Post-Stroke Fatigue and Its Psychological Correlates: Anxiety Components and Quality of Life

Mulvey, Anna (2026) Post-Stroke Fatigue and Its Psychological Correlates: Anxiety Components and Quality of Life. Doctoral thesis, University of East Anglia.

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Abstract

Aims: This portfolio explores the aetiology of Post-Stroke Fatigue (PSF) by exploring the predictive strength of two risk factors: anxiety and quality of life (QOL). Anxiety is categorised into three domains: cognitive, physical and behavioural, allowing for a detailed examination of its predictive strength.

Structure: This portfolio includes a systematic review of studies examining the relationship between PSF and QOL among stroke survivors. An empirical paper follows, which examined how three components of anxiety (behavioural, physical and cognitive) accounted for individual differences in PSF. Hierarchical regression models were used to determine whether behavioural, cognitive, and physical anxiety symptoms accounted for additional variance in PSF once demographic, clinical, and emotional factors were consideredThe portfolio finishes by reflecting on this research.

Results: The systematic review found a significant relationship between QOL and PSF levels, consistent across all studies. It also found that demographic factors, such as female sex and younger age, were related to higher PSF and lower QOL. The empirical paper found that depressive symptoms were the strongest emotional predictor of PSF, with behavioural, cognitive, and physical anxiety symptoms showing meaningful associations at the unadjusted level but not contributing independently once depression was included. The paper also found that stroke type (haemorrhagic) significantly improved the model's prediction of PSF.

Conclusions: We found evidence that depressive symptoms were the strongest emotional predictor of PSF, with behavioural, cognitive, and physical symptoms of anxiety only showing meaningful associations before controlling for depression. This may indicate that the relationship between anxiety and PSF is mediated by co-occurring depressive symptoms. Overall, this study’s findings support the need for routine screening of non-motor symptoms and for ensuring that emotional distress is considered within PSF formulation.

The potentially elevated risk observed in specific demographic groups offers a further area for future research. Future work could examine whether demographic characteristics help identify which stroke survivors may be more likely to develop PSF. This would allow for closer monitoring of individuals at higher risk, ensuring that their fatigue is recognised early and not overlooked within rehabilitation pathways.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	09 Nov 2026 14:46
Last Modified:	09 Nov 2026 14:46
URI:	https://ueaeprints.uea.ac.uk/id/eprint/105026
DOI:

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