways (in signal detection theory terms, reduced sensitivity or
d-prime). I shall return to this in the section on vigilance.
In support of the homogeneity hypothesis, Poffenberger (1927)
found a clear decrement for continuous additions (over several hours,
until participants were unable to continue), but not for three other
demanding but more varied tasks (judging essays, sentence comple-
tion and intelligence test items, the last showing continuous improve-
ment over several hours). It is also consistent with the account of Noll
(1932), who found no decrement with a three-hour battery of highly
demanding (but varied) college ability tests. A similar recent study
by Ackerman and Kanfer (2009) examined the effects of very long
test sessions (3.5, 4.5 or 5.5 hrs) of SAT test batteries on performance
and subjective fatigue. While reported fatigue increased as a function
of both time on task and length of session, overall performance was
not impaired in the longer sessions. Again, these long sessions were
made up of very many individual tests of different types, with fre-
quent breaks, and may be considered to have provided participants
with sufficient variety to offset fatigue. Newburger (1942) varied both
homogeneity and difficulty within the same analogies task, and found
greater decrements for sets of items that were highly similar, irrespect-
ive of difficulty level. In their own test of the homogeneity hypothesis,
Robinson and Bills (1926) found that the size of the decrement from
continuously writing letter sequences decreased as the size of the set
of letters used increased from two to three to six. A later study by Bills
and McTeer (1932) found essentially the same results with alternat-
ing one-minute trials of fixed and varying three-letter sequences. The
cumulative decrement for fixed sequences was increasingly reduced
with greater differences between the two sets of letters. Their findings
are summarized in Figure 3.2, with a common baseline, as adopted by
Bills and McTeer.
53
52
51 rest
Output (sequences/min)
50 1
49
2
48
47 3
46
45
all
44
43
1 2 3 4 5 6 7 8
Successive odd minutes
Figure 3.2 Data of Bills and McTeer (1932), showing the number
of three-letter sequences completed during successive odd minutes,
separated by sequences with different numbers of letters in common
Oddly, the question of recovery from fatigue, and whether a change

of task might be as effective as a complete rest, appears to have been
largely ignored by modern research. Yet, it presents rich opportunities
for research on fundamental mechanisms of human performance. The
only systematic study of recovery that I am aware of is concerned with
effects of rest breaks (Schmidtke, 1976b). This showed a direct relation-
ship between the intensity and length of paced work on mental arith-
metic problems and the time needed for complete recovery. However,
there are no comparable studies on what conditions of changed work
are effective for recovery.
After-effects of fatigue
The above studies on fatigue transfer and recovery focus on the alle-
viation of decrement by interpolating activity of a different kind. An
alternative method is to examine the direct after-effects of the loading
task on a subsequent activity. While the classical literature supports the
idea of fatigue being a relatively specific process, there is also more than
a hint of it having the general effect hypothesized by Kraepelin. This
is implied, for example, in the reports of asymmetry in transfer effects,
with recovery occurring only when ‘easier’ tasks are interpolated in

the performance sequence (as in the studies by Weygandt, Vickery
and others). The most likely explanation for such general effects is
that they are dependent on the use of common executive processes; a
highly demanding task does not relieve fatigue from a continuing activ-
ity because it makes further demands on the system that is failing, the
executive control system.
The strongest feature of after-effects of fatigue is the observed resist-
ance to (further) effort on later tasks, and a modern perspective on
mental fatigue is that resistance to further effort is the main defining
feature of the state. As I have already mentioned, this was pointed out
by Thorndike (1900) and frequently emphasized by later reviewers
(e.g., Bartley & Chute, 1947). However, it has only become well estab-
lished through more recent analyses, such as those of Cohen (1980) and
Holding (1983). Effort is considered unambiguously in this volume as
a property of executive activity, so we may expect to find the strong-
est after-effects on tasks that depend on executive function. There are
a growing number of examples of such impairment from demanding
mental activity. In particular, Meijman, van der Linden and their col-
leagues have demonstrated widespread after-effects on tasks (such as
the Tower of London and Wisconsin card sorting test) used to assess
frontal executive impairment and on mental operations requiring
focused attention (e.g., Smit, Eling & Coenen, 2004; van der Linden &
Eling, 2006; van der Linden, Frese & Meijman, 2003; van der Linden,
Frese & Sonnentag, 2003).
Vigilance and sustained attention

Following the important work of Robinson and Bills during the 1930s,
research on time-dependent decrements and recovery more or less
came to a standstill. Nothing new was being discovered about the work
curve, nor had any clear understanding been reached of the processes
underlying performance impairment and fatigue. However, the prob-
lem benefitted from renewed impetus with the publication of Norman
Mackworth’s (1948) landmark paper on the vigilance decrement, a
topic that dominated research on human performance for the next 30
years.
In 1943, during the Second World War, Mackworth began the investi-
gation of a problem raised by the Royal Air Force. This was the apparent
(and surprising) occurrence of decrements in detecting targets during
two-hour sessions by experienced radar operators on anti-submarine
patrol. In his published paper on the results of his work Mackworth
cited the findings of Wyatt and Langdon (1932), Ditchburn (1943) and
Anderson et al. (1944), all of whom found that performance deteriorated
within a period of 30 min or so of starting similar tasks. Yet, while earl-
ier research on the work curve and time on task effects had also made
it clear that such a decrement was likely, Mackworth made no reference
to this extensive body of research. He also did not appear to be aware of
Robinson and Bills’ (1926) demonstration that work decrements were
more likely with repetitive tasks. It is possible that he regarded the earl-
ier work as of little relevance to situations requiring continuous atten-
tion to rare environmental events, as embodied in such industrial tasks
as watch keeping, inspection or monitoring. However, such research
clearly provided a basis for expecting decrements in continuous work in
general, and it is surprising that he ignored it completely.
To study these effects within the laboratory, Mackworth (1948) devel-
oped a simulated radar task known as the ‘Clock Test’ in which a pointer
(clock hand) moved around the circumference (clock face) in a series of
small jumps over a two-hour period. A critical event (signal or target)
was indicated by an occasional double jump of the pointer, a change
that was readily discriminable to operators when they were alerted to it.
Mackworth found that detection of targets fell dramatically within the
first half hour of the session, then levelled off, confirming the general
pattern of earlier findings from field studies. Interestingly, Mackworth
(p. 18) suggested that the relatively low level of target detection dur-
ing the later part of the session should be regarded as the normal, sta-
ble state of the system, while the higher performance during the first
half-hour was the result of an abnormal and unstable level of alertness.
This reminds us of Kraepelin’s concept of initial spurt: highly effective
performance caused by an unrealistic and unsustainable start. In add-
ition, it argues against a true fatigue-driven decrement. This seems per-
verse. As I will argue later, such a dramatic change in performance may
represent what may in fact be the essence of a fatigue effect, or at least
one main feature of it: the difficulty of sustaining attention to a specific
task set for an extended period of time, particularly when, as in the case
of vigilance, it is so restricted in terms of cognitive variety. Mackworth’s
findings were, almost single-handedly, responsible for a resurgence of
interest in the work decrement. Vigilance research addressed problems
not only within the applied areas of radar detection, factory inspection,
air traffic control, and monitoring/surveillance, but also questions of
mainstream experimental psychology, where the paradigm offered the
opportunity of examining effects of factors such as drugs and stres-
sors on attention processes (Broadbent, 1971; Hockey, 1986; Koelega,
1993). More recently, this interest has extended to include problems
associated with the increased monitoring demands of automated sys-

tems (Parasuraman, 1987; Warm, Dember & Hancock, 1996). The
vigilance decrement is, by the standards of experimental psychology, a
very reliable finding, though the details vary, depending primarily on
the nature of the tasks involved, such as modality, signal probability
and event rate (Davies & Parasuraman, 1982).
What causes the vigilance decrement?

A relevant question for this chapter is whether the vigilance decrement
may be accounted for by the same processes that have been suggested
for other forms of continuous work: low relevance for the individual, a
low variety of task events, and executive limitations on effort deploy-
ment. Vigilance has not always been considered a suitable topic for inclu-
sion in a discussion about fatigue. The vigilance decrement was once
regarded as a problem mainly of monotony leading to boredom and low
arousal: too little stimulation to sustain an adequate level of activation
and effectively engage attention (Deese, 1955; Welford, 1968). Unlike,
say, the high demand computational tasks of early research on the work
curve, little appeared to happen in the vigilance task, which was char-
acterized by a low rate of highly monotonous events, requiring only
occasional overt actions (Frankmann & Adams, 1962; Loeb & Alluisi,
1984; Welford, 1968). This was assumed to reduce the level of activity
in brain systems responsible for maintaining cortical activation (such
as the brainstem reticular formation and diffuse thalamic projection
system), resulting in a fall in general alertness. A modern expression
of this view is the conceptualization of vigilance as an induced state of
‘mindlessness’ or general inattention, brought about by lack of a suf-
ficient level of input to drive attention (Manly, Robertson, Galloway
& Hawkins, 1999; Robertson, Manley, Andrade, Baddeley & Yiend,
1997). However, it now seems more likely that the act of attending is
indeed effortful, and that vigilance requires a high level of mental effort
to maintain a fragile task set (Grier et al., 2003; Warm, Parasuraman &
Matthews, 2008). Further evidence for the effort demands of vigilance
is the finding of Smit, Eling and Coenen (2004) that vigilance perform-
ance is impaired when it is preceded by a fatiguing two hours of intel-
ligence testing.
As with the earlier work decrement literature, initial confidence in
the vigilance decrement has been partially dented by later research.
It was assumed that the typically observed fall in the rate of hits (cor-
rectly detected signals) was a marker of reduced perceptual processing
ability or sensitivity. But the effects of other factors soon became clear,
including motivational changes, expectancies about the flow of tasks

events and the payoff of different kinds of errors (missing signals or
reporting non-signals). Schmidtke (1976a) commented that the identi-
cal clock test produced varying levels of detection with different groups
of performers, and attributed these differences to motivation and inter-
est in the task. The application of signal detection theory (SDT) to vigi-
lance (Broadbent, 1971; Swets & Kristofferson, 1970) typically showed
that reductions in hits were attributable not to reduced sensitivity of per-
ceptual processing but to changes in decision criteria for responding. I
will not dwell on details on SDT, but sensitivity is normally assessed by
d-prime (d′) or the non-parametric alternative index (A), and decision
bias by β (or log β), or by the various non-parametric alternatives; see
the reviews by See, Howe, Warm and Dember (1995) and See, Warm,
Dember and Howe (1997). In short, rather than becoming less able to
detect differences between signal and non-signal events with time on
task, participants seemed to be more reluctant to report task events as
signals. In terms of the utilities of different outcomes this means that
the costs of false positives (reporting a non-target event as a signal)
increased relative to those of a missed signal.
In fact, while it is clear that the drop in sensitivity is not always
observed, it remains very common under some circumstances. Two
factors that appear to be central to the pattern of performance are the
rate at which task events are presented, and whether decisions about
signals and non-signals have to be made on the basis of sequential or
simultaneous events (Davies & Parasuraman, 1982; See et al., 1995).
In general, sensitivity decrements are found only for tasks that present
events at both a high rate and in succession, the typical design of vigi-
lance tasks since the earliest models of radar monitoring and industrial
inspection. The meta-analysis by See et al. (1995) suggested an add-
itional moderator: whether tasks require primarily sensory or cognitive
(typically letters or digits) judgements. While this may complicate the
simple picture, the lack of large numbers of cognitive tasks (except for
the high event rate/successive type, which shows the same large effect
as for sensory tasks) may make generalizations unreliable. Overall, the
results of high event rate tasks of both types show a dramatic fall in the
efficiency of information processing. This occurs in almost all cases
within the first 10–20 minutes of the task though, as I shall discuss
later, the decrement can be found much earlier than this – within the
first few minutes – but only when frequent sampling of detection per-
formance in available.
There has long been a general belief that complex monitoring is
less sensitive to decrement (Adams, Stenson & Humes, 1961). This is
consistent with the homogeneity theory of fatigue (Robinson & Bills,

1926), since tasks that are more complex would be expected to involve
a greater variety of events, or different sub-tasks, so be less repetitive.
This does not appear to have been directly tested within the vigilance
area; for example, I have not been able to find any studies that vary
display features over the session. It is also consistent with the idea
that more complex tasks engage motivation and effort more effectively
(Ryan & Deci, 2000; Warm, Howe, Fishbein, Dember & Sprague,
1984). However, complexity is an ill-defined property, often referring
to nothing more than the use of multiple displays of the same type
of stimulus: tasks such as Broadbent’s (1954) 20 dials and 20 lights,
and Jerison’s (1957) three Mackworth clocks, where the main threat is
from the problem of divided attention, rather than complexity per se. It
seems likely that more specific forms of complexity (that, for example,
increase demands on working memory) would make performance more
vulnerable to disruption over time, as has been found for real-life tasks
such as air traffic control, industrial process control and transport; see
reviews by Parasuraman (1986) and Wiener (1984). Actual decrements
may not be observed because of the compensatory effect of increased
effort, though the costs associated with maintaining performance are
increased under such conditions (Hockey, 1997).
Habituation and executive control

Overall, the evidence on vigilance fits surprisingly well with that from
the broader work performance literature. In both areas, the occurrence
of a decrement over time appears to depend on two processes. The first
is the inhibitory response to repetition in successive task events, coupled
with a high rate of work. Along with others (Cowan, 1988; Mackworth,
1969; Posner, 1978) I will refer to this process as habituation: a reduced
response to repeated event patterns that are found not to be of value to
the individual. Habituation is distinguished from sensory adaptation
in that it is an attenuation of response at the central (neuronal) level
(Sokolov, 1963; Thompson, 2009). The second is the need to maintain
orientation towards the task through effortful control of alertness. This
top-down control involves the executive system in helping to maintain
selection of the task goal, and (partially) combat the inhibitory effects
of habituation. From the habituation perspective, despite the top-down
control of attention afforded by executive processes, the experience of
rapid, unvarying displays will quickly render task events ineffective in
driving task goals, making them vulnerable to displacement through
orienting to currently unattended events, as indicated, for example, by
physical changes in the environment, or events having either personal

significance or primed by recent cognitive activity. For some, it may
seem to be stretching definitions of habituation to regard this as a pro-
cess directly related to fatigue, since distinctions between the two have
always been emphasized and the mechanism is well-established in its
own right (Thompson, 2009). However, I would argue that habitu-
ation may be considered part of what might be considered a suite of
fatigue operations designed to maintain coherent motivation-driven
behaviour.
The sensitive task

In addition to the standard vigilance task, the resurgence of interest in
the work decrement involved research on other continuous work activ-
ities, including tracking and continuous serial reaction (following on
from the work of Bills). Such tasks became part of a new approach to
the study of effects of fatigue and stress on performance at the Applied
Psychology Unit in Cambridge during the 1950s and 1960s, based on
Broadbent’s (1957, 1958) identification of the characteristics of what
he called ‘the sensitive task’. Like vigilance such tasks were designed
to deny the attention control mechanism any safe period for inactivity,
having either, or both, a high rate of task events and uncertainty about
when (or where) events would occur. As we have seen, earlier research
had not always been shown to reflect effects of prolonged work or envir-
onmental stressors because they often lacked features that would tax
the mental apparatus.
Continuous work tasks such as these all showed evidence of decrement
over prolonged work. The work has been reviewed extensively elsewhere
(Broadbent, 1971; Hockey, 1986), but a brief summary is relevant. The
core of the programme involved the five-choice serial response task,
which required participants to respond to a random sequence of five
lights in a pentagonal display by tapping a matching contact with a sty-
lus (for reviews, see Broadbent, 1963, 1971). As expected, choice errors
increased over the 30-minute period. With the self-paced version, there
was surprisingly no change in the work done over the session (as also
under various stressors; I will discuss these results more fully in the
next chapter). Broadbent reasoned that, since rate of work was under
the control of the performer, episodes of slowing could be compen-
sated for by later speeding up. However, errors typically increased over
the session (and in noise), as did disruptions of the flow of responses.
These were very slow reactions to lights (latencies of 1.5 s or longer)
referred to as ‘gaps’. They are the same phenomenon as the ‘mental
blocks’ discovered by Bills (1931) in continuous colour naming (another

self-paced task), and the ‘lapses’ identified by Williams, Lubin and
Goodnow (1959) in sleep-deprived serial responding. I will discuss the
relevance of these disturbances in the control of task responding later
in the chapter.
Work intensity, effort and executive control

The early part of this chapter has been concerned primarily with
effects of time at work. However, irrespective of how long a task lasts,
it may also bring about fatigue by virtue of the momentary intensity of
demands it makes on the performer. This issue has come to be recog-
nized by the term workload. From the perspective of fatigue and per-
formance degradation, it is a relatively simple question: whether the
performer can just have too much work to do. Is there a critical level
of work intensity above which the ability to manage tasks breaks down
(overload)? For example, Schmidtke (1976a) found that a vigilance task
involving a very high workload (simulated collision avoidance moni-
toring) showed much larger decrements over a four-hour session than
normally observed. Similarly, Hall, Passey and Meighan (1965) found
greatly increased levels of decrement on monitoring tasks when a bat-
tery of cognitively demanding tasks had to be carried out at the same
time.
Workload, capacity and resources

A general assumption of modern resource theories of workload and
attention (e.g., Wickens, 1984) is that performance will be impaired if
demands exceed some hypothetical information processing capacity.
This use of the twin concepts of capacity and resources has its origins
in the idea of mental function being constrained by limited energy,
but they also derive from the limited capacity model of the human
operator. A major development in the application of capacity ideas to
workload was Moray’s (1967) analysis. Moray showed that, rather than
assuming a fixed capacity serial processor model, the mental apparatus
could be treated as a more flexible resource in which a stock of pro-
cessing units could be distributed between different activities. This
has remained the core meaning of mental resources, and the basis of
Kahneman’s (1973) influential model, in which a single, undifferen-
tiated resource may be allocated flexibly among different tasks, with
performance breakdown occurring only when the overall capacity is
exceeded.
The general resource idea was developed further by Norman and

Bobrow (1976), who showed that limitations of resource availability
may not be the only cause of performance decrements. While some
tasks (resource limited) may depend mainly on effective allocation of
resources, others (data limited) depend more on the quality of informa-
tion available to the processor (for example, reading text in poor light
or trying to retrieve half-remembered facts). An important corollary of
this is that there may be task situations in which concentrating or trying
harder may do little to prevent performance decrement. Whilst propos-
ing scarcity of general resources as the limiting factor in task perform-
ance, Kahneman (1973) also recognized that some task interference
was related to what he called structural factors – competition for dedi-
cated resources (such as the need to perform two simultaneous visual
or manual tasks) – and later theorists have successfully argued the need
to recognize a number of separate, more or less dedicated, resources,
serving different families of processing needs (Navon & Gopher, 1979;
Wickens, 1984).
Effort and executive control

An alternative conceptualization of the problem of high workload or
intensity is the idea of commitment of effort to the control of task
goals (Curry, Jex, Levison & Stassen, 1979; Jex, 1988). This has a
greater relevance to a motivational control perspective, in which task
goals need to be actively managed under threat of distraction or loss.
The idea of a limited supply of resources for information processing is
still widely used to account for performance failures under high work-
load. However, it has always had an alternative meaning, referring to
the mobilization of mental effort. In fact, Kahneman (1973) made
an explicit connection between the two constructs: mental activities
made demands that attracted processing costs and required effort to
maintain task performance. The relation between the information
processing and effort conceptions of resources is a fuzzy one. Effort is
sometimes referred to as mental energy, linking it explicitly with the
energy perspective that dominated the early fatigue literature, and
identifying it with a commodity that can be objectively defined, and
that is, in principle, exhaustible. In many uses, effort, capacity and
resources have been regarded as essentially synonymous; in still oth-
ers, as in the widely used ‘processing effort’ of Norman and Bobrow
(1976), there appears to be a built-in ambiguity with respect to the
two meanings. Of major theoretical positions, only that of Kahneman
(1973) includes any direct discussion of the possible energetical
consequences of the allocation of processing effort. Following the

important insight by Moray (1967) that central processing capacity
may be allocated strategically by higher level (executive) influences,
Kahneman identified effort with the action of specifically main-
taining a task activity in focal attention, showing that only some
(resource-intensive) activities, such as rehearsal, comparison, motor
control, now thought of as involving the central executive, depended
strongly on effort. Kahneman argued not only that effort provided an
increase in overall resources (to meet prevailing demands), but that it
attracted costs in terms of sympathetic activation, such as increased
pupillary dilation (Beatty, 1982).
As with most other theorists, Kahneman’s use of the effort con-
struct is associated chiefly with variations between tasks in process-
ing demands (effort as controlled processing), with level of effort being
primarily dictated by the intrinsic demands placed on the performer
by the task. (He even argues that high effort investment may not be
possible for very easy tasks, whatever the costs of failure.) However,
both Kahneman and others (Hockey, 1997; Mulder, 1986) have recog-
nized that the deployment of effort may also be under voluntary con-
trol, especially in support of highly demanding resource-limited tasks.
Effort is always being applied at a sub-maximum level (Kalsbeek (1968)
referred to this as the ‘willing to spare’ capacity), and is known to adjust
to meet the changing assessments of prevailing demands. For example,
studies of workload transitions reveal a drop in effort on a low demand
task following one where demands are high (Stark, Scerbo, Freeman &
Mikulka, 2000; Young & Stanton, 2002). A central idea to the discus-
sion of fatigue and performance in the next two chapters is that effort
is set to meet the anticipated demands of the task, and adjusted to meet
changing utilities of both current and competing goals. The point has
been made more generally by Brehm and Self (1989), who distinguish
between ‘potential motivation’ (in this case, optimal effort demands of
the task) and ‘motivational arousal’ (the actual level of effort applied to
the task by the performer), and also by Kalsbeek (1968) and Schmidtke
(1976b), who both refer to a ‘willing to spend’ capacity, with a reserve
supply available for meeting unexpected demands. As I shall discuss in
Chapter 4, this second sense of effort (effort as compensatory control)
has been implicated in performance maintenance under stress, over-
load or external distraction (Hockey, 1997; Mulder, 1986; Wickens &
Hollands, 2000). Whether the two manifestations of effort really are
different, as Mulder (1986) implies, or part of the same general mecha-
nism remains to be determined, though both impose a problem for task
management. For the present, since I can see no strong arguments for
overriding the principle of parsimony, the two kinds of effort are con-
sidered different reflections of the same goal maintenance process.
The role of effort in the development of fatigue is a core feature of the
arguments put forward in this book. As argued in the regulatory model
presented in Chapter 6, an effort-based compensatory control mech-
anism may be needed not only for maintaining tasks under disturb-
ance by stressors, but also for preventing the loss of task goals under
all circumstances, including increased intensity of processing demands
and competition from other tasks. In his critical appraisal of the con-
struct of general resources, Navon (1984) suggested such a directive
role for motivation (or effort); rather than simply increasing resources,
task-directed effort may be employed to manage a process more effect-
ively, for example by maintaining a goal under executive control. In the
next few chapters, I further develop the argument that effort corres-
ponds to sustained regulatory activity by the executive control system,
probably through activation of midbrain dopamine systems, supported
by a focused stress response, and that this sustained control activity is
the primary factor in the genesis of the fatigue state. On this view, it is
not high workload per se that drives the fatigue process, but the per-
former’s adoption of a high effort response to the perceived demands
of the task.
A major challenge for any analysis of the work–fatigue relationship is
to identify the conditions that give rise to what appear to be two separate
outcomes of work: the occurrence of a decrement in performance, and
feelings of fatigue. While there are many situations where they co-occur,
the absence of a consistent relationship between the two effects has long
been recognized (Poffenberger, 1928; Thorndike, 1900), though there
has been little attempt to explain why such a dissociation may occur.
The view developed further in the next two chapters is that perform-
ance impairment is but one aspect of goal regulation, and that decre-
ment and fatigue feelings are often mutually exclusive. Decrements are
found, generally, in the absence of sustained effort-based maintenance
strategies; however, the act of sustaining effort, while helping to main-
tain performance, also gives rise to strong feelings of fatigue. Only under
more extreme conditions, where high levels of effort are no longer able to
maintain task goals, would both decrement and fatigue be expected.
Although there is much circumstantial evidence for the effort →
fatigue linkage (Hockey & Earle, 2006), there have been few direct tests
of it, for example by inducing changes in effort independently of task
demand. One exception is a study by Earle (2004), in which partici-
pants were instructed to adopt either normal or high effort strategies
in a process control task with different levels of objective workload.
She found that ratings of fatigue over the task increased more under
higher workload conditions, but only when participants adopted the
high effort strategy. Thus, fatigue appears to depend not only on a high
level of demands, but on a high effort response to those demands.
A reappraisal of the work curve

This review of the work decrement shows a mixed bag of effects, with
some evidence of impairment over prolonged work periods set against
a general pattern of stability or very small effects. In the earlier work,
there is little consistent evidence of decrement, with few studies show-
ing a fall even as great as 10 per cent of initial value. Thorndike (1914)
and Dodge (1917) argued that the fatigue-like work curves sometimes
found in laboratory experiments, or observed in studies carried out in
schools or industry, could not, in any case, be regarded as caused by
any real reduction in the efficiency of neural or muscular functions.
Thorndike regarded them as being caused by a loss of interest in the
act of doing the task (what he referred to as the reduced ‘satisfyingness’
of the work). The findings on vigilance are more consistent, with more
widespread findings of decrement, though these too may not always
represent a genuine reduction in perceptual or cognitive functioning;
instead, they may reflect a strategy of more cautious responding. It
seems clear, on the other hand, that tasks requiring rapid sequential
decision-making normally show a genuine drop in sensitivity. Robinson
(1934) suggested that Thorndike’s view came from the kind of tasks he
used, which emphasized accuracy of work and provided considerable
feedback on errors, though his data are not, in fact, very different from
those of others who used different kinds of task. More likely, any decre-
ment occurred very early in the session, and could be detected only by a
fine-grained method of analysis. I now turn to these rapid onset effects,
which have been observed in both kinds of study.
Rapid onset of decrement

One of the limitations of the standard work curve study was the time
scale over which measurements were taken, often as infrequently as
every 30 minutes or every hour, though this is understandable where
testing is continued over very long periods, as in the study of Arai (1912).
Interestingly, Kraepelin’s group often used work periods of five minutes,
with a view to establishing the exact point when the decrement occurred,
though this precision was often offset by effects of practice, warm-up
and other factors that affected the work curve. However, a number of
early studies assessed changes over much briefer periods, and found
evidence of a rapid fall in performance. For example, Poffenberger and
Tallman (1915) found that a set of typical mental tests (such as cancel-
lation and addition) were all performed more quickly during the first
half of the test, even though no test lasted longer than one minute.
Such results suggest that decrements with time are the norm, but that
the effects may occur rapidly and not normally be detected, especially
when there are opportunities for recovery during the inevitable brief
breaks in most task sequences.
In fact, a number of further studies around this time all showed that
a marked decrement (of the order of 25 per cent) could be detected
within the first few minutes. These are noteworthy in making use of
extended practice before carrying out the testing, and are remarkably
consistent in showing a dramatic fall in performance, even within the
first minute or two of the test. Chapman (1915) examined performance
on addition over two ten-minute sessions on each of five days. When
performance was broken down into two-minute periods he found a
marked decrement, which reached asymptote within the first four min-
utes. Using tasks based on the four fundamental arithmetic operations,
F. M. Phillips (1916) observed the same rapid decrement, again within
one to two minutes, as did a follow-up of the earlier Chapman study by
Chapman and Nolan (1916), with periods of 30 seconds. Morgan (1926)
also used 30-second periods and found decrements in both cancellation
and addition within the first minute, though the effect was stronger for
additions (in terms of the percentage fall). This is in line with early find-
ings on fatigue transfer (Chapman, 1917; Vickery, 1931), implying that
additions was the more demanding task, in the sense of its reliance on
executive control, and therefore more susceptible to rapid impairment.
As an illustration of these findings I include a summary of Morgan’s
detailed data on cancellations and additions (Figure 3.3), though
those from other studies on rapid decrement are very similar in form.
Interestingly, all these effects were discussed at the time in terms of the
phenomenon of initial spurt, as discussed earlier in this chapter, rather
than as decrements of normal performance, though Chapman (1917)
suggests an origin more in line with the present suggestion: ‘the phe-
nomenon of initial spurt is probably due to an interference effect which
results from continued work’ (p. 170). Note, however, that the decre-
ment in Figure 3.3 is not complete after the initial drop in performance.
As with all such findings, the dramatic effect in the first 30 seconds is
followed by a more prolonged decrement over the rest of the work ses-
sion (12 minutes for additions and 15 minutes for cancellation). I shall
return to these observations shortly.
2,100
10,700
2,000
10,500 1,900
Total cancellations
Total additions
10,300 1,800
1,700
10,100
1,600
9,900
1,500
9,700
1,400
9,500 1,300
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29
Successive 30-s periods
Figure 3.3 Data from Morgan (1926), showing rapid decrement in

cancellation and addition
The hypothesis of a very rapid decrement is difficult to test in the

case of vigilance, because of the core definition of the task as a problem
associated with response to rare events over long periods. Typically,
the majority of the decrement is evident within the first 15–20 min-
utes (Teichner, 1974), though fine-grained (signal-by-signal) analysis
shows that much faster decrements may occur. A re-analysis of N. H.
Mackworth’s (1948) results by Jerison (1959) showed the major part
of the decrement to have occurred within the first few minutes. Since
then, the same rapid effects have been observed using brief, high event
rate tasks with a higher rate of sampling (Helton, Dember, Warm &
Matthews, 2000; Helton et al., 2007; Nuechterlein, Parasuraman &
Jiang, 1983; Temple, Warm, Dember, Jones, LaGrange & Matthews,
2000), and it is now clear that the vigilance decrement may be observed
within the first one or two minutes. The same pattern is evident in rapid
self-paced serial reaction time tasks, such as the psychomotor vigilance
test, or PVT (Dinges & Powell, 1985; Lim & Dinges, 2010), in which
participants have to respond as quickly as possible to events occurring
at unpredictable intervals (between two and ten seconds). As with other
vigilance and continuous performance tasks, speed of detection on the
PVT has been found to slow dramatically even within the first few min-
utes of a ten-minute task (Balkin & Wesensten, 2011; Loh, Lamond,
Dorrian, Roach & Dawson, 2004).
The occurrence of a rapid decrement (within the first 15–30 seconds)

can be interpreted in several ways. The most appealing is that this is the
real fatigue effect – a catastrophic failure to maintain control of the task
goal – that the early researchers were looking for, but they didn’t find
it because it happened too quickly for their measurement techniques to
pick up. William James (1890) was quite clear that effective attention
was short-lived: ‘there is no such thing as voluntary attention sustained
for more than a few seconds’ (p. 42). The trouble with this view is that
rapid decrements have none of the defining characteristics of the phe-
nomena they sought: neither the long, slow build-up of reduced effi-
ciency, nor the growing state of weariness brought on by the assumed
depletion of energy. Many of the early investigators attributed the
superiority of the early part of the session (now seen to be, at most, the
first 30 seconds or so) to an ‘initial spurt’ (one of the Kraepelin work
curve factors); but what causes this and why isn’t it maintained? The
rapid development of the fatigue effect in the above studies has a num-
ber of implications for our understanding of performance changes with
continuous work. First, it makes it unsurprising that tasks that adopt
a strategy of low frequency performance sampling fail to detect decre-
ments. This was certainly true of many of the early studies, although,
of course, some did show clear decrements. In addition, it is clear that
slower decrements may also be observed; the classic vigilance decre-
ment may be found even though performance sampling has rarely been
more frequent than four to six times per hour. Furthermore, a differ-
ent source of evidence confirms the suggestion of continued disruption
over prolonged task engagement, in the forms of blocks, gaps or lapses
in continuous responding. How do these findings relate to the rapid
decrements seen in Figure 3.3 and the slower changes evident in trad-
itional prolonged work studies?
Interruptions of control: blocks, gaps and lapses

Blocks are brief interruptions in the flow of responses in serial tasks,
first reported by Bills (1931, 1935) during colour naming (and also
letter writing, mental arithmetic and various other tasks). They were
defined as responses taking at least twice as long as the overall mean,
and occurred about two or three times per minute even at the begin-
ning of a task session, increasing over time to ten or 12 per minute. As
with the more usual measures of decrement, blocks were more com-
mon in highly repetitive (homogeneous) continuous tasks, as well as
those having a high degree of response competition (having to name
one of six colours, rather than one of two). The important insights from
this work reveal a mechanism that is different to the rapid decrement

discussed above. The time course of blocks is much slower than the
habituation effect; rather than happening within seconds it shows only a
gradual increase in time and duration of interruptions over the task ses-
sion. Bills (1935) assumed that these phasic disruptions were necessary
interruptions in the flow of behaviour, allowing the mental apparatus
to recover from the build-up of fatigue (and prevent the occurrence of
a major breakdown). However, they may also be signs of an inadequate
compensatory response to increases in task load, usually self-imposed
in serial response tasks, as a result of speed instructions. In the present
context they may be considered as periodic losses of task control that
serve both as warnings of catastrophic breakdown and enforced inter-
ruptions in control that help protect the system.
Bills’ findings concerning blocks have been confirmed in later work
on serial responding, but given the alternative names of gaps or lapses.
Gaps were identified in the work reported earlier on the five-choice task
(see reviews by Broadbent, 1971; Hockey, 1986), and found to be sen-
sitive to both prolonged work and effects of stressors such as noise and
sleep deprivation. The term lapse was used by Williams et al. (1959) to
describe the similar brief interruptions in serial responding observed
under sleep deprivation, previously identified by Warren and Clark
(1937) and Bjerner (1949). Rather than resulting in a general shut-down
or degradation of performance, sleep deprivation produced brief inter-
ruptions of performance, accompanied by an increased frequency of
sleep-like bursts of EEG activity; Broadbent (1963) suggested that per-
formance during sleep loss more closely resembled an engine period-
ically misfiring than the running down of a wind-up toy. In line with
current practice, I shall use lapse as my default term for all three kinds
of interruption. Some sleep theorists (for example, Durmer & Dinges,
2005) have argued that these ‘microsleeps’ under sleep deprivation are
caused by the intrusion of homeostatic sleep processes into the waking
state. It is also possible that brief sleep intrusions may underlie failures
of control in serial responding in the normal non-deprived state.
For the moment, it is enough that these different examples of disrup-
tion show that fatigue has at least part of its effect through phasic minor
breakdowns of control, rather than gradual lowering of the quality of
performance. It may even be argued that this is actually the only way
in which fatigue from continued work has its effects on performance
under normal controlled conditions. Such disturbances are evident only
when performance is continuous and rapid, and when a fine-grained
level of analysis is adopted, though they can be assumed to play a role
in all task management. The detailed microstructure of what happens
in the control of responding when a lapse occurs was revealed in a study

by Bertelson and Joffe (1963) using a four-choice task. They found that
lapses were typically preceded by a period of instability over five or six
responses (three to four seconds), with an increase in both mean reaction
time and errors, and followed by an immediate recovery and stabilized
performance. Such findings are supported by EEG and fMRI data that
show transient disturbances of frontal control processes just before lapses
(Padilla, Wood, Hale & Knight, 2006; Weissman, Roberts, Visscher &
Woldorff, 2006), consistent with the interpretation that the lapse is a
marker of the trimming or resetting of a central control process.
Three sources of performance decrement

The analysis of work decrements, from both early studies on the work
curve and later work on vigilance and workload, has thrown up a range
of findings. To summarize:
(1) decrements are not always observed, even in quite long and demand-
ing tasks. Where they were observed, they may be the result of a
loss of interest in the work, rather than a genuine impairment of
processing effectiveness;
(2) decrements occur more commonly in tasks that are highly repeti-
tive, fast and continuous;
(3) decrements are generally greater when work is more intense, in
terms of workload and effort requirements;
(4) both rest and a change of task help performance to recover from
decrement, though not when the change task makes major demands
on executive control;
(5) following a period of executive control, there is a resistance to con-
tinue in a high effort mode;
(6) under some conditions, decrements can be observed to occur very
rapidly, within the first minute;
(7) rapid continuous tasks show increasing interruptions in the form of
lapses, preceded by increased slowing and errors, and followed by
faster, more accurate responding.
To accommodate these various observations, the form of the work
curve (performance decrement function) may need to be considered
as a composite of three separate processes, operating in a cascade of
fatigue-driven changes in the relation between the performer and the
task. The first of these I have already identified as habituation, the result
of experiencing closely spaced successive events of a similar type. By
definition, this phase should be less prominent when events are widely
spaced in time or more varied. In many of the earlier studies on rapid

decrement such effects were identified with a loss of initial spurt, rather
than a fatigue-like suppression. The second and third phases are related
to the meaning and value of the task to the performer, and its changing
costs and benefits in relation to alternative goals. Again, the problem
was understood 100 years ago; as Dodge (1917) pointed out:
In mental work we are often distinctly aware of … changes in the intensity
of the inner stimuli that keep us at a disagreeable or monotonous task. Mere
interest in the task may lose its force comparatively early. Then the task is con-
tinued from stubbornness, the dislike to fail, sense of obligation, honor, fear of
ridicule, or hope of reward, etc. All of these may operate in succession. In the
end all of them may lose their force and we say, ‘I do not care what happens,
I cannot go on with this thing any longer to-night.’ There may have been no
important work decrement until the break, as Yoakum calls it. But the process
is none the less a real fatigue if the continuation of work depends on a change
of the stimuli. (p. 102)
I refer to these two later phases as strain and disengagement. In modern
terms, strain involves an attempt to overcome the early loss of attract-
iveness of the task by increased compensatory effort, though the level
of effectiveness may be lower than required and subject to increasing
effort requirements in order to maintain task goals. Disengagement is a
strategy for withdrawing from the commitment to task goals when they
can no longer be adequately realized.
Figure 3.4 shows the three phases of the decrement in schematic form,
as three overlapping decay functions (representative of the many differ-
ent possible levels and slopes of performance changes). The rapid dec-
rement during habituation is replaced by a phase of strain, or effortful
resistance to the fatigue process. Performance is typically stabilized at a
level that is consistent with task goals, with a tendency for impairment
over time with increased strain. If the goal is not sufficiently valued
this phase may not last very long, or be altogether absent. The disen-
gagement phase is also optional, and in the case of highly valued task
goals may not occur at all. Disengagement is triggered by a strategic
decision that maintenance of the goal is no longer tenable in its current
specification. It may be simply too demanding in terms of effort or not
sufficiently rewarding to justify such effort. This does not mean that
the goal is abandoned altogether. As in Figure 3.4, the performance
level may be reset to one that can be maintained with minimal effort.
Disengagement may also mean that the performer accepts a lower level
of performance in return for reduced costs. Tulga and Sheridan (1980)
found that a further increase in task demands sometimes resulted in a
decrease in both performance and subjective workload; as they could
Performance
habituation
strain
disengagement
Time on task
Figure 3.4 Three phases of the work decrement function
no longer meet the task requirements, operators reduced their level of

effort to transform the task into one that was manageable. This is a
common experience in situations where it is not possible to stop the
activity altogether and do something else (for example, being trapped
in commitments to carry out tedious work or laboratory tests). In such
cases the task is usually continued at a lower level of commitment. Of
course, when possibilities of abandonment are available this is often
the preferred option and performance drops to zero, or a mixture of
the two.
One implication of such an analysis is that the typical gradual decline
observed in sustained attention studies (for the group as whole) may,
in some cases, be an artefact of different individual strategies, particu-
larly in terms of strain and disengagement. There is known to be con-
siderable individual variation in goal commitment, with corresponding
impact upon achieved performance (Hollenbeck & Klein, 1987; Locke,
Latham & Erez, 1988). There are also differences in tolerance of effort
(Dornic, Ekehammar & Laaksonen, 1991) and need for cognition
(Cacioppo & Petty, 1982; Cacioppo, Petty, Feinstein & Jarvis, 1996).
Some performers will actually enjoy engaging in effortful activities,
and associate successful performance on the task with greater potential
benefits and lower costs. Others may be more comfortable with a lower
level of aspiration, or experience failure and guilt if they do not main-
tain orientation towards the goal at all times. Such patterns of indi-
vidual variation in decrements with time at work have been known for
many years (see Ackerman, 2011), though I know of no formal analysis
of such data. It would be instructive to do this with one of the many
Summary 85
large data sets that presumably exist in the filing cabinets or SPSS fold-
ers of vigilance researchers. I suspect that a careful, fine-grained ana-
lysis would address some of the issues raised here, and reveal some of
the hypothesized hallmarks of the fatigue management process: mainly
differences in strain (the period of resistance to decrement) and abrupt
changes in level during the post-strain phase, associated with the use of
disengagement strategies.
Summary
Chapter 3 focused on the work–fatigue hypothesis – the long-held view
that fatigue is a direct result of doing work – and concluded that it is only
partially supported by the evidence. First, impairment in continuous
work is routinely observed only under certain conditions, for example
when task events are rapid or highly repetitive, or sustained executive
control is required. Decrement is less likely when task events are var-
ied, or activities are perceived to be interesting, or when they afford
the performer a high level of personal control. Second, the effort of
maintaining task goals, rather than work demands per se, appears to be
the main cause of fatigue. The observed pattern of decrement with con-
tinuous work may be a product of three different processes, and reflect
the fatigue management strategies employed by task performers.
4 Stress, coping and fatigue
Background
The growing sense of effort in prolonged task activity reflects the
increasing strain of maintaining work goals under low control condi-
tions. In this and the next chapter I extend the discussion of fatigue
and performance to address the problem of task management under the
stress imposed by environmental demands. An obvious link between
the two areas is that tasks themselves may be considered to act as stres-
sors (Gaillard, 1993); for example, high levels of workload may generate
anxiety associated with threat to task outcomes or fear of failure from
ineffective coping (Schönpflug, 1983). While the response to environ-
mental stress is essentially an adaptive process, serving to protect the
individual from danger or loss, it may also act as a source of threat and
disruption of ongoing cognitive performance. Chapter 4 examines the
broad issues relating to the ways in which stress and environmental
demands pose problems for the maintenance of task performance, and
the costs and benefits of coping strategies used to address these prob-
lems. Fatigue is identified as a likely outcome of coping failure under
conditions of low control. Chapter 5 takes this further by focusing on
the regulatory control of behaviour under stress, including the role of
effort and control in work management strategies.
Stress, homeostasis and allostatic load

A normal and inevitable characteristic of all environmental change is
that it makes demands upon the stability of the individual’s biological
state, calling into action the regulatory homeostatic mechanisms that
maintain bodily systems within their controlled limits. The same proc-
esses are also designed to provide the body with an emergency response
to stressors (Chrousos, 2009; McEwen, 1998). These are environmen-
tal conditions that are recognized as threatening not only to specific
body processes such as nutrition, ventilation or thermoregulation, but
86
Stress, homeostasis and allostatic load 87
also broad motivational goals such as personal survival or protection of

the young, and which trigger a ‘fight or flight’ reaction via intense sym-
pathetic activation (Cannon, 1929). But which events are stressors? In
many uses of the term, a stressor is defined as an environmental event
or state that triggers a response of the stress system. This leads to cir-
cularity of definition, since stress responses are also commonly defined
as those physiological and behavioural changes that occur in response
to stressors. It is more helpful to identify stressors in terms of their dir-
ect effects, as events that disturb or threaten homeostasis (Chrousos,
2009). However, as such effects are normally hidden from view, and
have little meaning at the psychological level, a more widely accepted
view of stressors is that they are events that are perceived as unpredict-
able and/or uncontrollable (Levine & Ursin, 1991).
Our modern understanding of stress as a major problem comes from
the extensive research of Hans Selye, who built on Cannon’s work, with
studies of responses of rodents to noxious agents, such as cold, hunger,
physical trauma and noxious chemicals. Selye (1936) showed that the
adaptive response of the body may go beyond the immediate needs of
the organism described by Cannon. He described three stages of the
General Adaptation Syndrome (GAS): an alarm reaction, followed by
a period of resistance to the stressor, in which the system may return
to baseline or lead to a third stage, in which continued exposure results
in exhaustion and breakdown of the adaptive response. From a modern
human perspective, such extreme consequences are rare, yet the essence
of the stress response still occurs in the face of pseudo-threats such as
personal conflicts, disappointments and high workloads. We perceive
threats everywhere, but – outside of war (or sport) – we normally have
no need to be fearful, or to fight or run away. This represents a prob-
lem of adaptation for humans, since the extreme physiological response
to stress is no longer appropriate for the low metabolic demands of the
situation (Chrousos, 2009; Sapolsky, 1998). Under conditions of low
control over events, immediate action does not resolve the problem,
and the normally adaptive stress responses may result in organic dam-
age, particularly when extended over time (McEwen, 1998; Romero,
Dickens & Cyr, 2009).
Stress is, therefore, a state in which homeostasis is threatened (or
perceived to be threatened) by environmental conditions that are
unpredictable and uncontrollable, and stabilized through a complex
repertoire of both behavioural and physiological adaptive responses,
including autonomic, hormonal and metabolic systems. Recently, the
concept of allostasis (McEwen, 1998; Sterling & Eyer, 1988) has often
been preferred to distinguish the flexible response to stressors from the
fixed homeostatic regulation of critical systems, such as body tempera-

ture, pH or blood oxygen, in which control occurs within narrow limits.
Allostatic regulation (stability through change) refers specifically to the
more dynamic control systems of the body. These have set points that
can adapt to varying conditions, allowing for behavioural-driven adap-
tation to environmental challenge. For example, blood pressure, heart
rate and blood sugar are consistently lower during sleep and higher
during physical activity than their ‘normal resting level’, and meta-
bolic rate may be lowered when food supply is limited. This is a useful
distinction, though commentators such as Day (2005) have suggested
that it may be illusory; Cannon’s original description of homeostasis
(Cannon, 1929) recognized that only parameters relevant for survival
of cell tissue required strictly controlled conditions, while others would
need to respond to gross changes in demands for activity and environ-
mental adaptation. On this basis, while stress responses involve typic-
ally major changes, they may still be discussed within the broad rubric
of adaptation and homeostasis. However, allostasis emphasizes the flex-
ible, dynamic nature of the response to stress that is characteristic of
human coping. Furthermore, ‘allostatic load’ (McEwen, 1998) is more
descriptive of the ‘wear and tear’ imposed on the body by the cumulative
physiological impact of the adaptive response to changing environmen-
tal circumstances, and of the longer-term physiological consequences
of unresolved stress encounters, argued to be the major cause of work
stress. These may result in sustained autonomic and neuroendocrine
activation, typically accompanied by perseverative cognition and anx-
iety, which help to sustain the stress state (Brosschot, 2010; McEwen &
Wingfield, 2007). In Chapter 8 I discuss a possible mechanism through
which this process may also be implicated in the development of per-
sistent fatigue.
The response to stress

In the discussion of stress in this volume I use the term stress response
to refer not only to the physiological activity elicited by stressors, but
also to behavioural responses (fight or flight, or their modern equiva-
lents: actions triggered by emotions such as anger and fear) and cog-
nitive-emotional responses, such as appraisal and coping strategies.
These may be considered the various controlling variables designed to
restore equilibrium, of both bodily and psychological systems. Within
the context of an analysis of the relationship between stress and fatigue,
my main focus will be on strain, the effortful state of commitment to
task goals that helps maintain them in focal attention. While strain is
often used to mean the physiological response to stress, I shall use it

primarily to refer to a state of maintaining an active coping strategy in
the face of sustained stress or high demands. Fatigue may be consid-
ered to result directly from sustained activity in all stress responses, as
Cameron (1973) has suggested, though strain is proposed here as the
fundamental mechanism through which this occurs. Before looking at
the strain process in detail in Chapter 5, it will be helpful to briefly
review the main features of the stress response, as well as the relation-
ship between stress and emotion.
Adaptive physiological systems

The most obvious characteristic of the physiological stress response
has been assumed to be its generality, that it takes more or less the
same form, irrespective of the prevailing threat conditions. However, it
is now accepted, following Mason (1968, 1971), that the patterning of
stress responses is strongly influenced, not only by the specific config-
uration of environmental demands, but also by the experience and cop-
ing style of the individual and the opportunities for control available to
them (Ursin, 1998). Such a description makes stress appear more like
specific emotional states, such as fear and anger, and it may perhaps be
conceptualized as a generalized form of negative emotion.
Whatever the case, the stress response is aimed at a rapid resolution
of the threat, through the normally adaptive fight or flight response
(Cannon, 1932), though Selye’s later work (Selye, 1936, 1956) showed
that there was also a longer-lasting set of effects that may result in organic
damage under conditions of low environmental control. The core func-
tions of the stress response include the need to mobilize energy quickly
from glucose (as well as from proteins and fats) stored in liver and mus-
cles, to increase metabolic activity (through increased heart rate, blood
pressure and respiration), and to increase the transport efficiency of
nutrients and oxygen. To support these short-term needs of the body,
there is a concomitant inhibition of functions such as growth, digestion
and sex. These changes are executed through coordinated activation of
three systems: the autonomic nervous system (ANS), endocrine system
and immune system. Only the first two are considered here, since they
are more directly relevant to understanding the transactional relation-
ship between stress, coping, fatigue and performance.
The fundamental features of the adaptive response to stressors are
generally considered to involve two main pathways, referred to by Henry
and Stephens (1977) as the sympathetic adrenomedullary (SAM) axis
(Cannon’s ‘fight or flight’ response) and the hypothalamic pituitary
SAM
SNS
Adrenaline
Detection of Adrenal
Noradrenaline
stress event Medulla
via limbic Hypothalamus
system and
cortex Cortisol
Adrenal
CRF Anterior Cortex
Pituitary
ACTH
HPA
Figure 4.1 The two axes of the stress response
adrenocortical (HPA) axis (the focus of Selye’s GAS). A highly sim-

plified summary of the mechanisms that drive these changes is pre-
sented in Figure 4.1, as a prelude to examining stress effects and work
management strategies. When a threat is perceived via limbic and cor-
tical mechanisms, the hypothalamus activates two parallel pathways
(or axes) to provide both fast (seconds) and slow (minutes or hours)
responses to the threat. The fast (SAM) route acts through the sympa-
thetic (branch of the autonomic) nervous system (SNS), which triggers
the adrenal medulla to releases the catecholamines, adrenaline (epi-
nephrine) and noradrenaline (norepinephrine) into the bloodstream,
causing increases in heart rate, blood pressure and ventilation, and
other metabolic changes that prepare the organism for emergency reac-
tion. In the slower (HPA) route, the hypothalamus transmits corticotro-
pin-releasing hormone (CRH) to the anterior pituitary, which releases
adrenocorticotropin hormone (ACTH), which stimulates the increased
production of cortisol and other glucocorticoids from the adrenal cor-
tex. These have a variety of effects, including the breakdown of stored
glycogen from the liver, for use by the brain as glucose, and from fat
stores for use by peripheral muscles. Feedback loops to both pituitary
and hypothalamus help to stabilize the level of cortisol and to damp
down production when the threat has passed.
For our present interest in stress and fatigue, the most relevant infor-
mation is that adrenaline and noradrenaline are typically increased
under task conditions where sustained attention and high effort are
involved, with adrenaline responding more strongly to mental demands
and noradrenaline to physical demands; ACTH and cortisol are gener-
ally observed in situations where controllability is low or stress is contin-
ued for long periods (Henry & Stephens, 1977). The normal experience
of acute fatigue is often assumed to be associated with SAM activation
in short-term stress management, and longer-lasting fatigue more with

HPA activation (Frankenhaeuser, 1986). However, a detailed review
by Sluiter, Frings-Dresen, Meijman and van der Beek (2000) found
that carry-over effects of neuroendocrine activation occurred equally
with the two systems, over post-work periods ranging from an hour
to several days. The discrepancy may partly be related to the fact that
carry-over effects are associated with low control, in which case both
SAM and HPA systems are active. In any case, the sustained stress
from unresolved coping attempts may involve chronically raised levels
of stress mediators, such as cardiovascular responses and glucocortic-
oid secretion, as well as perseverative cognitive states such as worry
and rumination (Brosschot, Gerin & Thayer, 2006). As I mentioned in
relation to allostatic load, such conditions impair the capacity for cop-
ing and have significant costs for normal regulatory functions, such as
tissue repair or immune system activity (Romero et al., 2009).
Psychological stress and coping

Selye’s view of stress has been criticized, notably by Mason (1968,
1971), as focusing too much on stereotyped responses to extreme and
unfamiliar situations, with little opportunity for appraisal and control.
It is now clear that the response to stress (most obviously in humans, but
also in other animals) is mediated by cognitive and emotional processes
(or coping behaviour) which moderate its impact. Henry and Stephens
(1977) identified two general patterns of behavioural adaptation in both
animals and humans: active coping and passive coping. Active coping
is broadly equivalent to Cannon’s emergency reaction, typified by dir-
ect engagement with the threat: fighting and aggression in territorial
animals, confrontation and engagement with the problem in humans.
Passive coping, on the other hand, is associated with withdrawal and low
levels of aggression, or indirect responses such as avoidance and escap-
ism. Coping responses affect not only the outcome of the stress process
but also the detailed patterning of the physiological stress response. I
shall discuss this in the next chapter, but, in brief, active (problem-
focused) coping is associated with sustained SAM axis activity, such
as adrenaline and effort, while passive coping involves HPA activity,
with increased cortisol, anxiety and depressed state (Frankenhaeuser,
1986). Coping patterns are sometimes more complex, however, even
in animals, and whether a person acts directly or indirectly appears to
depend on an appraisal of whether a threat exists and, if so, what can
be done about it. In human coping, the threat is related not only to
physical harm or loss, but to personal goals and commitment to work
tasks. These distinctions have been developed by Lazarus (1966) and

co-workers (e.g., Lazarus & Folkman, 1984) into a transactional the-
ory of coping, in which a cognitive appraisal process precedes choice of
coping activity.
Fatigue and the costs of coping

Lazarus and Folkman (1984) used the term problem-focused coping
to refer to the strategy of directly engaging with threats to goals, and
emotion-focused coping for the indirect strategy of managing the emo-
tional repercussions of failing to deal with the stressor. Active-problem
focused coping is generally more successful in resolving stress-related
problems, since it directly addresses the problem. Passive-emotion
focused coping is usually regarded as less effective since it deals with
the feelings that the stressor arouses, rather than with the problem or
the stressor itself. However, such a view may be too simple. Emotional
expression may be adaptive if it is a response to the emotional state
aroused by the situation itself (rather than to the feelings aroused
by self-criticism or failed coping attempts), and suppression of emo-
tion through self-regulation is costly and fatiguing (Baumeister et al.,
2007). As with the adaptive value of emotions, coping strategies need
to be matched to environmental contexts. Lazarus and Folkman (1984)
and others have acknowledged that coping activity is useful only if it
is appropriate to the prevailing conditions; and these are, in any case,
often changing. An active (problem-focused) strategy can be effect-
ive only if stress encounters are controllable, if something can be done
to resolve the situation. Where this is not the case – as in the extreme
situation of stress associated with irretrievable loss, such as bereave-
ment – an active strategy (to try to get over it, or throw oneself into
one’s work) may be initially counterproductive, and a passive-emotion
focused process of grieving more appropriate. On the other hand, per-
sistence with passive strategies and rumination impedes future adjust-
ment, and needs to be replaced by more active coping at a later stage in
the process (Stroebe & Schut, 2001).
Bereavement is a clear-cut condition, where the appropriateness of
coping may be readily evaluated. In contrast, some problems, particu-
larly involving work or domestic stress, are intrinsically ambiguous.
For example, long-running conflicts at work or in the home normally
require the application of active problem-focused coping, since they
may threaten highly valued personal goals (work success and mari-
tal harmony). But such situations may not be controllable (or control-
lable only some of the time), and the problem cannot be resolved. As
is apparent (Cohen, Evans, Krantz & Stokols, 1986; Frankenhaeuser,

1986; Schönpflug, 1983) active coping is costly, because of the sustained
demand for monitoring the status of threats, and the effortful manage-
ment of appropriate strategies for dealing with them. Similarly, when
work tasks act as stressors (for example, a deadline for a book manu-
script) problem-focused strategies are normally appropriate, but a lack
of adequate controllability means that sustained effort is often needed to
keep task goals in place, and to monitor for potential threats to targeted
outcomes. Under all such circumstances, both active and passive modes
are appropriate. In many cases, if coping activity is effortful, and the
goal relatively unimportant (say, an attempt to book a particular holiday
on an unhelpful website), the goal can be abandoned without much loss.
But important goals – notably work tasks or family priorities – normally
attract continued striving to maintain them. In such cases, as with any
sustained activity under high effort and low control, the persistence of
active coping and its attendant costs provide the foundation for the devel-
opment of fatigue. I will address issues relating to task management and
coping under stress in Chapter 5. First, I briefly review what is known
about the effects of stressors on the performance of mental tasks.
Task performance under stress

A concern with the effects of stress on task performance has a long
history in psychology, driven by both practical and theoretical issues.
However, since the 1970s or so, there have been two major insights that
affect our understanding of how stress affects behaviour: (1) that the
nature of the specific task-stressor combination is a strong determinant
of the nature of stress effects; and (2) that there is also a general prob-
lem of coping with stressors that affects most task performance. The
key to understanding this apparent paradox is alluded to above. While
task goals can be protected by active coping, under extreme stress we
might expect them to be abandoned in favour of activities that help
to directly address the stressor, or towards a concern with changes in
bodily states. Such considerations may also apply to less dramatic stress
encounters such as those experienced in laboratories, suggesting a need
to examine changes in task management strategies, rather than per-
formance alone. In this section I briefly summarize the effects of stres-
sors on performance, showing how the modal stress pattern reflects
both specific and general responses to stress. In the following section I
consider theoretical issues at greater length, and show how an adaptive
regulatory perspective enhances our understanding of the nature of the
problem.
Early research on stress and performance

A common assumption is that performance is inevitably impaired when
tasks have to be carried out in the presence of environmental stressors
or strong emotion. Yet, as with continuous work and high workload
activities, this is not always the case. The approach taken here to under-
standing the effects of stress is the same as that adopted for effects of
fatigue from prolonged or demanding work; it focuses on the general
problem of managing the threat to task goals through adaptive changes
in behaviour. A point that has not generally been recognized is that,
even under normal conditions of sustained work, the development of a
stress state often precedes fatigue, because of the anxiety of meeting task
demands and the performer’s concern with failing performance (Davis,
1948; Lazarus, Deese & Osler, 1952; Schönpflug, 1983), as well as the
increased physiological activation from the effortful engagement neces-
sary to maintain performance under such conditions (Frankenhaeuser,
1986; Hockey, 1997).
It has been known since the earliest studies of distractors such as
noise that stressors rarely have a strong impact on performance. In
general, apart from transient disruption, the extensive early research
on performance of visually based tasks under noise and other ‘distrac-
tors’ (Cassel & Dallenbach, 1918; Morgan, 1916) regularly failed to
show any clear decrements, even, in one study, when marching bands
were introduced into the classroom; for a review of this early work,
see Kryter (1970). Only with the intensive programme of work carried
out in the 1950s and 1960s (notably at the Applied Psychology Unit in
Cambridge, UK) were decrements regularly observed, using stressors
such as noise, sleep deprivation, incentives and drugs. Prolonged work
was also considered a stressor in these studies, and reinforces the point
that fatigue and stress are closely related states.
The success of the Cambridge programme of work in demonstrating
reliable impairment of performance under stress was the direct result
of their developing a range of what Broadbent (1957, 1958) called ‘sen-
sitive tasks’. Broadbent and his colleagues recognized that effects may
be present, but masked or compensated by the built-in redundancy
and strategy options available to the performer (such as working faster
between momentary disruptions); I have already discussed some of
these effects in Chapter 3. They designed tasks that challenged the lim-
its of this regulatory process, for example, by presenting information
very rapidly or in unpredictable locations, without breaks (serial reac-
tion) or making critical events rare and unpredictable (vigilance). The
effects observed were, however, rather subtle, and generally small. For
example, rather than reducing overall response speed, stressors tended

to increase errors or lapses, essentially as Bills (1931) had observed for
prolonged work.
The modal stress pattern

This is not the place for a formal review of effects of stressors on per-
formance; many such reviews have already been carried out (see, for
example, Hancock & Desmond, 2001; Hockey, 1986; Sanders, 1983;
Smith & Jones, 1992; Staal, 2004). These have tended to consider
stressors as having general effects, though an analysis by Hockey
and Hamilton (1983; Hockey, 1984) identified distinctive patterns
of baseline effects associated with stressors. This concluded that
different types of stressors imposed different constraints on under-
lying cognitive processes, assessed in terms of a standard set of per-
formance indicators: speed, accuracy, working memory, selectivity
and alertness. Such patterns may be considered general templates
or profiles of the kinds of information processing problems that are
expected under specific stressors, but in the absence of effective
problem-focused coping. For example, while both noise and sleep
deprivation impair tasks that rely heavily on working memory, they
differ in their effect on the speed–accuracy trade-off; noise tends to
increase errors while sleep loss causes a slowing down of perform-
ance. Tasks that demand a high degree of attentional selectivity are
impaired by sleep deprivation, though not by noise. Both noise and
sleep deprivation have effects that are more pronounced when tasks
involve long periods of work without breaks. Working in hot condi-
tions has widespread effects on most performance indicators, includ-
ing a reduction in both accuracy and speed, and especially where
there is a high executive load; the size of effects are related to the
exposure time and effective temperature.
The most general pattern of decrement is associated with conditions
such as noise, danger, and conditions that give rise to threat or anxiety.
This may be regarded as the modal stress pattern. In addition to a sub-
jective state of high activation (tension, energy, alertness), it involves a
bias towards speed rather than accuracy, reduced effectiveness of work-
ing memory and executive control, and increased selectivity (focus-
ing) of attention. From the point of view of the connection of stress
effects with the development of fatigue, it is of interest that decrements
associated with the modal stress pattern are more common on tasks of
long duration, and generally grow with time on task (Broadbent, 1971;
Hockey & Hamilton, 1983). This is also true of sleep deprivation, but
not of heat, whose effects appear to be relatively steady throughout the

exposure period. In all cases, it has become clear that it is difficult to
separate the direct effects of stressors on underlying processes from
those relating to indirect changes in performance goals or strategies.
An increase in reliance on one kind of process may be the result of
a strategic reduction in the use of another. Because of this, patterns
of stressor effects cannot be discussed without reference to an under-
standing of what the performer is trying to do when carrying out a task:
whether he or she is attempting to maintain task goals by active coping
or concerned more with reducing the impact of the stressor on feelings
and bodily state.
Theoretical perspectives on stress and fatigue

Effects of stressors on performance have often been treated in a largely
atheoretical manner, as practical questions to be addressed. However,
an awareness of the theoretical bases for such effects is relevant to
understanding the mechanisms through which they occur, and of gen-
eralizing to other stressors and contexts.
Distraction and arousal

Traditional treatments of effects of stressors on performance have
usually considered either their specific impact – noise as distraction
or threat, sleep deprivation as causing sleepiness, shift work as dis-
rupting bodily rhythms, time pressure as increasing mental load – or
their common influence on the underlying state of arousal (Broadbent,
1971; Hockey, 1984, 1986). Effects of noise, for example, were origin-
ally assumed to be explicable in terms of their potential for capturing
attention as unwanted physical events (Broadbent, 1957; Kryter, 1970;
Teichner, Arees & Reilly, 1963). A simple distraction view would pre-
dict reduced impairment from habituation with repeated stimulation;
this is what was found in most of the earlier studies, where effects were
generally small and transient (Kryter, 1970). However, the use of more
sensitive tasks, such as vigilance and serial responding, showed that
noise may have larger effects, and also that these typically increased
with time on task (Broadbent, 1971; Hockey, 1986).
Largely because of such findings, and the increasing take-up of general
arousal theory at the time, later views favoured an explanation in terms of
noise and incentives having a direct effect of increasing arousal, while sleep
deprivation reduced it (Broadbent, 1971; Hockey, 1984; Wilkinson, 1962).
Arousal was assumed to be increased through non-specific ascending
activation between the reticular formation and the cortex (Duffy, 1962;
Hebb, 1955; Welford, 1968) and necessary to provide the general energy
or drive of all behaviour. The arousal theory of stressors was highly influ-
ential, and appeared to explain many of the anomalies in the literature,
such as patterns of interaction of combined stressors (Broadbent, 1963).
For example, while noise and sleep loss both impaired performance on
serial responding, noise was found to improve performance under sleep
loss (Corcoran, 1962; Wilkinson, 1963), while incentives (which normally
improved performance) were less effective under noise (Wilkinson, 1961).
Within this framework, fatigue from prolonged work was considered to be
a state of low arousal, equivalent to sleepiness and early times in the wak-
ing day (Broadbent, 1963; Welford, 1968).
Limitations of general arousal

It has been clear for at least 30 years that the theory of general arousal
is too simple to offer anything like an explanation for how stressors
affect behaviour. First, arousal is, itself, a more complex set of proc-
esses than had been previously assumed, with no evidence for the uni-
tary conception required for such an explanation (Gray, 1979; Neiss,
1988; Routtenberg, 1968; Tucker & Williamson, 1984). Second, there
is no direct evidence for the widely claimed inverted-U hypothesis that
is the basis of theorizing about stress and performance. In particular,
there is no direct support for validity of over-arousal as an explanation
of impairment, and even less for the grossly misapplied Yerkes-Dodson
law (Hancock & Ganey, 2003; Hanoch & Vitouch, 2004; Hockey, 2008;
Neiss, 1988). In any case, as Hanoch and Vitouch argue, there is no rea-
son why emotional arousal should function as a general-purpose drive
process. Far more likely, as evolutionary theorists such as Nesse (1990)
and Tooby and Cosmides (1990) point out, is that emotions operate to
provide special purpose responses for specific problems. This is not to
insist on a high degree of specificity, but modern theory on emotion
and affective arousal agrees that at least two dimensions or states are
required. These issues are discussed later in the chapter.
Easterbrook (1959) provided an influential account of the effects
of over-arousal in terms of decreasing range of attention to the envi-
ronment. However, Näätänen (1973) and others (Hanoch & Vitouch,
2004; Hockey, 1979; Hockey & Hamilton, 1983; Neiss, 1988, 1990;
Teigen, 1994) have argued that such effects are more straightfor-
wardly explained by reference to increasing distraction, not from
physical aspects of stressors, but from their appraisal as threats, with
attendant emotional and cognitive events such as anxiety, unwanted
thoughts and awareness of bodily responses. Neiss (1988) has pointed

out that the inverted-U hypothesis is essentially irrefutable, because
of the impossibility of defining arousal levels independently of per-
formance outcomes, and the fundamental circularity of interpretation
that it entails. A third problem with arousal concerns the separation
of the intensity aspect of the state from more specific motivational or
goal-oriented issues. In terms of general arousal, noise is assumed to
be equivalent to caffeine, physical danger or incentives, since they all
increase arousal. I would suggest that a simple thought experiment is
sufficient to question the usefulness of such an idea. While it is (just)
conceivable that these very different conditions do have something
in common, corresponding to a general increase in brain activation,
their impact on behaviour is determined far more by the motivational
and emotional changes they produce; in the case of the last two, the
difference is extreme: to escape, or to become more engaged with
task goals.
Many of these limitations of arousal were recognized in Broadbent’s
(1971) monograph Decision and stress, which presented a thorough inte-
gration of effects of stressors on performance. Broadbent also referred
to specific problems that did not fit the simple theory, such as the fact
that noise and sleep loss appeared to be opposites, in that they tend
to counteract each other, but were similar in that both effects occur
later in the work period. Broadbent’s solution, almost at the end of the
book (pp. 440–447), was to propose a simple two-level model of per-
formance. In this, a higher level acted as an executive controller (main-
taining stability of performance) for activity in the lower level, which
was concerned with the execution of familiar, skilled responses. What
he considered arousal-related effects, such as those of noise, sleepless-
ness and incentives – perhaps more appropriately considered in terms
of the modal stress state – were assumed to act at the lower level; how-
ever, they were argued to affect performance only if functioning of the
upper level was impaired. Fatigue, on the other hand, assumed to be
induced by prolonged work, and also by depressants such as alcohol,
was conceptualized as a loss of control of the upper system. This meant
that noise and sleep loss would have their effects only when fatigue had
taken its toll on the effectiveness of executive control, which typically
occurred later in the work period. Broadbent was careful not to make
any strong claims for the physiological basis for his model. However, as
I shall show in Chapter 6, there is now a considerable amount of neuro-
psychological and neuroscience evidence for a distinction between top-
down executive control processes and bottom-up effects of emotion,
stress and fatigue.
Stress and emotion as distractors

The position taken in this volume is broadly consistent with Broadbent’s
(1971) conceptualization; fatigue is considered to reflect a compromise
of upper level control, and direct effects of stressors to have their effect
at the lower level. However, rather than influencing arousal, stressors are
best characterized by their distracting effect (as defined above), at least
when task goals need to be maintained. The idea of stressors as gener-
ally distracting is not meant to imply that they do not have any specific
effects on performance. Indeed, as the modal stress pattern indicates,
individual stressors inflict specific threats on cognitive functioning.
However, knowledge of the physical or cognitive threat that specific
stressors pose for our bodies and brains is rarely sufficient to allow us to
predict what will happen to task performance. This is because all such
effects, when they are experienced and felt as threatening, are subject to
overriding executive control and choice of coping strategy.
While a dimensional framework for emotional arousal is useful for
understanding general states such as moods and feelings, the spe-
cific state view (e.g., Cosmides & Tooby, 2000; Frijda, 1988; Hanoch
& Vitouch, 2004; Izard, 2009) may be more relevant whenever strong
emotions are aroused. Such states are better considered not as variants
of a general-purpose arousal mechanism, but as separate dedicated sets
of changes designed to solve specific problems: resolving a dispute at
work; dealing with a house fire; finding a lost child. From an evolution-
ary psychology perspective (Cosmides & Tooby, 2000; Nesse, 1990)
emotions are considered to operate as high level programmes, directing
activities of the organism on the basis of current environmental and
goal contexts. This means that the effort to carry out an activity (and
the pattern of stress coping exhibited) will reflect its relevance for the
situation identified by the emotion; fear makes it harder to respond to
threat by fighting, while anger makes it easier. On the other hand, the
details of the emotion matter less in terms of its effects on task perform-
ance, and the general distraction view still holds. More effort will be
required to maintain task goals under any emotional state, at any level;
as long as the goals of this state are incompatible with those of the task a
compensatory (high effort) strategy will be required to override them.
As I have already indicated, this is a different type of distraction to
that discussed at the beginning of the previous section (in the case of
noise, for example, the loud sound that cannot be ignored); such effects
do indeed habituate, and their disruptive potential recede. The source
of the distraction from emotional states and stressors is their widespread
threat implications. Although these vary, depending on the emotional
state induced by the situation, they are assumed to have a common

effect of diverting attention away from the ongoing task, which has to
compete not only with the intrusive effects of the physiological and emo-
tional impact of the stressor – anxiety from potential harm, thoughts
about the possible origins of the noise and what it may signify, aware-
ness of a disturbed autonomic state – but also the additional execu-
tive activity required to manage these changes. For example, Eysenck’s
attention control theory of anxiety (Eysenck & Calvo, 1992; Eysenck &
Derakshan, 2011) argues that anxiety impairs the efficiency of execu-
tive activity, so that increased processing effort is required to maintain
performance.
The general arousal framework fails to consider the transactional
nature of the relationship between stressors and individual goals. When
people carry out work under stress, they are not normally entirely at
the mercy of the prevailing conditions, with performance changes sim-
ply reflecting whether arousal increases or decreases; instead, they are
active participants in a transactional process. Rather than responding
reactively to whatever changes are imposed on them, they evaluate the
nature of the threat and their options for dealing with it; this may result
in either a reduced level of performance or a less adequate response to
the stressor, though the maintenance of a sustained high effort (strain)
state will increase the feeling of fatigue. Of course, such problems occur
only when tasks have to be carried out that are nothing to do with the
stressor. When this is not the case, stressors can be dealt with directly,
and the task becomes one of dealing with the stressor; reconciliation
can be attempted; flames extinguished; a search process implemented.
On a more prosaic level, noise can be turned off or avoided, and sleep
loss can be remedied by going to bed.
Emotional states and feelings

I suggested earlier that stress and emotion may not be readily distin-
guished from each other, and that feelings of stress may be regarded as
a generalized form of negative emotional states such as fear and anger,
or generalized negative affect (NA). In some ways, this is not saying
much, since fear and anger are clearly an integral part of the emergency
(flight or fight) response to environmental threats. In a more positive
way, however, as Lazarus (2006) has argued, identifying stress with
emotion has the advantage in drawing together two sets of issues that,
although closely related conceptually, have come to be treated separ-
ately. Lazarus makes the point that most emotions (not only strong
negative ones) have the potential to produce stressful responses, both
physiological (increased adrenaline, heart rate and blood pressure) and
Emotional states and feelings 101
psychological (threat, anxiety and distraction); furthermore, stress

states often give rise to specific emotional patterns, not only anger and
fear but more complex feelings such as jealousy, guilt and sadness.
Emotions and affective states are also assumed to be mediated through
appraisal coping, and, like stress, must be regarded as a potential threat
for ongoing cognitive activity (Eysenck, 1979; Mandler, 1975; Oatley &
Johnson-Laird, 1990; Taylor, 1991).
Specific emotions and general feelings

In broad terms, all emotional regulation and expression is associated
with the operation of the limbic system (Derryberry & Tucker, 1992),
but what constitutes a distinctive emotion or a feeling is problematic.
On the one hand, it is claimed (e.g., LeDoux, 2000; Panskepp, 2007)
that a number of basic emotional states (such as fear, anger and disgust)
are identifiable in terms of distinctive brain circuitry and as having quite
specific goals (though recent meta-analyses by Murphy, Nimmo-Smith
and Lawrence (2003) and Phan, Wager, Taylor and Liberzon (2002)
show little agreement in localization of basic emotions, apart from a
correspondence between amygdala and fear). On the other hand, while
at a detailed neuronal level some specificity may be evident, there also
appears to be a clustering of emotional states across a wide range of
everyday experience; anger, fear and sadness tend to occur together, as
do affection, pride and joy (Barrett, 2006). This has suggested the exist-
ence of two underlying emotion systems, corresponding to positive and
negative affective states, leading to the idea that broad emotional qual-
ities and moods may be better described in terms of their relative posi-
tions on two affective dimensions. As already mentioned in Chapter 1,
these have been identified as either valence (positive-negative feelings)
and intensity/arousal (Barrett, 2006; Russell & Barrett, 1999), or posi-
tive and negative affect (Watson & Tellegen, 1985; Watson, Wiese,
Vaidya & Tellegen, 1999). Both dimensional theories provide a good fit
to the data, though I would argue that the positive and negative affect
(PA/NA) framework provides clearer insights into changes experienced
under stress and emotion. Positive affect (PA) corresponds to a state of
elation and mental vigour, and low levels to depressed or fatigued feel-
ings. Negative affect (NA) refers to anxiety and anger, and low levels to
the baseline calm, relaxed state.
The adaptive value of feelings

The PA/NA framework also maps well onto the widely acknowledged
distinction in motivation and emotion between a positive/approach/
reward seeking system and a negative/avoidance/punishment avoidance

system. Achievement motivation theory (Atkinson & Birch, 1970) dis-
tinguishes between the separate motives to achieve success and to avoid
failure, while Gray’s (1990) two-process theory of motivational con-
trol includes, in addition to an emergency SAM-like response, separate
systems for approach and avoidance. A behavioural approach system
(BAS) is argued to mediate responses to positive, reward situations,
while a behavioural inhibitory system (BIS) inhibits responses to nega-
tive, low reward or punishing situations. In both of these approach-
avoidance frameworks, changes in PA may readily be seen as a corollary
of reward seeking or approach behaviour, while NA maps well onto
behaviour motivated by avoiding failure.
But do these feelings have a function? Are they a part of the apparatus
that the organism uses for controlling behaviour, or just a by-product
of the motivational processes at work? There is a strongly emerging
view that emotions, feelings and moods provide intrinsic information
about the status of bodily and mental states (Carver, 2003; Frijda, 1988;
Gaylin, 1979; Higgins, 2006; Morsella, 2005; Schwartz, 2011). For
example, Frijda (1988, p. 354) states that ‘emotions exist for the sake of
signalling states of the world that have to be responded to, or that they
no longer need response and action’. I would also argue that feelings
have a functional role in guiding behaviour. It is now recognized that
they may provide information, for example about the relation between
current actions and goals (Carver & Scheier, 1990) or the costs and
benefits of alternative decisions (Higgins, 2006). Carver (2003) expli-
citly links the experience of high levels of PA with effective progress
towards approach goals and NA with poor progress towards avoidance
goals. Such considerations apply not only to strong emotions such as
fear and anger, but also to less intense states such as moods, and – of
more immediate relevance – feelings such as effort and fatigue.
Fatigue as an emotion
The suggestion of fatigue as an emotion may be explored further.
Carver (2003) argues that the encouraging effect of positive feelings
allows for a pulling back of effort (‘coasting’ behaviour), so that other
desired activities may come into consideration as goals. The argument
put forward here and developed further in Chapter 6 makes a similar
claim – but from the opposite end of the PA dimension – that fatigue
(and its precursor, effort) reflect increasing control difficulty of an
activity, associated with its falling utility, or ratio of benefits to costs,
and encourages reappraisal of behavioural direction. The difference
Fatigue as an emotion 103
between the effects of high and low PA is that high PA allows additional
goals to be considered because the task is being managed with ease,
while low PA (if we can think of fatigue in this way) forces a change of
actions to be considered because the current goal is proving difficult
to manage. Fatigue has properties that overlap with low levels of PA
(Hockey et al., 2000), so may be considered (along with feelings of sad-
ness or depression) to be a marker of poor goal progress.
While this is an interesting idea, I would suggest that fatigue has a
different, more fundamental, function. Rather than simply indicating
dissatisfaction with progress, it serves the function of preventing fix-
ation on low reward or costly activities: goals that have little intrinsic
value for the individual. This view of fatigue that I have been moving
towards over the course of the chapter is, of course, highly consistent
with the evolutionary psychology perspective. Fatigue, as with emo-
tional states such as fear and anger, basic drive states such as hunger
and sex, and generalized mood states such as NA and PA, may be con-
sidered to serve an adaptive function (Cosmides & Tooby, 2000; Nesse,
1990; Öhman, 1987; Tooby & Cosmides, 1990), with its roots in earl-
ier evolutionary advantages. While anxiety may be experienced as an
unpleasant state, we can readily agree that it also has a positive func-
tion in alerting the individual to potential threats that may interrupt
ongoing cognitive activity (Eysenck, 1979; Oatley & Johnson-Laird,
1990; Öhman, Flykt & Esteves, 2001).
There is almost no discussion of fatigue per se within theories that
emphasize the adaptive functions of emotion. One way of thinking about
it is as a kind of low level or generalized form of depression. Low mood
states in general are thought to function as a mechanism for annulling
the commitment to unrewarding goals and encouraging disengagement
from them (Carver & Scheier, 1990; Klinger, 1975), allowing for the
pursuit of alternative (more attainable or rewarding) goals. Klinger also
makes the point that, while the end result (rest or change) has a gener-
ally positive feeling, the aversive disengagement process itself (the low
mood state) may be necessary to prevent failure (of goal attainment and
persistence) from becoming an attractive option for behavioural plan-
ning. Conceptualizing fatigue as a low level of positive affect allows
an alignment with Gray’s two-process theory of motivational control,
and suggests that it has a function of encouraging withdrawal from
an approach bias towards current actions. Meijman and his colleagues
(e.g., Meijman, 2000; van der Linden, 2011) have referred to fatigue as
the ‘stop emotion’, in recognition of its role in interrupting and reset-
ting motivational direction. The form of disengagement is less dramatic
than that observed for depression, or for the specific attention-attracting
effects of anxiety, but may be considered more widely applicable. Fatigue

may act as a general uncoupling device, interrupting attention to any
activities felt to be unrewarding, and making the individual aware of
opportunities to pursue alternative, more rewarding, goals.
On balance, then, I believe that it is realistic to think of fatigue itself
as an emotion, albeit one with a highly generalized function. The idea
seems odd, I think, only because fatigue is devoid of the strong feelings
and facial expression that define canonical emotional states. However,
the feeling is a universally distinctive one, and we recognize that some-
one can look and feel tired. In fact, fatigue can be shown to have most
of the standard characteristics of emotion. From an evolutionary per-
spective, Nesse (1990) argued that emotions may be conceptualized as
specialized adaptive mechanisms, serving to increase the capability of
managing threats and opportunities imposed by the environment. They
also have a motivational function, initiating specific kinds of actions
that serve specific goals. The way I have characterized fatigue fits well
with this description. I propose that fatigue has evolved to serve a very
general and invaluable function: to alert the organism to both the costs
of persisting with effortful, unrewarding activities and the benefits of
engaging with more rewarding ones, and thus maintain effective motiv-
ational equilibrium. Indeed, although it is almost never mentioned as
any kind of emotion at all, fatigue may even be considered as a mem-
ber of the exalted class of what are known as ‘basic emotions’. These
are assumed to be universal, selected through evolutionary pressure,
and biologically primitive (e.g., Ortony & Turner, 1990). In addition,
according to Izard (2007):
A basic emotion may be viewed as a set of neural, bodily/expressive, and feel-
ing/motivational components generated rapidly, automatically, and noncon-
sciously when ongoing affective-cognitive processes interact with the sensing
or perception of an ecologically valid stimulus to activate evolutionarily adapted
neurobiological and mental processes. (pp. 261–262)
All of these features are consistent with the view of fatigue presented
here. Fatigue is readily interpreted as a basic solution to a very primi-
tive problem: how to maintain a motivational equilibrium between the
complementary goals of exploiting current activities and exploring new
ones. It does this by interrupting ongoing behaviour whenever its utility
is perceived as falling below those of competing tendencies. In fact, the
only question mark that I can put on the fatigue-as-emotion checklist
is that it does not have a clearly defined neural basis. But this is not
surprising, as no one appears to have carried out any direct research on
the problem; furthermore, as I discuss in Chapter 6, there are a number
Summary 105
of promising candidates for this role. A recent review by Kurzban et al.

(in press) refers to the adaptive function of perceived effort in this way,
providing a signal of opportunity costs, or the loss of benefits from not
engaging in other available activities. Such information is known to be
used to influence behavioural direction through a network of neural
processes based on the prefrontal cortex, anterior cingulate cortex and
basal ganglia (e.g., Aston-Jones & Cohen, 2005; Bush, Luu & Posner,
2000; Salamone, Correa, Farrar & Mingote, 2007). At the neuronal
level it may not even be necessary to distinguish fatigue from its precur-
sor (effort) or from related feelings states (boredom, discomfort, frus-
tration), since they are all assumed to be part of the fatigue process and
of the general interruption mechanism.
This idea of fatigue as having an adaptive role in task management is
central to most of what follows in this volume. At this stage it does not
matter much whether fatigue is regarded as a basic emotion with highly
distinctive patterning and behavioural effects, or a low level of general-
ized positive affect. But it is argued to be an active functional state – a
reaction to the current dynamics of behaviour – rather than simply a
passive feeling that reflects aversive effects of work. In Chapter 3, I sug-
gested that the fatigue process may begin very early in task engagement,
with habituation and rapid decline in performance in high intensity
activities. In subjective terms, such events are associated with only a
vague sense of cognitive discomfort, while strong feelings of what we
recognize more readily as the conscious experience of fatigue become
evident only at a later stage. I do not see any contradiction in this. The
same is true of the phenomenology of anxiety, in which the process of
alerting the individual to threat often starts as a similar vague feeling
of unease, and only later grows to a definable conscious state of worry
and distraction. I suggest that the strength of both kinds of feeling grow
with continued failure to act on the information they provide. In the
case of fatigue, the full-blown subjective state is argued to result from
the protracted maintenance of the strain state: the increasing attempt
to maintain low utility goals through effort.
Summary
Chapter 4 discussed the general relationships between stress, coping
and fatigue, and how a consideration of goal management strategies is
necessary in order to interpret effects of stressors on both work perform-
ance and fatigue. Stressors may threaten the integrity of performance
because they distract attention away from current goals and towards
the source of the stress. Fatigue was discussed as an emotional state,
serving to disengage attention from current goals, and allow opportun-

ities for changes of motivational direction. The feeling of fatigue only
becomes strong when the signal for change is overridden by effort. Such
effects are likely to be stronger in the presence of stressors because of
the additional need to cope with the changed environmental conditions.
The requirement to maintain work goals (or any other cognitive plan)
under stress effectively means having to take on additional demands
associated with the requirement to manage the stressor.
5 Effort, strain and fatigue
Background
Chapter 5 considers the fatigue process in relation to effort manage-
ment in the problem of maintaining task goals. The engagement of a
high effort state is not an automatic response to the stressor, but the
result of an active decision-making process, informed by an appraisal of
environmental and emotional demands as a threat to the current abil-
ity to maintain task goals (Frankenhaeuser, 1986; Hockey & Hamilton,
1983; Schönpflug, 1983). I have sometimes used the term ‘operator
functional state’ (or OFS) to refer to the broader system characteristics
of the human operator in this context (e.g., Hockey, 2005). This rec-
ognizes that performance under environmental threat can be under-
stood only by considering not only task measures, but also the broader
adaptive capability of the individual, including their motivational pri-
orities, current strain commitments, and capacity for effort. The focus
of the theoretical perspective taken here is that effective work or task
performance requires people to make decisions about how and when
to manage their motivational state. What are their priorities for tasks
and other goals? How willing (and able) are they to make a sustained
effort to maintain required performance standards under difficult
circumstances?
A systems perspective on performance

decrement
The central problem in the treatment of fatigue adopted here is to
understand what happens to selected task goals, and in particular to
understand the nature of decrement. Sometimes, prolonged work,
high demands and stress cause impairment; in other situations, tasks
are executed effectively. But what determines the outcome? And what
roles do other aspects of the human-environment system play?
107
Assessing the costs of task management: effectiveness

and efficiency
The essence of the problem of assessing decrement is that the perform-
ance of the task itself (the primary goal-directed behaviour) provides
only partial information about the underlying state of the computa-
tional mechanisms underlying performance. Specifically, the capability
of an operator to carry out a task cannot be inferred solely from whether
or not performance is impaired, since the apparent stability of perform-
ance may mask genuine problems of task management.
Most human performance testing is based on the assessment of a
limited range of overt responses to highly specified externally imposed
goals. Unlike, say, assessment of the performance of a chemical plant,
or a railway or an office, it does not typically assume a broader interest
with the competence of the overall system or with the auxiliary factors
that help determine the effectiveness of end-point actions; neither is it
explicitly concerned with the relation of the task goals to the individ-
ual’s motivational priorities – whether he or she actually wants to do this
work, and what else they might rather be doing. Whereas it is routine
practice – even essential – to consider the physical energy used in meet-
ing industrial output targets, or the environmental and maintenance
costs of a modified transport system, analysis of human performance is
rarely concerned with the cognitive, emotional and psychophysiological
costs of maintaining overt task criteria.
Adoption of a systems thinking perspective means taking into
account not only the overt outputs of task performance but also
other system components involved in its production. This enables
us to make a distinction between the system’s effectiveness and effi-
ciency (Eysenck & Calvo, 1992; Hockey, 1997; Schönpflug, 1983).
These terms are often misused in accounts of human performance.
Effectiveness (or productivity) refers to how well goals are accom-
plished, while efficiency takes account of the costs of achieving these
goals. Efficiency is a major requirement for industrial processes;
they need to be productive, but also to maintain costs within accept-
able limits. The same is surely true of human activity, though by far
the majority of studies that use performance methods to assess the
effects of tasks are concerned only with effectiveness – with how well
specific output targets are achieved – and rarely with efficiency: the
costs to the system as a whole in achieving these outputs. When a task
requires more effort, or a performer is already tired, performance
may be equally effective but less efficient, since the costs of attaining
a given performance level are greater. This is particularly relevant
when comparing conditions in which primary task performance does

not differ, since it implies that success in maintaining the required
standard is achieved at the expense of disruption to other (currently
less important) processes. I have referred to these spillover effects as
latent decrements, since they reflect hidden costs of regulatory con-
trol. While not currently evident in overt behaviour of the system,
they may nevertheless impose constraints on adaptive responses in
the face of further demands.
Goal competition in task performance

A related problem in the analysis and interpretation of decrements con-
cerns the logic of performance testing. The researcher measures per-
formance to test whether a specific manipulation has a hypothesized
effect on cognitive function. But testing methods assume an unusual
level of compliance and commitment on the part of the performer. From
his or her perspective, the task represents an externally imposed (and
usually highly specific) goal, requiring them to direct behaviour towards
the achievement of specified target outputs and to maintain this goal
state over the duration of the session; a similar point has been made
by others (Duncan, 1990; Hancock, Desmond & Matthews, 2012;
Kurzban et al., in press). This means maintaining task goals in mem-
ory, selectively attending to task information, avoiding distraction from
other potential (often more personally relevant) goals, and suppressing
affective responses such as frustration and boredom, or the urge to yield
to the growth of fatigue feelings. It is clear that the performer often fails
to do this, becoming distracted, losing task motivation, or just deciding
that other goals are more attractive. How are such changes to be under-
stood in terms of the investigator’s research question? What inferences
can be made about the operation of underlying mental processes, even if
the predicted decrement occurs?
One problem may be that, in this kind of use of testing methodology,
cognitive psychologists have partly lost sight of the essential motivational
context of behaviour, that the individual’s behaviour with respect to an
assigned cognitive (task) goal needs to be considered in relation to his or
her broader motivational repertoire. This is the conflict between decid-
ing to try to maintain a current goal or change to a new one: to stay or to
shift. As I have indicated, my own approach to work decrement is based
on the assumption that all task goals are vulnerable to disruption by
other (more compatible, or attractive, or compelling) activities, so need
to be actively maintained in the face of competition. The inevitable
conflict between goal contentions means that the task goal always has to
compete for control of action (as is widely acknowledged: for example,

Desimone & Duncan, 1995; Shallice & Burgess, 1996; Simon, 1967).
Varieties of goal: have to, want to and need to

The focus of this discussion is on task goals, though, as I have argued,
these have a somewhat specialized status within human behaviour.
Tasks may be conceptualized as activities that have to be carried out,
through a sense of duty, contractual obligation or mutual agreement.
I treat tasks as the default (cognitive) goal state in my analysis of stress
and fatigue, since the maintenance of task goals in the face of a grow-
ing need for effortful control is argued to be the primary source of the
experience of fatigue. However, for the purposes of this discussion, I
need to make a distinction between tasks and two other kinds of activity
that may promote goal competition and assume control of action; I refer
to these as personal goals and somatic (bodily or emotional) goals.
In one sense, of course, all goals may be regarded as cognitive goals,
since they involve a mental representation of a desired state or outcome
to guide action sequences, even essentially physical activities such as
running in the woods or building a wall. Nevertheless, the distinction is
a useful way of highlighting the motivational origins of different kinds
of activity. In contrast to the have to nature of tasks, personal goals are
activities or thoughts that people choose or want to engage with: plan-
ning a trip for the coming weekend, meeting a friend in town for lunch,
or being outside the laboratory and enjoying the unexpected sunshine.
Whereas task goals are typically driven by extrinsic motivation, such
as pay or tangible short-term rewards, personal goals are motivated
by their intrinsic incentive value for the individual, or by long-term
reward contingencies such as professional advancement or the benefits
of friendship. They are relevant to the individual’s short- or long-term
intrinsic motivational priorities, concerned with the pursuit of mean-
ingful, desired activities, and integrated into the developed motiv-
ational structure of the individual. This makes them easier to maintain
in focal attention when selected, and more likely to act as distractors
when other goals are in place. The distinctions are not always clear-
cut. Sheldon and Elliot (1998) pointed out that some personal goals feel
more like tasks since they are adopted out of a sense of duty or guilt,
rather than anticipated pleasure (practising the piano to please your
mother; joining a gym to get fit and lose weight; attending a depart-
mental seminar because you feel you ought to), so do not readily attract
commitment or attainment (or, I would add, much competitiveness as
goal contenders).
Personal goals, because of their compatibility with the individual’s

motivational priorities, are often pursued without conscious control,
and may be experienced as occurrences of mind wandering or task unre-
lated thoughts (McVay & Kane, 2010; Smallwood & Schooler, 2006),
which can break through into awareness and momentarily dislodge cur-
rent task goals. They may also be considered more specifically as current
concerns (Klinger, 1975, 2009), or repetitive thoughts (Watkins, 2008).
These are, in effect, personal goals that have been set up but remain
unresolved: a long-term plan for personal improvement; an overdue job
application; a promise to visit a relative in hospital; a pending exam-
ination result. Because of their motivational status, current concerns
remain accessible until either completed or abandoned, and, since they
may be activated by other thoughts or by environmental cues, are also
regular contenders for the control of attention. However, while all per-
sonal goals may be regarded as being of the want to type, some current
concerns may be highly disruptive. For example, they may be unrealistic
or unattainable, so unable to be terminated satisfactorily, or the result of
unsuccessful coping with stress (Brosschot et al., 2006; Watkins, 2008):
wishing you had done something differently; failing to meet a deadline;
ruminating about health symptoms; failing to resolve a conflict at work.
Such cognitive perseveration (Brosschot et al., 2006) is associated not
only with unwanted distraction but also with a sustained stress response,
which may provide a route for stress-related disease and, as I suggest in
Chapter 8, play a role in the development of chronic fatigue.
In contrast to both tasks and personal goals, somatic (or emotional)
goals are neither demanded of, nor normally desired by, the individual.
Rather, they are consequences of the ongoing environmental interac-
tions that maintain the equilibrium and optimal states of bodily func-
tions. Before becoming cognitive representations, somatic goals are
experienced as bodily feelings or emotions, and only achieve goal status
when they become target states for the direction of behaviour designed
to meet the needs of such states. They may be referred to as need to
goals, since they are driven by seemingly urgent motivational or emo-
tional demands – for eating, drinking, sex, waste elimination – but also,
perhaps, by milder needs, such as for change or rest or sleep, or an urge
to sit in the sun. Somatic goals may also be activated by external envir-
onmental events. These may be stressors such as loud noises that orient
the individual towards possible danger, or social interactions that pro-
voke stress-induced feelings of worry or anger, or they may be environ-
mental cues that trigger bodily states, such as hunger or sex feelings.
The distraction potential of somatic goals is considerable. Such activ-
ities are often sustained by powerful neurobiological events (Cannon,
1932; Izard, 2009; Taylor, 1991), and their potency in capturing attention
and overriding cognitive control (Cosmides & Tooby, 2000; Damasio,
1994, 2003; Frijda, 1988; Metcalfe & Mischel, 1999; Öhman et al.,
2001; Vuilleumier, 2005) reflects their status as markers of fundamen-
tal emotional or motivational significance. A similar argument has been
put forward in a different context by Pessoa (2009) to account for the
tendency for motivational and emotional goals to intrude on executive
processing. The adaptive value attached to personal and somatic goals
means that they readily compete for access to attention and the control
of behaviour. In contrast, task goals are typically transient, arbitrary
and context-specific, and, as such, need to be maintained actively.
The vulnerability of task goals

The message from the previous section is that task goals are highly vul-
nerable to disruption by personal and somatic competitors. Yet, as this
chapter will make clear, human performance can be extraordinarily
resistant to disruption. Kahneman (1970) pointed out that attentional
selectivity is highly effective over a wide range of demanding condi-
tions. In the context of the default expectation of decrements with time
on task, distractors and stressors, and the hypothesized conflict with
other goals, this statement seems surprising. However, it has long been
known that cognitive goals stand up well to external threats (Broadbent,
1971; Hockey, 1997; Kahneman, 1970). How is this achieved?
One possibility is that the vulnerability of cognitive goals is, para-
doxically, the basis of their (normally) effective control. Maintaining
have to goals requires effortful resistance against the threat of loss or
displacement, through active coupling of the goal with the selective
attention mechanism. Particularly in the case of novel goals, tasks need
to engage executive control processes, which operate by effecting a bias
towards the goal; this locks it into a cycle of refreshing goal activa-
tion whenever it becomes weakened or threatened by competing goals
(Miller & Cohen, 2001; Sakai, 2008; Sarter, Givens & Bruno, 2001)
or environmental stressors (Broadbent, 1971; Hockey, 1997). Such
intensity of effortful control is not without its costs, and the feeling of
effort (leading to fatigue). There is a growing body of evidence indi-
cating that effort may be considered a general marker of the costs of
maintaining selectivity, and that effortful activity is avoided as a default
strategy (see Kool et al., 2010; Kurniawan, Guitart-Masip & Dolan,
2011; Kurzban et al., in press). Only when this selective bias is relin-
quished (as a result of fatigue or strategic change of attentional focus)
or breached (by intrusive events or thoughts) does the vulnerability of
Protection of performance under stress 113
the cognitive goal become evident. I will argue that whether or not this
occurs is, ultimately, a strategic issue, based on an evaluation of the rel-
ative benefits and costs of competing activities. Maintaining a specific
cognitive goal means necessarily suppressing all others (investigating
novel environmental events, attending to emerging thoughts, acknowl-
edging a need for sleep or rest). Such active protection is effortful, and
places increasing demands on the executive mechanisms that serve to
maintain goals.
Protection of performance under stress:

effort, strain and fatigue
The modal stress pattern described in Chapter 4 provides a summary
of the underlying changes in information processing that help deter-
mine how tasks are carried out under stress. However, such effects are
by no means automatic. Modern treatments of psychological stress
and performance emphasize the cognitive transactions that mediate
between the occurrence of stressful events and the adaptive response to
them (Hancock & Warm, 1989; Hockey, 1997; Matthews, 2001). This
appraisal process evaluates the implications of the stressor for both cur-
rent goals and personal wellbeing, and what strategies are appropri-
ate for managing both the stressor and any ongoing activity. One of
the most important such choices is whether to protect performance by
increasing effort in support of task goals, or to neglect them in order to
more effectively combat the stressor and its impact. This latter strategy
will be more effective in reducing the effects on bodily or emotional
states, but inevitably lead to a decrement in performance. Performance
protection appears to be the usual response in everyday situations where
the individual is highly skilled, the task sufficiently important, and the
stressor familiar and manageable (workshop noise, non-specific wor-
ries, performance evaluation procedures). Serious disruption is rare for
high-priority activities and is usually associated with traumatic events.
Direct effects of stress on task performance have, as with effects of
prolonged and intense work, been difficult to demonstrate (Hockey,
1997); impairment is common only where there is little active resistance
to performance breakdown. However, this does not mean that there
is no impact on performance of high demands, or that job design and
healthcare should no longer be concerned with such problems. On the
contrary, theoretical and methodological shortcomings have disguised
the nature and extent of these performance decrements. Such effects
are mainly of an indirect nature; because an active attempt to man-
age performance involves sustained effort, successful task coping often
carries a deferred cost to emotional stability and wellbeing. High strain

work situations require individuals to maintain their commitment to
high cognitive demands in the absence of adequate levels of control.
This typically leads to tiredness, and may also have longer-term effects,
such as the carry-over of fatigue from one day to the next.
In general, evidence from studies of performance under high work
demands and stress offers strong support to Kahneman’s (1970) claims
for the effectiveness of attentional selectivity. I have argued elsewhere
(Hockey, 1993, 1997, 2005) that this is because performance is pro-
tected through the operation of a compensatory control process which
functions to maintain primary goals in focal attention. Such an approach
is not a new way of conceptualizing the nature of performance decre-
ment. Compensatory mechanisms were implied by very early attempts
to explain the scarcity of direct effects of work fatigue on task perform-
ance (Dodge, 1917; Thorndike, 1912), and the control models were made
explicit by the application of cybernetics to human behaviour (Powers,
1973; Wiener, 1948). The compensatory principle has been widely
adopted because of its natural fit with theories of self-regulation and
motivation control (e.g., Bandura, 1996; Carver & Scheier, 1982; Frese
& Sabini, 1985; Hyland, 1988; Karoly, 1993), as well as work motivation
(Edwards, 1992; Klein, 1989; Lord & Levy, 1994), stress (Cummings
& Cooper, 1979; McGrath, 1976; Teichner, 1968), and cognitive models
of sequential behaviour and action (e.g., Broadbent, 1971; Kahneman,
1973; Miller, Galanter & Pribram, 1960; Norman & Shallice, 1986).
In the next chapter, I shall develop an explicit motivational control
model of fatigue, in which the costs of performance maintenance have a
central role. My earlier theorizing on compensatory regulation (Hockey,
1993, 1997) was informed by the analysis of stress effects carried out by
Teichner (1966, 1968). Teichner (1966) proposed a compensatory con-
trol process that helped maintain performance targets within normal
limits under abnormal work conditions. For example, individuals typ-
ically adopted a sub-maximum level of work intensity, so could increase
effort where necessary to meet increased demands; they were also able
to use alternative strategies for task completion under stress, for example
allowing an increased focus on central task requirements, with reduced
attention to peripheral events. Teichner (1968) illustrated his argument
with reference to homeostatic regulation of variables such as core body
temperature. For example, in response to heat stress of 40oC the crit-
ical variable of body temperature remains relatively constant, suggesting
(to a casual researcher) that such a temperature does not act as a stres-
sor for the body. However, as in all control systems, the target state (or
controlled variable; in this case, core temperature) is maintained within
narrow limits by regulatory (or controlling) mechanisms, while marked

changes (costs) are observable in the variables that reflect this compen-
satory activity. Core temperature is maintained under heat stress, but
only at the cost of changes in these indirect indicators of stress: increased
levels of sweating, skin temperature and peripheral blood flow.
We clearly would not wish to conclude that heat stress had no effect on
the body simply because rectal temperature showed no change. Indeed,
the changes in the values of controlling variables, if large and persist-
ent, may indicate that continued exposure to extreme conditions may
cause the control process to break down and core temperature to move
outside its set point limits. Equally, as discussed earlier in this chapter,
we should be wary of concluding that there are no effects of stressors
on performance, just because primary task activities are observed to be
more or less within normal limits. By analogy with body temperature,
while there may be no measurable effect on the primary task, there may
be a number of indirect indicators of the problems of cognitive control
under these conditions.
Indirect effects of stressors on performance

There is now considerable evidence of these (normally hidden) second-
ary effects of performance protection on a range of changes, relating to
the costs of managing task goals under stress. In previous publications
(Hockey, 1997, 2003, 2005) I have referred to these by the term latent
degradation. This is because they are evidence of changes that imply an
effective reduction in the safe working margins of the adaptive control
system; primary performance may be on the verge of breaking down,
and may do so if new demands emerge, or if effort is difficult to main-
tain at this level. The four general types of indirect effects of stressors
include two that are directly relevant to performance (secondary task
decrements and strategy changes) and two that reflect the costs of the
control activity itself (psychophysiological activation, including sub-
jective state changes, and fatigue after-effects). These should not be
considered mutually independent. For example, strategy changes are
always likely to be involved in decisions to protect some aspects of the
task and neglect others. Rather, they emphasize different broad charac-
teristics of the different types of threat.
Secondary task decrements

As we have already seen in Chapter 3, decrements in secondary aspects
of performance are the most common effect of high workload. Primary
tasks are normally protected against breakdown, and effects on second-

ary tasks are taken to imply the increased difficulty of maintaining an
effective response to the primary task under increasing load (Wickens
& Hollands, 2000). Such effects have been studied less systematically in
assessing indirect threats from environmental stressors, although they
show the same patterns of decrement. Finkelman and Glass (1970)
found that intermittent noise impaired performance on a subsidiary
digit recall task, but not on the primary task. Using a simulated cabin
air management system (CAMS), Hockey, Wastell and Sauer (1998)
found no effect of sleep deprivation on primary control performance,
but impaired performance on two subsidiary tasks (responding to
alarms, and checking system values). One of the most reliable findings
of secondary task impairment under stress is that of increased selectiv-
ity (attentional narrowing), most clearly observed in spatially complex
tasks. For example, Hockey (1970) found no impairment of a central
pursuit tracking task under noise, but detection of signals in the vis-
ual peripheral was impaired. Similar attentional narrowing has been
found under both laboratory and field conditions and for a wide range
of environmental conditions, including noise, heat, anxiety associated
with deep sea diving, and threat of shock (Baddeley, 1972; Broadbent,
1971; Hockey, 1979).
Strategy changes
A second type of indirect effect on performance is a change in the way
that participants configure the task, with the goal of making it easier
to manage under stress. By providing multiple options for decision-
making and timing of actions, a high level of control allows the task to
be carried out effectively with little loss of efficiency (Hockey, Briner,
Tattersall & Wiethoff, 1989), though shortcuts may be necessary in less
favourable situations. Bainbridge (1974) was among the first to observe
that operators in complex tasks often adapted the way they managed the
work, depending on prevailing demands and available control options.
Reducing commitment to secondary activities in order to protect the
primary task may be considered one such change, though it was specific
enough to be considered separately. For example, during periods of sud-
den heavy demand, experienced industrial process operators may shift
from their familiar open-loop (predictive) mode to one of closed loop
control (Bainbridge, 1974; Umbers, 1979). Open loop control demands
a high level of executive involvement as sequences of actions are guided
mainly under the control of the operator’s internal mental model and
knowledge of system behaviour, whereas a closed loop strategy allows
actions to be carried out one at a time, making use of feedback from

the display. Such a strategy change may fail to optimise the process (for
example, because feedback control is slower), but it may reduce the risk
of serious error.
A well-known example of this is Sperandio’s (1978) analysis of the
workload management strategies adopted by French air-traffic control-
lers. Under low workload conditions they were observed to adopt an
individual plane-by-plane technique for dealing with aircraft contacts;
however, when workload exceeded a comfortable level, they switched
from individual routing instructions to a fixed procedure for all con-
tacts (for example, by the use of holding patterns). By minimizing the
demands for planning and aircraft management, they reduced the need
to involve the vulnerable executive and working memory systems. The
strategy change is adaptive in that secondary goals such as airport
schedules and passenger comfort are compromised in the service of the
primary goal of safety.
Despite their obvious diagnostic value, such effects have not been
systematically studied in research on effects of environmental stressors.
This may be partly because of the tendency to employ relatively simple
task environments, where strategy options are limited. In complex task
situations, however, such effects have been commonly reported, often
taking the form of reduced dependence on working memory and execu-
tive control. Schönpflug and his colleagues (e.g., Schönpflug, 1983;
Schulz & Schönpflug, 1982) examined effects of noise and time pres-
sure on simulated stock management tasks. Participants typically held
relevant information about stock holdings and unit prices in memory
while making decisions, but, under noise or time pressure, made more
frequent checks of databases containing this information. Reducing
their reliance on working memory under stress helped them minim-
ize decision errors, though the task took longer to carry out. Again,
the change is adaptive because accuracy matters more than speed in
such work. However, in situations in which speed is also important, the
hidden loss of efficiency represents a genuine stress-induced impair-
ment. A specific example of this is the finding by Steinhauser, Maier
and Hübner (2007) that a stress state induced by a demanding IQ test
prevents participants from shifting strategies adequately during task
switching sequences.
Sometimes, changes in strategy, while adaptive in the short term, can
be seen to increase overall risk. In the CAMS study mentioned above
(Hockey et al., 1998), operators controlled the system almost as well
when sleep-deprived as when they had slept normally. However, they
did this by spending less time on monitoring system parameters (which
helps in the prediction of developing problems), instead waiting until

alarms had occurred before carrying out manual interventions. While
such a reactive strategy works reasonably well for simple failures, opera-
tors would not have the necessary understanding of the system state to
be able to rectify unfamiliar faults.
Psychophysiological activation
One of the most reliable costs of the use of increased effort to pro-
tect performance is the observation of increased levels of activation
(Frankenhaeuser, 1986; Hockey, 1997; Kramer, 1991). These may be
thought of as stress-related side-effects of the compensatory behav-
iour that helps to maintain primary performance under threat from
environmental conditions. The most common changes involve the
physiological systems that are activated by the SAM and HPA stress
responses (sympathetic dominance in the ANS, neuroendocrine hor-
monal responses, and musculoskeletal activity). Such effects are typ-
ically accompanied by changes in subjective reports of emotional and
mood states reflecting the affective response to sustained coping effort,
and by the level of effort and control experienced by participants. An
early example is a study by Wilkinson (1961) in which impairment of
arithmetic computation following a night without sleep was found to be
smaller for participants who had a response of increased muscle tension;
this may be taken as evidence for effort having a compensatory effect
in combating sleepiness and maintaining orientation towards the task.
Peters et al. (1998) showed that effort was accompanied by activation of
the SAM pattern (increased heart rate, blood pressure and adrenaline),
while a low control condition was associated with both SAM and HPA
responses, notably increased cortisol and noradrenaline (also observed
by Frankenhaeuser, 1986).
Within this framework, the patterns of specific decrement outlined
earlier may be considered a baseline or default pattern of decrement
under different stressors: how performance might be expected to suffer
in the absence of compensatory control activity. The performance-cost
trade-off is seen more clearly in several studies of noise effects; these
have shown increases in heart rate, blood pressure, adrenaline and sub-
jective effort in tasks where performance has been maintained under
noise, but not otherwise (Carter & Beh, 1989; Tafalla & Evans, 1997;
Veldman, 1992). The clearest example of such effects is a pair of studies
carried out on the effects of noise on an arithmetic task. Frankenhaeuser
and Lundberg (1974) found that performance was unimpaired by
noise, although adrenaline and reported stress were both increased.
In contrast, a later study (Frankenhaeuser & Lundberg, 1977) showed

performance to be increasingly impaired by higher levels of noise, but
no corresponding change in the adrenaline response. These findings
were confirmed in all essential details by Tafalla and Evans (1997), with
effort manipulated directly by the provision of feedback motivation.
They found that arithmetic performance was impaired by noise only
under the low effort condition, with no change in noradrenaline, while,
under high effort, effective performance in noise was accompanied by
increased noradrenaline.
Two of the most sensitive markers of increased effort have been
found to be heart rate variability and frontal midline theta. As part of
the stress response, the management of high workload and stressors
gives rise to a defence reaction of the cardiovascular system, causing
an increase in blood pressure and heart rate (HR). It also results in
a decrease of heart rate variability (HRV) and diminished effective-
ness of the baroreflex, which normally exercises homeostatic control
over blood pressure (Mulder & Mulder, 1981). HRV has been found
to be suppressed under high workload in many studies, including avi-
ation (Tattersall & Hockey, 1995; Veltman & Gaillard, 1998) and driv-
ing (Aasman, Wijers, Mulder & Mulder, 1988; Meijman, Mulder, van
Dormolen & Cremer, 1992), even though performance may not show
major decrement. A second promising indicator of effort or task engage-
ment is frontal midline theta (EEG frequencies of 4–8 Hz). Although
theta is more typically a sign of drowsiness, when measured at frontal
midline sites it is strongly associated with executive control activity
and increased use of working memory (Fairclough & Venables, 2004;
Gevins & Smith, 2003; Scerbo, Freeman & Mikulka, 2003; Schacter,
1977). In our own studies using CAMS, observations of maintained
performance during progressive increases in manual control load are
accompanied by both HRV suppression and increases in frontal mid-
line theta (Hockey, Nickel, Roberts & Roberts, 2009).
The most satisfactory explanation of these (and other similar) findings
is that increased workload and stressors such as noise imposes an add-
itional burden on our ability to maintain adequate orientation towards
task goals. If we (decide to) make an additional effort under stress we
may be able to protect the task from disruption, although only at the
cost of increased regulatory strain. Alternatively, we may be unwilling
(or unable) to make such an effort, in which case performance is likely
to suffer but we will experience less strain. Such trade-offs are the rou-
tine consequences of having to manage stress and other environmental
demands while maintaining our commitments to external task goals.
This idea has long been recognized as central to an understanding of
the reasons for performance changes. Brehm and Self (1989) reviewed
work showing that motivational intensity (how hard individuals strived
to achieve a goal) was determined not only by the intrinsic value of the
goal but by the subjective costs of achieving it. Wright et al. (2007)
showed that fatigue induced increased blood pressure in response to
new task challenges only when anticipated outcomes were valued and
achievable.
Such effects illustrate the role of compensatory regulation in the pro-
tection of performance and may be seen as a trade-off between the pro-
tection of the primary performance goal and the level of mental effort
that has to be invested in the task. They also indicate that the regulation
of effort is at least partially under the control of the individual rather
than being driven by task or environmental conditions.
Fatigue after-effects
As I mentioned in Chapter 3, fatigue after-effects reveal compromised
performance and other strategic changes on probe tasks administered
after loading tasks have been completed. After-effects have been studied
comparatively little, and generally within a traditional workload–fatigue
paradigm, though they have been found to provide a more sensitive
index of fatigue impact than primary task decrement (Broadbent, 1979;
Cohen, 1980; Glass & Singer, 1972; Holding, 1983). For example, Smit
et al. (2004) found an increased decrement on a vigilance task after par-
ticipants had spent the previous 70 minutes carrying out a demanding
(intelligence test) loading task.
Many studies of after-effects have used versions of real-life tasks,
where effort is an option, rather than a fixed requirement as in most
laboratory situations. Given a choice of options, fatigued individuals
adopt less effortful strategies to solve a problem, and seek less infor-
mation before making a decision. For example, Cohen and Spacapan
(1978) found that both time spent working on insoluble puzzles and
amount of helping behaviour was reduced after a sustained (30-minute)
rapid multiple choice reaction task, compared to a slower version of
the task. Webster, Richter and Kruglanski (1996) showed that par-
ticipants fatigued from a two-hour academic examination made much
less use of available information in making social judgements. In our
own work (Hockey & Earle, 2006) we found a similar effect to that of
Webster et al. (1996) from two hours of simulated office work, with
more fatigued participants taking more short cuts in reaching deci-
sions about travel plans. In this case, however, the effects of workload
were moderated by control. Participants who were able to determine
their own work schedule showed greatly reduced effects on both fatigue
from work and its after-effects. Of course, such real-life tasks are also
dependent on executive processing. They rely on being able to maintain
goals in memory while updating information, making multiple compar-
isons and evaluating alternative decisions. Cohen (1980) showed that
such effects occur across a variety of task conditions, including not only
demanding work but also uncontrollable or unpredictable stress.
The strongest modern evidence for after-effects of fatigue comes from
recent research by Baumeister and his colleagues on what is known as
the ‘ego depletion’ paradigm (e.g., Baumeister et al., 2007; Baumeister,
Bratslavsky, Muraven & Tice, 1998; Baumeister, Muraven & Tice,
2000), which was developed to study the demands of self-regulatory
activity, known to make severe demands on executive function. In a
typical study, participants are required to carry out some act of self-
control (for example, suppressing emotional responses to an upsetting
film, or eating radishes rather than chocolates), then tested on subse-
quent probe tasks also requiring self-control. Strong after-effects are
typically reported, in which performance on the probe task is impaired
relative to controls. A recent meta-analysis (Hagger et al., 2010) con-
firms the robustness of the ego depletion effect across many different
types of self-regulatory activity and task combinations. After-effects of
self-regulation have been found both on performance of the probe task
itself, and also on a wide range of other outcome variables, including
reported effort, fatigue and mood (Hagger et al., 2010). There are also
reported reductions in blood glucose under ego depletion conditions
(e.g., Gailliot, 2008); I shall return to these findings when discussing
energy explanations of fatigue in Chapter 7.
Baumeister and his colleagues have interpreted the findings as show-
ing that such self-control acts, which require the suppression of natural
responses, deplete a limited resource of energy, which prevents their
being used effectively on the probe task. They have adopted an energy
or strength model, in which regulatory control is likened to a muscle,
losing strength with repeated use. However, since motivational instruc-
tions (to try harder on the probe task) can be shown to overcome the
hypothesized deficit (Muraven & Slessereva, 2003), this kind of account
appears over-simplified. Instead, the demonstrated effects seem more
like those found in the broader performance/fatigue and task control lit-
eratures. As commentators such as Robinson, Schmeichel and Inzlicht
(2010) have argued, all such results are better understood in terms of
motivational control factors, which determine the level of top-down
control and effort exerted by prefrontal and anterior cingulate execu-
tive mechanisms (Sarter et al., 2006). Rather than revealing a severe
constraint on energy supply, the after-effects on the probe task may

reflect a motivational limitation: an unwillingness to continue with
the use of aversive effortful strategies (which make further demands
on executive control). This interpretation is supported by related mod-
erating effects, showing that impairment on the probe task is affected
both by the level of anticipated demands (Muraven, Shmueli & Burkley,
2006) and the relevance of the depleting task for personal goals (Moller,
Deci & Ryan, 2006; Muraven, Gagné & Rosman, 2008). Impairment of
the probe task is reduced when participants expect a low-demand con-
trol task to follow, or, for example, if the act of resisting cookies is per-
ceived as a natural aspect of a dietary strategy. In defence of the energy/
muscle position, Muraven et al. (2008) nevertheless attribute these lat-
ter findings to motivated self-control being energizing, and thus com-
bating effects of ego depletion. But there is nothing here to combat; for
personally motivated participants the depletion task is something they
prefer to do – a want to activity – and, in terms of the present discussion,
not fatiguing simply because it does not demand effort.
The interpretation of the general nature of the after-effect of fatigue
as a problem of executive control is strengthened by the many results
showing that routine tasks are not affected, even when continued for
very long periods. For example, Chiles (1955) reported no reliable
impairment on pursuit tracking from fatigue induced by up to two days’
continuous work on a flight simulator, including prolonged sleep depriv-
ation. The most likely explanation for this is that participants were able
to overcome their state momentarily by increasing their level of add-
itional effort. Unless specific measurements are made it is not possible
to detect this compensatory activity. When there is no choice, and the
task is considered important by the participants, no effect of fatigue (or
stress) may be discernible. One of the problems in interpreting such
effects, as Holding (1983) has pointed out, is that participants are nor-
mally able to compensate for the impact of fatigue and sleep deprivation
by maintaining an increased effort response to the challenge of the new
test, especially when they are brief. Broadbent (1971) argued that tasks
such as vigilance may be more sensitive to stressor effects because they
do not allow participants to predict when they will need to be attentive.
Holding and his colleagues showed that tired participants provided with
alternative ways of carrying out the post-work test were more likely to
choose a low effort strategy, even though it may entail an increased risk
of error.
These findings have been confirmed in laboratory studies of simulated
work (Hockey & Earle, 2006; Schellekens, Sijtsma, Vegter & Meijman,
2000). Hockey and Earle found reduced persistence on an informa-
tion search task after two hours of office work under time pressure and
effort, though only for participants required to work under conditions

of low control during the normal task session (being made to follow a
particular task schedule, as opposed to choosing their own). They have
also been shown to reflect fatigue in practical work contexts, with after-
effects of more demanding work days in driving examiners (Meijman,
Mulder, Dormolen & Cremer, 1992) and bus drivers (Aasman, Wijers,
Mulder & Mulder, 1988). The study of after-effects of fatigue reveals
it to be a state in which there is a shift towards preferring activities
requiring less effort or less involvement of working memory and execu-
tive control. The moderating effect of control is evident in these effects.
I have already mentioned that Hockey and Earle found such an effect
for demanding office work, and many such effects have been demon-
strated since the influential work of Glass and Singer (1972). They
showed after-effects of noise on the Stroop test and proofreading, but
only when noise was perceived to be uncontrollable; when participants
believed that they could reduce the level of noise if they wished, no such
effects were observed.
A major review by Cohen (1980) summarizes a large number of
after-effects of stressors – noise, threat of shock, crowding and social
stress – and concludes they are more common when stressors are
either uncontrollable or unpredictable, but also simply when a high
effort response is demanded. The link between stress and fatigue is a
very strong one. Along with Cohen (1980), I would argue that fatigue
is a result of the demands of active coping, particularly under reduced
control conditions. The effort requirements of actively managing
stress in order to protect performance goals results in an extended
use of executive control, which continues as long as the stressor poses
a threat. When the stressor is no longer present, a period of low effort
engagement is implemented as a default state, allowing recovery.
Strain and fatigue at work

The impact of jobs on wellbeing and long-term health has been a cen-
tral concern for occupational psychology for many years, and there
have been many extensive reviews of the literature. In discussing this
material here, my main purpose is to highlight the key roles of effort
and control in the development of strain.
Work strain
The work psychology literature has long recognized the role that
human interpretation and coping play in managing the impact of work
demands, not only on performance and fatigue, but also more generally
on strain, wellbeing and health (e.g., Hackman & Oldham, 1976;

Karasek, 1979; McGrath, 1976; Siegrist, 1996). The most influential
and widely applied framework has been Karasek’s demands-control
model (Karasek, 1979), or the modified demands-control-support
(DCS) model of Karasek and Theorell (1990). This emphasizes the
moderating influence of work resources (personal control and sup-
port) on the demands-strain linkage. Extensive research based on this
approach (e.g., Frese 1989; Ganster, 1989; Wall, Jackson, Mullarkey &
Parker, 1996) has demonstrated not only that high levels of demands
in the workplace can give rise to chronic effects on health and well-
being, but that these may be mitigated by high levels of controllabil-
ity. Van Yperen and Hagedoorn (2003) showed that the same pattern
also occurred for fatigue (based on Karasek’s exhaustion scale). Similar
observations have been accounted for within the main alternative
model of work stress, Siegrist’s (1996) effort-reward imbalance (ERI)
framework, which identifies the agent of strain as the lack of adequate
rewards for invested effort. Again, there is abundant empirical support
for the model; see review by Van Vegchel et al. (2005).
The moderating effect of control in these examples has typically
been inferred from questionnaire studies of naturally occurring work,
though such effects are also evident in controlled laboratory studies.
The Hockey and Earle (2006) study referred to earlier is a rare example
of an experimental study of simulated office work, in which workload
was manipulated by time pressure and controllability by opportunities
for individual task scheduling. Hockey and Earle found that a range
of fatigue-related effects of work (both performance decrements and
reported fatigue) were all stronger under high workload, but only when
control over work flow was low (participants being made to follow a
particular task schedule, as opposed to being able to choose their own).
The low control group also showed an after-effect of fatigue from high
workload, in terms of reduced persistence on an additional task requir-
ing a search for information, though again only when they had worked
under conditions of low control during the normal work period.
It is not appropriate to decide between these two influential models
of work strain. Some commentators (e.g., Bakker & Demerouti, 2007)
have asked why they are so narrow in conception; why is control (or
autonomy) not relevant within an ERI approach? Or effort (rather than
demands) recognized as the focus of workload? What about the role of
specific demands or social relationships? It seems to me that, while the
two models have much in common, even though they also have a differ-
ent focus, DCS identifies the key factors in the work environment itself,
while ERI emphasizes their meaning for the employee in relationship to
their job. First, the high demands of DCS are functionally related to the
high effort of ERI; as I have argued in several places, effort – rather than
demands – is the trigger for strain and fatigue. Second, the low control
of DCS has much in common with the perception of low rewards; while
high control jobs offer the opportunity for intrinsic rewards, those that
are low in control depend more on extrinsic rewards. Of course, dif-
ferent jobs may generate rather different reasons for work strain and
ill-health, just as different personal lives do. I assume for the purposes
of this analysis, however, that a sustained strain response underlies the
development of long-term stress, fatigue and ill-health. The major fac-
tors in this are effort and control.
The major problems with work stress and fatigue are associated
with what Karasek (1979) defines as high strain jobs: those with high
demands and low controllability, or, within Siegrist’s (1996) ERI frame-
work, high levels of effort coupled with low rewards. Strain-related
effects are often transient, but may also build up over many years. For
example, a recent carefully conducted set of studies by Marmot and his
group (e.g., Chandola, Brunner & Marmot, 2006; Marmot, Bosma,
Hemingway, Brunner & Stansfeld, 1997) provides convincing evidence
of a causal link over a 14-year period between sustained high strain
work and the development of metabolic syndrome (high levels of vari-
ous cardiovascular risk indicators). Major effects of strain such as car-
diovascular disease are not a central topic for this book. However, the
role of chronic strain in wellbeing is clearly relevant to the development
of fatigue-related illnesses, such as burnout and chronic fatigue syn-
drome. In addition, while high strain may not always lead to serious
health problems, it is likely to play a major role in disturbances of motiv-
ation and the integrity of work–life balance. These issues are discussed
further in Chapter 8.
In the context of the present volume, I will consider work stress in a
more restricted sense, as a condition in which goals are perceived to be
threatened by environmental or task demands, and strain is the result
of attempts to maintain these goals. This applies not only to work tasks,
but to longer-term aspirations and strivings, such as the fulfilment of
work-related personal goals and career ambitions. As I have mentioned
before, strain is not an inevitable consequence of stress, since goals may
be abandoned or trimmed to manageable levels without incurring major
costs. In terms of affective responses, anxiety is common to all stress
experiences, since it reflects the sensing of the threat (to oneself or to
one’s goals). However, fatigue would only be expected to play a signifi-
cant part when strain is present; that is, fatigue results from an effortful
attempt to maintain goals under low control conditions.
Laboratory versus real-life stress

The patterns of latent degradation outlined earlier are indicative of the
general tendency for performance of primary task goals to be protected
under stress. But, of course, such protection is not always implemented;
we have seen ample evidence of performance decrement in both the
present chapter and the previous one. As I have previously mentioned,
clear decrements under stress are more common in laboratory studies
than in real-life work situations (Hockey, 1997). The reasons for this
do not appear to have been formally addressed, although differences
in skill level and motivation are likely to be important. Laboratory
tasks are generally less well learned, and provide the performer with
goals that are essentially transient, arbitrary and trivial. Participants
are encouraged to work as fast as possible or without making errors
(or both) for the duration of the task. Under stress, or when additional
demands are imposed, work may deteriorate as they withdraw from
the strict task requirements, in order to minimize effort or attend to
stress-related goals. By contrast, work goals are well learned and highly
familiar. They help to define us individually within the organization,
and are likely to be personally meaningful and long lasting. As such,
they encourage commitment to the maintenance of a high standard
of execution. They are also often implemented in the public domain,
which makes them subject to peer evaluation and feedback. All these
factors help to protect real-life work activities under stress or heavy
environmental demand.
There is also another major difference: the expected level of effort
employed to drive the task. Surprisingly, there is hardly any direct evi-
dence on this. Analyses of task motivation show that on-task effort is
moderated by individual perceptions of demands and skill level, as well
as by how much task goals are valued and the likelihood of success
(Brehm & Self, 1989; Meyer & Hallermann, 1977). For the most part,
real work tasks are expected to be carried out well within the capacity
of individuals. They are therefore more stable, and more readily main-
tained by an increase in effort when necessary, in response to a per-
ceived threat to a performance goal. In practical work contexts, the
maintenance of effort over long periods, or under stress, is expected to
be more readily manageable because of well-established strategies for
carrying out the required work; individuals learn how much effort is
appropriate to be able to maintain a comfortable pace of work. Finally,
since work tasks are well practised, more strategies are available for
responding to disturbances and new demands, and more options avail-
able about how to manage performance change.
The above discussion reads as if all jobs are the same; but, of course,
there are many important differences between them. Not all work is
meaningful or important, and likely to be protected under stress. Below,
I discuss some of the issues relating to these concerns that have been
identified by the occupational stress literature; in particular, the rele-
vance of work demands, effort and control. A specific problem concerns
the stress associated with jobs where any loss of performance causes
widespread problems. In these – the safety-critical industries, hospitals,
public transport, and others – any significant shortfall in performance
may have serious consequences, and must be prevented if possible. In
such cases, the motivational constraints of the work context strongly
drive the maintenance of task goals, and of sustained effort; whatever
problems are encountered, employees cannot entertain the option of
reducing their rate of work or taking breaks as long as the problem
persists. Clearly, in some jobs at least, performance is maintained only
under strain, and may be subject to the indirect effects discussed earl-
ier. Furthermore, when strain is a regular feature of the job, it may give
rise to physiological stress responses and health problems.
Modes of work management

From the foregoing discussion, it is clear that the theory of fatigue based
on the management of work demands must account also for the influ-
ence of effort and controllability. The particular outcome of any work
experience is likely to depend on the compatibility of task requirements
with available control opportunities and the individual’s goal commit-
ment, or effort. In practice, mismatches appear to be the rule, which is
why work is generally not the preferred way for most people to spend
their day. What is clear, however, is that different modes of work man-
agement may be identified, based on different strategies for managing
demanding work under high or low control, and mapping onto active
and passive coping modes.
In a series of studies carried out during the 1970s and 1980s,
Frankenhaeuser (1986) and her group (Frankenhaeuser, Lundberg
& Forsman, 1980; Lundberg & Forsman, 1979; Lundberg &
Frankenhaeuser, 1980) identified three modes of adaptive response to
choice reaction and vigilance tasks. These are summarized in Table
5.1, along with some additional features derived from Hockey’s (1997)
analysis of goal-management modes. A major feature of this is the sepa-
ration of effort from other affective responses, in order to emphasize its
pivotal role in the patterning of the adaptive response, as a marker for the
orientation of the individual towards task goals. I have also interpreted
Table 5.1 Modes of work management
Coping Subjective Stress

Mode strategy Control Effort Performance state markers*
Strain proactive → low high high anxiety + A↑, Co↑

reactive fatigue
Disengaged reactive low low low anxiety Co↑
Engaged proactive high moderate optimal flow A↑, Co↓
*A = adrenaline, Co = cortisol, ↑ = increase, ↓ = decrease.
distress and pleasure in terms of affective dimensions related more spe-

cifically to anxiety and fatigue.
Table 5.1 also shows my preferred set of terms for the three work
management modes (or coping strategies). These are not meant to be
exact matches, since they refer to somewhat different configurations
of demands and control, though they address the same broad distinc-
tions. As an alternative to Frankenhaeuser’s ‘effort with distress’, I have
used the term strain (as throughout this volume) to refer to the use of
a high effort strategy to attempt to overcome disruption of task goals
in the absence of control; for ‘distress without effort’ I use the term
disengaged, referring to the (partial) relinquishing of task goals under
low control; and, instead of ‘effort without distress’ I propose the term
engaged (for the same reason, in this case to emphasize the strong coup-
ling between goals and actions). In addition, I have indicated how these
may map onto a more traditional active-passive classification of coping,
preferring the terms adopted by Koolhaas et al. (1999) of proactive (for
active) and reactive (for passive). Proactive coping more effectively cap-
tures the important features of planning and prevention that character-
ize the engaged work mode, while reactive coping is a more apt term for
the disengaged mode; it is not passive in the sense of being unresponsive
or helpless, but a strategic choice. The strain mode is best thought of as
including both strategies, changing from an initial proactive strategy to
one of reactive as the requirement for effortful control increases.
Strain. Strain (effort with distress) involves a sustained attempt to
maintain performance under low control conditions. The high effort
strategy generates feelings of both anxiety and fatigue, and a stress
response that usually includes both neuroendocrine axes: SAM (adren-
aline) and HPA (cortisol). This is probably the most studied of the three
modes, since it represents the typical response in standard laboratory
tasks. These have confirmed the general pattern in a range of situations
where effort and control have been independently manipulated. The

combination of high effort and low control has been found to include
increased sympathetic activation, including respiration and blood pres-
sure, reduced heart rate variability and increases in both adrenaline
and cortisol (Backs & Seljos, 1994; Frankenhaeuser, 1986; Jorna, 1992;
Mulder, 1986; Peters et al., 1998; Tafalla & Evans, 1997).
Disengaged. The second mode, disengaged (Frankenhaeuser’s dis-
tress without effort), is characterized by a low effort strategy under low
control, typically resulting in reduced engagement with task goals and
the acceptance of a lower standard of performance. This means that
fatigue is not a typical consequence of this work mode, though anx-
iety and depression may be increased through a concern with task fail-
ure (Ahrens & Abramson, 1991). In neuroendocrine terms, the stress
response is dominated by the HPA axis, with an increase in cortisol,
but not adrenaline. The reduced commitment to work goals may be
achieved by reducing required levels of accuracy or speed, by adopt-
ing strategies which make less of a demand on limited resources such
as working memory, or by neglecting secondary activities. In some
cases, individuals may disengage completely from task goals, especially
when an attempt at direct coping has little effect (Schulz & Schönpflug,
1982). This would be unusual (though not unheard of) in work con-
texts, though it is a common adaptive response in optional activities
(such as home tasks or hobbies). In Chapter 8, I suggest that a switch
from the strain mode to one of disengagement may underlie the loss of
motivational control in chronic fatigue.
Engaged. A third pattern is particularly interesting from the point
of view of a theory of fatigue. This is an engaged mode of work under
high control that Frankenhaeuser referred to as effort without dis-
tress. Under these conditions a strategy of moderately high effort is
accompanied by increased adrenaline and often a reduction of corti-
sol to below baseline levels. In addition, both anxiety and fatigue are
absent, and operators typically report feelings of increased energy and
alertness. Under high control the use of the term active coping may be
considered as misleading, since stressors tend to be, by definition, low
control events (Mason, 1975), and coping is therefore not required at
all. However, it may have general value as a label for any strategy based
on active engagement with current goals, although it may be experi-
enced in terms of a positive challenge, rather than as a problem to solve
(Dienstbier, 1989). In very high control conditions (for example, when
activities are self-selected and managed), effort without distress may be
regarded as approaching the flow state identified by Czikszentmihalyi
(1977, 1990), when skills can be exercised without constraint to meet a
challenge, through a combination of clear goals, intrinsic feedback, and

a good fit between challenges and skills. This is close to the character-
istics identified by Hackman and Oldham (1976) as central to effective
work motivation and job satisfaction. Although effort is not normally
a part of the description of flow, this may be an artefact of differences
in the two methods used to obtain the data. While Czikszentmihalyi’s
participants may not have spontaneously described their experiences as
effortful, they may nevertheless have rated their effort as high if asked
to do so. In this sense effort has a similar meaning to that of engage-
ment, involvement or commitment.
All three patterns have also been identified as variations within the
day-to-day experiences of the same individuals. Hockey, Payne and
Rick (1996) assessed daily levels of a range of demands, control, feel-
ings and neuroendocrine responses over a six-week period in two junior
hospital doctors (interns). Using canonical correlation analysis, they
found evidence for two adaptive modes within each of the two indi-
viduals, though different combinations for each. Under enabling work
conditions (high control and demands on medical knowledge and skills,
rather than general hospital duties), both showed the engaged pattern,
with high loadings on effort, energy (reduced fatigue), adrenaline and
reduced cortisol. However, difficult work conditions (low control and
high levels of general hospital demands) were associated with different
responses from the two junior doctors. One revealed a variant of the
strain pattern (high effort, anxiety, fatigue and adrenaline), and the
other the disengaged mode (high anxiety, adrenaline and cortisol).
Fatigue and recovery from stress

In the above descriptions of the three modes of work management,
I have not said much about their relevance to fatigue. I have argued
that fatigue is a major characteristic only of the strain mode, but not
spelled out the process through which it develops. A sustained period
of high effort is an aversive and unstable experience; it occurs only
where opportunities for personal control are limited, and if perform-
ance standards cannot easily be reduced (for example, because of
the consequences of error). Performance is protected at the cost of
increased effort and strain, with an end-point of fatigue. However, the
strain state is functionally and physiologically equivalent to the stress
response, and, if not resolved, can carry over to the post-work period. I
have described after-effects of strain in an earlier section, though only
in relation to immediate post-work activity. More problematic is the
possibility of a much more sustained stress response – into the evening
Summary 131
of work days or even over the following days – that can act as a precipi-
tator of maladaptive work strategies and persistent fatigue (Brosschot,
2010; McEwen, 1998; Wyller, Eriksen & Malterud (2009). I consider
this further in Chapter 8.
Summary
Chapter 5 showed how the management of task performance must be
considered within a broader systems view that includes both current
and alternative goals. It reviewed the roles of effort and control in the
management of stress and argued that the fatigue feeling is the result of
sustaining a high effort response under low control. In general terms,
as with prolonged duration and high workload, tasks are normally car-
ried out surprisingly well under stress, particularly when performers
are highly motivated, though there are costs associated with protect-
ing performance from disruption. In both cases, the major threats to
integrity of performance are interpreted as those of failing to manage
the demands of the environment. The chapter examined the various
costs associated with the use of compensatory strategies to protect per-
formance under stress and fatigue, and discussed different patterns of
adjustment to variations in control and effort in working life.
6 A motivation control theory of fatigue
Background
In previous chapters, I have reviewed material relating to the impact
of work and stress on performance, argued that fatigue is neither an
unwanted by-product of work nor caused by the depletion of energy.
Rather, I have developed the alternative view that fatigue may be con-
sidered as an emotion, having an adaptive, goal-directing function
and a central role in the system responsible for maintaining motiv-
ational priorities: the flow of control between competing action plans.
I now deal explicitly with this idea, and develop the theory in more
detail. As I indicated in Chapter 1, and referred to throughout, a con-
ception of fatigue along these lines was recognized intuitively in early
reviews of the problem (Dodge, 1917; Thorndike, 1900), and Bartley
and Chute’s (1947) comprehensive survey concluded that fatigue was
best considered an outcome of conflict between competing behav-
ioural tendencies. These views acknowledged the volitional or choice
character of the fatigue feeling, driven by reluctance rather than
incapability.
In Chapter 2, I reviewed the evidence that fatigue had not always
been understood to be an aversive state; rather, it was experienced
as a natural outcome of transactions with the environment. I sug-
gested that the modern perspective became established as a result of
two dramatic influences on working experience during the Industrial
Revolution: (1) the normalization of the perception of work as an activ-
ity having high demands and low control, driven by the widespread
shift to factory-based operations; and (2) the parallel acceptance of
tiredness as being caused by a loss of energy, an idea emerging from the
growth of popular understanding about the role of energy in the work
of machines, and (by extension) that of humans. The core material
covered in Chapters 3, 4 and 5 shows that breakdown in performance is
not an inevitable consequence of doing work for long periods, or under
stressful conditions. More typically, fatigue occurs only under effortful,
132
Background 133
low control conditions, when demanding (normally externally imposed)

tasks have to be performed well.
I have already sketched out the basic elements of this position else-
where (Hockey, 2011, 2012). In the present chapter, I will elaborate on
the arguments in relation to general cognitive and motivational con-
structs, and then specify the theory of fatigue more fully in the form of
a control model. In essence, this represents an extension and modifi-
cation of the compensatory control model (Hockey, 1993, 1997, 2005),
developed to help explain the pattern of performance changes observed
under stress and high workload, through the optional use of execu-
tive control strategies. The approach is extended here, to elaborate on
the nature of task management, performance decrement, effort and
fatigue. It also draws on recent research on brain structures that may
underlie the proposed relationships shown in the model. Given the bur-
geoning research activity on the neuroanatomy of attention, executive
control and effort (e.g., Botvinick, Cohen & Carter, 2004; Corbetta
& Shulman, 2002; Croxson, Walton, O’Reilly, Behrens & Rushworth,
2009; Miller & Cohen, 2001), it is appropriate to examine possible
mappings between the core psychological constructs of the model and
possible neural mechanisms. A caveat is required, however. While I
make use of both control theory and the neuropsychology of executive
function to inform the theory, and try to ensure that the arguments
developed are consistent with the constraints imposed by both, the the-
ory of fatigue presented is essentially a psychological one; it is driven
primarily by the phenomenology and behavioural evidence of perform-
ance in relation to work, goals, effort and fatigue, and the associated
costs of task management.
I use the term motivational control in two senses here. Informally,
it refers to traditional questions about the ways in which motivation
guides the direction of behaviour, and the factors that influence that
process; what is it that makes us do what we do (and not do other
things)? How is it that we can keep on doing one thing and resist oth-
ers? What causes us to abandon one activity and engage with another?
In a more formal sense, motivational control refers to the applica-
tion of control models to motivation theory. For example, such an
approach was adopted by Campion and Lord (1982) to explain the
ways in which students revised study strategies in relation to feed-
back from tests. A review by Hyland (1988) demonstrated that a range
of apparently different approaches to human motivation, including
Atkinson’s achievement motivation (e.g., Atkinson & Birch, 1970),
Deci and Ryan’s (1985) intrinsic motivation, Locke’s (1968) goal
setting, and Weiner’s (1985) attribution theory, could be readily
integrated through a meta-theoretic framework based on control the-

ory. The main reason for the ready fit that Hyland was able to dem-
onstrate between these apparently different perspectives was that, as
with all such theories focused on purposive behaviour, they are con-
cerned with the problem of how people orient their actions through
the management of goals.
Goals in motivation control

I discussed the problem of goal competition in Chapter 5, as central to
the understanding of decrements in performance. From a control the-
ory perspective, goals are the starting point of all behaviour (Powers,
1973); a goal represents the desired behaviour or outcome (referred to
in control theory as the standard or reference signal) which any con-
trol system is designed to achieve. Motivation is an integral part of the
information processing system that initiates and guides goal-directed
behaviour, by reference to well-established rules for evaluating the
relative benefits and costs of alternative actions. This means that the
selection of goals is guided not only by desire or need, but also by an
evaluation of the goal as a worthwhile pursuit: what rewards it brings
and how much effort it costs to achieve them. Most personal goals (at
least, of the kind I discussed in Chapter 5) have high value anticipated
outcomes, with few costs; and even where costs are high (as in phys-
ical exercise or studying or self-improvement) the maintenance of such
activities is supported by the very high expected benefits. An excep-
tion to this appears to be the situation where want to goals have lost
their earlier reward value and become a chore, effectively becoming
have to activities. This occurs commonly for self-improvement inten-
tions (Polivy & Herman, 2002), where the thrill of anticipated out-
comes meets the reality of time commitments, frustration and practice
needs (as with my saxophone playing). In contrast, task goals (at least
in laboratory situations) may offer little more than the gratitude of the
researcher or a few course credits. In real-life work tasks, of course,
the reward is normally much greater, which may make such activities
more resilient to breakdown. But, unless they offer high levels of con-
trol, this is only normally achievable only at the expense of sustained
high effort (strain).
In the next section, I propose to draw together the ideas I have
introduced throughout the earlier part of the book, and present what
I consider to be a broadly new perspective on the nature and function
of fatigue.
Outline of the theory

As I have already said, the account of fatigue developed within this
monograph is one in which it is argued to serve an adaptive function
of preventing motivational fixation on current activities, and redirect-
ing behaviour towards those that have a higher utility (greater rewards
or lower costs). In a performance context, tasks (as have to activities)
are assumed to attract high costs, both because they are often low in
terms of motivational priorities and since they are tightly constrained
by performance criteria of speed and accuracy. By interrupting atten-
tion to ongoing tasks, fatigue allows a reconsideration of motivational
priorities, with a bias towards preferred or personally meaningful goals.
If task goals need to be retained, as is often the case, an effortful task
maintenance strategy is required in order to overcome the increasing
resistance afforded by the fatigue process. Before expanding on the the-
ory I will summarize the core facts, findings and phenomena of the
fatigue problem that need to be accounted for, through a recap of the
evidence from earlier chapters. More (and different) phenomena will
need to be dealt with in later chapters – for example, concerning energy
constraints, sleep, physical exercise and chronic fatigue – but these are
not central to the development of the motivation control hypothesis,
which focuses on the issue of fatigue as a short-lasting cognitive control
mechanism. Instead, such broader issues will be treated as challenges
for the general application of the theory, and further issues that need to
be incorporated into it.
Elements of the fatigue state

Since I have already dealt with the core material in some detail, I shall
state the evidence here as broad conclusions, without much elaboration
or qualification. The evidence is summarized in three, necessarily
overlapping, areas: phenomenology, task performance, and effort and
costs.
Phenomenology. Subjective feelings of fatigue are more complex than
tiredness alone, including elements of effort, anxiety, discomfort, frus-
tration, boredom and loss of engagement with the goal. Such feelings
grow with unbroken time spent on imposed tasks (have to goals), but are
not common with self-selected or desired (want to) activities. In affect-
ive terms, I would argue that two stages of fatigue may be distinguished,
with different phenomenological qualities: (1) an early-onset inhibi-
tory response to task engagement, associated with subtle disruptions of
performance (such as lapses), in which fatigue may be experienced only

as a vague sense of cognitive discomfort; and (2) a later, effort-driven
process, associated with the strain of continued active resistance to the
interruption of task goals, where feelings of effort, striving and stress
give rise to a growing feeling of the familiar aversive state of mental
tiredness and need for release from the task. A break from the activ-
ity, or even a significant change of goal, usually removes these feelings,
except in cases where the new activity may be equally or more demand-
ing. In any case, a period of demanding work reduces the willingness to
continue immediately afterwards in a high effort mode.
Task performance. Performance decrements are more likely to occur
under specific conditions: with imposed (rather than freely chosen)
tasks; under heavy workload or stress; under laboratory (rather than
real-life) conditions; and under conditions that do not permit perform-
ers to exercise a high level of control. However, where goal mainten-
ance is valued, even under unfavourable work conditions, performance
protection strategies may be employed to prevent or limit impairment.
Because of this active regulatory management of task goals, fatigue
effects need to be assessed in terms of the efficiency of goal mainten-
ance: with how much compensatory control is required to maintain task
goals, and the costs of this control in terms of the arousal of the stress
response and effort. Even before fatigue or effort is perceived and per-
formance protection strategies become necessary, fine-grained analysis
may reveal growing control difficulties in the form of increased vari-
ability and interruptions (lapses). As with subjective fatigue, perform-
ance typically recovers after a brief rest or change of task.
Effort and costs. Under low control situations where little or no decre-
ment is observed we would expect to find evidence of increased effort,
growing over time, and related costs in the form of secondary task decre-
ments, strategy changes, physiological activation and after-effects. Both
the subjective and performance effects of fatigue are directly related to
the sustained use of effort under low control, rather than to the execu-
tion of mental or physical work per se. Felt effort represents the strain
of maintaining a task goal under low control and increased competition
from other goals. Effort is increased under strain only when task goals
are evaluated as worthwhile and achievable; otherwise, it may remain
unchanged or reduced, allowing performance standards to fall.
The interruption function of fatigue

I have suggested that fatigue is a mechanism for maintaining motiv-
ational equilibrium. It responds to falling utility (benefits to costs ratio)
of current behaviour by interrupting the flow of control, thus allowing

a reassessment of the cost and benefits of alternative actions. While
this can occur at any point in a behaviour sequence, such a mechanism
is most useful when goals are maintained through executive guidance
and top-down control. As used here, the term interruption does not
mean that the goal is necessarily displaced; the intended meaning is of
a hiatus – a break or pause in the action – that allows for a re-evaluation
of behavioural options. Interruptions are assumed to be triggered by
an increasing sense of the goal’s diminishing value over time and by
the increasing effort required to maintain it. These have the effect of
disengaging the strong influence of the executive control afforded to
ongoing tasks and of allowing other candidate goals to compete for
access to selective attention. If the goal’s value can be reinstated (for
example, through the promise of financial or other rewards, awareness
of the negative consequences of failing, or the reimposition of extrin-
sic values, such as duty) the disruption caused by fatigue can be over-
come by further effort. If not, a shift to an alternative activity, or rest,
is implemented. As I have suggested on several occasions, notably in
Chapter 4, one of the considerations for such an analysis of fatigue is
its possible function as an emotion. From a reverse engineering per-
spective, we may ask ‘What is fatigue for? What does it do?’. The short
answer proposed here is that it acts as a brake on current activities to
allow a re-evaluation of changing motivational priorities. Do you really
want to continue with what you are doing? Would you rather do some-
thing else? Without such a mechanism, the transition between actions
required of any organism may still occur, since goals lose activation for
a number of reasons. However, such transitions would be very sluggish,
and unlikely to reflect underlying motivational priorities.
In Chapter 5, I suggested that fatigue is not the only reason why goals
may be interrupted. Some interruptions occur through context-driven,
bottom-up intrusions, associated with attention capture by environ-
mental, somatic or cognitive events. By contrast, the fatigue-based
interruption is hypothesized to operate at a higher level, involving com-
plex evaluations of competing goal options. The general argument for
an interruption mechanism in goal management was made by Simon
(1967), as a requirement for the multiple goals nature of all human
(and animal) behaviour. Most goals are self-terminating, ending, for
example, when some specified state, or acceptable level of aspiration,
has been attained, or – as in the case of many laboratory tasks – when
some time limit has been reached, or the experimenter says ‘stop’. But
other goals may make demands on attention before this point has been
reached. Simon argued that a mechanism was required that allowed the
current goal to be interrupted and emerging possibilities to be evalu-

ated. This would prevent fixation on whatever was currently in focal
attention, and allow what he called ‘real-time needs’ (unpredicted bio-
logical, environmental or cognitive events that call for action) to break
into the control loop. Both Simon and other theorists (Mandler, 1975;
Oatley & Johnson-Laird, 1990) identified the arousal of an emotional
state as the neural basis for the interruption mechanism.
By linking the hypothesized fatigue mechanism with Simon’s inter-
ruption idea, I appear to acknowledge the specific link with emotion,
which is consistent with the view of fatigue as an emotion expressed
earlier. For example, the feelings of fatigue relate directly to Simon’s
suggestion of interruption by discouragement or frustration at failing
to reach the goal (a state I have sometimes referred to as cognitive dis-
comfort). However, I suspect that the bald use by Simon of the term
emotion may be an over-simplification. Certainly, it is too restrictive
a view for the process of interruption that we are considering, unless
emotion is meant in a very general way, to include curiosity or fascin-
ation, where attention is captured by external events. Other events (an
unexpected movement or sound, or even an intrusive thought) may
attract attention through their eliciting an orienting response, without
any perception of emotional change (Berlyne, 1960; Öhman, 1987).
Emotional changes may result from any of these bottom-up influences,
and are likely to intrude on whatever is currently being attended to.
But emotion is not involved directly in somatic events such as hunger
or a growing perception of a need to pay a visit to the lavatory, both of
which may distract attention to events in a vigilance task, though not
because of fatigue.
There may be a case for postulating two different interruption
mechanisms. Fatigue is assumed to have its effect through a con-
tinuing motivation-driven monitoring of goal priorities and changing
utilities. However, where conditions evoke other need to states – emo-
tional responses or basic bodily needs – perception of such events may
automatically break into the control loop and hijack behavioural dir-
ection (as do other bottom-up distractors, such as sudden environmen-
tal events or intrusive thoughts). A bottom-up interruption hypothesis
might suggest that fatigue is a generalized affective state that interrupts
ongoing attention in the same way. However, bodily manifestations of
fatigue are relatively slight, and, as Bartlett (1953) pointed out, arrive
too late to be effective for behavioural change. Instead, the evidence
from earlier chapters indicates that the effects of fatigue operate on cen-
tral processes, only indirectly related to bodily changes. Overall, then,
there may be two kinds of interruption mechanism, one (fatigue) acting
through top-down motivational regulation, and another responding to

automatic, bottom-up distraction.
A control systems implementation

The theory is implemented here in terms of a control model. The use
of control models in psychology and biology comes from the applica-
tion of cybernetics to engineering process control. On this basis, overt
performance is the outcome of a comparison between what is required
of the behaviour (the reference signal or goal state) and the perceived
feedback of what is currently being achieved (the output or behaviour).
The process through which this occurs is known as ‘negative feedback’,
since (in technical systems, at least) control is driven by the difference
between the standard and the measured output. The negative feedback
principle is central to all control processes, whether in psychology, biol-
ogy or engineering, and is one of the most effective ways of ensuring sta-
ble levels of behaviour, or any other controlled variable (Powers, 1973).
Task goals specify the output criteria for performance – which events
to respond to, how fast to work, what level of accuracy is required, the
sequencing of actions, and so on – and modifies these until the diffe-
rence (error signal) is reduced to zero (or, effectively, an acceptable level
of error). It has to be said that this way of understanding the control
of action has its critics. For example, both Locke (1991) and Bandura
(1996) argue that control models tell us nothing about the range of
reactions individuals may have towards a perceived discrepancy. How
do they appraise them? Do they respond with increased or decreased
task motivation to correct them? These are relevant issues, but surely
topics for research, rather than simply debate. Essentially, such com-
ments argue against a strict version of the engineering control model,
rather than the appeal to general control principles that most theorists
make of it. Part of the present modelling is designed to accommodate
such concerns, by specifying conditions under which different actions
will emerge from such evaluation.
Although control models can be applied very effectively to human
behaviour, at least one distinctive aspect of human goals needs to be
recognized. Engineering systems are designed to meet specific indus-
trial targets (however complex), and employ a specific control loop for
each process, normally with fixed reference points. Humans, on the
other hand, must satisfy many different – and changing – goals on dif-
ferent occasions. This intrinsic need for flexibility means that switches
between goals over the course of the day (and much smaller time peri-
ods) are not only common but necessary features of responding on
many motivational fronts. As with specialized industrial systems, rela-

tively low level operations involving, say, motor control or eye track-
ing are known to make use of dedicated control loops (Powers, 1973).
However, it is thought that high level goal management, such as those
responsible for conscious thought and successful task performance,
may make use of a generalized executive control system (or small set
of systems), able to operate flexibly under different goal conditions
(Norman & Shallice, 1986). This active top-down bias allows the goal
to be maintained in focal attention, and purposive behaviour promoted
(Austin & Vancouver, 1996; Carver & Scheier, 1982; Hockey, 1997;
Hyland, 1988).
While the flexibility of such a system has obvious advantages, there
are also dangers of goals being displaced by competitors, leading to the
well-documented errors of everyday cognition, such as slips and lapses,
strong habit intrusions, or goal capture (Norman, 1981; Reason, 1990).
Effective task performance requires that such flexibility be resisted,
allowing for important goals to be maintained as a target state for
the direction of behaviour, and adjustment of output to be continued
(speeded up, made more accurate) in response to any detected discrep-
ancy. If maintaining goal orientation involves overcoming competition
and temptations to switch to other goals, as suggested earlier, this ought
to be reflected in increased costs of regulatory activity, as well as to
increased fatigue. We have seen in Chapter 5 that this is indeed what
happens, and such observations are supported by the broad literature
on coping and behaviour control (e.g., Frankenhaeuser, 1986; Hockey,
1997; Schönpflug, 1983). The attempt to maintain performance stand-
ards under difficult or demanding conditions is effortful, and involves
increased engagement of the somatic systems involved in stress and the
response to challenge.
The compensatory control model

My own approach to motivational control is more constrained than that
of Hyland (and my own goal more modest), though it assumes the same
general applicability of control theory. In Chapters 4 and 5, I intro-
duced the concept of performance protection, in which sensed threats
to task goals may be overcome by a recruitment of additional effort.
The conceptualization of fatigue in control theory terms grew out of
an approach I developed some years ago (Hockey, 1993, 1997, 2005),
following related earlier theoretical frameworks that made use of con-
trol ideas (Broadbent, 1971; Carver & Scheier, 1990; Hamilton, Hockey
& Rejman, 1977; Kahneman, 1973; Teichner, 1966, 1968). It adopted
control theory as a way of integrating the disparate and often inconsist-

ent findings on the effects of prolonged work, increased workload and
stress. I will summarize the essentials of that earlier approach here, as it
provides the foundations for the motivation control theory of fatigue.
The compensatory control model was conceived as a simple,
two-level control system: a lower level relating to routine performance
of well-learned activities, and an upper level, concerned with regulation
of effort and task goals through executive functioning. In simple terms,
this allowed the performer the choice of two strategies when faced with
increased task strain: (1) to increase effort and maintain task perform-
ance; or (2) to maintain or reduce the present effort level and allow per-
formance to fail. In the latter case, task goals are adjusted downwards to
more easily match performance standards. A control description with
two levels, one responsible for coordination of the other, appears to be
a minimal requirement for the architecture of any behaviour control
system. One way of understanding how the model works is to imagine
how it operates with and without effective top-down regulation. As in
the case of Broadbent’s (1971) analysis, an upper level of control nor-
mally ensures that, whatever the state of the lower level, the integrity
of top-level goals is maintained, so that primary task performance is
able to match specified goal requirements. However, if executive con-
trol is ineffective (whether chronically, because of specific neurocogni-
tive impairment, or temporarily, because of fatigue) we would expect
perturbations in the lower level to result in uncompensated changes,
consistent with those identified in Hockey and Hamilton’s (1983) ana-
lysis of stress patterns (discussed in Chapter 4). For the modal stress
state, this would mean a reduction in accuracy but not speed, increased
selectivity, and widespread memory-related deficits.
Revising the model

The specific origins of the compensatory control model – as a frame-
work for understanding stable performance under stress – meant that
its focus was on the management of task performance and effort, rather
than on fatigue and its more general ramifications. Fatigue was treated
as a specific property of regulatory activity, for example as the direct
result of increased effort, but not included as a general feature of the
model. It is now apparent that the earlier model fails to account for
the broader range of findings on fatigue, effort and performance. It
has also been overtaken by recent evidence on the nature of executive
control and goal conflict from research in neuroscience. However, as a
control framework of the adaptive processes underlying performance
management, some of the assumptions of the earlier model can be

retained: namely (1) the active, compensatory nature of performance
protection in the face of threats to goal stability; (2) the cost–benefit
trade-off between the choice of protecting performance by increasing
effort or accepting a lower level of performance; and (3) the role of
motivational decision-making factors in the choice of regulatory out-
come: to stay with the task or to shift to a new goal.
The development of the model to provide an account of fatigue brings
with it the need to consider in more detail the nature of executive con-
trol, which is a central feature of the theory. In common with most
earlier cognitive theories based on executive control (Baddeley, 1986;
Broadbent, 1971; Kimberg & Farah, 1993; Norman & Shallice, 1986)
the compensatory control model treated it as a single, undifferentiated
entity. Executive function was assumed to be responsible for both selec-
tion and maintenance of goals, as well as the management of effort.
A preliminary version of the motivational control theory of fatigue
(Hockey, 2011) advocated separating the functions of goal mainten-
ance and effort management. In many cases, goals may be maintained
without the need for effort (automatic activities, high priority personal
goals, or those with high controllability). Effort is then treated as an
auxiliary mechanism: only when goal maintenance becomes difficult
is increased effort an appropriate control option and a direct cause of
tiredness, the end state of fatigue.
However, this also now seems too simple a model to capture the nature
of control failure in fatigue. In terms of the ideas outlined towards the
end of Chapter 3, fatigue may be thought of as a process that starts as
soon as a task begins, taking the form of an increasing bias against cur-
rent task goals. Such effects occur in advance of perceptions of fatigue
in terms of sensed effort, though they may be felt vaguely as a state
of cognitive discomfort, and observed as minor disturbances of per-
formance, such as increased variability of timing or lapses in response
sequences. In addition, as I argued earlier, there may be a need to dis-
tinguish between the hypothesized top-down interruption effect of
the fatigue process and that due to bottom-up intrusions from somatic
events, task-unrelated thoughts or current concerns. There is no reason
to assume other than that the interruption device is the same in the two
cases, though different control loops may be involved.
A second complication comes from extensive recent evidence on the
brain mechanisms underlying executive control and effort, which makes
a strong case for separating different fundamental functions of execu-
tive control. The most generally agreed distinction is between prefrontal
cortex (PFC) and anterior cingulate cortex (ACC). Briefly, while the
PFC is recognized as having a central role in goal maintenance through

top-down coordination and guidance of competing actions, the ACC is
thought to have a more specialized function of detecting conflicts and
evaluating the outcomes of actions (e.g., Botvinick et al., 2001; Miller &
Cohen, 2001; Sarter et al., 2006). This monitoring or evaluation func-
tion of ACC appears to fit the general requirements for coordination of
the proposed interruption function. Thus, despite an overall desire for
parsimony in theorizing, I am led to consider inflating the number of
executive processes in the model to three: goal maintenance, monitor-
ing/interruption and effort management. Later in the chapter I exam-
ine the fit between the model and the evidence from neuroscience in
more detail. Then, in Chapter 7, I address limitations of the theory, and
its relation to the broader evidence from neuroscience relating not only
to goals and executive control, but also to energy metabolism, fatigue in
physical work, and sleep regulation.
Control model description

The above ideas are integrated in the control model shown in Figure
6.1, which includes the three executive functions: goal maintenance,
monitoring/interruption and effort regulation. It is worth repeating the
major caveat introduced earlier in the chapter, that the control model
is not intended to provide a direct mapping of cognitive constructs
onto the putative neuroanatomical structure of control. Partly, this is
because the evidence from brain research is not yet clear enough to
confidently allow us to match brain structures with specific cognitive
functions, and little of this research has, in any case, been addressed
directly to effort–fatigue changes during task performance. In addition,
I am concerned primarily with putting forward a psychological model
of fatigue, one that embodies the essential phenomena of performance,
effort, choice and feelings. On the other hand, I feel the need to show
that the elements included in the model have some feasibility in terms
of the reality of neural architecture, however indirect the mapping at
this stage of our understanding.
As we saw earlier, the performance protection strategy is costly in
terms of its demands on regulatory activity, so is adopted only when
threatened goals are regarded as important, or when anticipated ben-
efits are high compared to costs. Figure 6.1 makes explicit the assump-
tion that executive selection of a specific task goal inevitably excludes
others, including strong contenders for control of action. It shows the
current (task) goal (G) activated and maintained by executive bias,
along with currently non-selected, but competing, goals (g1 and g2).
GOAL
REGULATION
PERFORMANCE EFFORT
EVALUATION REGULATION
goal options
G, g1, g2 .. effort → fatigue
cognitive effort
events active monitor overt
goal (G) action actions
routine control
somatic monitor
events
environmental external
events disturbances
Figure 6.1 Motivational control model of executive control, effort

and fatigue
These are assumed to be personal goals, currently relevant to motiv-

ational priorities, so able to compete strongly for control of atten-
tion. The task goal is selected and maintained by top-down control
through a goal regulation mechanism, which activates relevant schemas
and inhibits competitors. Under routine conditions (when the task is
well-learned; when the individual is fresh; when there are no strong
distractors), the task runs without executive management through the
lower control loop. Minor deviations from goal criteria are detected via
the negative feedback loop, where an action monitor compares the feed-
back from current output to that specified by the goal. For well-learned
tasks, fine-tuning of actions can be carried out automatically by small
adjustments in the parameters of schemas. The goal regulator is needed
to reinstate the goal only when major control slippages occur. This may
be because of the occurrence of errors (wrong responses) or failures of
response execution (missed responses, such as lapses, or timing errors),
or when the goal is disrupted by breakthrough from other goals.
In addition to competition from other candidate goals, three other
sources of possible intrusion are shown, as discussed in Chapter 5:
cognitive events, somatic events and environmental events. These
may capture attention directly, or act as cues to elicit personal goals,
as recognized in other control models, such as those of Shallice and
Burgess (1991) and Toates (2004). In the flow chart (Figure 6.1)
these are shown as directly interrupting control of the selected goal,
though this could also occur at an earlier stage, by disrupting goal
maintenance. Such conflicts are detected by a second executive func-

tion, the performance evaluation controller. This is the central feature
of motivational control in that it coordinates all regulatory activity. It
evaluates threats to goal execution and signals the need for corrective
action through the goal regulator. However, as I mentioned earlier, it
is likely that the evaluation mechanism also deals with information
from a second source. This is the perception of increasing demands
for effort, even in the absence of overt performance failures. I have
identified this in the model through the output of a second comparator
that detects discrepancies between planned and actual control effort.
Brehm and Self (1989) showed that the amount of effort allocated to a
task is determined primarily by how much the performer assumes will
be required, which – through experience with both this and similar
tasks – may be estimated quite accurately and implemented in an effort
budget (or working maximum). As in the case of task goals, the setting
of an effort budget (or reference level) has the advantage of allowing
the task to be managed without the need for moment-to-moment effort
changes; as long as sensed effort is within the budget assigned to the
task, no executive action is required. However, when effort demands
threaten to breach the operating limit, the performance evaluation sys-
tem is assumed to call for an increase in the effort budget, through the
effort regulation system. Under conditions of high goal value (such as
work having a high cost responsibility or involving major deadlines)
this is assumed to be the default option, allowing task goals to remain
in place but with a higher level of effort. However, if the assessment of
costs becomes too high, compared to the benefits of continuing with
the goal, effort may not be increased. Instead, it may be maintained
at the present level, or even reduced, allowing task goals to remain
in place but at a lower level of fulfilment (reduced aspiration), or to
be abandoned altogether and be displaced by one of the competitors.
A further possibility, especially where there are no strong competing
goals, is that all goal-oriented actions are abandoned and the effective
outcome is one of rest.
Where is fatigue located in the control model?

A reasonable question to ask is which part of this flow chart corresponds
to the process and experience of fatigue. Since fatigue and effort are
general characteristics of the operation of the whole system, this is not a
straightforward question. Within the context of an effort–fatigue com-
pensatory loop a sensed need for greater effort reflects the same affect-
ive state as a sensed increase in fatigue, so that the end-point subjective
fatigue state may be identified broadly with the frequency and intensity
of activation in the effort regulation mechanism (represented in Figure
6.1 by the top right loop, shown in heavy lines). If the fatigue process
starts from a detection of reduced task utility, as proposed earlier, then
the monitoring function may be the hub of this circuit. A possible neuro-
anatomical mapping for this is discussed in the next section, but would
need to include at least ACC and other limbic and basal ganglia struc-
tures involved in effort regulation, acting through dopamine-mediated
influences on PFC. Earlier in this chapter, in setting out the phenom-
enological evidence to be addressed by the theory, I discussed the pos-
sible distinction between early-onset fatigue and strain-induced fatigue.
An interesting question is whether the conscious perception of fatigue
is a product only of activation of the effort regulation loop, or whether it
responds also to activity in feedback to the task monitoring mechanism,
which drives the early-onset feelings. As I suggested earlier, we might
expect these more subtle disturbances to correspond to the more muted
feelings of cognitive discomfort, though I am not aware of any attempts
to measure such subjective states directly.
Evidence from neuroscience

Earlier, I alluded to recent evidence on the neural basis of executive
function. It is now appropriate to ask how the motivational control the-
ory of fatigue maps onto the burgeoning research activity on attention
control and effort in neuroanatomy, neurochemistry, EEG and func-
tional neuroimaging. Can we identify brain mechanisms that may
be involved in the operations addressed by the control model, such
as the regulation of task goals, monitoring, interruption and effort?
Evidence on all these issues is restricted, not least because there have
been few studies concerned specifically with fatigue per se, and no for-
mal research directed at the problem. I am also aware of only one pre-
vious attempt to review the evidence on neuroanatomy in relation to
fatigue (Boksem & Tops, 2008). Nevertheless, while little of the current
research effort into the neuroanatomy of attention and executive func-
tions has been specifically focused on mechanisms of fatigue, much
of the work addresses the related issues of goal management, atten-
tion, effort and decision-making. A second potential constraint is that
the majority of research in this area has used animal models; however,
although this may limit the application of findings to problems of human
goal management and motivation, the fundamental neural mechanisms
and brain structure are assumed to be sufficiently similar to be able to
generalize to human performance in most cases.
Goal maintenance and monitoring

I mentioned earlier that prefrontal cortex (PFC) and anterior cingulate
cortex (ACC) have been identified as having major executive functions
in task control. I discuss them together here because of the coordinated
nature of their executive activity (Milham, Banich, Claus & Cohen,
2003). It has long been known that the prefrontal cortex (PFC) and
associated structures have a distinctive role in the management and
regulation of ongoing mental activity, including the selection, plan-
ning and maintenance of goals (Luria, 1973; Miller & Cohen, 2001). In
addition to its extensive connections with most other brain structures,
the PFC is the only cortical structure capable of collating inputs from
sensorimotor and cognitive processes and those from emotional and
motivational interactions (Royall et al., 2002). While earlier theoret-
ical accounts of executive function tended to assume a single undiffer-
entiated mechanism, recent analyses have shown that some degree of
separation may be necessary. The number and specificity of executive
functions remains unclear, but the most widely agreed position is that
at least two broad control networks are necessary, based on distinc-
tions between the PFC and the medial frontal cortex (particularly the
anterior cingulate cortex, ACC, which is considered part of the limbic
system).
The PFC is widely agreed to be distinctively involved in the manage-
ment of goals, maintaining active patterns of appropriate neural activ-
ity to keep desired goals in control of action (Miller & Cohen, 2001;
Sarter et al., 2006). Such activity may be impaired with the growth
of fatigue states in prolonged work. For example, an EEG analysis by
Lorist, Klein, Nieuwenhuis, Jong, Mulder and Meijman (2000) showed
reduced activity in frontal areas with time on task, while an fMRI study
by Lim, Wu, Wang, Detre, Dinges and Rao (2010) showed that dec-
rement from a 20-minute PVT session was accompanied by reduced
fronto-parietal activity. The top-down influence that PFC exerts on
information processing appears to operate through biased activation of
task-relevant cognitive structures, with the effect of establishing and
maintaining required configurations of schemata in relation to percep-
tual and motor constraints of the task. It is also thought to respond
to information about goal execution generated by the ACC in order
to regulate behavioural outputs and make appropriate compensatory
adjustments.
The ACC is the basis of the second component of executive control.
As part of the limbic system, it may be seen as a bridge between old
and new brain; between emotion and cognition. ACC is thought to have
a pivotal role in the management of emotional states and in focused

problem-solving, and has become identified in recent research with
monitoring conflicts in task situations where distractors or competing
responses are present (such as flanker or Stroop tasks) or detecting errors
in goal execution (e.g., Botvinick et al., 2001; Botvinick, Cohen & Carter,
2004; van Veen & Carter, 2006). Lorist, Boksem and Ridderinkhof
(2005) found that error-related negativity, a proxy indicator of ACC
activity, was attenuated after an hour of continuous work on a reac-
tion time task. The monitoring function of ACC has also been linked to
the evaluation of outcomes of actions, responding strongly to situations
that are aversive or non-rewarding (e.g., Gehring & Willoughby, 2002;
Rushworth, Behrens, Rudebeck & Walton, 2007). This suggests that
ACC makes use of a form of cost–benefit analysis of predicted outcomes
to influence the selection of competing actions. These different perspec-
tives on the function of ACC may be reconciled by considering con-
flict detection as a component of avoidance learning (Botvinick, 2007),
though they do not appear to be fundamentally contradictory. Stated
broadly, the function of the ACC is considered to be one of evaluating
conflicts between required and actual actions, and of resolving threats
to positive outcomes from competing cognitive, somatic or environmen-
tal events. It has also been implicated in the maintenance of a high effort
response to tasks (Paus, 2001; Pessoa, 2009; Winterer, Adams, Jones
& Knutson, 2002). Paus (2001) has hypothesized that the ACC is the
brain’s key structure for effortful engagement with task goals, because
of its strategic location between limbic drive mechanisms and the pre-
frontal control system, as well as having extensive connections with the
motor areas underlying overt actions.
From this brief summary, it appears that the broad goal regulation
and monitoring components of the proposed control model may be
related with some confidence to what we know about brain function.
The PFC is readily identifiable with the role of overall goal manage-
ment, including goal selection, maintenance and change. ACC may,
likewise, satisfy the criteria for the monitoring function, detecting prob-
lems in task execution using feedback from two sources, as in Figure
6.1: either directly from the goal execution loop (the action monitor), or
from the effort sensing loop. It is widely agreed (e.g., Braver & Cohen,
2000; van Veen & Carter, 2006) that such information is made avail-
able to the PFC for regulatory action. But what determines whether
goals are maintained or changed on the basis of these alerts? And if new
goals are implemented how are they selected? The computational view
of the brain, accepted by most neuroscientists, emphasizes the utility of
alternative actions. A current goal may lose activation, either through
repetition-induced habituation or from diminishing access to expected

benefits. This may lead to it dropping out of contention as being no
longer sufficiently rewarding, and being replaced by a goal that is poten-
tially more beneficial (or less costly to maintain). The basal ganglia are
assumed to play a major role in this, acting as a kind of complex routing
system between cortical-sub-cortical control loops and motor outputs
(Alexander, DeLong & Strick, 1986).
Effort regulation
As I have argued, the primary determinant of the outcome of such deci-
sions is an assessment of both the anticipated benefits and the effort
requirements (costs) of alternative actions, including the maintenance
of current goals. Sarter has pointed out that effort is a necessary mech-
anism for restoring failing performance under both normal regulatory
activity and when performance is threatened by demanding task con-
ditions (Sarter et al., 2001, 2006). But is effort regulation a separate
executive function, or one of the several roles attributed to the ACC
monitor? Effort is the psychological state that corresponds to the regu-
latory costs of implementing and maintaining actions. Computational
frameworks of motivational control assume that a high cost goal (one
that requires a high level of effort to maintain) may be pursued only if
its anticipated rewards are sufficiently high. In the above analysis of
the ACC evaluation function, information about current demands for
effort may be equivalent in computational terms to tracking ongoing
changes in the costs and benefits of alternative actions. Thus, one indi-
cator of conflict may be the growing awareness of effort requirements
as the performer attempts to maintain or regain control of task goals
(Kurzban et al., in press; Sarter et al., 2001). Kurzban and his col-
leagues argue from an evolutionary perspective that effort corresponds
to the felt opportunity costs of the present activity; that is, the costs of
missing out on the benefits associated with other potential goal direc-
tions. Boksem and Tops (2008) suggested, along similar lines to those
proposed here, that fatigue may be understood in terms of the manage-
ment of rewards and costs by the brain, with fatigue occurring when
costs (energy requirements in their model) outweigh the anticipated
benefits of continuing an action.
Most neuroscience accounts have linked effort with inputs to ACC
activity from midbrain neurotransmitter systems, primarily dopamine
circuits (Kurniawan et al., 2011; Salamone, Correa, Farrar & Mingote,
2007; Walton, Kennerley, Bannerman, Phillips & Rushworth,
2006), though also noradrenaline (Aston-Jones & Cohen, 2005) and
acetylcholine (Sarter et al., 2001, 2006). Dopamine (DA) activation

of PFC has been shown to be necessary in order to connect the goal
to appropriate action through the basal ganglia, with the nucleus
accumbens (NAc) acting as a gate or amplifier for information from
limbic and cortical areas, selectively promoting only those motor out-
puts that promise high benefits (Braver & Cohen, 2000; Everitt et al.,
1999; Salamone, Correa, Mingote & Weber, 2005). Animal studies have
generally adopted an energetic definition of effort, based on the relative
costs of the physical work tolerated to obtain anticipated benefits (for
example, a small reward for a routine response versus a large reward that
may be obtained only by climbing a high barrier). Such studies strongly
implicate the recruitment of emotional or stress responses to threat in
the maintenance of ACC activation. In addition, ACC has been shown
to be strongly implicated in the control of tasks that are high in diffi-
culty or effort demands (Paus, Koski, Caramanos & Westbury, 1998)
and to have a major control function in relation to the ANS response to
stress or effort, including the HRV suppression typical of mental effort
(Critchley, 2003). Walton et al. (2006) showed that effortful choices
made by rats (working harder to obtain greater rewards) are mediated
by ACC in conjunction with ascending midbrain DA pathways. Choice
of the high effort option depends on intact dopaminergic connections
between basal ganglia/limbic sites and ACC, with impairment of effort-
ful decision-making associated with damage to either the ventral stria-
tum (Mingote, Weber, Ishiwari, Correa & Salamone, 2005) or dorsal
ACC (Floresco & Ghods-Sharifi, 2007; Walton et al., 2006). In sup-
port of Paus’ (2001) argument that ACC is the primary controller of
effort, one of the dedicated control loops of the basal ganglia involves
both the limbic system and ACC (Alexander et al., 1986). This suggests
that a managed dopaminergic surge may underlie the sense of effort
in maintaining task performance under strain, as well as the feeling of
fatigue that follows sustained effort. This interpretation is supported
by the view of the basal ganglia as a likely source of fatigue-related mal-
functions across a range of neurological conditions, including chronic
fatigue syndrome (Chaudhuri & Behan, 2004). Most of the evidence on
the link between effort, costs and dopamine concerns the response to
extrinsic (physical) demands. However, similar effects have been found
for human cognitive decision-making (Kool et al., 2010), and a recent
human fMRI study (Boehler et al., 2011) shows increased DA activity
when high demand tasks are predicted, even though they are not car-
ried out. This finding is important in providing a basis for assumptions
of effort as a voluntary, preparatory process, and its role in the manage-
ment of performance under strain.
The activation of central dopamine, under the control of ACC, there-

fore appears to be a strong candidate mechanism for the regulation of
effort. However, while dopamine is identified as the primary currency
for the execution of effortful behaviour, other neurotransmitter systems
may also be involved. For example, Sarter et al. (2001) described a
circuit that involves top-down regulation by ACC/PFC of both dopa-
minergic and cholinergic activation from midbrain and basal fore-
brain sites. A review by Salamone, Correa, Nunes, Randall and Pardo
(2012) showed that excitatory effects of dopamine were moderated by
the inhibitory neurochemical adenosine, acting through the nucleus
accumbens (NAc). Changes in adenosine inputs into NAc allow DA
activation to switch between high and low effort modes, providing a
possible basis for the regulation of effort assumed in the control model.
Tentatively, then, while the details of the neuroanatomy of effort remain
to be established, it may be argued that the evidence does not clearly
support a separable executive component of effort management. At
present, the most likely mechanism is that of dopaminergic innerva-
tion through ACC control of the limbic/basal ganglia loop. Research
on ACC has indicated a close link between two of its proposed func-
tions, monitoring/evaluation and effort control, and direct connections
from ACC to prefrontal control and goal maintenance functions. A
simple caricature of the neural dynamics of control under fatigue is
something like the following: when disturbances occur in planned task
performance, these are detected by the performance evaluation system
(ACC), which alerts the goal regulator (PFC) of the need to reset the
goal parameters. When this becomes difficult because of a loss of goal
activation or competition from other goals, ACC elicits increased sup-
port from the limbic-basal ganglia effort system. This helps the current
goal to be maintained by increasing tolerance of high effort regulation
through the action of DA circuits operating between limbic system/
basal ganglia and ACC. When the expected benefits are no longer suf-
ficiently high compared to the growing costs, the goal is either modified
or relinquished, and supplanted by another.
Goal interruption
A remaining question is whether there is any evidence for the hypoth-
esized interruption of current goals. There is a long-acknowledged link
between cognitive interruption and emotion (Mandler, 1975; Oatley
& Johnson-Laird, 1990), allowing emotion-serving events to take over
the control of attention in response to perceived emergencies. Mandler
(1990) has argued that interruptions are the result of a discrepancy
between expected and actual outcomes of the operation of schemas,

and typically generate a state of autonomic activation. This perspective
fits well with evidence from neuroscience, which shows an interrupt
role for noradrenergic activity in the maintenance and loss of task goals
(Aston-Jones & Cohen, 2005; Dayan & Yu, 2006), in order to achieve
a balance between maximizing exploitation of the current situation
and exploration of new situations. Briefly, this is thought to operate
through switching between two modes of activation of neurons of the
brainstem nucleus, locus coeruleus, the sole source of noradrenaline
(NA) in the brain. In the phasic mode, bursts of NA activity accom-
pany effective responses, helping to maintain current task goals. These
bursts rapidly habituate, but may be reinstated by feedback from the
ACC (and also orbitofrontal cortex, OFC) confirming the continuing
reward value of the task. When the utility of the task falls (the trigger
for the hypothesized fatigue-based interruption) the phasic response is
attenuated, causing the current goal to lose activation. Instead, there
is an increase in the tonic level of NA activity, which allows other,
more currently rewarding, activities to gain access to the control of
behaviour. Aston-Jones and Cohen (2005) suggest that OFC and ACC
signal different features of the utility function, OFC coding the value
of rewards (as also inferred by Wallis, 2007) and ACC the costs or
effort.
Relation between effort and interruption

We have seen that dopamine (DA) has been identified as essential to the
regulation of effort and reward, while noradrenaline (NA) is implicated
in the interruption of ongoing activities when their utility drops below
an acceptable level. But both DA and NA, as with other neurotransmit-
ters, have a variety of functions, depending notably on their frequency
and patterning of transmission, and almost certainly operate only in
the context of moderating effects of other neurotransmitters. As dis-
cussed above (Aston-Jones & Cohen, 2005), NA appears to have both
stay and shift modes; rapid bursts facilitate the maintenance of current
activities, while sustained tonic activation allows for a switch to a new
goal. It is now clear that DA also has stay and shift modes, as well as a
general mediating role in interactions of the organism with the envir-
onment (Schultz, 2007). The two main types of dopamine receptors
(D1 and D2) are thought to have opposite effects on the selectivity
of activation in PFC (Seamans & Yang, 2004). Behaviour relating to
interruptions and updating the response to changing reward opportun-
ities is thought to occur through a dominance of the very fast responses
of D2 type receptors, while much slower or tonic responses (associated

with D1 receptors) appear to be involved in the extended transactions
underlying the maintenance of more focused motivational sequences
(through sustained effort). An alternative view of this relationship
(Cohen, Braver & Brown, 2002) is that the tonic and phasic modes
are not independent, with tonic DA activity indirectly modifying the
level of phasic bursts. The effective outcome is a shift in the balance
between updating and maintenance (interruption and effort) modes as
the tonic level of DA changes over its full range. There appears to be
an optimum level of tonic DA activity for any behaviour (Cohen et al.,
2002; Seamans & Yang, 2004), with very low levels pushing motiv-
ational control towards change or updating (causing behaviour to be
variable, distracted and impulsive), and very high levels encouraging
maintenance at the expense of updating (with a resulting behavioural
pattern of hyperselectivity and rigidity). In any case, there appears to
be a clear role for dopamine in the balance between the maintenance
and interruption of current goals, as well as a possible supplementary
role for noradrenaline.
This is, however, only part of the picture. As I have mentioned earlier,
goal disruption may also result from non-effortful experiences, such as
minor breakdowns in task performance and breakthrough from envir-
onmental events. Since detecting such disturbances is considered part
of the ACC repertoire (Botvinick, 2007; Carter & van Veen, 2007) it
is clearly possible that ACC coordinates both these functions – routine
performance evaluation and the need for effort recruitment – with PFC
acting upon the outcomes of ACC activity to maintain task goals. In
this case the separate executive component of effort shown in the con-
trol model would not be needed. Instead, it could be replaced by a con-
trol loop that generated effort but did not manage it. However, at this
early stage of theorizing, such uncertainty is not a major issue for the
general requirements of the model. This assumes only that a process
of effort regulation mediates the regulation of the response to detected
changes in task strain.
Finally, it is unclear whether non-effort intrusions are better consid-
ered as part of the fatigue interruption mechanism, or as a quite separ-
ate process (though the way in which interruption occurs centrally may
be the same in the two cases). On balance, they may be better under-
stood as two different forms of interruption, having different functions.
Whereas non-effortful (automatic) interruption serves to draw attention
to other, currently more rewarding, behavioural options, effort-driven
interruption (fatigue) acts as a more specific indicator of the increas-
ing strain of maintaining a specific goal in attention. Of course, effort
is an ambiguous construct. In the neuroscience literature, it is typ-

ically defined as a high level of instrumental activity or motivational
intensity, such as willingness to climb a wall to get to a bigger reward
(equivalent in terms of human activity to running harder to win a race).
However, in the context of performance and mental tasks, effort may be
more generally related to a commitment to strategies that make greater
demands on working memory or executive function. Are these the same
thing? Probably not, though it may not matter much in terms of cen-
tral mechanisms. Both kinds of effort require persistence with activities
that have high costs; and, as the human fMRI study of Boehler et al.
(2011) demonstrates, both involve increased levels of dopamine.
Summary
Chapter 6 proposed a motivational control model of fatigue, empha-
sizing its fit with evidence from the core psychological literature: the
phenomenology, performance and effort aspects of the fatigue process.
The essence of the approach is that fatigue acts to alert the executive
control mechanisms to the falling utility of current activities in rela-
tion to other options. It does this by interrupting the flow of control
and allowing alternative goals to be considered for selection. The chap-
ter also considered recent evidence from brain research on executive
function, motivation and effort, and showed how this material influ-
enced the details of the model and was broadly consistent with its main
elements.
7 Extensions and limitations: energy,
physical work and sleep
Background
In the previous chapter, I sketched out the main elements of the motiv-
ation control theory of fatigue, and showed how it related to some
aspects of current research in neuroscience. I now extend this approach
to consider the wider neuroscience and physiological literature. This
includes more on executive control, but also relevant evidence concern-
ing energy metabolism, physical fatigue and sleep. I consider these three
areas, in turn, and try to assess their relevance for the motivational con-
trol model of fatigue.
Brain energy
I have referred throughout to the long-standing question of the rela-
tionship of fatigue to energy: the assumption that fatigue is the indir-
ect result of doing work, somehow caused by a depletion of energy
stores. As I argued in Chapter 2, the energy depletion view of fatigue
originally had the status of a metaphor – the body appeared to behave
as if it were a thermodynamic engine, though, because of its bio-
logical plausibility, the metaphor became a literal explanation; we
(still) routinely think of fatigue in terms of energy depletion. This
is especially true for physical work, where the idea of an energetic
shortfall is intuitively appealing, for example because of high meta-
bolic demands on the cardio-respiratory system and skeletal mus-
cles (though, as I mentioned earlier, this does not appear to be true
in any simple way). And what about mental fatigue? Does the brain
really use up more energy when doing more demanding mental tasks?
And is that lost energy sufficient to account for the various phenom-
ena of fatigue? It is time to re-evaluate the energy assumptions of
fatigue, and place them within the context of modern understandings
of energy metabolism.
155
156 Extensions and limitations
Energy use by the brain

To be able to interpret the relation between energy and mental proc-
esses, including effort and fatigue, we need at least a basic understand-
ing of the mechanisms underlying the production and deployment of
energy in brain and body. A key feature is that the management of
resources between these two systems is strongly biased towards main-
taining a stable level of brain energy. It has long been known that the
brain is a hungry consumer of the energy produced from food inges-
tion. Although making up only around 2 per cent of the average adult
body weight it receives 15 per cent of the cardiac output, accounting
for 20–25 per cent of the total oxygen consumption and 25–30 per cent
of the body’s glucose utilization (Clark & Sokoloff, 1999). Despite a
well-established research tradition, our understanding of the detailed
relationship between brain energy and both mental and physical activity
remains somewhat unclear. Earlier attempts to demonstrate the impact
of mental activity on brain energy proved largely unsuccessful. Van den
Berg (1986) observed that Hans Berger, who developed the EEG as a
result of his interest in measuring the energy demands of mental work,
later concluded that the level of metabolism in the resting brain was so
high that changes with mental tasks would be very difficult to detect.
This was confirmed by Kety and Schmidt (1948), whose method was
the first reliable procedure for use with unanaesthetized humans, and
is still widely used today. (It is based on the assumption that cerebral
blood flow is directly related to the rate of uptake and clearance of an
inhaled inert diffusible gas, such as nitrous oxide.) Much of the research
that followed found little evidence of any appreciable change in overall
brain energy under a very wide range of mental demands, including the
definitive study of Sokoloff, Mangold, Wechsler, Kennedy and Kety
(1955), using mental arithmetic as the task. This view of the stable
brain has been the dominant one for the last half century (Van den
Berg, 1986). In recent years, it has become clear that the level of glucose
utilization varies across both brain regions and states of the organism
(e.g., Fray, Boutelle & Fillenz, 1997; McNay & Gold, 1999), and that
different task demands are associated with blood flow towards specific
regions (Cabeza & Nyberg, 2000). Nevertheless, it remains the case
that the average level of brain energy appears to be effectively constant
under a wide range of conditions (Raichle & Mintun, 2006).
Until comparatively recently most reliable evidence on the mecha-
nisms of brain energy metabolism came from animal studies. However,
sophisticated non-invasive analyses of the response of the brain to
external demands, in both humans and animals, has become possible
Brain energy 157
with the advent of neuroimaging techniques: positron emission tom-

ography (PET) and functional magnetic resonance imaging (fMRI).
These show changes in cerebral blood flow (CBF), which can be used
to infer the level of activity of specific neuronal pathways. Briefly, PET
reveals localized changes in glucose metabolism, blood flow and oxygen
take-up, while fMRI measures changes in the difference between oxy-
genated and deoxygenated blood (the blood oxygenation level-dependent
(BOLD) contrast) between resting and task conditions. Such analyses
rely on long-held assumptions that increases in neural activity are
closely related to changes in blood flow and oxygenation (Sherrington,
1906), and provide information about regional brain changes, rather
than simply overall levels of metabolic activity. It is now apparent from
PET and fMRI studies that, whereas mental activity has little impact
on brain energy as a whole, there are consistent shifts towards brain
areas currently relevant for task functions. The comprehensive review
by Cabeza and Nyberg (2000) shows that, for example, frontal sites are
consistently activated by tasks involving executive control: sustained
attention, working memory and problem solving.
However, Raichle and Mintun (2006) point out that effects detected
by PET are actually quite small, with task-dependent regional changes
in blood flow of no more than 5–10 per cent of resting levels. They also
argued that, since glucose utilization in the regional response to task
events involves a much lower uptake of oxygen, local changes resulting
from specific mental activity correspond to an increase of no more than
1 per cent in terms of actual energy consumption. They also empha-
size the intense energy demands of intrinsic brain activity, identified
as a ‘default mode network’ of the brain (Raichle, MacLeod, Snyder,
Powers, Gusnard & Shulman, 2001). Resting brain activity (in the
absence of a task or evoked response to the environment) utilizes around
90 per cent of available glucose, with 60–80 per cent of all energy used
to support intrinsic communication between neurons. Thus, even when
no active cognitive work needs to be done, very high metabolic costs are
incurred by the brain. The default mode is thought to carry out basic
maintenance not only of neuronal tissue, but also of information and
routines needed for responding effectively to environmental and cog-
nitive demands.
Energy metabolism in brain and body

While a detailed account of the highly complex biochemistry of brain
energy metabolism is out of place here, a brief outline is necessary to
support the discussion of energetic issues in this chapter. The source of
energy for all cells is adenosine triphosphate (ATP), which is essential

for all neural activity. Very little ATP is available at any one time, either
in the brain or the body, and it is repeatedly resynthesized from the more
stable diphosphate (ADP) or monophosphate (AMP) forms produced
when ATP is broken down by chemical reactions. The various energy
substrates are obtained through the action of enzymes on ingested
food, and transported by the blood to specialized storage sites (mainly
liver, muscles and adipose tissue), to be available for ATP manufacture
when required. Glucose is the primary fuel for energy, being directly
available for conversion to ATP, while proteins and fats involve much
slower conversion rates. Both liver and muscles can convert carbohy-
drate to glycogen for storage, but only the liver is able to reconvert it to
glucose when required, for transport through the blood supply to other
cells, including the brain. The skeletal muscles produce ATP directly
from stored glycogen for dedicated use during physical activity, as well
as making use of lactate made available during this process.
A highly simplified account of ATP metabolism is something like the
following. For the body as a whole, ATP is made through the action of
three separate energy systems. The first two are particularly appropriate
to the needs of the body under intense physical work. The phosphagen
system applies only to the skeletal muscles, and is a very fast anaer-
obic process that replenishes used ATP through breakdown of creatine
phosphate, which is also stored in the muscles. This provides energy for
intense muscular work (as in sprinting) but only for short bursts of ten
seconds or so. The second process, glycolysis, provides energy needs for
longer lasting intense activity (such as middle distance running or long
tennis rallies). It involves the breakdown of glucose (or glycogen stored
in muscles) to produce pyruvate and a small amount of ATP, with fur-
ther conversion of pyruvate to either lactate (in the absence of oxygen)
or acetyl co-enzyme, which enters the Krebs cycle to produce further
ATP. The Krebs cycle is the most complex of the three systems, involv-
ing a sequence of metabolic reactions within the cell mitochondria to
produce ATP, along with CO2 and water. It takes place entirely under
aerobic conditions and is responsible for most of the energy produced
by the body. While the aerobic system is much slower, it produces an
abundant supply of ATP (18 times as much as through glycolysis), and
is the most widely applicable to bodily needs.
The general principles of energy metabolism apply not just to the
brain, but to the whole body (and to all other organisms). However, there
are two major differences between them. In the brain ATP is obtained
almost exclusively from glucose; this is because, while peripheral mus-
cle can make ATP from a range of sources (glucose, fats or protein) only
Brain energy 159
glucose is able to cross the blood–brain barrier. Also, unlike the liver
and skeletal muscle, the brain cannot store glucose, except in the more
durable form of glycogen in astrocytes (glia cells that line the blood
vessels entering the brain and act as the blood–brain barrier). This is a
very small amount, compared to 30 to 60 times as much stored in the
liver and muscle. As a result, most ATP produced in the brain comes
from oxidation of glucose available in the cerebral blood supply, requir-
ing almost all of the oxygen delivered by the blood to provide enough
energy to maintain neural processes. The anaerobic glycolysis proc-
ess is able to make use of the glycogen stored in astrocytes. While this
process accounts for only a small amount of total ATP, it is believed to
have a strategic role in maintaining brain glucose and ATP levels dur-
ing hypoglycaemic emergencies or sudden heavy processing demands,
partly because it is independent of the blood flow and therefore much
more rapidly synthesized (Brown & Ransom, 2007; Raichle & Mintun,
2006). However, most of the ATP required for integrity of brain activity
and neural activation in response to environmental demands is synthe-
sized in the presence of oxygen supplied by the cerebral blood.
The way in which the brain and body manage their separate energy
needs is still not completely understood. It was thought until quite
recently that the energy demands of both were regulated in parallel by
the hypothalamus, though this view has had to be revised in the light
of evidence showing that extreme energetic demands, such as those of
heavy exercise, fasting and starvation, had large effects on the body but
minimal impact upon the integrity of brain function. To account for
these disparate facts, and the general independence of brain energy on
peripheral supply, Peters and his group (Peters et al., 2004) developed
the ‘selfish brain’ model, arguing that the brain not only controlled the
regulation of all metabolic activity in the body but had privileged access
to blood glucose on an ‘energy on demand’ basis. This ensures energy
homeostasis for brain function, and stability of the neural availability
of ATP, irrespective of bodily demands. In addition to the accepted
regulatory control of fat and glucose by the hypothalamus, Peters et al.
proposed a control system for ATP, with set points for optimal levels
of ATP, and tightly controlled feedback processes that responded to
detected shortages by triggering an increase of glucose uptake across
the blood–brain barrier. Such a system would ensure a near-constant
supply of energy for neural activation, while, at the same time, caus-
ing temporary shortfalls in peripheral tissue (and a resultant felt need
for an increase in nutritional intake). The selfish brain theory argues
that increases in brain glucose are also triggered by the HPA (cortisol)
response to stress states, which cause glucose to be released into the
bloodstream from the liver glycogen stores. While this may help to sup-
port the behavioural response to emergencies, glucose is preferentially
allocated to the maintenance of the increased brain activity involved in
the stress response.
Does brain energy have a role in mental work and fatigue?

How does all this relate to the idea that fatigue is caused by depleted
energy? The overall conclusion is that, while specific mental activities
may involve local changes in energy use, the brain maintains overall glu-
cose levels and ATP availability within very narrow limits. Nevertheless,
despite the lack of clear evidence about changes in brain energy with
mental work, there remains a widespread belief, within both psychology
and everyday life, in the idea that fatigue is associated with a depletion
of an energy resource in the brain. This viewpoint has been boosted by
two types of evidence suggesting a relationship between peripheral glu-
cose levels and mental activity; see reviews by Gibson (2007), Messier
(2004) and Rogers and Lloyd (1994). These studies have demon-
strated: (1) that peripheral blood glucose levels may be reduced under
the impact of demanding mental work (e.g., Fairclough & Houston,
2004; Kennedy & Scholey, 2000); and (2) that supplementary carbo-
hydrate or glucose ingestion may improve performance, particularly on
tasks making high demands on working memory (e.g., Benton, 1990;
Lieberman, 2006; Manning, Stone, Korol & Gold, 1998).
This literature has been supplemented by the extensive research over
the past 20 years or so on the ‘ego depletion’ hypothesis (Baumeister
et al., 2007), discussed in Chapter 5 in relation to the after-effects
of fatigue. This work has shown that activities requiring the use of
self-control, rather than the more usual high demand cognitive tasks,
also increased fatigue and impaired performance on subsequent control
tasks; see the systematic review by Hagger et al. (2010). Recent develop-
ments using this paradigm in the search for a physiological basis for the
hypothesized energy resource construct have focused on demonstrating
links between the ego depletion effect and reductions in blood glucose
(e.g., Gailliot & Baumeister, 2007; Gailliot et al., 2007). In line with
the general evidence on glucose and cognition, these studies have also
found that blood glucose is reduced under ego depletion, and that glu-
cose supplements may counteract this effect.
Of course, these findings concern changes in peripheral glucose,
rather than in brain energy. Nevertheless, they seemingly contradict
the earlier evidence suggesting that overall levels of brain glucose were
effectively constant. To understand why, the rationale for measuring
Brain energy 161
and interpreting peripheral glucose changes needs to be made clear. If

demanding tasks have a greater need for brain glucose to support neural
processes, this has to be taken from the body, which will result in a reduc-
tion of measured peripheral blood glucose (in type 1 studies above); if
additional glucose is made available, this may enhance performance
(in type 2 studies) by preventing a fall in brain energy when demand-
ing mental work is required. Overall, the peripheral glucose findings
appear to make a case for cognitive activity making demands on brain
energy, particularly where executive or effortful processing is involved.
Since the brain stores almost no glucose, such results can be interpreted
as reflecting a compensatory increase of blood flow to the brain to pro-
vide additional glucose for ostensibly more demanding mental activity.
Under normal nutritional conditions, based on the selfish brain model,
this would be an automatic process, based on the detected shortfall in
brain ATP levels (Peters et al., 2004), though short-term deficits may
occur. In such instances, it is possible that glycogen reserves, although
small, play a major role in maintaining neuronal activation.
However, there are a number of problems with such a conclusion.
First, the evidence itself – despite the confident assertions of Baumeister
and his colleagues (Gailliot, 2008; Gailliot & Baumeister, 2007) – is
simply not clear-cut. Comprehensive reviews of the broader literature
on nutrition and performance (Gibson, 2007; Gibson & Green, 2002;
Rogers & Lloyd, 1994) conclude that neither of the two kinds of effect
noted above is routinely observed, with a significant number of stud-
ies reporting either no effect or changes in the opposite direction. For
example, in a study of the effects of mental effort on physical work,
Marcora, Staiano and Manning (2009) found the expected increases
in reported fatigue and heart rate for a high effort group of partici-
pants (who carried out 90 minutes of a demanding visual discrimin-
ation task), as compared to a control group (who watched emotionally
neutral films). However, they found no difference in peripheral blood
glucose, which declined equally over the session for both groups.
A second, specific, problem is that the main evidence for a glucose
reduction under self-control conditions (the series of studies reported
by Gailliot et al., 2007) has been challenged by Kurzban (2010), whose
reanalysis of the data concluded that there was, at best, only weak evi-
dence for the claimed effect. This is in line with the outcome of the
above reviews of the nutrition and cognition literature, which found
little convincing evidence of a benefit from glucose ingestion in healthy
individuals whose blood glucose levels were within the normal range.
An additional complication for the beneficial performance effects of
carbohydrate ingestion is a likely confounding with arousal of the HPA
(cortisol) stress response by demanding cognitive tasks (Gibson, 2007).

As mentioned earlier, the selfish brain theory (Peters et al., 2004)
argues that cortisol has a key role in regulation of the blood supply to
the brain via feedback to ATP set point receptors. Low levels of cortisol
promote increased glucose release from liver glycogen stores, while high
levels operate to shut down this process. It is therefore possible that
the reduction of blood glucose with demanding tasks is a response to
the stress needs of the brain, rather than to local neuronal energy use.
A final problem is the effect of exercise; there is now considerable evi-
dence (e.g., Hillman, Pontifex, Raine, Castelli, Hall & Kramer, 2009;
Tomporowski, 2003) that acute cardiovascular activity enhances cogni-
tive performance, despite the fact that exercise makes extreme demands
upon body glucose supplies (far in excess of any putative effects of men-
tal demands).
In summary, then, the evidence from studies of the depletion of
peripheral glucose during mental work is equivocal. There is also no
strong argument in favour of the more general ‘strength’ explanation of
such effects. As observed in the discussion of after-effects in Chapter
5, there is a strong overlap between the effects attributed to ‘ego deple-
tion’ and those associated with the fatigue and task control literatures,
with motivation control explanations better able to account for all such
effects. A rather separate problem is that such issues have not directly
focused on the central questions of fatigue. Rather, they have addressed
the broader issues of whether the brain uses more energy when it is
carrying out mental work, and whether executive-dependent tasks use
more than other kinds. Even if the findings supported this hypothesis it
would not be critical for the fatigue–energy question. To state this once
more, this is the argument that the experience and behavioural mani-
festations of fatigue occur as a direct result of a significant reduction in
brain energy (or glucose).
Such questions may be addressed only by direct assessment of
changes in brain energy under a range of mental demands, for
example through imaging studies; as far as I know, no such evidence
is currently available. An interesting possibility is that even a small
challenge to the availability of brain energy is enough to produce a
feeling of fatigue. In particular, such a state may be a response to
sensed changes in ATP availability or transfer of glucose from the
somatic system to the brain. A candidate basis for such a mechanism
is suggested by the selfish brain theory (Peters et al., 2004), which
includes two control loops that help to maintain necessary levels of
brain energy. Feedback from low ATP concentration in the cortex
promotes increased glucose uptake across the blood–brain barrier,
Brain energy 163
as well as activating limbic-controlled stress responses that serve to

inhibit glucose uptake by peripheral organs. In fact, in a later paper,
Gailliot (2008) himself argues against a direct effect of glucose deple-
tion under executive control, since brain glucose levels are more or
less constant over the waking day while self-control is more effect-
ive earlier than later. He suggested, instead, that the astrocyte glyco-
gen store may be deployed to deal with executive energy demands;
although a small amount (around one gram), it is much more than all
the glucose present in the brain at any one time. This is an interesting
hypothesis, though Gailliot’s argument is circular, predicated on the
assumption that executive activity does indeed require more energy.
There is still no clear evidence on this, nor of any other specific links
between glycogen and mental activity. However, as the sleep energy
hypothesis has argued (Benington & Heller, 1995; Brown, 2004),
brain glycogen may have a central role in the transition between sleep
and waking; I shall return to this in the next section.
Clearly, there is no simple relationship between brain energy and
fatigue. What do we know? (1) Brains use a lot of energy, but most of
it is used to maintain the infrastructure of neural tissue, even at rest;
(2) mental activity may or may not increase the overall energy demands
of the brain, but its impact is, at most, very small; (3) specific task
demands result in a regional shift of blood to the brain areas involved
in their execution, but energy demands are increased by no more than
1 per cent; (4) there is no clear evidence that tasks that make greater
demands on executive processing consume more energy overall. Little
in this list appears to tell us much of direct relevance to the specific
question of energy and fatigue. First, there is no sign of what might be
called ‘depletion’, or even a major shortfall. In fact, the selfish brain
model argues that (under normal nutritional conditions) it is not pos-
sible for the brain to be deprived of even a small fraction of its required
level. The problem is that the brain energy literature is not sufficiently
refined to address questions of effort and fatigue. Fatigue is typically
characterized by a transient period of degradation (or strain) followed
by a recovery to full function when the task is stopped; I could find no
observations of a parallel pattern in brain energy, such as an energy
refractory phase, or evidence relating to the time course of any (partial)
depletion and restoration process. There is similarly nothing on the
effect of effort on blood flow and glucose utilization, or on the moderat-
ing effects of the nature of the task. Are the observed increases in brain
glucose for high demand tasks still found when tasks are self-chosen or
highly controllable?
Overall, there is little evidence to support the view of fatigue as a state

of low energy. Under task conditions, relative blood flow reflects which
brain structures are required for processing, but the overall level of
available brain energy appears to be largely independent of what mental
activity is taking place, and for how long. There are, however, indica-
tions that some aspects of brain energy regulation may have a signal
function, perhaps promoting the sensation of tiredness. What is needed
to clarify these issues is research that specifically examines brain energy
metabolism in relation to variables that maximize or minimize the men-
tal fatigue state, in particular tasks that vary in terms of external versus
personal goals.
Physical work and exercise

A separate complication for a theory of fatigue is the difference between
physical and mental demands. Are all fatigue states different expres-
sions of the same underlying psychological and bodily events? The phe-
nomenology of fatigue is that specific situations give rise to different
detailed experiences. Even considering mental fatigue alone, it is not
clear whether the same general fatigue state applies to all conditions. For
example, is the subjective response to heavy mental demands over short
periods the same as that to seemingly lighter demands over longer peri-
ods? We may also include emotional fatigue. This may also be regarded
as a mental state, but one experienced in situations that demand strong
and sustained emotional responses. As a result, emotional fatigue may
be argued to represent a distinctive fatigue state from that related to
purely cognitive demands. I will say more about this in Chapter 8, pri-
marily in terms of its recognition as a specific focus for understanding
problems in stress and chronic fatigue. While differences between these
various mental fatigue states can certainly throw light on the response
to environmental demands, there does not seem to be any strong rea-
sons for separating them in terms of the proposed fatigue mechanism.
In all cases, the limiting factors may be argued to be the early warnings
of an adaptive interrupter, and the cognitive strain that comes from the
need to manage goals actively (at an executive level) in the face of com-
petition from other motivational priorities.
Whether or not we agree that mental fatigue may be regarded as a
single construct, many would argue for the need to distinguish between
mental and physical fatigue. A major starting point for this belief is
that the two appear to have quite different origins, in different kinds
of work. Physical fatigue is associated with the work of the body’s
musculature and cardiovascular system, necessitated by the need to
maintain locomotion and postural adjustment, and to carry out the

sustained movements involved in all exercise. There have been moder-
ately successful attempts to separate the two kinds of fatigue experience
through the use of psychometric tests. For example, Åhsberg (2000)
developed a five-factor test, which produced a general factor of ‘lack of
energy’ and four specific factors: physical exertion, physical discom-
fort, lack of motivation and sleepiness. While different occupational
groups all showed increased lack of energy after high workload, they
varied on other dimensions; only the most physically active occupation,
fire-fighters, showed marked increases in physical exertion and phys-
ical discomfort. A separate question, however, is to what extent men-
tal and physical activities draw on the same general-purpose fatigue
mechanism.
Peripheral and central fatigue in exercise

When we feel tired from carrying out physical work we often attribute
these feelings to the overuse of large muscle groups, or of limitations
of the cardio-respiratory mechanisms that deliver oxygen and glucose
to the muscles. Such views are supported by traditional theories of
physical fatigue (e.g., Conlee, 1987; Edwards, 1983). These argue that
exercise endurance is limited by fatigue of peripheral metabolic cap-
acity: the loss of the ability of the cardio-respiratory system and mus-
culature to support oxygen transport and energy production. On this
view, effort cannot be maintained because the system is depleted of the
necessary energy; fatigue is the end result of the metabolic limitation in
the exercising muscles, when the rate of ATP depletion exceeds that of
its production. This prevailing peripheral theory of exercise fatigue is
emphasized in the literature on exercise endurance, which is dominated
by a discussion of metabolic issues: cardiac output; maximum oxygen
uptake (VO2 max); muscle glycogen stores; lactate production and use.
For example, muscular fatigue – assumed to occur when the exercis-
ing muscle is no longer able to generate power – is widely believed (for
example, amongst runners and cyclists) to be caused by a build-up of
lactate, the end-product of anaerobic metabolism. Yet, lactate is used
by the muscle as a supplementary source of fuel, so cannot be the cause
of local fatigue; indeed, Stone, Pierce, Godsen, Wilson and Blessing
(1987) found that trained athletes used higher levels of lactate at all
workloads. Rather, the effect of training is to increase lactate toler-
ance, allowing the muscles to make use of the substrate for an extended
period, and to delay the point at which it can no longer be cleared from
the body.
Modern textbooks on exercise physiology (e.g., Åstrand, Rodahl,

Dahl & Stromme, 2003) remain generally supportive of the peripheral
fatigue perspective, though they usually acknowledge the distinction
between the peripheral fatigue of physical work and the role of cen-
tral fatigue in mental activities. Most of the relevant research on which
such views have been based have used endurance testing conditions
of extreme exercise, expressly with the intention that the limits of the
underlying mechanisms would be reached. The traditional approach
is to require participants to exercise to exhaustion (for example, on
exercise cycles or treadmills) under externally paced regimes, until the
performer reports being unable to continue. A widely adopted mod-
ern alternative uses self-pacing methods, requiring the management of
high levels of exercise over long periods. Of course, neither of these
has much in common with the conditions under which we routinely
experience physical fatigue in everyday life. We rarely approach such
limits, even when we go for a run or a long walk, or carry out some
work in the garden, or play a game of football, let alone engage in rou-
tine domestic or office activities. Even most professional athletes rarely
approach limits of physiological demand. Reilly and Thomas (1979)
found that professional footballers experienced only moderate meta-
bolic load. While the level of work is obviously much greater than that
experienced by amateurs, with average levels of around 65–70 per cent
VO2 max over the 90 minutes of the game (up to 75 per cent for a top
level midfield player), players had many rests, and spent around 60 per
cent of the time either walking or jogging. Yet players are often said to
be fatigued, particularly when they are required to play two or three
times in one week. The same general conclusions hold for hard phys-
ical work in factory conditions. For example, Hettinger and Rodahl
(1960) found no physiological changes over the working day that could
account for reports of fatigue in assembly line workers, and an average
of only 25 per cent of their maximum work capacity. Yet, the tiredness
we feel is a valid experience. What causes it?
The hegemony of the peripheral fatigue hypothesis has been increas-
ingly questioned in recent years, and a rival explanatory framework
proposed, based on central control mechanisms. As Kayser (2003)
puts it, ‘Any voluntary exercise endurance starts and ends in the brain’
(p. 411). Of course, the performer makes a (conscious) decision to apply
effort to the execution of a physical goal, and a later decision to stop
that activity. However, this may be considered a trivial statement. The
decision to stop, rather than being influenced by some limiting process,
may instead reflect an arbitrary response to environmental events; we
may stop during a run because we meet a friend, or, while digging the
garden, to look at a bird. But there is also a non-trivial meaning. The

interesting question for us is to ask what factors are taken into account
when the decision to stop is driven by the feeling of fatigue; the goal to
continue exercising usually remains in place, but no further effort can
be expended. Such a view does not deny the primary importance of
peripheral cardio-respiratory and metabolic factors; instead, it regards
mental control activity as the ultimate regulator of exercise behaviour:
if and when to begin exercise; how much effort to make; how to distrib-
ute effort over a period of activity; if and when to stop.
The central governor hypothesis

In fact, the idea that bodily fatigue is controlled ultimately by the brain
or mental processes is a very old one; in the first systematic research
on physical work, Mosso (1906) concluded that ‘(the) fatigue of brain
reduces the strength of the muscles’. Such views have long been rec-
ognized in research on the fatigue effects in small muscle groups; see
review by Gandevia (2001). For example, Ash (1914) showed that finger
contractions on an ergograph ceased well before the muscle had lost
its ability to contract. The broader limiting role of cognitive control in
exercise duration has become well-known since the review by Holding
(1983), which showed that cognitive, rather than physical, factors were
responsible for self-imposed exercise limitations; for example, Caldwell
and Lyddan (1971) showed that strength of pull on a dynamometer was
greater, even on the first trial, when participants knew they would have
a break between trials, while Schwab (1953) found that participants
under instructions to hang onto a bar for as long as possible lasted twice
as long when offered a five-dollar reward. In both cases (and others like
them) the activity appears to be controlled by a motivated plan, rather
than simply by physical capability.
However, this perspective has only recently been considered seriously
as a factor in extended whole body exercise. Noakes and his colleagues
(e.g., Noakes, 2008, 2012) have criticized the traditional periph-
eral fatigue hypothesis on a number of grounds (for example, that
near-maximal levels of cardiac output are never reached during pro-
longed exercise, and knowledge of the length of exercise session allows
endurance performance to be optimized through pacing). They have
proposed an alternative model, based largely on their extensive research
on self-pacing and energy management during natural endurance run-
ning and cycling. The ‘central governor’ hypothesis (Noakes, St Clair
Gibson & Lambert, 2005; St Clair Gibson & Noakes, 2004) argues
that muscle activity during prolonged exercise is managed by a brain
Experience
Cortex/conscious brain
of fatigue
feedback from
increasing effort Adjustments to
exercise plan
Sub-cortical circuits
afferent
feedback Set level of
power output
Peripheral organs:
cardiovascular system,
musculature, etc.
Figure 7.1 Main elements of the central governor model: after St

Clair Gibson and Noakes (2004)
strategy for energy management, built up over many years of experi-

ence and feedback. Exercise is regulated by a plan or mental model of
the activity, which paces the metabolic and power outputs in order to
meet the performer’s goals without threatening homeostatic stability.
Oddly, there has been little attempt to provide a detailed model of the
central governor, or to be explicit about the brain mechanisms involved.
My interpretation, shown in Figure 7.1, is based on the simple model
illustrated by St Clair Gibson and Noakes (2004). This operates as a
control system, with feedback from both peripheral and sub-cortical
sensors serving to adjust the exercise profile (for example, by modify-
ing recruitment of the exercising musculature). The two-way feedback
between cortical and sub-cortical components represents the possibil-
ity for adjustment of the exercise plan according to current state and
changing goal values. For example, the emergence of a feeling of fatigue
will tend to promote a reduction in the set level of power output, though
it may also be overridden if the exercise goal is highly valued (as in a
competitive event).
The central governor is calibrated so that effort and pacing/speed
profiles are normally maintained within acceptable ranges, prevent-
ing catastrophic breakdown of bodily systems. In their conception
of exercise limitations Noakes and his colleagues (St Clair Gibson &
Noakes, 2004) argue that the subjective experience of fatigue reflects
an emerging discrepancy between the current rate of energy use and its
projected long-term profile, as sensed by feedback from peripheral fac-
tors such as the neural recruitment of muscle fibres and cardiovascular
load. In other words, the pacing of exercise is a self-limiting cognitive
process. The fatigue feeling is evoked by disturbances that disrupt the
activity and make it difficult to meet the goal; when these cannot be
managed by mental control, exercise is reduced or stopped before dam-
age can be done to the physical system. In a similar way to that which I
have argued for fatigue in mental work, the governor model advocates
an adaptive function for the experience of fatigue, which serves as a
warning to slow down or stop when limits for metabolic activity are
approached.
A related view of central fatigue has been put forward by Marcora
(2008), with exercise duration controlled by motivational factors rather
than by bodily limitations. Marcora and Staiano (2010) showed that
supposedly fatigued muscles (following cycling to exhaustion at a fixed
80 per cent of peak aerobic power) were capable of no less than three
times as much power output on a brief test of maximum voluntary cyc-
ling power given immediately afterwards. This shows that the so-called
fatigue point in the exercise to exhaustion activity cannot be due to
any absolute limitation in the exercising muscles. Instead, the trigger
for stopping is the perception of having reached a limit of perceived
effort. In this, as in many such studies of exercise to exhaustion, rat-
ings of perceived effort (RPE) reached maximal levels just before the
stopping point. RPE typically increases linearly with the planned time
of the exercise, irrespective of the duration or required power output,
for example showing the same profile over different distances in cycling
time trials (Joseph et al., 2008). Furthermore, the RPE level during the
first few minutes of an exercise is a very good predictor of the duration
of the activity (Crewe, Tucker & Noakes, 2008), even across a range of
environmental conditions and exercise intensities. An analysis of track
athletes by de Koning et al. (2011) showed that momentary PRE is also
able to predict sudden changes of pace in competition. In line with
the central governor model, athletes behaved as if they are continually
comparing how they feel with how they expected to feel, and adjusting
their pace accordingly; they increased speed when momentary PRI was
lower than the value set by their internal model and reduced it when it
was higher. Perceived exertion has usually been taken to be a marker
of the limit of the physical exercising system, but it seems more likely
to indicate the progress of a planned strategy for managing physical
tasks. In this, subjective exertion or physical effort is a standard used to
drive exercise behaviour through a negative feedback control loop, as in
de Koning et al.’s (2011) findings. Fatigue represents the accumulated

strain from maintaining effortful engagement within planned limits.
In support of their motivational hypothesis, Marcora et al. (2009)
showed that 90 minutes of a demanding mental task impaired perform-
ance on a subsequent cycling task, both reducing time to exhaustion
and increasing perceived ratings of exertion (PRE), even though there
were no changes in muscular, cardiovascular or metabolic indicators.
Such a result implicates executive control processes underlying both
mental and physical fatigue, and is consistent with both Noakes’s and
Marcora’s models. However, Marcora (2008) has argued that the cen-
tral governor model is unnecessarily complex, including an automatic
regulator as well as an executive level control. My own view is that
Marcora’s may be too simple, allowing for control at only an executive
level. There does not seem sufficient data to separate the two approaches
at this stage, but, as with the control model of fatigue in Chapter 6, pro-
vision for routine control at a sub-executive level seems essential, with
executive control reserved for the voluntary effort-driven intervention.
The Marcora et al. (2009) result has also been observed for a carry-over
from physical workload to mental performance. Schmidtke (1976a)
found a marked increase in the vigilance decrement on Mackworth’s
clock test when participants had spent the previous hour exercis-
ing at 70–80 per cent VO2 max. Both of these studies examined the
after-effects of one type of workload on the other, and both demonstrate
that fatigue carries over from mental to physical work or from physical
to mental work, and limits the level of engagement with the demands
of the second task. In order to test the impact of simultaneous demands
for executive control, we conducted a study in which participants were
required to carry out an auditory cognitive vigilance task (Bakan, 1959)
at the same time as maintaining a high (70–80 rpm) fixed cadence on
an exercise bicycle. Executive demand was manipulated by increasing
then decreasing cycling load over seven successive eight-minute peri-
ods. As Figure 7.2 shows, vigilance performance (expressed in terms
of the signal detection parameter, d′) decreased with increasing phys-
ical workload, then recovered during the unloading phase. However,
the data also reveal an incomplete and delayed recovery, characteris-
tic of hysteresis effects (Farrell, 1999). Fatigue builds up during the
loading phase and is dissipated only partially during unloading. The
large impact on vigilance performance suggests that the requirement to
maintain a high cycling cadence demands an increasing level of execu-
tive control, which diverts effort from the cognitive goal.
Overall, the central governor model suggests strongly that, as with
mental activities, demanding physical tasks ultimately depend for their
2.4
2.2 increasing
physical load
2
Detectability (d�)
1.8
1.6
1.4
decreasing
1.2 physical load
1
1 2 3 4
Exercise load
Figure 7.2 Effect of exercise load on cognitive vigilance performance

(d′). Full lines = increasing phase of the load cycle; broken lines =
decreasing phase
maintenance on mental control. However, Noakes’ approach has not

been without its critics. While the complexities of these arguments
and counter-arguments are beyond the scope of this volume, a sense
of the issues is relevant. The model has been criticized by Weir, Beck,
Cramer and Housh (2006) on the grounds that it over-simplifies the
role of peripheral factors and their role in specific kinds of performance
impairment, rejecting the idea of a unifying model of fatigue and opting
instead for a task-dependent perspective. In fact, Noakes’ model does
not claim that there is no fatigue in peripheral musculature, but that
this is not the limiting factor in the cessation of exercise. A second set
of criticisms relate to the claim that the model does not allow any possi-
bility of catastrophic breakdown. Esteve-Lanao, Lucia, de Koning and
Foster (2008) point out that such problems are known to occur occa-
sionally, for example during marathons run in hot conditions, or when
athletes are very highly motivated to overcome perceived limitations.
However, as I have already mentioned, there is no reason why a central
exercise management model should be infallible, or that it could not
allow the possibility of a performer overriding the perception of fatigue.
On the contrary, from what we know of fatigue in mental tasks, such
effects may not be uncommon when performers are highly motivated.
Such observations do not invalidate the idea of a default mode of con-
trol, nor the adaptive value of a fatigue state. In any case, it is likely that
the homeostatic set points are similarly conservative in the two cases,
so that (1) they may easily be overridden, and (2) serious consequences
are very unlikely. It also seems possible that regulatory breakdown
may occur if the individual’s internal model is not adequately devel-
oped through relevant experience, or if cognitive capacity is impaired
through distraction. However, while the details of the central governor
model are a source of debate for exercise physiologists, its emphases on
central regulation and subjective feelings as the source of fatigue are
not seriously questioned. In any case, the central governor model pro-
vides a promising link between physical and mental task management,
and with the motivational control hypothesis. Tasks that demand phys-
ical endurance can be managed only by sustaining high levels of effort,
and are ultimately abandoned when maximum effort levels are reached.
It also fits well with the growing acceptance of the need to consider
physical fatigue as a goal-driven process (Marino, Gard & Drinkwater,
2011), and the many demonstrations (Holding, 1983) that the limiting
condition for physical endurance is a cognitive one: the willingness to
overcome resistance to further effort or pain. However, more sophis-
ticated cognitive methods may be required to test the hypothesis that
both physical and mental fatigue depend on the same mechanism for
assessing effort demands in relation to goals, through involvement of
the executive control system.
Effects of physical exercise on cognition

The implied commonality between physical and mental activity in their
reliance on mental representations of effort and fatigue suggest that
there should be mutual cross-training benefits, for example of aerobic
exercise on the performance of demanding mental tasks. In practice,
however, while there has been much research on the effect of exercise
on cognition, there appear to be no studies that have considered the
complementary hypothesis, that cognitive fitness enhances physical
performance. For the former question, formal reviews (Colcombe &
Kramer, 2003; Etnier, Nowell, Landers & Sibley, 2006) have shown a
positive training effect of exercise on cognition. Colcombe and Kramer
considered only older adults (55 years or older) and found much stronger
effects on tasks that involved executive or controlled processing. This
may be partly due to the greater impairment of executive ability with
ageing (West, 1996), which provides more room for improvement, but
nevertheless indicates the effectiveness of exercise. The underlying
assumption in such studies has been that any advantages are associated
directly with changes in cardiovascular fitness, through their effects on
cardiac efficiency and cerebral blood flow. From the perspective taken
in the present volume, it may also be expected that a fitter heart and
lungs may support a more efficient stress response, with less strain dur-
ing high effort task management. However, there is no evidence of a
dose-related effect; the extent of improvement in VO2 max or reduced
basal heart rate does not predict the size of the effect on cognition. It
may be more likely that effects of training will be mediated by mecha-
nisms that have more direct relevance to cognitive efficiency, such as
changes in neurotransmitters or the stress response.
Sleep and fatigue

In the previous section I examined how well ideas of fatigue based on
the motivational control hypothesis could be applied to physical work
and exercise. A further complication concerns sleep. Is fatigue from
disruption of sleep different from that associated with either physical
or mental fatigue? Even if the performance of mental and physical
work can be considered as being subject to the same kind of regular-
ity control, a logical case can be made for distinguishing all kinds of
work-based fatigue from that associated with sleep disturbances. The
latter are caused not by doing work but by the prevention of a funda-
mental bodily need, sleep. Again, in phenomenological terms, a feel-
ing of fatigue from lack of sleep seems quite different from mental or
physical tiredness. Sleepiness is a distinctive state, with its own bodily
expression; we have a strong urge to go to sleep, and find it difficult to
keep our eyes open or our head from dropping onto our chest. Unlike
mental fatigue, it never encourages us to go for a run to get rid of the
feeling; unlike physical fatigue, it rarely displays strong bodily changes.
Yet, hard physical work does sometimes makes us feel sleepy, and we
may fall asleep easily if we lie down.
One problem is that sleepiness and mental fatigue are a source of
confusion in understanding and treating fatigue complaints (Lavidor,
Weller & Babkoff, 2003) as well as often being used interchangeably in
academic discussions. Hossain, Reinish, Kayumov, Bhuiya and Shapiro
(2003) have argued that sleepiness and fatigue are essentially different
states, both under normal conditions and when viewed as pathologi-
cal symptoms. In an attempt to provide distinctive diagnostic crite-
ria, Pigeon, Sateia and Ferguson (2003) defined sleepiness in terms
of drowsiness, sleep propensity and decreased alertness, while fatigue
is characterized more by feelings of weariness, weakness and depleted
energy. Yet, the two states are often conflated in human experience
and difficult to separate in clinical contexts. Just what do they have
in common, and how much do their experienced differences depend

on fundamentally different mechanisms? How does sleep interact with
work? For example, is the need for sleep stronger after more demanding
work days? Within the sleep research community sleep deprivation is
treated as if it were the core meaning of fatigue, and models of sleepiness
are often referred to as models of alertness or fatigue, without qualifica-
tion (e.g., Åkerstedt & Folkard, 1996; Dawson & McCulloch, 2005) or
concern with the effects of workload or task demands. I shall return to
this point later. A further issue is the relation of sleep to energy man-
agement in the brain. Is energy depleted more under sleep deprivation?
And does sleep serve to restore that energy loss?
Models of sleep and alertness

It is now accepted that sleep behaviour is controlled by two opposing
processes. The key components are a sleep homeostat that produces
an increasing drive for sleep with time spent awake, and a circadian
regulator that aims for wakefulness peaks during the middle of the day.
The additive combination of these two processes provides the basis for
a number of models of sleep and alertness; see the review by Mallis,
Mejdal, Nguyen and Dinges (2004). These have proved effective in
predicting levels of subjective alertness and fatigue (as well as some
aspects of performance), particularly in jobs affected by shift work or
extended working time. Some models (e.g., Achermann & Borbély,
1994; Åkerstedt & Folkard, 1996) also include a transient third compo-
nent, sleep inertia, reflecting the time required to attain full alertness
after waking. Oddly, however, given the care and desired precision of
these models, very few include any formal recognition of how much
waking time is spent working, and none of the nature of the work
demands; so, a very busy or stressful day would be expected to have
no greater impact on alertness and fatigue than a relaxing day with a
high level of control. Yet, effects of task duration are known to interact
with sleep fatigue; for example, performance decrements over time on
task are greater when sleep drive is high and the need for wakefulness
low (Van Dongen, Belenky & Krueger, 2011), and Baulk et al. (2007)
found increased fatigue and impaired PVT performance during high
workload, especially during night shifts. Angus and Heslegrave (1985)
found that ratings of both fatigue and sleepiness were higher when par-
ticipants were carrying out tasks than when they were resting between
tasks. Such effects are commonplace, and demonstrate that both sub-
jective fatigue and its effects on performance are a function of both task
and sleep variables.
It is not at all clear, then, why work variables are excluded from models
of sleep and alertness. Of course, compared to the objective time-based
measures used by sleep researchers, they are more difficult to measure
reliably (though I have not seen this argument made explicitly, and it
would be a weak one). Even physical work and exercise are ignored,
although exercise typically increases feelings of sleepiness and length
of sleep, even in athletes (Shapiro, 1981). A more pertinent question is
how much difference this extra predictor would make to the effective-
ness of the alertness index, since standard models routinely account for
between 60 and 95 per cent of the variance in alertness or fatigue rat-
ings (Åkerstedt & Folkard, 1996; Fletcher & Dawson, 2001). However,
such figures may be misleading. Sleep models aim to predict normative
or group levels of alertness or fatigue, whereas, from a practical point
of view, it is often necessary to identify performance vulnerability at an
individual level. It seems likely that predictions would benefit consid-
erably from including work variables, partly since the between-person
variability of the response to work is probably greater than that for the
impact of sleep and circadian factors.
Compensatory control in sleep deprivation

As we saw in Chapter 4, fatigue from sleep deprivation (SD) may have pro-
found effects on human performance, particularly resulting in increased
errors on tasks that are heavily dependent on executive functioning, or
controlled attention (Harrison & Horne, 2000; Muzur, Pace-Schott &
Hobson, 2002; Pilcher, Band, Odle-Dusseau & Muth, 2007). This is,
of course, very much the picture I have drawn for the effects of men-
tal fatigue associated with prolonged or intense work, or conditions of
stress. And there are other similarities between the two. As with mental
fatigue, impairment from SD is more likely to occur later in a work ses-
sion, and, where detailed analysis has been carried out, it also takes the
form of an increased frequency of brief losses of control (lapses), rather
than a tonic drop in performance level. So, are they the same thing? Do
they have the same origins in brain processes? One source of evidence
is the different effects that prolonged work and sleep deprivation appear
to have on brain energy. We have seen that there is no direct evidence
of demanding mental work having a discernible overall impact on brain
energy. In contrast, several studies have shown that even a single night
without sleep can reduce brain glucose metabolism (e.g., Thomas et al.,
2000; Wu et al., 1991) and cerebral blood flow (Drummond, Brown,
Stricker, Buxton, Wong & Gillin, 1999), in both cases correlated with
the extent of impaired performance.
Although impairment under SD is commonly observed, there are

also reports of performance being maintained. Resistance to effects of
SD, particularly for complex tasks that require executive control, has
sometimes been attributed to effects of interest and motivation (e.g.,
Wilkinson, 1962, 1992; Williams et al., 1959), though Harrison and
Horne (2000) have shown that executive tasks are actually more, rather
than less, vulnerable to SD impairment. The motivation control theory
perspective provides a mechanism for this in the form of the compensa-
tory strategy of performance protection; as I have stated previously, we
should never be surprised when even extreme conditions fail to upset
task performance, since an increase in regulatory effort is usually an
option, though such protection normally comes at a cost. What is inter-
esting in this context is that the above-mentioned effects on brain energy
under SD occur only when performance is found to be impaired. In
cases where performance is not affected, activation and energy metab-
olism in frontal cortical regions have been found to increase rather
than decrease (Drummond & Brown, 2001; Portas, Rees, Howseman,
Josephs, Turner & Frith, 1998; Szelenberger, Piotrowski, Dabrowska
& Justyna, 2005). Drummond, Brown, Salamat and Gillin (2004)
also showed that such compensatory effects occurred only for more
executive-hungry tasks, with both increased PFC activation and more
widespread activation of supporting regions. These findings suggest
that enhanced executive control activity is instrumental in preventing
performance from impairment under sleep deprivation. Further sup-
port for such an interpretation comes from a study by Killgore, Grugle,
Reichardt, Killgore and Balkin (2009) showing that individuals who
were resistant to effects of SD on performance were also better at stand-
ard prefrontal executive function tasks (such as the Stroop test), though
not other kinds of task.
The energy hypothesis of sleep

Clearly, such studies offer strong support to the role of a top-down
compensatory control process in managing the extent of a decre-
ment under SD-induced fatigue. In this respect, fatigue from mental
demands and sleep disruption appear to have much in common. On
the other hand, the demonstration of changes in brain energy under
SD indicates a major difference between the two in the origins of the
fatigue effect. I shall return to this question later in this section. First,
I need to address the question of the energetic consequences of sleep.
Based on a landmark study by Benington and Heller (1995), it is now
widely agreed that energy restoration is, in fact, one of the key functions
of sleep. Benington and Heller argued that sleep is triggered by a build-

up of adenosine over the waking period, brought about by progressive
depletion of the glycogen stored in astrocytes. Adenosine has a general
inhibitory influence, blocking the excitatory influence of neurotrans-
mitters such as glutamate and acetylcholine; see Porkka-Heiskanen and
Kalinchuk (2011) for a detailed review. This view is broadly supported
by a wide range of observations (Chikahisa & Sei, 2011; Scharf, Naidoo,
Zimmerman & Pack, 2008). For example, during slow wave sleep cere-
bral blood flow and metabolic rate have been shown to decrease (Braun
et al., 1997; Maquet, 1995), while concentrations of glucose and ATP
are elevated (Netchiporouk, Shram, Salvert & Cespuglio, 2001; Reich,
Geyer & Karnovsky, 1972).
The idea that sleep has a primary function of restoring brain glyco-
gen stores has an intuitive appeal. Being awake and active appears to
provide an energetic challenge for the brain; sleep restores the energy
balance, while sleep deprivation puts a strain on it by preventing or
delaying maintenance of the back-up supply. However, recent evidence
(reviewed by Scharf et al., 2008) suggests that adenosine changes alone
are not sufficient to explain how changes in brain energy are linked
to sleep. The assumed role of glycogen depletion is also complicated.
Brain glycogen is depleted suddenly on awakening to provide ATP
(Swanson, 1992), which appears to make it part of the waking rather
than sleep mechanism, while studies in mice and rats show no consist-
ent effects of glycogen changes in response to SD (Scharf et al., 2008).
Despite these uncertainties, however, while the mechanisms by which
sleep regulation is accomplished are now thought to be more complex
than those proposed by Benington and Heller, the energy hypothesis of
sleep remains central to the understanding of sleep and wakefulness.
Local brain sleep as a basis for fatigue?

To return to the question I posed earlier, is there any evidence that
mental fatigue and that caused by sleep disturbances could have a com-
mon basis? There is currently no clear evidence on this, and I have
found little attempt to address the question directly in the separate
literatures. The significance of the sleep energy evidence for mental
fatigue is actually quite limited. This is because it applies only to gross
differences between the waking and sleeping states, and not at all to
what kind of work is done while the individual is awake. This is, of
course, a central issue in predicting mental fatigue, though again, I
cannot find any research on the problem. A rather different perspec-
tive comes from emerging evidence that sleep may be best considered
not simply as an overall reduction in the level of brain activation, but

as a property of local brain regions, dependent on their pattern of use
during waking activity (Krueger, Rector, Roy, Van Dongen, Belenky &
Panskepp, 2008; Rector, Topchiy, Carter & Rojas, 2005). It has been
proposed that different sets of neurons are active during waking and
sleeping, and that sleep onset is driven by the activation of specifically
sleep-promoting neurons, located in the hypothalamus. Van Dongen,
Belenky and Krueger (2011) have suggested that mental fatigue and
sleep fatigue may involve the same neurobiological pathways, with
local neuronal assemblies being switched off by continuous use (both
through cumulative demands during the day and during specific sus-
tained mental tasks). This is an intriguing possibility, though it remains
highly speculative at this early stage.
Elements of an integrated fatigue framework?

The material in this chapter has introduced some different perspectives
on the nature of fatigue, and on possible mechanisms. Yet, at the same
time, there are clear links with the depiction of fatigue as a problem of
motivational control, within both sleep deprivation and physical exer-
cise. An intriguing question is whether we may be able to integrate
these different insights into a more general understanding. Both the
selfish brain model of energy regulation and the central governor model
suggest ways in which neurochemical processes may be involved in the
generation of the experience of fatigue, in the form of feedback from
falling concentrations of ATP and from exercising muscles (or recruit-
ment of motor neurons). The evidence from the local sleep hypothesis
also suggests a source of the sense of loss of engagement with a task,
through the refractory phase induced in working neural circuits. An
integrated model would need to start with the experience and feeling of
fatigue, in its various forms, and show how it is generated by changes
in the various separate control loops, including mental work, physical
work and sleep, as well as energy management. While these different
systems would need to be specified by separate control models, appro-
priate to their distinctive functions, it seems possible to begin to explore
linkages between them, with subjective fatigue acting as a final com-
mon output. At present, there appears to be little relevant evidence that
would allow us to build on these suggestions. For example, we know
little about the effect of mental work and exercise on feelings of sleepi-
ness; monitoring of changes in subjective fatigue and task performance
has not been carried out routinely during brain imaging; and almost
nothing is known about the time course of hypothesized effects of sleep
Summary 179
in local neuronal assemblies in relation either to energy transformations

or to fatigue feelings and task disruptions. It is therefore too early to be
able to do more than note these various possibilities, though an inte-
grated model of fatigue does not seem too ambitious a goal for future
research. I pick up these issues again in the last chapter.
Summary
Chapter 7 examined research on fatigue from the broader literature
on energy metabolism, physical exercise and sleep. It concluded that
the energy depletion hypothesis of fatigue was not strongly supported
by the research on glucose uptake, and that more targeted work was
required to clarify the role of energy changes in both performance and
subjective fatigue. Despite obvious differences in energy demands,
physical fatigue was found to be closely related to mental fatigue, with
limitations to exercise being set primarily by a central control pro-
cess. Fatigue from sleepiness was considered to have a different origin
from both, but also subject to the same central regulation under task
conditions. The possibility that local neuronal sleep mechanisms may
underlie mental fatigue was discussed, along with other neurochemical
feedback mechanisms, but more empirical evidence is required.
8 The psychopathology of fatigue
Background
This chapter is about the psychopathology of fatigue: what happens
when the normally adaptive role of fatigue in motivational control fails.
Rather than feeling tired momentarily, and unable (or unwilling) to
make an effort to engage in further demanding activities for the next
few minutes or so before recovering, an individual may feel tired for
long periods, or most of the time. The feeling of ever-present fatigue
is very common, at least over periods of a few weeks or months. It may
not be eased by rest, however long, or even a good night’s sleep. It
is also a major complaint in most illnesses and post-operative states
(Torres-Harding & Jason, 2005; Wu, Berenholtz, Pronovost & Fleisher,
2002). I refer to the widespread form of this condition as prolonged
or persistent fatigue, to distinguish it from both the normally adap-
tive everyday transient fatigue that is the core topic of this book and
the more debilitating condition recognized by the medical diagnosis
of chronic fatigue syndrome (CFS). In fact, as will become clear in
this chapter, I take the general position that the more commonly expe-
rienced persistent fatigue may be considered, for most purposes, as a
mild form of CFS, and I shall sometimes use chronic fatigue and per-
sistent fatigue interchangeably when discussing the psychopathology
of fatigue in a broader context. Apart from the defining characteristic
of persistent tiredness, the core psychological features of all forms of
chronic fatigue are an aversion to (or exaggerated sense of) effort, and
reduced motivational control over task goals: a lack of interest in doing
very much at all. In clinical contexts, where a lack of goal-directed
behaviour is considered to be the main problem, the term apathy is
sometimes preferred to chronic fatigue (Brown & Pluck, 2000; Marin,
1991). Both symptoms are common across a wide range of neurological
and psychiatric disorders, and identified with a malfunction of motiv-
ational mechanisms, specifically failures in the control of goal-directed
behaviour.
180
Prevalence of persistent fatigue 181
The focus of the chapter is on the extensive literature on the formal

diagnostic condition of CFS and related conditions that imply a mal-
function of the fatigue mechanism. I will also consider the literature
on fatigue in more specific chronic medical conditions, where many of
the same effects are observed. But the most common problems of per-
sistent fatigue are found not in medically diagnosed conditions but in
everyday life. These have usually been associated with the demands of
work, especially jobs in the caring professions, although they may also
occur as a response to the demands of non-work and family activities. I
will briefly review this material later in the chapter. In general, I argue
for a continuity of acute and chronic fatigue. While specific causal fac-
tors may need to be taken into account for different manifestations of
chronic fatigue, my general hypothesis is that persistent fatigue of all
kinds is caused by a breakdown in the normal mechanisms underlying
the control of motivation, effort and goal orientation. In this, I make
the assumption that at least part of the problem of fatigue in chronic
illness is the loss of control over the management of goals in relation to
the benefits and costs of alternative actions. It appears very likely that
specific causes, relating to identifiable and measurable physical mecha-
nisms, will be shown to play a major role in the patterning of CFS
and related conditions (as they do in multiple sclerosis, Parkinson’s dis-
ease and cancer). Such causes may also have other consequences, cur-
rently unrevealed by diagnostic tests, and what we now identify as CFS
may eventually be seen as a family of related but different illnesses.
Nevertheless, irrespective of such considerations, I maintain that the
experience and impact of chronic fatigue need to be explained through
its relationship to the normal mechanisms of motivational control: goal
management, effort, executive functions, and a breakdown of the every-
day mechanisms of acute fatigue.
Prevalence of persistent fatigue

How widespread is persistent fatigue? Its prevalence is hard to gauge,
not least because, as with all symptoms based on feelings or emotional
states, it is often only vaguely identifiable and under-reported by suffer-
ers. It also depends on what questions are asked. For example, Lewis
and Wessely (1992) comment that only half as many respondents agree
that they are ‘exhausted’ than claim to suffer from ‘general fatigue’,
while ten times as many report being ‘tired all the time’ than say that
they feel ‘weak’. However, formal estimates are available from several
large-scale surveys, typically asking participants about feeling tired.
One UK study (Cox et al., 1987) reported that as many as 20 per cent
of men and 30 per cent of women reported ‘always feeling tired’ during
the previous month, while a US survey (Chen, 1986) obtained values of
14 and 20 per cent, respectively, for feeling ‘tired all or most of the time’.
A Swedish study of fatigue in women (Bengtsson, Edstrom, Furunes,
Sigurdsson & Tibblin, 1987) reported a figure of 42 per cent for general
fatigue. There are many reasons for the differences, including the form
of the questionnaire and the time frame of fatigue experiences, but it is
clear that a state of persistent fatigue is experienced by a large propor-
tion of the population.
It is common for women to report a higher level of fatigue than men.
Lewis and Wessely (1992) summarized data from 16 community sur-
veys. For the nine that supplied separate data for women and men the
mean rates were 29 per cent and 19 per cent respectively. Lewis and
Wessely also reported data from primary care studies. Fatigue is con-
sistently towards the top of the list of frequency of reports of complaints
to doctors, despite a marked tendency for under-reporting (Morrell,
1976). Of the five studies showing both women and men, the mean rates
were 24 per cent and 15 per cent, respectively. We might have expected
fatigue prevalence to be higher, rather than lower, for people attending
clinics, since the relevant population is more likely to be unwell, though
different criteria have often been adopted in the two settings. I could
find only one study (Ingham & Miller, 1979) that employed the same
case definition of fatigue in the two settings, and this showed higher
rates for patients (45 per cent and 28 per cent for women and men)
than for the general population (28 per cent and 17 per cent). In both
community studies and clinics there may also be a confounding effect
of co-morbidity (the presence of overlapping, multiple symptoms); this
may either inflate rates (when not corrected) or deflate them (when
tiredness is not recorded as a result of it being considered a support-
ing, rather than main, symptom). It may also inflate the reported preva-
lence for women, who are more highly represented in general practice
clinics and tend to report more psychological symptoms (Chen, 1986).
A large-scale longitudinal study of primary care patients by Wessely,
Chalder, Hirsch, Wallace and Wright (1997) obtained prevalence rates
for both common chronic fatigue and CFS. Population estimates were
around 11 per cent, reducing to 4 per cent when cases with co-morbid
symptoms were excluded, though this used a very strict criterion of six
months continuous symptoms, the same as for CFS. In addition, as with
the Chen (1986) study, once the data had been adjusted for the level of
general psychological disorder in the sample, there was little evidence of
higher prevalence in women. Using strict definitions of CFS, prevalence
was around 1–3 per cent, depending on the specific criteria adopted.
Chronic fatigue syndrome (CFS)

While the data on prevalence suggest that persistent fatigue is a wide-
spread problem, affecting around a third of the population, its formal
acknowledgement as a clinical condition (CFS) is very slight. The value
of 1–3 per cent obtained by Wessely et al. (1997) is consistent with
most estimates. This is because the diagnostic criteria for caseness are
very strict, including the need to have been suffering from chronic
fatigue for six months or more, and being free of a wide range of other
symptoms (co-morbidity). I first briefly review the clinical context of
chronic fatigue, and then examine evidence for persistent fatigue in
major chronic illness.
The clinical context of chronic fatigue

As I discussed in Chapter 2, the idea of chronic fatigue is a very old one.
It has long been acknowledged as a central feature of melancholia, and
of its nineteenth-century counterpart, neurasthenia, which, by the end
of the nineteenth century, was the most commonly diagnosed mental
disorder. Nevertheless, during the period following the end of the First
World War, diagnoses of neurasthenia and of fatigue-related disorders
more or less disappeared. This was, in part, because of increasing aca-
demic criticism of the term’s over-inclusiveness and lack of diagnostic
clarity – it was never clear whether the problems of exhausted patients
concerned their energetic capacity for bodily activity or their mental
state – but also, according to Shorter (1992), because of a paradigm
shift that treated psychosomatic disorders as psychological, rather than
organic, in origin.
In any case, the fact of chronic fatigue is still with us, as both a symp-
tom and a syndrome; and, needless to say, the problems of interpret-
ation still apply. Apart from sporadic occurrences during the earlier part
of the nineteenth century, the problem was ‘rediscovered’ in a clinical
context during the 1950s and 1960s, primarily through the recognition
of difficulties of explaining outbreaks of widespread flu-like symptoms
in a number of hospitals, and became established as a recognized med-
ical condition during the 1980s and 1990s. The term chronic fatigue
syndrome (CFS) was adopted widely as the preferred label for the
condition following a report by the United States Centers for Disease
Control and Prevention (CDC) (Holmes et al., 1988). This medically
accepted condition needs to be distinguished from the common prob-
lem of prolonged or persistent fatigue I referred to at the beginning
of this chapter, though, in practice, such differences may be slight. In
extreme cases, prolonged fatigue is so debilitating that the everyday

life of the individual is severely affected; in some, but not all cases,
they seek medical help and, of these, some are diagnosed with CFS. I
use this term in preference to a number of alternative labels that have
been applied to the condition over the past 30 years or so – epidemic
neuromyasthenia, myalgic encephalomyelitis (ME), post-viral fatigue
syndrome (PVFS), chronic fatigue immune dysfunction syndrome
(CFIDS), and a number of other more aetiology-specific terms – for
two reasons: (1) because CFS is neutral with respect to organic origin
or causal mechanism of fatigue; and (2) to emphasize the continuity
I believe exists, not only between CFS and more general prolonged
fatigue, but also between both of these persisting states and the normal
fatigue experiences of everyday life.
In the limited treatment of chronic fatigue possible within this vol-
ume, I will not try to disentangle the many competing medical posi-
tions, or be overly concerned with resolving problems of co-morbidity;
fatigue is a very general response, so nearly always occurs in tandem
with other feelings or experiences. My approach, instead, is to focus on
the ways in which the prolonged fatigue state is manifested and to ask
how it differs from effects of extreme fatigue in non-pathological states.
Why should such fatigue occur at all, when sufferers are so inactive?
And why does it not dissipate? Does persistent fatigue have anything in
common with the everyday experiences of acute fatigue?
What causes CFS?

There is still no absolute agreement about what formally constitutes
CFS, but the generally accepted criteria, based on the CDC report,
include: having chronic fatigue for six months or more, with at least two
accompanying symptoms, such as cognitive impairment (memory and
concentration), ineffective sleep, long-lasting effects of exercise, and
various bodily symptoms, such as sore throat, headache and joint or
muscle pain (Fukuda, Strauss, Hickie, Sharpe, Dobbins & Komaroff,
1994). The diagnosis of CFS in a patient is a highly conservative pro-
cess, in that it must also take care to rule out other conditions, such as
fibromyalgia, depression or sleep disorders that may also give rise to the
symptoms. However, for all we know, generalized chronic fatigue may
itself be the primary condition, giving rise not only to CFS and other
persistent fatigue patterns, but to many of these other symptoms.
Despite an intensive research effort over the past 15–20 years, we
are still unable to explain what causes CFS or how the condition is
best managed. No consistent changes have been found in body or brain
tissue that can be used to satisfy standard clinical criteria for diagno-
sis or treatment. The most common assumption has been that such
diseases have an origin in viral infection, mainly because a persistent
fatigue state is a common characteristic of the post-infection stage,
though in the case of CFS the symptoms last very much longer. Recent
suggestions that CFS may be linked to the presence of retroviruses have
generally failed to be supported by follow-up studies (Weiss, 2010),
though this remains a possibility. Among the other factors that have
been hypothesized to play a role in CFS are immune system dysfunc-
tion, stress and emotional disorders, imbalances in various neurotrans-
mitters, or more likely some combination of these. In addition, CFS has
often been bracketed with a range of other ‘mysterious’ illnesses, such
as fibromyalgia, multiple chemical sensitivity, and post-traumatic stress
disorder; such conditions are often co-morbid with CFS (and with each
other) and some researchers (e.g., Pall, 2007) have argued that they all
have the same stress-induced aetiology. It is also commonly assumed
that CFS is perpetuated by inactivity and by maladaptive illness beliefs
(Afari & Buchwald, 2003; Wyller, 2007). The most popular treatment
for CFS, cognitive behaviour therapy (CBT), in addition to implement-
ing a programme of graded increases in physical activity, specifically
targets problems associated with illness thoughts and beliefs of suffer-
ers, with some degree of success (Deale, Chalder & Wessely, 1998).
Effort and motivational control in CFS

In diagnosing and treating CFS there is a need, as in the physical exer-
cise literature, to distinguish between peripheral and central fatigue.
Whereas peripheral fatigue refers to a functional inability of the muscle
to generate force, central fatigue refers to the subjective sense of exer-
tion and exhaustion, even in the absence of a functional limitation. In
CFS the problem is recognized to be one of central fatigue, though,
as we saw in Chapter 7, this may have effects on both physical and
mental endurance. Patients with CFS show an inability to fully recruit
their muscles, despite normal muscle capacity, and have an exaggerated
perception of effort at all levels of exercise (Gibson, Carroll, Clague &
Edwards, 1993; Sisto et al., 1996). Central fatigue in motor control has
been argued by Chaudhuri and Behan (2004) to be caused by abnor-
malities of the basal ganglia, with a reduced drive to the motor cortex
caused by dysfunction of the limbic connections with the prefrontal
cortex. In the terms of the framework proposed here, this equates to a
loss of motivational control over task goals, operating through the ACC/
PFC executive system. Chaudhuri and Behan argue that self-initiated
work is a result of two major influences: motivational priorities and per-

ceived exertion (or felt effort), based on feedback from sensory-motor
and cognitive activity. Their model includes a set point for perceived
exertion, which acts as the reference point for the management of effort,
and which appears to be set at a lower level in CFS patients. This is, of
course, very similar to the core idea of effort control in both Noakes’
central governor model (REFS) and the model of effort and fatigue
presented in Chapter 6, except that the lower set point for allowable
effort is a fixed feature of CFS, rather than a temporary adjustment.
Chaudhuri and Behan’s (2004) model shows how effort may be seen
as the key controlled variable of the motivational control system. It is
determined both by inputs from motivational and cognitive priorities
and by feedback from ongoing activity, such as the effort demands of
cognitive tasks or exercising muscles.
Although a concern with physical fatigue has been the most obvious
feature of CFS, problems with cognitive functioning are amongst the
most common symptoms, with around 90 per cent of patients report-
ing difficulties of memory and concentration (Jason et al., 1999). It has
become increasingly recognized amongst clinically-oriented research-
ers that the core problem of both physical and mental fatigue may be a
dysfunction of effort and executive control. A meta-analysis carried out
by Cockshell and Mathias (2010) confirmed the view that performance
was impaired much more on activities that made demands on executive
function, such as speeded tasks, memory and sustained attention, or
those that demanded effortful processing. Other findings and clinical
observations also implicate the central role played by the demand on
effort. Lawrie (1997) has argued that the key to understanding CFS is
to think of it as a ‘disturbance of the sense of effort’. He suggested that
CFS patients feel more fatigued because they have an increased require-
ment to actively manage task goals, as would be the case if executive
function were impaired or not adequately supported by the effort con-
trol system. Consistent with Chaudhuri and Behan’s (2004) model, the
attempt to maintain motivational control leads to both a greater sense
of effort and a lower tolerance for high demand activity (both physical
and mental). A specific focus on effort perception does not appear to
have been addressed directly by therapeutic approaches, including both
CBT and other treatments. Even a broader concern with treating cog-
nitive difficulties has not been a primary goal for such methods. While
a systematic Cochrane review (Price, Mitchell, Tidy & Hunot, 2008)
found some support for the efficacy of CBT, the analysis was based
on improvement in physical, rather than cognitive, activity. Yet, there
is no evidence that enhancing physical conditioning is a causal factor

in the effectiveness of treatment (Deale et al., 1998; Wiborg, Knoop,
Stulemeijer, Prins & Bleijenberg, 2010). I shall return to ideas relat-
ing to effort management towards the end of the chapter, when I put
forward a general model for how persistent fatigue of all kinds may
develop.
Fatigue in chronic medical conditions

In addition to its status as the core symptom in CFS, experiences of
fatigue are also very common across a wide range of other illnesses,
including depression, irritable bowel syndrome, stroke, multiple scler-
osis, Parkinson’s disease and cancer, as well as being a regular feature of
common colds, flu and other infections (Smith, 1990). In fact, fatigue
is so common in depression, multiple sclerosis and Parkinson’s disease
that it is often regarded as an early sign of their onset, and may lead to
misclassification. One complication of interpreting fatigue in major ill-
ness is the well-established impact of surgery, affecting between 20 and
50 per cent of patients (Wu et al., 2002). Fatigue symptoms may last
for a month or more, even with uncomplicated surgery (Christensen &
Kehlet, 1993), though they do not appear to be related to the time spent
in surgery or anaesthesia. Of course, surgery is a major stressor, and
more severe and prolonged symptoms are associated with major proce-
dures (Rubin, Hardy & Hotopf, 2004). It is likely, as Christensen and
Kehlet (1993) and Rhoten (1982) have suggested, that post-operative
fatigue is mediated by sustained neuroendocrine stress responses, serv-
ing the adaptive function of inhibiting competing activity while the body
recovers full function. Such considerations are clearly relevant to major
illness, where surgery or therapeutic interventions are nearly always
involved, in some cases repeated over a number of cycles. However, it
is assumed that they are separate to the longer-term fatigue states asso-
ciated with chronic illness. While recognizing the multi-deterministic
nature of the wide range of neurological and psychiatric conditions that
include fatigue as a major symptom, it would be inappropriate (and
presumptuous) to attempt to resolve the many complex debates about
the origins of fatigue in these diseases. However, a brief review of the
evidence is appropriate. A relevant question is whether the experience
and impact of fatigue is similar across these different conditions. I here
briefly summarize findings from the three most commonly studied
chronic medical conditions where fatigue is a major problem: cancer,
multiple sclerosis and Parkinson’s disease.
Cancer
Approximately 50–90 per cent of cancer patients experience chronic
fatigue (Campos, Hassan, Riechelmann & Del Giglio, 2011), par-
ticularly when undergoing courses of radiotherapy and chemother-
apy (Flinton & Pettet, 1999; Gutstein, 2001; Servaes, Verhagen &
Bleijenberg, 2002). As with CFS, fatigue in cancer is increasingly
found to be associated with problems of executive control, planning
and memory (Jansen, Miaskowski, Dodd, Dowling & Kramer, 2005).
The reasons for fatigue in cancer are unclear. One possibility is that the
adaptive function of fatigue is more readily apparent in such situations,
serving to encourage the individual to disengage from effortful activity
in order to maximize body repair and recuperation. While I have pro-
posed such an adaptive motivation control function for fatigue under
normal conditions, it clearly has a more direct relevance in relation to
major threats to health. Aistars (1987) has suggested that the fatigue is
a response to the stress of living with the diagnosis and threat of the ill-
ness. Such a mechanism, with fatigue being generated by the executive
demands of managing the intrusive thoughts triggered by attempts to
cope with stressful events, has been demonstrated for a wide range of
conditions by Brosschot (2010); I will discuss this further towards the
end of the chapter. An even more specific trigger for fatigue is likely to
be the requirement of dealing with chronic pain, which competes for
attention (Eccleston & Crombez, 1999) and requires executive effort to
manage (Nes, Roach & Segerstrom, 2009).
Multiple sclerosis
The same general pattern of fatigue is found in chronic neurological
conditions such as multiple sclerosis (MS) and Parkinson’s disease
(PD). In the case of MS, it might be assumed that fatigue would be
correlated with the extent of CNS damage, since more effort may be
needed to compensate for the reduced processing power. Evidence from
neuroimaging studies is equivocal (Lazeron, Rombouts, Scheltens,
Polman & Barkhof, 2004). However, Rocca et al. (2002) found evi-
dence of compensatory effects of more widespread activation of brain
areas when MS patients carried out motor tasks, with stronger effects
for patients with more extensive lesions. Again, the core cognitive
difficulty appears to be related to impairment of executive function,
particularly when tasks demand a high speed of response (Langdon,
2011). This is supported by findings such as those of Lazeron et al.
(2004), showing that performance is markedly impaired on the ‘tower
of London’ task. However, there is evidence that patients may be able

to make compensatory adjustments to mitigate the intrinsic limitations
of executive capacity. Denney, Hughes, Owens and Lynch (2012) found
that planning performance could be maintained by MS patients taking
longer over their decisions, while Malikova et al. (2003) found evidence
of increased activation of prefrontal brain areas during a serial reac-
tion task. Another possibility is that, while there is no clear relationship
between brain energy and fatigue in normal brains, glucose metabo-
lism may be limited in some MS patients because of extensive neuronal
damage. Roelcke et al. (1997) found reduced glucose metabolism in
MS patients in frontal cortex and basal ganglia, but also higher levels
in ACC, while Bakshi, Miletich, Kinkel, Emmet and Kinkel (1998)
found widespread reductions in glucose metabolism across cortical
and sub-cortical regions. In both studies, the relevance of the data for
fatigue and effort is unclear, since they were collected at rest, rather
than when participants were carrying out mental tasks. However, they
suggest that a chronic shortage of brain energy may, at least partly,
account for the experience of increased fatigue in MS.
Parkinson’s disease
Parkinson’s disease (PD) has typically been treated as a problem of
movement and motor control, but it too has been found to have marked
effects on both fatigue and cognitive dysfunction, with a third to a half of
sufferers reporting major fatigue symptoms (Friedman et al., 2007). As
with cancer and MS the most common problem, outside of motor impair-
ment, appears to be with the use of executive control, as demonstrated
mainly under conditions of dual task management (Dalrymple-Alford,
Kalders, Jones & Watson, 1994; Wu & Hallett, 2005). As with Rocca
et al.’s (2002) results for MS, Wu and Hallett (2005) found that PD
patients showed more widespread activation of brain regions (including
the PFC) than did controls when required to perform more demanding
tasks. A specific problem with PD would appear to be the deficiency
of dopamine (DA) transmission associated with basal ganglia damage
(DeLong, 1990). Evidence from the neuroscience literature, discussed
in Chapter 6, suggests that this should impair the capacity for engaging
in effortful choices, and perhaps reduce the threshold for the experience
of fatigue. Testing of this hypothesis is made difficult by the routine
administration of drugs such as levodopa, which are designed to replace
the depleted DA in the brain. In general, while treatment with levodopa
has beneficial effects on motor function and peripheral fatigue, there
is no clear evidence for improvement in mental fatigue and motivation
(Hagell & Brundin, 2009; Pavese, Metta, Bose, Chaudhuri & Brooks,
2010). Pavese et al. (2010) found that fatigue in PD patients was more
strongly related to impaired serotoninergic function than to DA dif-
ferences. For the moment, this remains an open question, though it is
possible that fatigue experiences in different chronic conditions may be
associated with disturbances of various neurotransmitter systems.
These various chronic illnesses all show strong evidence of persistent
central fatigue, in all cases manifested in problems of motivational drive
and executive function. Such effects are similar in many ways to CFS,
suggesting a common aetiology of the fatigue process. Before consider-
ing this, however, we need to summarize what we know of more typical
patterns of persistent fatigue. These are associated not with illness or
disease, but with everyday problems of work.
Persistent fatigue from work stress

The previous two sections dealt with major dysfunction of the fatigue
management system, as experienced in CFS and major chronic illnesses.
A less dramatic source of long-term fatigue, though one that is far more
widespread, is associated with work stress. The link between unfavour-
able work experiences and both fatigue and other manifestations of psy-
chological ill-health is well-established, and enshrined within the core
theories of work psychology (Karasek & Theorell, 1990; Siegrist, 1996;
Warr, 1987). Stress is typically associated with extreme working condi-
tions, such as exposure to long working hours, unusual work schedules,
shift work, high levels of demand or low levels of resources, such as
control and support. However, while short-term effects are commonly
observed, it is unclear whether extreme working conditions per se are
enough to cause a long-lasting breakdown in motivational control. I
briefly examine the evidence on this before considering the more spe-
cific problem of burnout.
Work conditions, extended hours and shift work

Amongst the major work factors identified as causing fatigue are long
hours, high levels of physical or cognitive demands, and low control and
support. These issues have been well reviewed within the context of work
stress, in particular in relation to the two major theories of work stress,
the demands-control-support model (e.g., Karasek & Theorell, 1990;
de Lange, Taris, Kompier, Houtman & Bongers, 2003; van der Doef
& Maes, 1999) and effort-reward imbalance model (Siegrist, 1996; van
Vegchel, de Jonge, Bosma & Schaufeli, 2005), so do not need detailed
discussion here. Surprisingly, little of this research has been specifically

about fatigue-related outcomes, although strain, affective disorders and
impaired work engagement are strongly associated with unfavourable
work environments: high demands coupled with low resources (control
and support), or high effort requirements with low rewards. In this brief
review I examine effects on fatigue of work conditions, extended hours
and shift work.
An analysis of Swedish survey data collected over 20 years (Åkerstedt,
Fredlund, Gillberg & Jansson, 2002) examined the impact on two
indicators of persisting fatigue, general tiredness and sleep problems,
of various markers of stressful work. They found strong effects of
both ‘hectic work’ (intense pacing and high work rate) and physically
strenuous work, and also of long working hours (50+ hours per week).
Interestingly, the findings suggest a different route for the two kinds
of fatigue problem. While the above effects of demanding work were
associated with tiredness, shift work appeared to have a much stronger
effect on sleep problems. In the context of the present discussion, how-
ever, these findings may have only limited relevance, since they rely on
reports of fatigue effects over a relatively short-lasting period (during
the last two weeks). Nevertheless, they clearly suggest the possibility
of work conditions leading to a protracted fatigue condition, probably
linked to after-effects of work and inadequate recovery (Sonnentag,
2011).
The requirement to work long hours is the most widely assumed
potential cause of persistent fatigue. Along with the demands of over-
time, long hours have been implicated in problems of both fatigue and
general health (Spurgeon, Harrington & Cooper, 1997). This is par-
ticularly evident in countries (for example, Japan or South Korea),
where working weeks of 60 hours or more are not unusual, and have
widespread impact on employees (Nagashima et al., 2007; Shimomitsu
& Levi, 1992). In the large-scale study by Nagashima et al. (2007)
weekly working hours varied between 50 and 70+, with effects on gen-
eral tiredness and chronic fatigue increasing markedly with work hours
even over this already high average level. Such problems may occur
not only through the direct taxing effects of sustained work effort, but
also because of the reduced opportunities for recovery away from work
(Sonnentag, 2011). However, there is less evidence that working hours
per se are responsible for ill-health. A meta-analysis by Sparks, Cooper,
Fried and Shirom (1997) found a small overall effect size (a correl-
ation of only 0.13) for a range of health measures, including tiredness.
Similar conclusions can be drawn from more recent reviews (Caruso,
2006; Van der Hulst, 2003), though it is possible that very high levels
of work hours or overtime, such as those in Japan, have more consistent

negative impacts. The damaging effects of long working hours appear
to be mainly associated with jobs that are low in control, or where long
hours are obligatory; where control is available, it appears to moderate
the impact of extended work time (Ala-Mursula et al., 2006; Bliese &
Halverson, 1996; Hughes & Parkes, 2007). A study of highly motivated
Dutch workers who reported high levels of control (Beckers, van der
Linden, Smulders, Kompier, van Veldhoven & Van Yperen, 2004) found
no relationship between the level of overtime and reported fatigue.
Fatigue has also been associated with work patterns that include a
high level of shift work (Åkerstedt & Wright, 2010; Costa, 2003). While
the most direct impact appears to be on sleep problems rather than
mental fatigue (Åkerstedt et al., 2002), it is clear that shift workers are
vulnerable to disturbances of their circadian rhythms and have a lower
level of restorative sleep. Hossain et al. (2003) have argued for a func-
tional link between sleep pathology and prolonged fatigue, through a
lowering of what they referred to as the ‘fatigue threshold’. One way in
which this may operate, for example, is that sleepiness may encourage
the development of fatigue by requiring the individual to employ more
effortful engagement strategies at work. Such effects would be expected
to build up over time, with carry-over effects into leisure time, and pro-
vide the basis for the development of long-term fatigue.
The need for recovery from work

Overall, there does not seem a strong basis for associating persisting
fatigue problems with long working hours or shift work, though it is
likely that both are contributory factors in the development of such
conditions. More likely, they act as indirect causes, by reducing the
opportunity for sleep and recovery from work stress, as well as limit-
ing the buffering effects of family and social activities. There is now
abundant evidence of the need for detachment from work and recov-
ery from its effects (Sonnentag, 2011). It is well-established that high
strain work days are more likely to be associated with fatigue in the
evening, as well as sustained levels of stress hormones such as adrena-
line (Frankenhaeuser, 1986; Meijman et al., 1992; Sonnentag & Bayer,
2005). High strain days also result in higher levels of rumination and
inability to detach from work mode during leisure time (Cropley &
Purvis, 2003), which help to maintain the fatigue state. Under favour-
able conditions, after-effects of work may be countered by post-work
leisure activities that include desired (want to) goals, such as social-
izing and personal hobbies, and which also encourage more effective
engagement with work on the following day (Bakker & Demerouti,

2007; Sonnentag, 2011; Winwood, Bakker & Winefield, 2007).
Emotional demands and burnout

A more direct source of stress and fatigue is the emotional demands
of the workplace, which have been associated with burnout. First
recognized as a distinctive fatigue-related problem of work stress by
Freudenberger (1974), burnout is characterized by prolonged emotional
exhaustion and fatigue, job disengagement and reduced performance,
and a pattern of depersonalized relationships with clients. The end state
of burnout is one that appears to fit the definition of persistent fatigue,
in that it may continue over many months or years, though it includes
a strong element of depression, as well as fatigue (Schaufeli & Buunk,
2003). As Leone, Wessely, Huibers, Knottnerus and Kant (2011) point
out, the work-based origins of burnout make it very similar to the earl-
ier definition of neurasthenia, while its effects on psychological fatigue
are similar to those of CFS.
A possible distinctive feature of burnout is that it may be particularly
related to dealing with emotional problems, rather than cognitive or
physical demands. Emotional fatigue was mentioned in Chapter 7 in
relation to the possibility that it may be considered different from cog-
nitive fatigue, being caused specifically by emotional demands and the
need to respond to others’ problems. While the expression of emotion in
work contexts is generally recognized as benefitting social cohesion, it
may also be a direct source of conflict (Zapf, 2002). Hochschild (1983)
pointed out the perceived need to manage emotions in the workplace,
whether by the requirement for ‘acting’ – suppressing spontaneous feel-
ings or faking responses – or by the necessity of responding appropri-
ately to the problems of vulnerable clients. Failure to manage emotional
demands effectively has been recognized as a central component in
many clinical disorders (Gross, 1998) and work stress, including burn-
out (Maslach, Schaufeli & Leiter, 2001; Zapf, 2002). Although such
problems are assumed to be characteristic of certain kinds of ‘people
work’ (for example, the service and caring professions) they are an inte-
gral part of all work (Leiter & Schaufeli, 1996), being aroused whenever
conflict, anxiety, concern or sensitivity come into focus in the course of
daily activities. Even under normal circumstances, emotional demands
may impair performance on cognitive or physical tasks because they are
distracting, competing strongly for the control of attention (Eysenck
& Calvo, 1992; Oatley & Johnson-Laird, 1990; Taylor, 1991). Current
work performance is likely to be compromised by a shift of processing
towards other, more personal, goals whenever these are persistent (e.g.,
worry over an upcoming promotion interview, or your child’s impend-
ing exam results; unresolved anger over a perceived injustice).
Burnout appears to be an appropriate extension to the energy/fuel
metaphor of fatigue, since it captures the sufferer’s experience of being
completely ‘used up’, and the hypothesized catastrophic breakdown in
adaptive capacity. It is sometimes referred to by other names – exhaus-
tion syndrome, compassion fatigue (Figley, 1995), or secondary trau-
matic stress disorder – though all assume a primary role for a failure
of emotion regulation. In essence, these various conditions may be
very similar in their effects on the individual to those of other forms
of persistent fatigue, including CFS. However, I will consider burnout
separately at this stage, since it has a distinctive place in research on
work stress. Burnout is considered not simply as an end state but as
a process in which the individual’s relationship with his or her work
changes, so that they no longer feel engaged with what they are doing.
Maslach and Jackson’s (1981) burnout inventory includes three compo-
nents: emotional exhaustion, low accomplishment and depersonaliza-
tion. Emotional exhaustion is the core characteristic (Lee & Ashforth,
1996; Shirom, Melamed, Toker, Berliner & Shapira, 2005), defined
in terms of feeling ‘overwhelmed, drained, and used up’. In fact, of
course, such terms do not distinguish emotional fatigue from tired-
ness in other contexts, and perhaps such fine differences are not readily
expressed. Exhaustion affects performance by influencing goal motiv-
ation; if people stay in the job, they are likely to withdraw from effortful
activity aimed at organizational striving (the presumed source of the
original problem) and focus more on attracting social support and per-
sonal relationships (Habelsleben & Bowler, 2007). As with other forms
of persistent fatigue, burnout may be characterized as a state in which
individuals have an increased sense of the effort demands of work (in
relation to available rewards or desired work goals), though cause and
effect cannot easily be established without carefully designed longitu-
dinal studies.
But how does burnout develop as a process? What causes an effective
relationship between professionals and their work to become so dysfunc-
tional? One of the most widely held views is that burnout results from
an overloading of the stress system, leading to adaptive withdrawal from
engagement with high demands (e.g., Melamed, Shirom, Toker, Berliner
& Shapira, 2006). Hobfoll and Shirom (2000) have focused on the pro-
gressive loss of ‘intrinsic energetic resources’, defined as ‘physical, cog-
nitive and emotional energy’. They argue that the process is triggered by
a perceived loss of resources in relation to the demands of the job, which
leads to an increase in compensatory effort in an attempt to renew them

or recruit alternative resources. When this fails to maintain expected
performance, effort is withdrawn and a cycle of low investment/low
reward ensues. In my own terms, energetic resources equates to coping
resources, including the use of effort to control motivational priorities.
The burned out individual moves from a mode of active resistance to
experienced work obstacles (strain) to one of disengagement when antic-
ipated rewards cannot be achieved by sustained effort. I will develop this
argument more generally in the next section.
A motivation control analysis of persistent fatigue

The various manifestations of fatigue pathology discussed in the pre-
ceding sections are somewhat distinctive in their aetiology and specific
organic dysfunction, though they have much in common in relation to
the experience of fatigue and cognitive problems. In all cases, fatigue
appears to be associated with an exaggerated sense of effort (or high
perceived effort in relation to the anticipated or actual rewards) and a
reduced capacity for carrying out tasks that rely on executive control.
From a purely motivational control perspective, we may argue that all
are examples of what happens when the normal mechanisms responsi-
ble for the management of goals are disrupted. There may be different
reasons for this in the different cases of CFS, the various chronic ill-
nesses, burnout and work fatigue, but – at least at a general level – the
end result appears to be much the same.
To develop this view further, I do not need to make the assumption
that there is no identifiable organic damage in CFS or, for that mat-
ter, burnout or work fatigue; there certainly is in cancer, MS and PD,
and there may well be in CFS, at least. I take the view that all these
conditions – as they present in terms of behaviour and the experi-
ence of fatigue – have at their core a failure of motivational control.
A possible route through which such changes might occur is outlined
below, starting with the simpler cases of work fatigue and burnout,
then considering the more complex problem of CFS. The essence of
the hypothesis is that persistent fatigue is a compromised motivational
state, developed through a cycle of failures of coping with stress, fol-
lowed by inadequate recovery. This leads to increasingly unsuccessful
experiences of engagement with tasks, resulting eventually in a pref-
erence for a low effort mode of engagement with the environment. In
describing this process I will consider primarily the case of stress from
work, although the argument applies equally to stress from domestic
or personal transactions.
Carry-over effects of coping failures

The starting point for the process is taken to be a persistent failure to
resolve everyday stressful encounters, for example because of work con-
ditions that make excessive demands without offering adequate con-
trol or access to resources. Interactions with environmental demands
are an intrinsic feature of all life. We are equipped to deal with these
through the adaptive stress systems of the body, notably the sympa-
thetic adrenomedullary (SAM) and hypothalamic pituitary adrenocor-
tical (HPA) axes, discussed in Chapter 4. These respond to perceived
disturbances and environmental challenges by mobilizing both emer-
gency (SAM) and sustained (HPA) responses that help to restore the
homeostatic status of bodily processes. Following successful resolution,
the activity of these systems diminishes, allowing recovery of homeo-
stasis, as stress mediators – circulating adrenaline and noradrenaline,
cardiovascular variables and glucocorticoids (such as cortisol) – return
to baseline levels. It is apparent that frequent successful encounters with
stress and environmental demands can have a training effect (Ursin &
Eriksen, 2004), resulting in what Dienstbier (1989) refers to as ‘tough-
ening’ of the adaptive response, including a lowered base rate of activ-
ity in the SAM system, coupled with high responsiveness to demands
when required.
This may be considered the default pattern of coping, allowing fatigue
and its associated physiological strain to dissipate within the daily
cycle, as well as strengthening the general response to environmental
demands. However, it is clear that stress resolution is not always pos-
sible, and recovery at home may be prevented by domestic conflict or lack
of support (Repetti, 1989). Problems often persist, not just during the
post-work period but over many days, typically mediated by persistent
worries and concerns generated by the stress encounter. The failure to
resolve stressful episodes may therefore lead to prolonged physiological
activation, as well as ruminative cognitive states (Cropley & Purvis,
2003; Klinger, 1975; Watkins, 2008) that help maintain a state of stress-
ful engagement with problems. Such cognitive demands are assumed
to be largely unconscious (Bargh & Chartrand, 1999; Dijksterhuis &
Nordgren, 2006), but, as I discussed in Chapter 5, may nevertheless
break into ongoing goal-directed activity; they can also increase execu-
tive load by requiring effortful compensatory control activity to sup-
press them and restore desired goals. Brosschot (2010; Brosschot et al.,
2006) has argued that this ‘perseverative cognition’ is the mechanism
through which sustained stress is mediated, causing elevated levels of
stress responses of all kinds and reducing the quality of sleep.
In the context of work, many stressors are chronic, in the sense that
they are ever-present: for example, an imbalance of daily demands and
control, interpersonal conflicts, or frequent evaluation. This also applies
outside of work, with the stress of family life on a limited budget, dif-
ficult relationships that go on for a long time, or having to manage
the chronic illness of partners. Successful coping means that problems
are dealt with as they arise, and do not carry over to future occasions.
This requires both a satisfactory level of control in the workplace (or at
home) and a personal coping style that is able to effect a strong engage-
ment with work. However, where control is not available, or cannot be
used effectively, stressful encounters may not be managed within the
time allowed for their completion, and may carry over from work to
non-work leisure time. As I mentioned earlier in this chapter, the failure
to recover from the stress experienced during a working day, and from
the effortful engagement required to overcome it, can impair recovery
from work stress (Sonnentag, Dormann & Demerouti, 2010) and result
in physiological stress that lasts into the off-duty period, accompanied
by sustained fatigue (Geurts & Sonnentag, 2006; Pieper & Brosschot,
2005). McEwen and his colleagues (McEwen, 1998; McEwen &
Wingfield, 2010) have referred to this as allostatic load, emphasizing
the integrated activation induced by the sustained response to environ-
mental stressors over a period of time. Such a process is compatible with
Cameron’s (1973) conceptualization of fatigue as a generalized stress
response. Fatigue develops as a result of the after-effects of stressful
transactions, and has knock-on effects for later cognition and feelings.
A proposed model: the effort–fatigue disengagement spiral

The relation between coping patterns and somatic effects of stress is
a growth area in the understanding of wellbeing and health. It seems
increasingly likely that perseverative cognition is the driver of both
increased allostatic load and stress-related illness, and that high lev-
els of allostatic load are the primary pathogenic pathway in the devel-
opment of serious somatic diseases (Brosschot et al., 2006; McEwen,
1998). Although there does not appear to be any direct research on the
role of fatigue in this process, there are strong reasons for believing
that sustained stress may also be the primary driver in the development
of chronic fatigue. If not resolved, the tiredness that follows stressful
days at work may lead to both perseverative cognitive problems and
impaired sleep; it may still be present the following day, so that work
engagement and effectiveness is threatened. As described in Chapters
4 and 5, work goals can usually be protected by increased effort (the
high effort
unresolved stress
prolonged fatigue
+ effort
+ fatigue
+ stress
++ effort
++ fatigue
++ stress
disengagement
Figure 8.1 The strain disengagement spiral. Unresolved stress

from a sustained strain response to excessive demands leads to
prolonged fatigue. This increases the need for effort the following
day, with resultant further incremental effects on stress, fatigue
and effort. For simplicity, only two cycles of the spiral are shown,
with increasing strain indicated by the use of + and ++ modifiers.
When the compensatory limit is reached, the high effort strategy is
abandoned in favour of one of disengagement
strain response), though this will further increase fatigue. If more unre-
solved stress is added because of this, the post-work state becomes one
of even greater fatigue, with further sources of perseverative cognition,
and even greater threat to work goals.
I have tried to illustrate this process in Figure 8.1. What I am describ-
ing is a cycle of maladaptive goal management, based on the unrelenting
use of a compensatory strategy of reactive coping, which I have referred
to throughout as the strain mode. It may be technically better to refer
to the process as a spiral, rather than a cycle, to emphasize the shift to
a different position after completing each loop. The process is assumed
to have an essentially non-linear character, characteristic of all kinds

of approach-avoidance motivation (e.g., Guastello, Johnson & Rieke,
1999; Townsend & Busemeyer, 1989). It moves progressively towards an
unstable state of increased stress and fatigue, through a series of positive
feedback loops, with escalating needs for sustained high effort. For illus-
trative purposes, only two cycles of the strain disengagement spiral are
shown in Figure 8.1, but at some point the system is assumed to reach a
tipping point. This is defined as the state where the utility of task goals
(in terms of the costs and benefits of maintaining standards of perform-
ance) drops below an acceptable (or manageable) level. At this point a
switch occurs, in which the default high effort mode is replaced by a strat-
egy of low engagement; the attempt at sustained effort is abandoned and
replaced by what is, in essence, a passive strategy. In terms of the control
model presented in Chapter 6, the desire to maintain the required per-
formance standard can be achieved only by increasing the use of effortful
control strategies, but these also serve to drive and maintain the fatigue
state, and ultimately cause the system to flip into the disengaged mode.
Within a simple description it is difficult to convey the dynamic nature
of the disengagement spiral, but it seems likely that the crash of the moti-
vation control mechanism has a non-linear character, as observed by
Guastello et al. (1999) for discontinuities in the experience of flow over
time. Homer (1985) put forward a system dynamics model for burnout
that illustrates the need to break into the positive feedback loops by
major interventions that change the system’s parameters; for example,
by reducing work hours, effort or stress, or enhancing post-work recov-
ery. Rather than being concerned with low control and effort, as here,
Homer assumed a major maladaptive (workaholic) contribution from
the burned out employee, and emphasized the problem of working long
hours and the need to achieve a high level of accomplishments. In his
terms, such a strategy results in reduced energy levels (equivalent to the
way I have used effort), which cause a reduction in outputs and stress
from the experience of failure, requiring further energy investment and
even longer hours, and so on until energy is depleted. Homer makes a
number of simplistic assumptions about the relationships between work
hours, stress and energy, and doesn’t explain how a high-energy strat-
egy becomes one of disengagement. Nevertheless, his ideas are clearly
highly relevant to the model presented here, not least in their emphasis
on the dynamic properties of the burnout process.
In any case, once a state of prolonged tiredness persists, even over a few
weeks, it plays an increasing part in the engagement of the individual with
his or her work, as the burnout literature indicates. The high effort (strain)
response to work can be sustained only up to the individual’s upper limit
for effort tolerance (Cacioppo & Petty, 1981; Dornic, Ekehammar &
Laaksonen, 1991). Although highly motivated individuals (or workaholics)
may be able to persevere with this strategy for a long period, as Karasek
(1979) and others have shown, work becomes progressively harder to
maintain at the required level as the demand for effort increases. It seems
inevitable in such circumstances that the strain mode will eventually give
way to one of disengagement. In Bakker, Demerouti and Verbeke’s (2004)
job demands-resources model of burnout, this occurs when resources
are no longer effective in buffering the effects of high demands. An
effort-oriented approach such as the present one would argue that disen-
gagement occurs when the perceived costs of goal maintenance outweigh
anticipated benefits (Kurzban et al., in press). As I discussed in Chapter
5, only in extreme cases does this mean that the goal is abandoned alto-
gether, though such a response may be common in the context of optional,
non-work tasks. More typical is a reduction of performance criteria, such
as a reduced pace of work or a cutting of corners, so that work becomes
more manageable (Hockey, 1997; Schönpflug, 1983; Sperandio, 1978). In
many cases, this will allow individuals to retain an adequate, if blunted,
relationship with their work; in others, the level of disengagement may
be more complete, so that work is carried out largely through the use of
‘coasting’ strategies (clock-watching, taking long breaks, or just doing the
minimum to get by).
In fact, a high level of disengagement may be considered adaptive
in circumstances of escalating strain, in that it interrupts the harm-
ful effects of sustained stress. However, it also sets up a conflict in the
individual. On the one hand, reduced engagement with work goals may
lead to a loss of rewards, related to the personal satisfaction of effect-
ive work experience, as well as to low-level distress (Frankenhaeuser,
1986) and reduced self-efficacy (Stajkovic & Luthans, 1998). On the
other, the relief experienced during the change from the strain of inef-
fective striving to the comfort of the low effort approach to work may
outweigh this. The perceived benefits associated with pursuing effort-
ful goals may become chronically diminished by the increasing costs
required to attain them, giving way to an increasing attractiveness of
low effort modes of engagement. There is a natural link, of course,
with the mechanism of learned helplessness (Seligman, 1975), since the
experience with increasingly uncontrollable events is at the heart of the
development of reduced expectations of future control. I would further
suggest that a strategy of reduced engagement would be very likely to
generalize to all tasks, both work and non-work, and also, as the learned
helplessness theory predicts, even to activities where control is normally
available.
A reasonable question is to ask why this spiral into disengagement

appears to affect some individuals but not others. There are myriad
opportunities for sustained stress and post-work fatigue, and a high
prevalence of persistent fatigue, yet very few of these are converted into
CFS caseness. Of course, this may well be because CFS involves some
other, more specific, factors in its aetiology, but there may also be a role
for individual differences. Homer (1985) assumed that some individu-
als (workaholics or high achievers) were particularly prone to burnout
because they regarded work as their primary goal (Machlowitz, 1980).
In the CFS literature, there is a widespread clinical belief that patients
are more conscientious, goal-committed or driven in their premor-
bid lifestyle (e.g., Kato, Sullivan, Evengård & Pedersen, 2006; Ware
& Kleinman, 1992), and Van Houdenhove, Onghena, Neerinckx and
Hellin (1995) have shown that ‘action proneness’, a measure of high
commitment to goals, is higher in CFS patients than controls. At a more
general level we may also speculate whether fatigue-prone individuals
have a more developed sense of what Eisenberger (1992) calls learned
industriousness. This is the acquired habit of employing high effort
strategies, and the ability to tolerate high levels of effort, because of
the learned association of such strategies with high levels of reward (for
example, in educational or sporting activities). Conscientious behav-
iour also appears likely to fit the proactive coping style described by
Aspinwall and Taylor (1997), in which stressors and problems are antic-
ipated and planned for, rather than responded to reactively. Normally,
proactive coping is adaptive, but the high effort involved in trying to
‘stay ahead of the game’ is costly and may not always be efficient (for
example, because it displaces activities that may be needed for recovery
from earlier coping attempts).
Such goal management styles would suggest a tendency to persist with
a high effort response to both work goals and post-work fatigue-related
cognitive demands, with correspondingly increased vulnerability to the
motivational consequences of the disengagement spiral. Ironically, this
suggests that the most industrious individuals may be the most at risk.
I can find no direct research on this, but such a link is quite possible;
industriousness may be not only learned but also unlearned, through
the repeated experience of failure associated with continued attempts
at effortful coping.
Physiological implications of CFS

The disengagement spiral addresses the psychological processes of
adaptation to changing work (or home) experiences. But this says little
about the presumed physiological impact from the sustained allostatic

load. In support of the sustained stress hypothesis of persistent fatigue,
Wyller, Eriksen and Malterud (2009) have argued that sustained acti-
vation may play a central part in the development of CFS, through a
progressive dysregulation of the stress response, including effects on
immunological, endocrine and cardiovascular systems (for example,
set point changes to the control of autonomic variables such as blood
pressure). The argument is strengthened by the likelihood that CFS
sufferers often experience additional long-lasting major stressors such
as infections, life events or perceived chronic difficulties.
One of the most widely assumed physiological factors, observed in
many studies (Parker, Wessely & Cleare, 2001) is a (mildly) attenuated
response of the HPA axis. This does not fit easily with the hypothesized
development of sustained stress acting as the distal trigger for persist-
ent fatigue. However, Van Houdenhove, Den Eede and Luyten (2009)
have suggested that a tipping point (or non-linear system ‘crash’) may
occur during the early stages of CFS, resulting in a change from HPA
hyperactivity to a chronic lower level, with many patients describing the
onset of their symptoms as a dramatic ‘loss of resilience’. In fact, there
is considerable ambiguity about the direction of the effects of stress on
HPA, but a review by Miller, Chen and Zhou (2007) shows that the
HPA response changes from an increase to a decrease with prolonga-
tion of the stressor. While phasic reduced activation of the HPA axis
may be considered an adaptive response to chronic stress, protecting
the body from the damaging impact of continuing exposure to gluco-
corticoids, large rebound effects with continued stress exposure, such
as those referred to by Van Houdenhove et al. (2009), may be consid-
ered maladaptive (Fries, 2008); by causing the HPA axis to stabilize at
an attenuated level, such a change seriously compromises future coping
capacity.
Attenuation of HPA function may have another relevant effect.
While midbrain dopamine concentrations are increased by gluco-
corticoids under normal HPA activity (Piazza et al., 1996), repeated
stress may reverse this effect, resulting in a chronic shortfall of dopa-
mine (Imperato, Cabib & Puglisi-Allegra, 1993). From the discussion
in Chapter 6, this would suggest a reduced propensity for effortful
decision-making. Furthermore, anticipated benefits of goal-oriented
behaviour do not always occur in chronic fatigue because of the failure
to maintain effort. This is echoed in the DA system by observations
of diminished DA activity when predicted rewards are not obtained
(Schultz, 2007), leading to a reduced contingency between effort and
successful outcomes. Intact DA input to the basal ganglia and anterior
Summary 203
cingulate cortex (ACC) is assumed to be essential to the deployment of

effort in the pursuit of goals, while depletion of DA reduces the max-
imum affordable costs of action choices (Assadi, Yu & Pantelis, 2009).
Cohen, Braver and Brown (2002) argued that effects of dysregulation of
DA on motivational control are bi-directional; depressed levels reduce
the ability to adequately support goal maintenance, while increased lev-
els cause control to be rigid and inflexible.
A reduction in the tonic level of dopamine is therefore a leading candi-
date explanation of two of the main characteristics of persistent fatigue:
a preference for low effort engagement, and a difficulty of maintaining
task goals. However, little appears to be known about changes in DA
function in CFS patients. Chaudhuri and Behan (2004) have suggested
that disruption of basal ganglia control, with associated attenuation of
DA, underlies the symptoms of central fatigue across a wide range of
neurological conditions, including CFS. However, as with all such ana-
lyses of CFS, deficits in both HPA and DA function are not universally
observed in patients; furthermore, any changes in DA function will
inevitably be accompanied by effects in other neurotransmitter sys-
tems, notably serotonin and noradrenaline.
Of course, the chain of reasoning is long, and the evidence some-
what incomplete. Because of this, I do not present these physiological
snippets as anything more than ideas for further investigation. At pre-
sent, there is no clear evidence for how a progressive state of fatigue
and motivational disengagement relates to the neurological and neuro-
chemical processes that control behaviour. Nevertheless, I believe that,
on the psychological or behavioural level, the disengagement spiral
model may provide a realistic basis for considering how the experience
of fatigue changes from its normal role in motivational control to the
maladaptive chronic condition of persistent fatigue. To emphasize the
point I made earlier, this does not mean that no other precipitating fac-
tors or specific disruptions are involved, or that these are the same in all
conditions. But, a process such as the one I have outlined does at least
appear capable of accounting for the transition between normal and
pathological fatigue states.
Summary
Chapter 8 reviewed material relating to the breakdown of the normal
adaptive response of fatigue, leading to a persistent state of fatigue. It
focused on chronic fatigue syndrome (CFS), but also dealt with fatigue
in chronic medical conditions and effects of stress at work. Despite
a variety of specific causes and patterns of organic dysfunction, a
common problem is identified in all these conditions. Persistent fatigue

is associated with an exaggerated sense of effort, leading to a markedly
reduced motivation to engage with both mental and physical demands.
The fatigue–effort disengagement spiral is proposed as a model of how
such a change in motivation might develop as a result of a failure to
manage the response to stress.
9 An agenda for fatigue: research and
application
Background
In the previous chapters I have presented a view of fatigue as an adap-
tive, emotion-like process that has a primary function of managing the
control of motivation. I have argued that the function of fatigue is to act
as a brake on the autonomy of ongoing behaviour, by interrupting the
flow of control and calling for a re-evaluation of motivational priorities.
Three general goal management options are available as reactions to
the interrupt. If current goals are sufficiently valued, they can be main-
tained through an increase in effort. Or, if a change of goal is not pos-
sible (for example, in work environments) the goal may be continued at a
lower level. A third alternative is that the goal is abandoned and replaced
by competing (preferred) activities. Chapter 6 suggested that the most
likely neural basis for the patterning of effort and fatigue is the manage-
ment of costs and benefits of alternative actions, expressed through the
modulation of dopamine activation via interactions of midbrain motiv-
ational systems with prefrontal and cingulate cortex executive mecha-
nisms. I have discussed how these ideas might relate to theoretical and
empirical developments in cognate areas, including brain energy, phys-
ical work and sleep, as well as to failures of the fatigue-motivation system
observed in chronic fatigue conditions. In essence, the fatigue process
always starts as information, but, under conditions of demanding work
and overriding effort-based control, often ends as stress.
In presenting this material I have tried to develop the motivation con-
trol hypotheses by appealing to research findings and hypotheses across
a broad range of approaches, and expressed the ideas within a simple,
general-purpose control systems implementation. This seems to me to
capture the essentially regulatory nature of goal-oriented behaviour
and its management in terms of motivational needs and priorities. In
addition, I have tried to take into account what is known about execu-
tive control and motivational factors such as effort and reward from
research in neuroscience. This material provided a way of anchoring
205
206 An agenda for fatigue
the theory in hard neural facts, and suggested various ways in which
the postulated effects of interruption, effort and goal management
strategies may be realized within brain systems. However, much of the
evidence is of only indirect relevance to the issues considered, being
driven by rather different top level research questions. Inevitably, there-
fore – given the paucity of suitable evidence – much of the argument
has had a speculative quality. In this final chapter I want to address this
problem by outlining an agenda for research that focuses specifically on
fatigue-related issues. Such evidence will allow us not only to test the
theory, but to answer quite basic questions that have been overlooked
thus far. Towards the end of the chapter I will also consider how know-
ledge about fatigue – both current and future – may be used to improve
work, health and everyday living.
So, what are the main issues for research on fatigue? The core need is
to develop a full scientific understanding and theory. I believe that this
will need to make use of both psychological and neuroscience methods,
and address such questions as: what is the function of fatigue; can evo-
lutionary analyses help to improve our understanding? How does this
relate to other adaptive feelings, such as anxiety? Under what condi-
tions does fatigue develop in normal behaviour? How is it managed and
overcome? What conditions allow for recovery from fatigue? Does it
have an identifiable representation in terms of brain mechanisms? What
happens when everyday fatigue mechanisms fail and the state persists
for long periods? In the following sections I will sketch an agenda for
the kind of research that I believe will help in providing answers to such
questions, as well as broadening the empirical evidence base necessary
for a better understanding of the fatigue problem.
Tests of the motivation control theory

The motivational control theory has been put forward in this mono-
graph in the form of a broad perspective, rather than as a tightly argued
set of postulates. This is partly because of a desire to set out a general
position and theoretical framework, but also because the present state
of knowledge is not sufficiently detailed to do much more than this. As a
result, while the theory offers an alternative to the conception of fatigue
as a general loss of energy or resources, the ideas remain somewhat
speculative. The challenge for future work is to understand the factors
that influence goal selection options on a moment-by-moment basis.
What determines whether a current externally imposed task will stay in
place with extended time on task, or be executed at a lower level, or be
displaced by something else? The effect of time is clearly fundamental;
Tests of the motivation control theory 207
why should maintenance of a goal become more difficult the longer it

has been in place? It is likely that goals lose activation with use and need
to be refreshed to maintain dominance over competing goals. Why does
a high level of controllability help? One reason may simply be that strain
from routine disturbances can be minimized by flexible changes in task
scheduling or more effective timing of effort, to coincide with peak
executive function (Hockey & Earle, 2006; Hockey et al., 1998). In any
case, a number of broad hypotheses present themselves as initial tests of
the theory, and a further set of issues are indicated as necessary empir-
ical data needed to allow a more specific testing strategy.
The work–fatigue relationship

The most general need is for the systematic study of the work–fatigue
relationship. I have argued throughout that it is not work per se that
causes fatigue, but a commitment to activities that are not desired by
the performer, and where effort is required to maintain them. However,
while such views have long been held (e.g., Bartley & Chute, 1947;
Thorndike, 1900), they are based mainly on subjective reports and
indirect evidence. As this is a fundamental postulate of the theory, it
clearly needs to be demonstrated directly and convincingly. The prob-
lem may be addressed by manipulating factors that affect task interest
and examining their effect on both performance and feelings (effort
and fatigue). As a simple example, consider everyday mental tasks (such
as cryptic crosswords, chess and bridge problems, or sudoku). Cryptic
crosswords are a favourite pastime of some people and a source of con-
sistent frustration and unfulfilled effort by others; for other kinds of
problems a different pattern exists. Ratings could be obtained for a set
of such activities in terms of personal interest and enjoyment, then per-
formance and fatigue examined when they are presented in the form of
prolonged continuous tasks (over, say, one hour). The theory would pre-
dict that highly preferred activities would be maintained for longer, and
the relationship between effort and fatigue would be lower. Conversely,
activities with very low preferences would be predicted to show marked
decrements and high levels of fatigue. Another way of tackling this
question would be to obtain individual personal goal hierarchies – a
rank ordering of everyday things people enjoy doing – and to use appro-
priate versions of these as secondary tasks in a sustained task paradigm.
The theory would predict that highly preferred secondary task activ-
ities would be more likely to compete for attention than non-preferred
ones, and interrupt performance of the primary task, resulting in more
impairment and higher reports of effort and fatigue.
Cost–benefit analysis
There is still little understanding of the role of effort and reward (costs
and benefits) in the fatigue process. While these have been studied in
the animal literature, it has been achieved through the manipulation of
physical costs, such as requiring animals to climb a barrier to obtain a
more desirable reward. In human activity, such physical effort clearly
has a role to play, as the physical exercise and chronic fatigue literature
illustrates. However, the focus of the effort construct within humans is
on mental concentration and the maintenance of cognitive direction.
With few exceptions, most findings on effort in cognition are based
on only indirect evidence, when what is needed is the same approach
of direct manipulation (for example, by instructions or required work-
load). Also in keeping with the findings of animal studies, such an
approach could be combined with manipulation of rewards, allowing
costs and benefits of alternative actions to be examined together. One
example of a human cost–benefit study (Croxson et al., 2009) varied
monetary reward and workload independently by cues for each block
of task events. However, the study has little relevance for fatigue; it
was concerned primarily with fMRI analysis, and performance was not
analysed in terms of time on task or lapses. From the fatigue perspec-
tive, performance on sustained tasks with multiple events, such as serial
reaction tasks, would be more appropriate, with values of task goals (time
or accuracy) rewarded by financial incentives, and effort manipulated
independently. Does high effort or high value prevent decrement? The
theory would predict an interaction, with high effort having a greater
effect when value is low. Another interesting possibility would be to use
a compensatory adjustment procedure, in which the value of maintain-
ing task performance was manipulated dynamically throughout a ses-
sion, in response to momentary ratings of effort; or effort instructions
modified in relation to perceived changes in task benefits.
Short-term recovery from fatigue

Research is also needed on the dynamics of recovery from fatigue.
Again, while we know that a change can sometimes be (nearly) as
good as a rest, we know very little about the conditions under which
this is true. What aspects of tasks make them effective as conditions
under which fatigue from a loading task can dissipate? Robinson and
Bills (1926) demonstrated that fatigue built up when task events were
drawn from a small set, or there was a high degree of response com-
petition. There has been little direct research on this question, apart
Contributions from neuroscience 209
from a tentative inference from the literature on after-effects (Holding,

1983) that recovery is prevented by a subsequent executive-intensive
task. What is needed is a systematic analysis of the characteristics of
change tasks that support recovery from fatigue: for example, effects
of sensory modality, alphanumeric class, levels of processing; and, if
executive activity prevents recovery, whether this also depends on the
similarity of task elements. The basis of these effects is probably much
more complex than suggested by our current understanding. Persson,
Welsh, Jonides and Reuter-Lorenz (2007) found negative transfer from
a loading task that required resolution of interference to a second task
that made the same executive demands (though with different types of
item). In contrast, there was no negative transfer if the loading task was
low in interference, or if there was no overlap in the type of executive
demands. This kind of result indicates that transfer of fatigue effects
may be specific to the nature of the mental operations involved. This
is consistent with the idea that executive control may be better consid-
ered in terms of a suite of specialized functions (Miyake, Friedman,
Emerson, Witzki, Howerter & Wager, 2000), rather than as the two or
three general mechanisms assumed both here and elsewhere. However,
some degree of commonality still appears likely (Duncan, 2010; Miyake
et al., 2000), with special functions drawing on many of the same com-
ponents of the neural networks involved.
Contributions from neuroscience

In all the above areas, research would need to combine assessment of
performance with that of costs. This is explicit in the third example,
where fatigue may have carry-over effects to other tasks, but such stud-
ies would also need to include measurements of effort and autonomic
activity, and inferred changes in brain function. I have suggested that
recent work in neuroscience has provided support for a theory of fatigue
based on motivation control. However, once again, most of this evi-
dence is indirect, and I can find no study in which fatigue or effort in
task maintenance have been central concerns. One problem is that the
level of analysis is necessarily more limited in intact human participants,
though some relevant questions may be addressed using neuroimag-
ing. For example, it should be possible to track changes in activation of
executive areas under failing sustained attention, and effects of control
and effort manipulation. What happens to brain activity in the pre-
frontal cortex and anterior cingulate executive areas when subjective
fatigue occurs during sustained performance? Are such changes dif-
ferent when performance is protected and fatigue is accompanied by
increased effort? The theory predicts increased activation of the system

that regulates effort, but it is unclear from current empirical data where
such effects occur. There is also considerable scope for more studies
of the kind I mentioned above (Persson et al., 2007) that pin down
specific fatigue transfer effects in terms of the executive sub-systems
involved.
It should also be possible to learn more about the role of dopamine
in relation to effort and changing cost–benefit perceptions. Although
direct assessment of human dopamine is not possible, it can be detected
using PET methods. It would be of interest to find data on the pat-
tern of dopamine transmission under sustained task conditions, and
to compare the use of high effort and low effort strategies. As with
the cost–benefit studies suggested above, it would be valuable to test
the hypothesized link between effort and dopamine regulation directly,
through the manipulation of task management strategies. An alterna-
tive approach is through the use of dopamine agonists such as ampheta-
mine, which mimic the effects of dopamine, increasing tolerance for
effort and low probability-high value rewards (Wardle, Treadway,
Mayo, Zald & de Wit, 2011). There is an established body of evidence
on amphetamine and performance (Koelega, 1993) showing, for exam-
ple, that it improves performance and prevents decrements in vigilance
tasks. However, this work has been carried out generally in the context
of a presumption of ‘no-cost’ effects of stimulants reducing fatigue (as
also with caffeine and nicotine), and has not directly addressed the kinds
of questions raised above. For example, if the effects of amphetamine
are to provide support for compensatory performance protection strate-
gies, are they associated with increases in reported effort and fatigue?
And do they produce carry-over effects for subsequent activities?
Brain energy
The relation between fatigue and energy is one of the central questions
of this book. I started out by claiming that depletion of energy could not
be seriously offered as an explanation for fatigue, except in the sense
of a well-entrenched metaphor, and reiterated this view throughout.
Nevertheless, energy transformations and regional changes do occur in
the brain when mental work is carried out, and there is a need to under-
stand these in relation to what happens during fatigue. In particular,
while fatigue may not be equated to a simple shortfall of energy, it is pos-
sible that it is sensed, at least partly, from signals that reflect these local
energy transactions, such as those suggested by Peters et al.’s (2004) self-
ish brain model and Noakes et al.’s (2005) central governor model, both
Physical and mental fatigue 211
discussed in Chapter 7. It may be the case that even a small challenge

to the availability of brain energy may be enough to trigger experiences
of fatigue. For example, it is possible that the feeling of fatigue derives
partly from an awareness of interoceptive events, such as feedback from
sensed changes in ATP availability or transfer of glucose from the som-
atic system to the brain. Further insights into these and other such
feedback systems, and their link to conscious and unconscious aware-
ness, are central to an understanding of the energy–fatigue link. Such
research would require the tracking of changes in feelings in relation to
rapidly changing metabolic and neural events, which may be beyond the
capability of current methods. However, it remains a relevant contribu-
tion towards the goal of integrating our knowledge on fatigue.
As with neuroscience research within executive control and attention,
there does not appear to have been any direct tests of human fatigue
paradigms using neuroimaging techniques. This is particularly surpris-
ing given the traditional link between the two. Certainly, a valid test of
the fatigue-as-energy-loss argument requires an analysis of changes in
brain metabolism over a period during which a high effort task is being
performed. It would need to show not simply a shift of blood flow to
brain areas used by the task but changes over time that were related to
the observed pattern of performance, effort and fatigue. For example,
is there any sign of an energy refractory phase – a transient reduction in
glucose metabolism coincident with task problems? I can find no study
that comes close to this, though the results would be of major relevance.
A second critical study in this area would involve the comparison of
high and low control tasks (or personal interest activities). It is clear
that these have different implications for subjective fatigue, but do they
produce different patterns of response in terms of brain energy? Care
needs to be taken to equate task demands in the two cases, although
high control does not mean that a task is necessarily simpler in informa-
tion processing terms; enjoyable activities may be highly demanding, as
demonstrated in Czikszentmihalyi’s (1990) flow mode.
Physical and mental fatigue

To date, there has been little direct research on the relationship between
physical and mental fatigue, within either mainstream psychology or
sport and exercise science. This is a promising area for development of
ideas about the nature of fatigue, since it combines issues from men-
tal and physical work with exercise physiology, energy metabolism
and motivation. The central governor model (Noakes et al., 2005) has
thrown down the gauntlet for researchers in this area, suggesting that
the cessation of physical activity is determined effectively by a psycho-

logical state. A recent development (Swart, Lindsay, Lambert, Brown &
Noakes, 2012) is the demonstration of a separation between the physical
sense of effort and the mental effort required to maintain the exercise
goal. Mental effort is aroused only when the level of exercise (pacing of
work) is greater than the planned profile, and fatigue is the direct result
of this mismatch.
There are many other questions of interest to a theory of fatigue.
What is the signalling mechanism that turns the control of pacing or
effort management into the sensation of fatigue? As with fatigue in
mental tasks, how do such feelings relate to changes in cost and benefits
of alternative actions? There are several areas where more research on
issues raised by the central governor model would help our understand-
ing of effort and fatigue: for example, in the development of individ-
ual models of effort management in relation to pacing; whether effort
and pain tolerance can be increased by training or relevant experience;
and whether such changes have their effects through an increase in the
upper limit for exercise endurance. A further question, relating to the
effects of a change in mental activity, is whether a change of physical
activity may have similar fatigue-reducing effects: for example, a switch
between cycling and running, or use of different muscle groups. If cog-
nitive control is the driver for physical fatigue, we should expect an
advantage for a change, as in mental tasks. Of course, there are intrin-
sic problems in controlling for energy requirements of the two activities
and incompatibilities of muscle groups, but the question is research-
able, and central to the physical–mental fatigue relationship.
A separate set of questions refers to the impact of physical and men-
tal activity on each other. It would be expected, if mental effort and
fatigue were the limiting factors, that there would be negative transfer
between the two, though only when executive processing is required
to maintain the two activities. While there are a number of studies of
effects of exercise on cognition, there has been hardly any research on
the complementary question: how does mental work affect exercise? A
rare example is the study of Marcora, Staiano and Manning (2009),
which showed that a prolonged period of executive demand impaired
subsequent cycling performance in terms of endurance and perceived
exertion. This kind of method could be used to provide a further test of
the central governor model, either by the same preloading induction of
mental fatigue, or by adding a separate demand to the control loop, for
example through cognitive distraction. What would happen to pacing
control and feelings of effort and fatigue during running or cycling if
athletes were already fatigued before the start of the session, or if they
had to devote some of their executive capacity to a secondary task pre-

sented through headphones?
A further question is whether a high level of mental or physical fitness
can help protect performance on a task that requires physical or mental
work, respectively. As we saw in Chapter 7, there is general support for
a small advantage of aerobic fitness for mental performance (Colcombe
& Kramer, 2003; Etnier et al., 2006), though the mechanism for this
effect is at present unclear. One possibility is that the increase in fitness
causes a reduction in the slope of perceived effort and exertion against
actual power output, so that physical work feels easier for a given load.
If this is a central effect, we would expect it to generalize to cognitive
tasks, with advantages for increased persistence and effort tolerance.
There are, however, no studies relating increases in cognitive fitness to
physical performance. Cognitive fitness in this context refers to some-
thing like a generally high level of functioning, in particular through
the use of executive skills, and in the tolerance of high effort strategies
in task management. If mental effort is common to both domains, we
might expect individuals who are better able to sustain attention on
executive tasks with low costs to also tolerate feelings of discomfort and
pain that contribute to the termination of exercise performance. This
seems a promising adjunct to the presumed link between physical and
mental fatigue.
Sleep and fatigue

The link between mental fatigue and sleep is another area that is in
need of clarification. Sleep researchers have typically treated fatigue
from sleep disturbances as the default fatigue state. Yet the two variants
have clearly different origins, and, I would argue, functions; sleepiness
acts as a push towards sleep, while mental fatigue serves to interrupt
unrewarding behaviour. It seems to me that a central question is often
overlooked in research on sleepiness; to what extent do sleep disruption
and demanding work affect the same fatigue mechanism?
Several lines of research seem to offer opportunities for enhanced
understanding. First, even in terms of the practical goal of predicting
fatigue through sleep models (Mallis et al., 2004), only sleep variables
are typically considered. This is because sleep models have focused on
the prediction of normative group levels of fatigue, where the marginal
increase in predictive power of including work variables is very limited.
However, it is surprising that no attempt has been made to include meas-
ures of workload, control or effort expenditure, since these vary consid-
erably between individuals and would add significantly to predictions
at the individual level. I know of no work of this kind at the present

time, though it would appear to present an obvious development of
modelling research and application. A second approach is to carry out
experiments that cross manipulations of sleep and work. For example,
is the need for sleep stronger after more demanding work days? And is
the impact of sleep deprivation greater? Is the effect of demanding work
days greater after a night of sleep deprivation?
There are also issues related to sleep and energy management in the
brain. There are suggestions in the literature that energy is depleted
under sleep deprivation. What are the implications of this for explana-
tions of body to brain glucose transfer, such as the selfish brain model?
Why does the brain appear to lose its protective strategy under such
conditions? If such effects are confirmed they may provide a strong
basis for distinguishing the two kinds of fatigue, since sleepiness (but
not mental fatigue) is associated with energy loss.
A further line of interest is the suggestion that sleep and mental
fatigue may both have an impact on the local sleep of neurons (Van
Dongen et al., 2011). This is an intriguing possibility, though it remains
highly speculative at this early stage. A relevant question is whether
this proposed ‘sleep switch’ can be demonstrated to account for the
broad phenomena of mental fatigue. There are many questions for such
work to address, but for such an integrative approach to work, the state
of sleep neurons would need to reflect the distinctive phenomena of
mental fatigue: that effects depend not only on mental work but on
executive demands, and on effort and control; and also that fatigue is
a cumulative process, driven by the requirement to sustain high levels
of effort.
Persistent fatigue and CFS

As will be clear from Chapter 8, much still needs to be known about
the aetiology and pathophysiology of chronic fatigue syndrome (CFS).
However, there is a need for a research focus on the more general ques-
tion of persistent fatigue of a sub-clinical nature, including problems
relating to work stress and burnout. The disengagement spiral was sug-
gested as a possible way in which maladaptive strategies may develop
through a failure to manage stress and fatigue after-effects. However, I
know of no relevant empirical data that can be used to test this hypoth-
esis. Ideally, such data would be obtained from intensive longitudinal
studies, following individuals through the whole cycle from normal
functioning to the pathological condition. For CFS this may be unre-
alistic in both scientific and practical terms, given the low base rate,
Persistent fatigue and CFS 215
though it may be possible for general persistent fatigue, where levels of

around 20–30 per cent are commonly reported. Longitudinal studies
typically obtain measurements on only two or three occasions, so are
unable to address the dynamic changes that might be involved in such
a process. A typical example is the large-scale cross-lagged analysis of
patterns of demands, resources and burnout by Hakanen, Schaufeli
and Ahola (2008). While this convincingly supports the separate effects
of job resources on work engagement and commitment, and of job
demands on burnout, it includes measures from only two measurement
times over three years: it tells us that such changes have occurred but
not how, or to whom.
Tests of the disengagement spiral hypothesis would be harder to
carry out; they require regular (daily, or at least weekly) testing over an
extended period, with assessment of carry-over effects and recovery, as
well as demands, resources, work management strategies, work motiv-
ation and stress responses. Such constraints make it more difficult to do
the kind of study that is needed to uncover the dynamic effects implied
by such a model, but an appropriate research programme is surely
a possibility. Procedures based on diary methods (Almeida, 2005;
Bolger, Davis & Rafaeli, 2003) or related techniques such as experience
sampling (Czikszentmihalyi & Larson, 1987) and day reconstruction
(Kahneman, Krueger, Schkade, Schwarz & Stone, 2004) are needed
for this. These allow for monitoring of frequent events on an individual
basis, with the possibility of identifying critical sequences of demands,
control, effort and fatigue that lead to abrupt motivational discontinu-
ities. If a large enough sample size is tested, a period as short as six
months or a year would provide enough data for individual cases of
burnout to be identified, along with the local changes in work motiv-
ation, stress and fatigue.
In more general terms, I would suggest there is a need for more
focused studies of cognitive function in chronic fatigue. In many ways,
such questions overlap with the proposed agenda for tests of the motiv-
ational control model, including questions about the use of effort and
control. The idea that the key factor in persistent fatigue is a low toler-
ance for effort (Chaudhuri & Behan, 2004; Van Houdenhove, Verheyen,
Pardaens, Luyten & Van Wambeke, 2007) offers a very important
insight into the nature of the problem. Treatments based on a modified
form of cognitive behaviour therapy (CBT) may be an appropriate way
to tackle such issues. Traditionally, the primary focus of CBT in CFS
has been on physical recovery, with less concern with recovery of cog-
nitive or motivational function (Price et al., 2008). However, a recent
mediation analysis of three randomized controlled trials (Wiborg et al.,
2010) shows that changes in physical activity are not responsible for
observed changes in fatigue with treatment. This suggests that any
improvement is more likely to be associated with cognitive changes,
including not only illness beliefs but motivation-related control strat-
egies. Clearly, a more focused approach to therapy is required, able to
pin down more clearly what is happening; where in the system is the
constraint located, and to what extent can it be retrained? For example,
what are the effects of manipulation of effort strategies? A reluctance
to use high effort is a motivational problem, which should be open to
modification. A further question is whether chronic fatigue sufferers
show the same difference between imposed tasks and self-chosen activ-
ities that appears to be the case for normal fatigue. Tasks rely more on
the ability to use effort to maintain them, because of their low control-
lability, while self-selected activities have high personal value and are
less likely to attract the fatigue interruption process.
There is still little agreement about the possible physiological mech-
anisms involved in CFS, though changes in HPA and basal ganglia
circuits have been claimed to play a major role in the condition. Such
issues have not routinely been examined in relation to changes in motiv-
ational and cognitive systems, making it difficult to separate the influ-
ence of the various possible causal processes. I believe that considerable
gains could accrue from a programme of research that integrated these
questions.
Some practical considerations

Finally, it should be possible to suggest some ideas about the practical
implications of the material in this book. The motivational control the-
ory puts fatigue in a different light from that of previous approaches.
Rather than it being an inevitable result of doing work, with the
assumed draining of energy that such a process entails, fatigue can be
considered to have a positive, adaptive function. When we begin to get
tired in the middle of some chore we may ask ourselves if this is the best
thing we could be doing; is there any reason why we should not stop
the task and do something we actually like doing? Of course, life isn’t
always that accommodating, and chores sometimes have to be toler-
ated; they pay the rent and put food on the table. Nevertheless, I believe
that an awareness of the dynamics of this adaptive function of fatigue
will allow us to make better choices at least some of the time, when the
advantages of completing chores are less obvious. In one sense, this is
another case of ‘listening to the body’. As Gaylin (1979) has argued,
feelings are vital signs of the individual’s relation with the environment;
Some practical considerations 217
they always provide valuable information about what he or she needs.

Feelings of anxiety tell us that all is not well, and that a threat may need
to be addressed; feelings of tiredness tell us that what we are doing is
not rewarding, and/or costly in terms of effort. Having said that, one
can always override feelings if it makes sense in the present context; you
should listen to the body but you don’t have to agree with its message.
In many areas of everyday life, however, opportunities to listen to
the message of fatigue feelings are quite limited. The management
of fatigue at work, for example, is influenced primarily by identifying
problems of either workload or sleepiness associated with shift work
(nearly always referred to as ‘fatigue’). For example, the UK Health
and Safety Executive (HSE, n.d.) states that:
Fatigue refers to the issues that arise from excessive working time or poorly
designed shift patterns. It is generally considered to be a decline in mental
and/or physical performance that results from prolonged exertion, sleep loss
and/or disruption of the internal clock. It is also related to workload, in that
workers are more easily fatigued if their work is machine-paced, complex or
monotonous.
While this may appear to recognize the broad range of work factors, a
supplementary list of 11 ‘key principles’ refers almost exclusively to shift
patterns and the threat from sleep and circadian disturbances. A simi-
lar message is evident from all official Western bodies. Occasionally,
as with the guidelines from the State of Queensland in Australia, there
is recognition of the need for rest and recovery: ‘Fatigue is caused by
prolonged periods of physical and/or mental exertion without enough
time to rest and recover.’ But none of these official pronouncements
address the critical factors I have emphasized (and which are promin-
ent in the DCS (Karasek & Theorell, 1990) and ERI (Siegrist, 1996)
models of work strain). As I have said, fatigue is caused only indirectly
by work: when it is externally imposed (fast-paced and continuous), or
when a high effort response has to be maintained to manage perform-
ance goals. It has also long been known to be reduced by opportunities
for control or autonomy, both at the individual and team level (e.g.,
Hackman, 1987; Hackman & Oldham, 1976).
I believe a lot may be achieved by shifting from a view of work as an
imposed, task-driven activity to one that emphasizes active engagement
and enablement: maximizing opportunities for autonomy and involve-
ment, and removing the requirement for employees to adopt a high
effort mode as a default strategy. The influential Swedish work psych-
ologist Bertil Gardell (Gardell, 1981) suggested some basic principles
for how work should be designed (following recommendations from the
London Tavistock Institute and International Labour Organization).

It should allow employees opportunities for control of how and when
work is carried out; it should facilitate their understanding of the work’s
purpose and methods; it should allow them to make use of and develop
personal skills; and it should provide opportunities for responding to
the requirements of their life outside work. Sometimes, at least some
of this seems to be true of some workplaces, usually because of local
or specialized circumstances (some small businesses, software com-
panies, universities), but no widespread informed strategy exists. Such
ideas were a core feature of Scandinavian innovations in work design
from the 1970s onwards, expressed in ideas such as participatory design
and semi-autonomous work groups, and the job enrichment/empower-
ing approach emphasizing motivational needs (Parker & Wall, 1998).
However, while such influences are undoubtedly still with us, the early
promise of such methods has not been fully realized. This is partly
because of problems of implementation and changes in manufactur-
ing practice, but also, I suspect, because of an underlying fundamental
incompatibility between paid work and personal motivation.
Designing working conditions along the lines suggested by Gardell
does not appear too difficult a goal. It would create a work environ-
ment with far less tendency to give rise to problems that persisted into
the post-work period and beyond, and would dramatically reduce the
threat of a chronic loss of engagement with work goals. There is also, I
believe, a gain for how we live our lives generally. A less driven approach
to the pursuit of all tasks and chores, coupled with an enhanced aware-
ness of the implications of the fatigue feeling for the expression of per-
sonal goals, would not only reduce the likelihood of long-term fatigue
effects but also have a positive influence on wellbeing.
Summary
Chapter 9 put forward some proposals for an agenda for research on
fatigue, arising from the various themes developed within the book.
These focused on tests of the motivational control theory, but also
included research on the related problems of brain energy, physical
fatigue, sleep and chronic fatigue. Suggestions were also made for how
work and non-working life might benefit from adoption of a view of
fatigue as an adaptive, informative process.
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Name index
Aasman, J., 119 Barch, D. M., 11, 148

Achermann, P., 174 Bargh, J. A., 196
Ackerman, P. L., 4, 51, 58, 65, 84 Barkhof, F., 188
Adams, C. M., 148 Barmack, J. E., 15
Adams, J. A., 69, 70 Barrett, L. F., 101
Afari, A. H., 47, 185 Bartlett, F. C., 13–14, 138
Ahola, K., 215 Bartley, S. H., 4, 5, 9, 11, 13, 17, 21, 51,
Åhsberg, T., 165 53, 67, 132, 207
Åkerstedt, T., 174, 175, 191, 192 Baulk, S. D., 174
Ala-Mursula, L., 192 Baumeister, R. F., 8, 33, 92, 121–122,
Alexander, G. E., 149, 150 160–161
Alluisi, E. A., 69 Bayer, U-V, 192
Almeida, D. M., 215 Bdzola, L., 18, 103
Amar, J., 43, 48 Beard, G., 29, 46
Amin, M., 2, 239 Beckers, D. G. J., 192
Anderson, H., 68 Beh, H. C., 118
Andrade, J., 69 Behan, P. O., 150, 185, 186, 203
Angus, R. G., 174 Behrens, T., 133, 148, 208
Arai, T., 54, 59–61, 63, 77 Belenky, G., 174, 175, 178, 214
Arees, E., 96 Bengtsson, C., 182
Arroyo, M., 150 Benington, J. H., 163, 176, 177
Ash, I. E., 12, 54, 167 Benton, D., 160
Ashforth, B. E., 194 Berenholtz, S. M., 180
Aspinwall, L. G., 201 Bergum, B. O., 57
Aston-Jones, G., 105, 149, 152 Berliner, S., 194
Åstrand, P. O., 166 Berlyne, D. E., 11, 138
Atkinson, J. W., 102, 133 Berman, A., 16
Austin, J. T., 140 Bertelson, P., 82
Bhuiya, P., 173, 192
Babkoff, H., 173 Bills, A. G., 53, 55, 64–65, 66, 67, 68, 71,
Backs, R. W., 129 72, 73, 80, 95, 208
Baddeley, A. D., 116, 142 Binet, A., 45, 48
Baddeley, B. T., 69 Birch, D., 102, 133
Bainbridge, F. A., 46 Bitterman, M. E., 14
Bainbridge, L., 116 Bjerner, B., 81
Bakker, R., 41, 124, 193 Bleijenberg, G., 187, 188
Bakshi, R., 189 Blessing, R., 165
Balkin, T. J., 79, 176, 177 Bliese, P. D., 192
Band, D., 175 Bobrow, D. G., 74
Bandura, A., 114, 139 Boehler, C. N., 150, 154
Banich, M. T., 147 Boies, S. J., 55
Bannerman, D. M., 149 Boksem, M., 10, 146, 148, 149
258
Name index 259
Bolger, N., 215 Chandola, T., 125

Borbély, A.A., 174 Chapman, J. C., 63, 78
Bose, S. K., 190 Chartrand, T. L., 196
Bosma, H., 41, 124, 125, 190 Chatzisarantis, N., 33, 121, 160
Botvinick, M. M., 10, 11, 133, 143, 148, Chaudhuri, A., 150, 185, 186, 190, 203
153 Chen, E., 202
Boutelle, M., 156 Chen, M. K., 182
Bowler, W. M., 194 Chikahisa, S., 177
Brandeis, L. D., 48, 49 Chiles, W. D., 122
Bratslavsky, E., 121 Christensen, T., 187
Braun, A. R., 177 Chrousos, G., 86, 87
Braver, T. S., 11, 148, 150, 153, 203 Chute, E., 4, 5, 9, 11, 13, 17, 53, 67, 132,
Brehm, J. W., 62, 75, 120, 126, 145 207
Briner, R. B., 116 Clague, J. E., 185
Broadbent, D. E., 14, 16, 52, 65, 68, 70, 71, Clark, J. B., 156
72–73, 81, 94, 95, 96–97, 98–99, 112, Claus, E. D., 147
114, 116, 120, 122, 140, 141, 142 Cleare, A. J., 202
Brooks, D. J., 190 Clough, P., 18, 103
Brosschot, J. F., 88, 91, 111, 131, 188, Cockshell, S. J., 186
196, 197 Coenen, A. M. L., 67, 69, 120
Brown, A. M., 159, 163 Cohen, J. D., 11, 105, 112, 143, 147, 148,
Brown, G. G., 175, 176 149, 150, 152, 153, 203
Brown, J. C., 212 Cohen, N. J., 147
Brown, J. W., 153, 203 Cohen, S., 14, 67, 93, 120–121, 123
Brown, R. G., 180, 189 Colcombe, S., 172, 213
Brundin, L., 190 Cooper, C. L., 42, 114, 191
Brunner, E., 125 Cooper, R. E., 4
Bruno, J. P., 112, 149 Corbetta, M., 133
Buchwald, D., 47, 185 Corcoran, D. W. J., 97
Burgess, P. W., 110, 144 Correa, M., 105, 149, 150, 151
Burnett, J., 30 Cosmides, L., 10, 97, 99, 103, 112
Busemeyer, J. R., 199 Costa, G., 192
Bush, G., 105 Cowan, N., 71
Buunk, B. P., 193 Cox, B., 181
Craig, A., 4
Cabeza, R., 156, 157 Cramer, J., 171
Cabib, S., 202 Cremer, R., 119, 192
Cacioppo, J. T., 84, 200 Crewe, H., 169
Calvo, M. G., 100, 108, 193 Crombez, G., 188
Cameron, C., 53, 89, 197 Cropley, M., 192, 196
Campion, M. A., 133 Croxson, P., 133
Campos, M. P. O., 188 Czikszentmihalyi, M., 9, 53, 129, 130,
Cannon, W. B., 87, 88, 89, 91, 111 215
Caramanos, Z., 150 Cummings, T. G., 114, 147
Carroll, N., 185 Cunningham, H., 39
Carter, C. S., 133, 148, 153 Curry, R., 74
Carter, K. M., 178 Cyr, N. E., 87, 91
Carter, N. L., 118
Caruso, C. C., 191 Dabrowska, A. J., 176
Carver, C. S., 102, 103, 114, 140 Dallenbach, K. M., 94
Cassel, E. E., 94 Dalrymple-Alford, J. C., 189
Castelli, D. M., 162 Dalziel, J., 20
Cattell, R. B., 10, 48 Damasio, A. R., 112
Cespuglio, R., 177 Davies, D. R., 4, 69, 70
Chalder, T., 182, 185 Davis, A., 215
260 Name index
Davis, D. R., 51, 94 Emerson, M. J., 209

Dawson, D., 79, 174, 175 Emmet, M. L., 189
Day, T., 88 Erez, M., 84
Dayan, P., 152 Eriksen, H. R., 131, 196, 202
de Jonge, J., 41, 124, 190 Esteve-Lanao, J., 171
de Koning, J., 169, 170, 171 Esteves, F., 103, 112
de Lange, A. H., 190 Etnier, J., 172, 213
de Wit, H., 210 Evans, G. W., 93, 118, 119, 129
Deale, A., 185, 187 Evengård, B., 201
Deci, E. L., 8, 71, 122, 133 Everitt, B. J., 150
Deese, J., 69, 94 Eyer, J., 87
Del Giglio, A., 188 Eysenck, M. W., 100, 101, 103, 108,
DeLong, M. R., 149, 189 193
DeLuca, J., 4
Dember, W. N., 69, 70, 71, 79 Fairclough, S. H., 119, 160
Demerouti, E., 9, 41, 193 Farah, M. J., 142
Denney, D. R., 189 Farrar, A., 105, 149
Derakshan, N., 100 Feinstein, C. H., 38
Derickson, A., 49 Feinstein, J. A., 84
Deroche, V., 202 Ferguson, R., 173
Derryberry, D., 101 Figley, C., 194
Des Chene, D., 43 Fillenz, M., 156
Desimone, R., 110 Fishbein, H. D., 71
Desmond, P. A., 4, 95, 109 Fletcher, A., 175
Detre, J. A., 147 Flinton, D., 188
Dickens, M. J., 87, 91 Floresco, S., 150
Dienstbier, R. A., 129, 196 Floyd, W. F., 4, 13
Dijksterhuis, A., 196 Flykt, A., 103, 112
Dinges, D. F., 79, 81, 147, 174 Folkard, S., 174, 175
Ditchburn, R. W., 68 Folkman, S., 92
Dobbins, J. G., 184 Forsman, L., 127
Dodd, M., 188 Foster, C., 169, 171
Dodge, R., 64, 77, 83, 114, 132 Frankenhaeuser, M., 107, 118, 119,
Dolan, R., 112 127–129, 140, 200
Donchin, E., 52 Frankmann, J. P., 69
Dornic, S., 84, 200 Fray, A. E., 156
Dorrian, J., 79 Freeman, F. G., 75, 119
Dowling, G., 188 Freeman, G. L., 14, 61
Drummond, S. P. A., 175, 176 Frese, M., 67, 114, 124
Duckworth, A., 10, 105 Freudenberger, H. J., 193
Duffy, E. A., 97 Fried, Y., 42, 191
Duncan, J., 109, 110, 209 Friedman, J. H., 189, 209
Durmer, J. F., 81 Fries, E., 202
Frijda, N. H., 99, 102, 112
Earle, F., 76, 120, 122, 123, 124, 207 Frings-Dresen, M. H. W., 91
Ebbinghaus, H., 48, 61 Furunes, B., 182
Eccleston, C., 188 Fusilier, M. R., 41
Edstrom, K., 182
Edwards, J. R., 114 Gage, J. C., 33
Edwards, R. H. T., 165, 185 Gaillard, A. W. K., 86, 119
Eisenberger, R., 201 Gailliot, M. T., 121, 160–162, 163
Ekehammar, B., 84, 200 Galanter, E., 114
Eling, P. A. T., 67, 69, 120 Galloway, M., 69
Elliot, A. J., 110 Gandevia, S., 167
Ellis, A. C., 61, 63, 185 Ganey, H. C. N., 97
Name index 261
Ganster, D. C., 41, 124 Heslegrave, R. J., 174

Gardell, B., 217–218 Hettinger, T., 166
Gates, A. J., 61 Hickie, I., 184
Gaylin, W., 102, 216 Higgins, E. T., 102
Gehring, W., 143, 147, 148 Hillman, C. H., 162
Gerin, T. W., 91, 111 Hobfoll, S. E., 194
Geurts, A. E., 42, 197 Hobsbawm, E., 31
Gevins, A., 119 Hobson, J. A., 175
Geyer, S. J., 177 Hochschild, A. R., 193
Gibson, E., 8, 160, 161, 162 Hockey, G. R. J., 4, 14, 18, 52, 53, 62,
Gibson, H., 185 68, 71, 72, 75, 76, 81, 94, 95–98, 103,
Gillin, J. C., 175, 176 107, 108, 112, 113–114, 115–118, 119,
Givens, B., 112, 149 120, 122, 123, 124, 126, 127, 130, 133,
Glass, D. C., 116, 120, 123 140–141, 142, 200, 207
Godsen, R., 165 Holding, D. H., 4, 9, 14, 67, 120, 122,
Gold, P. E., 156, 160 167, 172, 209
Goldmark, J. C., 48, 49 Hollenbeck, J. R., 84
Goodnow, J. L., 73, 81, 176 Hollingworth, H., 61
Gopher, D., 52, 74 Holmes, G. P., 183
Gray, J. A., 97, 102, 103 Homer, J. B., 199, 201
Grier, R. A., 69 Hopkins, E., 38, 45
Grugle, N. L., 176 Horne, J. A., 175, 176
Guastello, S. J., 199 Hossain, J. L., 173, 192
Guitart-Masip, M., 112 Hotopf, M., 187
Gusnard, D. A., 157 Housh, T., 171
Gutstein, H. B., 188 Hovland, C. L., 61
Howe, S. R., 70, 71
Habelsleben, J. R. B., 194 Howerter, A., 209
Hackman, J. R., 124, 130, 217 Howseman, A. M., 176
Hagedoorn, M., 124 Hübner, R., 117
Hagell, P., 190 Hughes, A. J., 189
Hagger, M., 33, 121, 160 Hughes, E., 192
Hakanen, J. J., 215 Huibers, M. J. H., 193
Hale, L. A., 82 Humes, J. H., 70
Hall, E. E., 162 Hunot, V., 186
Hall, T. J., 73, 126 Hyland, M. E., 114, 133, 134, 140
Hallett, M., 189
Halverson, R. R., 192 Imperato, A., 202
Hamilton, P., 95–96, 97, 107, Ingham, J. G., 182
140, 141 Inzlicht, M., 121
Hancock, P. A., 4, 69, 95, 97, 109, 113 Ioteyko, J., 48, 49
Hanoch, Y., 97, 99 Ishiwari, K., 150
Hardy, R., 187 Izard, C. E., 21, 99, 104, 112
Harrington, J. M., 191
Harrison, Y., 175, 176 Jackson, P. R., 124
Hassan, B. J., 188 Jackson, S. E, 194
Hawkins, K., 69 James, W., 54, 80
Hebb, D. O., 97 Jansen, C. E., 188
Heller, H. C., 163, 176, 177 Jarvis, W. B. G., 84
Hellin, J., 201 Jason, L. A., 180, 186
Helton, W. S., 79 Jerison, H. J., 71, 79
Hemingway, H., 125 Jex, H., 74
Henri, V., 45, 48 Jiang, Q., 79
Henry, J. P., 89, 90, 91 Joffe, R., 82
Herman, C. P., 134 Johnson, E. A., 199
262 Name index
Johnson, J. C., 2 Kramer, J., 188

Johnson, J. T., 169 Krantz, D. S., 93
Johnson, M., 26–27, 28, 33 Kristofferson, A. B., 70
Johnson-Laird, P. L., 101, 103, 138, 151, Krueger, A. B., 215
193 Krueger, J. M., 174, 178, 214
Jones, D. M., 95 Kruglanski, A. W., 120
Jones, D. W., 148 Kryter, K. D., 94, 96
Jones, K. S., 79 Kuhl, J., 33
Jones, R. D., 189 Kurniawan, I., 112, 149
Jong, R., 147 Kurzban, R., 10, 105, 109, 112, 149, 161,
Jonides, J., 209 200
Jorna, P. G. A. M., 129
Josephs, A. M., 150, 176 Laaksonen, T., 200
Justyna, A., 176 LaGrange, C. M., 79
Lakoff, G., 26–27, 28
Kable, J., 10, 105 Lambert, E., 167, 212
Kahneman, D., 73–75, 112, 114, 140, 215 Lamond, N., 79, 174
Kalders, A. S., 189 Landers, D., 172
Kalsbeek, J. W. H., 62, 75 Landes, D. S., 26
Kandelaars, K. J., 174 Langdon, D., 188
Kane, M. J., 111 Langdon, J. N., 62, 68
Kanfer, R., 51, 58, 65 Larson, R., 215
Karasek, R. A., 35, 40, 41, 124, 125, 190, Latham, J. P., 84
200, 217 Lavidor, M., 173
Karnovsky, M. L., 177 Lawrence, A. D., 101
Karoly, P., 114 Lawrie, S. M., 186
Kato, K., 201 Lazarus, R. S., 92, 94, 100
Kayser, B., 166 Lazeron, R. H. C., 188
Kayumov, L., 173, 192 Le Goff, J., 35
Kehlet, H., 187 Lee, R., 194
Kennedy, C., 156 Lee, R. S., 48
Kennedy, D. O., 160 Lehr, D. J., 57
Kennerley, S., 149 Leiter, M. P., 193
Kety, S. S., 156 Leone, S. S., 193
Killgore, D. B., 176 Levi, L., 191
Killgore, W. D. S., 176 Levine, S., 87
Kimberg, D. Y., 142 Levison, W., 74
Kinkel, P. R., 189 Levy, P. E., 114
Kleinman, A., 201 Lewis, G., 47, 181, 182
Klinger, E., 103, 111, 196 Liberzon, I., 101
Knight, R. T., 82 Lieberman, H. R., 8, 160
Knoop, H., 187 Lim, J., 79, 147
Knottnerus, J. A., 193 Lindsay, T. R., 212
Knutson, B., 148 Lloyd, H. M., 160, 161
Koelega, H., 52, 68, 210 Locke, E. A., 84, 133, 139
Komaroff, A., 183 Logan, G., 2, 52
Kompier, M. A. J., 190, 192 Loh, S., 79
Kool, W., 10, 112, 150 Lord, R. G., 114, 133
Koolhaas, J. M., 128 Lorist, M., 147, 148
Korol, D. L., 160 Lubin, A., 73, 81, 176
Koski, L., 150 Lucia, A., 171
Kozak, R., 143, 147 Lundberg, U., 118, 119, 127
Kraepelin, E., 48, 56–58, 59, 63, 66, 68, Luria, A. R., 147
77, 80 Luthans, F., 200
Kramer, A. F., 118, 162, 172, 213 Luu, P., 105
Name index 263
Luyten, P., 202 Mintun, M. A., 8, 156, 157, 159

Lynch, S. G., 189 Mischel, W., 112
Mitchell, E., 186
Mabe, M., 2 Miyake, A., 209
Maccari, S., 202 Moller, A. C., 122
MacCorquodale, K., 19 Moray, N., 73, 75
Machlowitz, M. M., 201 Morgan, J. J. B., 94
Mackworth, J. F., 65, 71 Morgan, L. T., xi, 78
Mackworth, N. H., 53, 67–68, 71, 79, 170 Morsella, E., 102
MacLeod, A. M., 157 Mosso, A., 4, 5, 48, 56, 167
Maes, S., 190 Mulder, G., 75, 119, 129, 147, 192
Maier, M., 117 Mulder, L. J. M., 119
Mallis, M. M., 174, 213 Mullarkey, S., 124
Malterud, K., 131, 202 Munsterberg, H., 48, 49
Mandler, G., 101, 138, 151 Muraven, M., 121–122
Mangold, R., 156 Murphy, F. C., 101
Manly, T., 69 Muscio, B., 12–13, 18, 20, 49
Manning, C. A., 160 Muth, E. R., 175
Manning, V., 161, 170, 200 Muzur, A., 175
Maquet, P., 177 Myers, J., 10, 15, 48, 105
Marcora, S. M., 161, 169–170, 212
Marin, R. S., 180 Näätänen, R., 97
Marmot, M. G., 125 Nagashima, S., 191
Marsh, H. D., 61 Naidoo, N., 177
Maslach, C., 193, 194 Navon, D., 74, 76
Mason, J. W., 89, 91, 129 Neerinckx, E., 201
Mathias, J. L., 150, 186 Neiss, R., 97, 98
Matthews, G., 4, 8, 69, 79, 109, 113, 188 Nes, L. S., 188
Maule, A. J., 18, 103 Nesse, R. M., 21, 97, 99, 103, 104
Mayo, L. M., 210 Netchiporouk, L., 177
McCulloch, K., 174 Newburger, M., 65
McEwen, B. S., 86, 87–88, 131, 197 Nguyen, T. T., 174
McGrath, J. E., 114, 124 Nickel, P., 119
McGuire, J. T., 10 Nieuwenhuis, S., 147
McNay, E. C., 156 Nimmo-Smith, I., 101
McTeer, W., 65, 66 Noakes, T. D., 167–169, 170, 171, 186,
McVay, J. C., 111 210, 211, 212
Meehl, P. E., 19 Noll, V. H., 65
Meighan, T. W., 73 Nordgren, L. F., 196
Meijman, T. F., 67, 91, 103, 119, 122, Norman, D. A., 11, 74, 114, 140, 142
147, 192 Nowell, P., 172
Mejdal, S., 174 Nuechterlein, K. H., 79
Melamed, S., 194 Nunes, E. J., 151
Messier, C., 160 Nyberg, L., 156, 157
Metcalfe, J., 112
Meyer, W.-U., 126 O’Hanlon, J. F., 16
Miaskowski, C., 188 O’Reilly, J., 133, 208
Mikulka, P. J., 75, 119 Oatley, K., 101, 103, 138, 151, 193
Miletich, R. S., 189 Odle-Dusseau, H. N., 175
Milham, M. P., 147 Oehrn, A., 59
Miller, E. K., 112, 133, 143, 147 Öhman, A., 103, 112, 138
Miller, G. A., 114 Oldham, G. R., 124, 130, 217
Miller, G. E., 202 Olmstead, M. C., 150
Miller, P. M., 182 Osler, S. F., 94
Mingote, S., 105, 149, 150 Owens, E. M., 189
264 Name index
Pace-Schott, E. F., 175 Reason, J., 140

Padilla, M. L., 82 Rector, D., 178
Pall, M. L., 185 Rees, C. M., 176
Pantelis, C., 203 Reich, P., 177
Parasuraman, R., 52, 69, 70, 71, 79 Reichardt, R. M., 176
Parker, A. J. R., 202 Reilly, R., 96, 166
Parker, S., 124, 218 Reinish, L. W., 173, 192
Parkes, K., 192 Rejman, M., 140
Parkinson, J. A., 150 Repetti, R. L., 196
Pashler, H. E., 2, 52 Reuter-Lorenz, P., 209
Passey, G. E., 73 Revilliod, L., 33
Paus, T., 148, 150 Rhoten, D., 187
Payne, R. L., 18, 130 Richter, L., 120
Pearce, J., 47 Rick, J. T., 18, 130
Pedersen, N. L., 201 Ridderinkhof, K., 148
Persson, J., 209, 210 Riechelmann, R., 188
Pessoa, L., 112, 148 Roach, A. R., 188
Peters, A., 159–160, 161, 162, 210 Roach, G. D., 174
Peters, M. L., 118, 129 Roberts, A. C., 119
Pettet, A., 188 Roberts, K., 82
Petty, R. E., 84, 200 Roberts, M., 119
Phan, K. L., 101 Robertson, I. H., 69
Phillips, F. M., 78 Robinson, E. S., 53, 55, 64–65, 67, 68,
Phillips, G. E., 54, 59 71, 77
Phillips, P., 149 Robinson, M. D., 121
Piazza, P. V., 202 Robledo, P., 150
Pieper, S., 197 Rocca, M. A., 188, 189
Pierce, K., 165 Rodahl, K., 166
Pigeon, W. R., 173 Roelcke, U., 189
Pilcher, J. J., 175 Rogers, P. J., 160, 161
Piotrowski, T., 176 Rojas, M. J., 178
Pluck, G., 180 Romanes, G. J., 39, 40
Poffenberger, A. T., 65, 78 Rombouts, S. A. R. B., 188
Polivy, J., 134 Romero, L. M., 87, 91
Pontifex, C. H., 162 Rosen, Z. B., 10
Porkka–Heiskanen, T., 177 Rosman, H., 122
Portas, C. M., 176 Rougé-Pont, F., 202
Porter, R., 17, 46 Routtenberg, A., 97
Posner, M. I., 55, 65, 71, 105 Royall, D. R., 147
Powell, J. W., 79 Rubin, J. G., 187
Powers, W. J., 157 Rudebeck, P., 148
Powers, W. T., 114, 134, 139, 140 Rushworth, M., 133, 148, 149, 208
Pribram, K. H., 114 Russell, J. A., 17, 101
Price, J. R., 186, 215 Ruthruff, E., 2
Prins, J. B., 187 Ryan, R. M., 8, 71, 122, 133
Puglisi-Allegra, S., 202 Ryan, T. A., 14
Purvis, L. J. M., 192, 196
Sabini, J., 114
Rabinbach, A., 7, 8, 26, 28, 29, 31–32, Saint-Amand, P., 33
34, 37, 43, 44, 45 Sakai, K., 112
Raichle, M. E., 8, 156, 157, 159 Salamat, J. S., 176
Raine, L. B., 162 Salamone, J. D., 105, 149, 150, 151
Randall, P. A., 151 Salvert, D., 177
Ransom, B. R., 159 Sanders, A. F., 95
Rao, H., 147 Sapolsky, R. M., 87
Name index 265
Sarter, M., 112, 121, 143, 147, 149, 150, Sisto, S. A., 185
151 Sluiter, J. K., 91
Sateia, M. J., 173 Smallwood, J., 111
Sauer, J., 116, 207 Smit, A. S., 67, 69, 120
Scerbo, M. W., 75, 119 Smith, A. P., 95, 187
Schacter, D. L., 119 Smith, K. R., 62
Scharf, M. T., 177 Smith, M. E., 119
Schaufeli, W. P., 41, 124, 190, 193, 215 Smulders, P. G. W., 192
Scheier, M. F., 102, 103, 114, 140 Snyder, A. Z., 157
Schellekens, J. M. H., 122 Soames-Job, R. F., 20
Scheltens, P., 188 Sokoloff, L., 156
Schkade, D. A., 215 Sokolov, E. N., 71
Schmeichel, B. J., 121 Sonnentag, S., 67, 191, 192–193,
Schmidt, C. F., 156 197
Schmidtke, H., 66, 70, 73, 75, 170 Spacapan, S., 120
Scholey, A. B., 160 Sparks, K., 191
Schönpflug, W., 54, 86, 93, 94, 107, 108, Sperandio, J-C., 117, 200, 250
117, 129, 140, 200 Sprague, R., 71
Schooler, J., 111 Spurgeon, A., 191
Schultz, W., 152, 202 St Clair Gibson, A., 167, 168
Schulz, P., 129 Staal, M. A., 95
Schut, H., 92 Staiano, W., 161, 169, 170, 212
Schwab, R. S., 167 Stajkovic, A. D., 200
Schwarz, N., 215 Stammers, R. B., 4
Seamans, J. K., 152, 153 Stansfeld, S., 125
Seashore, C., 64 Starch, D., 54
See, J. E., 70 Stark, J. M., 75
Segerstrom, S. C., 188 Stassen, H., 74
Self, E. A., 62, 75, 120, 126, 145 Steinhauser, M., 117
Seligman, M. E., 200 Stenson, H. H., 70
Seljos, K. A., 129 Stephens, P. M., 89, 90, 91
Selye, H., 87, 89, 90, 91 Sterling, P., 87
Servaes, P., 188 Sternberg, S., 55
Shallice, T., 11, 110, 114, 140, 142, 144 Stiff, C., 33, 121, 160
Shapira, I., 194 Stokols, D., 93
Shapiro, C. M., 173, 175, 192 Stone, A. A., 160, 165, 215
Sharpe, M. C., 184 Strachey, J., 7
Sheldon, K. M., 110 Stroebe, M. S., 92
Sheridan, T. B., 83 Stromme, S., 166
Sherrington, C., 157 Stulemeijer, M., 187
Shimomitsu, T., 191 Styles, E. A., 2, 52
Shipe, M. M., 61, 63 Sullivan, P. F., 201
Shirom, A., 8, 42, 191, 194 Swanson, R. A., 177
Shorter, E., 183 Swart, J., 212
Shram, N., 177 Swets, J. A., 70
Sibley, B., 172 Szelenberger, W., 176
Sicherman, B., 17
Siegrist, J., 40, 124, 125, 190, 217 Tafalla, R. J., 119, 129
Sigurdsson, J., 182 Tallman, G. G., 78
Sijtsma, G. J., 122 Tattersall, A. J., 116, 119
Sikorski, J., 61 Teichner, W. H., 53, 79, 96, 114,
Simon, H., 202 140
Simon, H. A., 110, 137–138 Tellegen, A., 17, 101
Simonson, E., 4, 11 Temple, J. G., 79
Singer, J. E., 120, 123 Thayer, J. F., 8, 18, 91, 111
266 Name index
Theorell, T., 35, 40, 41, 124, 190, Wager, T. D., 101
217 Wall, T., 124, 218
Thomas, K., 30, 35–36 Walton, P., 133, 148, 149, 150, 208
Thomas, M., 175 Wardle, M. C., 210
Thomas, V., 166 Ware, N. C., 201
Thompson, E. P., 36 Warm, J. S., 52, 69, 70, 71, 79, 113
Thompson, R. F., 71, 72 Warr, P. B., 18, 190
Thorndike, E. L., 5, 9, 10, 14, 28, 48, Wastell, D. G., 116, 207
51, 52, 53, 54, 56, 57–58, 59, 60, 61, Watkins, E., 111, 196
65, 67, 76, 77, 114, 132, 207 Watson, D., 17, 18, 101
Tibblin, G., 182 Watson, R. W., 189
Tice, D. M., 8, 33, 121 Weber, S. M., 150
Tidy, E., 186 Webster, D. M., 120
Toates, F., 144 Wechsler, R. L., 156
Toker, S., 194 Weiner, B., 133
Tomkins, S. S., 15 Weir, J., 171
Tomporowski, P. D., 162 Weiser, P. C., 4
Tooby, J., 10, 97, 99, 103, 112 Weissman, D., 82
Topchiy, L. A., 178 Welford, A. T., 4, 13, 16, 69, 97
Tops, M., 10, 146, 149 Weller, A., 173
Townsend, J. T., 199 Welsh, K., 209
Treadway, M. T., 210 Wenzel, S., 32
Tucker, D. M., 97, 101 Wesensten, N. J., 79
Tucker, R., 169 Wessely, S., 17, 46, 47, 181–183, 185,
Tulga, M. K., 83 193, 202
Turner, T. J., 104, 176 Westbury, C., 150
Westerman, S., 4
Umbers, L. G., 116 Weygandt, W., 63, 64, 67
Ursin, H., 87, 89, 196 Wiborg, J. F., 187, 215
Wickens, C. D., 52, 53, 73, 74, 75,
Vaidya, J., 17, 101 116
Van den Berg, C. J., 156 Wiener, E. L., 71
van der Beek, A. J., 91 Wiener, N., 114
van der Doef, M., 190 Wiese, D., 17, 101
van der Hulst, M., 191 Wiethoff, M., 116
van der Linden, D., 14, 67, 103, 192 Wijers, A. A., 119
Van Dongen, H. P. A., 174, 178, 214 Wilkinson, R. T., 96, 97, 118, 176
van Dormolen, M., 192 Williams, H. L., 73, 81, 176
Van Houdenhove, B., 201, 202 Williamson, P. A., 97
van Veen, V., 148, 153 Willoughby, A., 148
van Vegchel, N., 190 Wilson, D., 165
Van Yperen, N. W., 124 Winch, W. H., 61
Vancouver, J. B., 140 Winefield, A. H., 193
Vegter, E., 122 Wingfield, J. C., 88, 197
Veldman, H., 118 Winterer, G., 148
Veltman, J. A., 119 Winwood, P. C., 193
Venables, C., 119 Witzki, A. H., 209
Verhagen, C., 188, 248 Wohl, A. S., 38
Vernon, H. M., 48, 50, 55, 61, 62 Woldorff, M., 82
Vickery, K., 64, 67, 78 Wood, C., 33, 121, 160
Visscher, K., 82 Wood, R. A., 82
Vitouch, O., 97, 99 Wright, K. P., 182, 192
Vohs, K. D., 8, 33 Wright, R. A., 62, 120
Voth, H. J., 38 Wu, J. C., 180, 187
Vuilleumier, P., 112 Wu, T., 189
Name index 267
Wu, W. C., 147, 175 Yu, M., 152, 203

Wyatt, S., 62, 68
Wyller, V. B., 131, 202 Zald, D. H., 210
Zapf, D., 193
Yang, C. R., 152, 153 Zhou, E. S., 202
Yiend, J., 69 Zimmerman, J. E., 177
Subject index
acetylcholine, 150, 151, 177 caffeine, 98, 210

adenosine, 151, 177 cancer, see persistent fatigue
adenosine triphosphate (ATP), 157–160, carry-over effects, see after-effects,
161, 162, 165, 177, 178, 211 recovery
adrenaline, 90, 91, 100, 118–119, 130 central governor model, 167–169, 172,
after-effects, 66–67, 91, 114, 120–123, 178, 186, 211, 212–213
170, 192–193, 196–197, 202, 209, chronic fatigue, see persistent fatigue
210, 215, see also recovery chronic fatigue syndrome (CFS), 46,
air traffic control, 68, 71, 117 180–181, 183–187, 194, 214–216,
alertness, 68, 69, 71, 95, 129, 173, see also persistent fatigue
174–175 clincal context of, 183–184
allostatic load, 87–88, 91, 202 possible causes of, 184–185
amphetamine, 210 treatment of, 216
anterior cingulate cortex (ACC), 121, circadian rhythm, 55, 61, 62, 174, 175,
147–154, 203 192, 217
anxiety, 95, 101, 105, 128 cognitive behaviour therapy (CBT), 185,
in compensatory control model, 18 215–216
as component of strain, 35, 128, 130 cognitive discomfort, 5, 105, 136, 138,
interruption function of, 103, 217 142, 146
and negative affect, 18 compensatory control, 114, 118, 136, 176
relation of, to fatigue, 17, 18, 21, 22, 135 model, 18, 133, 140–146, 199
relation of, to negative affect, 17–18, 101 role of effort in, 71, 75, 112, 115, 196
as response to high workload, 86 in sleep deprivation, 175–176
and stress, 88, 91, 94, 100, 116, 125, control, 22, 25, 102, 136, 197,
193 210, 211, 213–214, 215, 218,
arousal, see also autonomic nervous see also compensatory control,
system (ANS), stress, stressors coping, demand-control-support
inverted-U relationship, 16, 97, 98 (DCS) model, executive control,
theory of stress, 96–98 motivational control
astrocytes, 159, 163, 177 loss of, with industrialization, 35–37
attention, see alertness, distraction, as moderator of fatigue, 120, 123, 124,
effort, executive control, goals, 207
performance decrement, sustained over physical endurance, 167, 169, 171,
attention, vigilance 179, 212
autonomic nervous system (ANS), 87, over stressors, 20, 53, 86–87, 89, 90,
118, 202, 209 91, 92, 93, 121
over task/work goals, 9, 72, 80, 81, 85,
basal ganglia, 105, 146, 149, 150, 151, 86, 116, 121, 124, 130, 136, 146,
185, 189, 203, 214–216 149, 150, 163, 180, 181
blocks, see lapses control models, 114, 139–146, 178
boredom, 17, 69, 105, 109, 135 coping, 91–93, 101, see also modes of
burnout, 195, 199, 201, 214, 215 work, stress
268
Subject index 269
active vs. passive, 91, 92–93, 127 reduced, as after-effect of fatigue, 67,
costs of, 91, 92–93, 113, 118, 123 120–123, 136
proactive vs. reactive, 128, 201 regulation, 141, 145, 146, 149–151,
problem-focused vs. emotion-focused, 153
92 relation of, to mental capacity and
strategies, 127–130, 199–200 resources, 73–76
cortisol, 90, 91, 118, 128, 129, 130, 159, in sleep deprivation, 118, 122, 176
162, 196 voluntary control of, 62, 75, 120,
costs and benefits, 102, 137, 142, 148, 170
149, 200, 205, 208, 209, 210, 212 effort-reward imbalance (ERI) model,
current concerns, 111, 142, 196 124–125, 190, 217
curve of work, see work curve ego depletion model, 33, 121–122,
160–162
default mode network, 157 emotion(s), 92, 97, 99–105, 138, 147,
demands, 47, 53, 89, 197, 215, 148, 151, 181
see also demands-control-support basic, 15, 101, 105
(DCS) model, physical work, stress, as distractors, 99–100
workload as ‘need to’ goals, 111, 138
emotional, 107, 193–195 specific vs. general, 99, 100–101
environmental, 86, 89, 107, 116, 119, emotional fatigue, 164, 193–195
196 energy
task, 18, 32, 69, 74–75, 83, 209, 211 brain, effects of sleep deprivation on,
work, 30, 31, 35, 37, 38–39, 45, 49, 175–176, 177
200, 215 brain, relation to mental energy, 8
demands-control-support (DCS) model, demands of mental work, 156
35, 40–43, 124–125, 190, 217 depletion, as explanation of fatigue, 9,
depression, 103, 129 25, 27, 31, 44–45, 63, 80, 132,
and burnout, 193 155, 160, 162–164, 194, 199,
and chronic fatigue, 184, 187 211
and neurasthenia, 45–46 in mental work, 160–164
relation of, to fatigue, 1, 15, 17, 21, metabolism, 155, 165, 211
103 engaged work mode, 129–130,
relation of, to positive affect, 103 see also coping, flow state
disengaged work mode, 129, 130, 199, environmental stressors, see stressors
200, 201, see also coping environmental threat, 4, 18, 74, 86, 89,
disengagement from goals, 85, 103, 193, 90, 91–92, 94, 95, 96, 98, 99, 100,
201, 203 105, 107, 116, 118, 123, 125, 150,
distraction, 96–97, 99–100, 101, 138 196, 198, 217
dopamine, 76, 146, 149, 205, 210 epinephrine, see adrenaline
and CFS, 203 evolutionary perspective, 10, 97, 99, 103,
and effort, 149–151, 152–153, 210 149
executive control, 10, 60, 67, 72, 76, 78,
EEG, 81, 82, 147, 156, 177 82, 95, 98, 99, 112, 117, 119, 122,
effectiveness vs. efficiency, 100 123, 133, 137, 141, 142, 147, 154,
effort, 22, 118, 166, 168, 169, 170, 173, 157, 163, 170, 172, 176, 186, 188,
215 189, 195, 209, 211
in compensatory control, 113–114, 119, neural basis of, 142, 146–149
141 executive function, 22, 24, 47, 67, 121,
costs of, 75, 93, 105, 118–120, 136 133, 141, 142, 143, 145, 146–154,
disturbed sense of, 185–187, 194, 175, 176, 181, 185–186, 188, 190,
212 209, 213
as executive control, 67, 74–77 exercise, see physical fatigue, physical
neural basis of, 121, 142, 149–151, 154 work
in persistent fatigue, 185–187 central fatigue, 185
in physical work, 161, 172 peripheral fatigue, 185
270 Subject index
fatigue homeostasis, 86–88, 114

and brain energy, 155–164, 189, 211 homogeneity of task elements, 53, 55,
definitions of, 11–14, 25 64–65, 209
as an emotion, 10, 15, 21, 102–105, hypothalamic-pituitary-adrenocortical
132, 137, 138 (HPA) axis, 89–91, 118, 128, 129,
generality of, 54, 55, 62–63, 209 159, 162, 196, 202–203, 216
historical perspective, 44–50
medicalization of, 45–47 idleness, 32–34
metaphors of, 8, 25, 26–29, 31, 44–45, impairment, see performance decrement
155, 194, 210 incentives, 94, 96, 97, 98, 208
and physical work, 7, 9, 63, 155, industrial psychology, 48–50
165–173, 178, 213 Industrial Revolution
and sleep, 173–178, 214 changes in leisure during, 39, 42
varieties of, 5–6, 23, 164–165, 173–174 changes in work hours during, 38, 42
feelings, see also anxiety, emotion, fatigue, impact on work and fatigue, 30, 37–39
mood working life in pre-industrial era, 36
of fatigue, 5, 7, 15–18, 27, 29, 31, 52, interruption, 10, 80, 136–139, 144,
76, 105, 135–136, 138, 146, 165, 151–154, 207
211–213 inverted-U, see arousal
as information, 11, 102, 104, 217
related to fatigue, 15–18, 105, 173 job demands-control model, see
fight or flight response, 87, 91, 100 demands-control-support (DCS)
flow state, 9, 53, 129, 130, 210–211 model
fMRI, see neuroimaging job demands-resources (JD-R) model,
41, 200
gaps, see lapses
glucose, 8, 23, 33, 89, 90, 121, 156, 157, lapses, 72, 80–82, 95, 136, 140, 142, 144,
158–159, 160–163, 165, 175, 177, 175, 208
189, 211, 214 learned helplessness, 200
glycogen, 90, 158–159, 160, 161, 162, learned industriousness, 201
163, 165, 177, 225, 226 leisure, 9, 29, 33, 36, 39–40, 192, 197
goals limbic system, 101, 147, 150, 151, 163, 185
commitment, 201 local brain sleep, 177, 178, 214
competition between, 109–112, 137,
140, 143, 207 mental energy, 2, 7, 8, 28, 31, 45, 74
in control of behaviour, 134, 140 modes of work, 127–130, see also coping
maintenance of, 4, 10, 14, 22, 33, 71, monotony, see boredom
83, 93, 99, 109, 110, 112–113, 119, mood
126, 127, 134, 136, 143, 147–149, circumplex models of, 17, 101
151, 152, 153, 200, 203, 205, 207, positive and negative affect (PA/NA),
212, 217 17–18, 101–103
personal (‘want to’), 9, 22, 91, 92, motivation, 71, 122, 125, 133, 176, 194
110–111, 122, 125, 134, 142, 144, extrinsic vs. intrinsic, 70, 110, 120, 133
194, 207, 217–218 in real-life vs. laboratory tasks, 126–127
somatic (‘need to’), 110, 111–112, 137, two-process theories of, 101–102, 103
138, 142, 144, 148 motivational control, 10, 11, 23, 74, 103,
task (‘have to’), 4, 14, 16, 60, 71, 114, 121, 133–134, 140, 142, 146,
74, 76, 83–84, 88, 93, 96, 98, 99, 149, 153, 172, 176, 180, 185, 205,
107, 108, 109–111, 112–113, 119, 207, 209, 215, 217
126–127, 128, 129, 134, 135, 136, failure in persistent fatigue, 185–187,
141–142, 145, 148, 149, 152, 180, 195–203
185, 186, 199, 203 multiple sclerosis, see persistent fatigue
varieties of, 110–112
negative affect, see mood
habituation, 65, 71–72, 96 neurasthenia, 29, 45–47, 183, 193
heart rate variability (HRV), 119 neuroimaging, 82, 146, 157, 162, 178,
heat stress, 95, 96, 115 188, 208, 209, 210, 211
Subject index 271
nicotine, 210 from stress, 130–131, 196, 197, 201,

noise, 72, 81, 94, 95, 96, 97, 98, 116, 117, 215
118, 119, 123 from work/fatigue, 23, 63–66, 78, 82,
noradrenaline, 90, 118–119, 149, 152 163, 170, 191, 192–193, 195, 197,
norepinephrine, see noradrenaline 199, 206–209, 215, 217
resources, 4
Parkinson’s disease, see persistent fatigue rest, 20, 22, 30, 33, 39, 48, 51, 63, 113,
performance decrement, 22, 51–85, 136 137, 180, 217
early research on, 58–62 vs. change, 63–66, 82, 136, 209
homogeneity effect in, 64–65, 71
methods in early study of, 56 selfish brain theory, 159, 161, 162, 163,
rapid onset of, 77–80 178, 211, 214
sources of, 82–85 self-regulation, see control models,
under stress, 93–96 motivational control
perseverative cognition, 91, 111, 196, shift work, 96, 174, 190–192, 217
197 sleep, 5, 23, 88, 163, 173–179, 184, 191,
persistent fatigue, 23, 214–216, 192, 196, 197
see also chronic fatigue syndrome energy hypothesis, 163, 176–177,
(CFS) 214
in cancer, 188 local brain sleep, 177–179
in chronic illness, 187–190 models, 174–175, 213
and motivation control, 202 sleep deprivation, 55, 73, 81, 94, 95, 96,
in multiple sclerosis (MS), 188–189 97, 98, 116, 117, 122, 174, 175–176,
in Parkinson’s disease, 189–190 214
prevalence of, 181–182, 215 sleepiness, 6, 23, 25, 29, 96, 97, 118, 165,
and work stress, 190–195 173–175, 178, 192, 213, 214, 217
PET scan, see neuroimaging speed-accuracy trade-off, 81, 95, 117,
phenomenology, 9, 15, 133, 135–136, 129, 135, 141
164, 173 strain, 18, 30, 41, 105, 107, 113–115, 119,
physical fatigue, 6, 23, 164, 165, 166, 123, 146, 153, 163, 170, 173, 196,
170, 173, 185, 186, 211–213, 200, 205, see also coping, effort
see also central governor model, disengagement spiral, 203, 214, 215
exercise, physical work mode of task coping, 14, 35, 83–85,
central fatigue hypothesis, 166–172 86, 88, 100, 114, 127, 128–129, 130,
motivational hypothesis of, 169–170 134, 136, 141, 150, 164, 198, 199
peripheral fatigue hypothesis, 165–166 work, 40, 123–125, 191, 192–193, 217
physical work, 5, 23, 44, 110, 164–173, stress, 53, 86–105, 195
191, 212, 213 in CFS, 198
effects on mental fatigue, 170 general adaptation syndrome (GAS),
energy demands of, 158, 166 87, 90
exercise, effects of, on cognition, response, 22, 87, 88–93, 202, 215
172–173 stressors, 86, 99, 100, 111, 116, 197
positive affect, see mood effects on performance, 93–96, 136
prefrontal cortex (PFC), 121, 147–154, indirect indicators of effects on
176, 185, 205 performance, 115–123
process control, 71, 76, 139 subjective fatigue, see fatigue, feelings,
prolonged fatigue, see persistent fatigue, tiredness
chronic fatigue syndrome (CFS) sustained attention, 51, 67–73, 157, 207,
prolonged work, see sustained attention 209
psychomotor vigilance test (PVT), 79, sympathetic adrenomedullary (SAM)
147, 174 axis, 89–91, 102, 118, 128, 196
rating of perceived exertion (RPE), 169, theta rhythm, 119

170 threat, see environmental threat
recovery, see also after-effects time of day effects, see circadian
from sleep deprivation, 60 rhythm
272 Subject index
tiredness, 1, 13, 14, 20, 21, 25, 26, 29, work curve, 48, 56–58, 59, 77–80,
34, 35, 36, 37, 42, 48, 114, 132, see also performance decrement
142, 164, 166, 182, 191, 194, 197, work decrement, see performance
216–217, see also feelings, fatigue, decrement
mood work–fatigue hypothesis, 9, 50, 51–85,
208
vigilance, 51, 53, 58, 67–73, 77, 79, 80, working life, 25, 30, 31, 223
82, 120, 122, 127, 138, 170, 210 changes in, with industrialization,
37–43
work pre-modern experience of,
as benign experience, 34 34–37
hours, 30, 35, 38–39, 42, 49–50, pre-modern, natural rhythm of, 35–36
190–192, 199 working memory, 60, 71, 95, 109, 117,
moderating effect of control on, 9 119, 121, 123, 129, 154, 157, 160,
pre-modern experience of, 29–34 184, 186, 188
stress, 40–43, 88, 123–127, 174, workload, 22, 51, 53, 58, 73–77, 82, 83,
190–195, 197, 199, 200, 205, 214, 86, 87, 94, 115, 117, 119, 120, 124,
215, 217–218 136, 165, 170, 174, 213, 217

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more information - www.cambridge.

Fatigue can have a major impact on an individual’s performance and

r o b e r t h o c k e y is Emeritus Professor of Human Factors and

Published in the United States of America by Cambridge University Press,

© Robert Hockey 2013

This publication is in copyright. Subject to statutory exception

First published 2013

Library of Congress Cataloguing in Publication data

ISBN 978-0-521-76265-6 Hardback

Cambridge University Press has no responsibility for the persistence or

List of figures page xi

1 The problem of fatigue 1

2 Changing experiences of fatigue: the

3 The work–fatigue hypothesis 51

The early research agenda 54

4 Stress, coping and fatigue 86

5 Effort, strain and fatigue 107

Psychophysiological activation 118

6 A motivation control theory of fatigue 132

7 Extensions and limitations: energy, physical work

8 The psychopathology of fatigue 180

The clinical context of chronic fatigue 183

9 An agenda for fatigue: research and application 205

1.1 Changes in frequency of fatigue

1.1 Possible patterns of the fatigue response to work tasks page 15

When I decided to write this book I became aware of an obvious but

interest in fatigue, and the plethora of popular books on the subject –

Total number of journals

Figure 1.1 Changes in frequency of fatigue publications 1890–2000

cognitive, physical, sleep, stress and neuroscience. Even so, if an adjust-

Rationale and focus of the book: the adaptive

The failure of classical fatigue theory

Limitations of the energy account of fatigue

understanding patterns of decrement in mental work. Of course, at

Fatigue is not (just) a negative state

though the environmental and cultural context of working life has

engagement or resistance. This reinterpretation of the nature of the

decrement: ‘There is no fatigue as long as a purpose itself is not fatigued’

Defining the field: what is fatigue?

different researchers have routinely given different weight to these vari-

finally, (3) feelings of fatigue and physical discomfort. Although per-

Table 1.1 Possible patterns of the fatigue response to work tasks

Acceptance minor (transient) fatigue yes no

Fatigue and related feelings

developed in task situations under low intrinsic motivation, and was

standard features of the typical fatigue-inducing task. One possibility

The conceptual status of fatigue

as a brain process or bodily condition? Or does it simply add an unneces-

these other competing hypotheses before we can support learning as

has to show that it can go beyond the empirical relationships observed

Some questions for a scientific theory of fatigue

to the process of developing a scientific theory of fatigue. I have not

Plan of the book

function and effort. In Chapters 7 and 8, I consider constraints placed

Roots of the energy metaphor of fatigue

in 1839. These seem related to energy, and may now be regarded as

it was clear that fatigue was not an inevitable consequence of work;

The pre-modern experience of work and fatigue

conceptions of fatigue generally attribute this to a lack of energy or

Fatigue, idleness and volition

the end of the Industrial Revolution, Revilliod’s (1880) medical trea-

Work as a benign experience

The loss of control over work

1.1 Possible patterns of the fatigue response to work tasks page 15