{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:39:23Z","timestamp":1787027963821,"version":"build-2736575974"},"reference-count":55,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ren\u00e9 and Susanne Braginsky Foundation","award":["793580"],"award-info":[{"award-number":["793580"]}]},{"name":"ETH Foundation","award":["793580"],"award-info":[{"award-number":["793580"]}]},{"name":"University of Zurich","award":["793580"],"award-info":[{"award-number":["793580"]}]},{"DOI":"10.13039\/501100000654","name":"European Union\u2019s Horizon 2020 research and innovation program","doi-asserted-by":"publisher","award":["793580"],"award-info":[{"award-number":["793580"]}],"id":[{"id":"10.13039\/501100000654","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Royal Society Te Ap\u0101rangi","award":["793580"],"award-info":[{"award-number":["793580"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Entropy"],"abstract":"<jats:p>Allostatic self-efficacy (ASE) represents a computational theory of fatigue and depression. In brief, it postulates that (i) fatigue is a feeling state triggered by a metacognitive diagnosis of loss of control over bodily states (persistently elevated interoceptive surprise); and that (ii) generalization of low self-efficacy beliefs beyond bodily control induces depression. Here, we converted ASE theory into a structural causal model (SCM). This allowed identification of empirically testable hypotheses regarding causal relationships between the variables of interest. Applying conditional independence tests to questionnaire data from healthy volunteers, we sought to identify contradictions to the proposed SCM. Moreover, we estimated two causal effects proposed by ASE theory using three different methods. Our analyses identified specific aspects of the proposed SCM that were inconsistent with the available data. This enabled formulation of an updated SCM that can be tested against future data. Second, we confirmed the predicted negative average causal effect from metacognition of allostatic control to fatigue across all three different methods of estimation. Our study represents an initial attempt to refine and formalize ASE theory using methods from causal inference. Our results confirm key predictions from ASE theory but also suggest revisions which require empirical verification in future studies.<\/jats:p>","DOI":"10.3390\/e26121127","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T04:33:29Z","timestamp":1734928409000},"page":"1127","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Refining the Allostatic Self-Efficacy Theory of Fatigue and Depression Using Causal Inference"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2991-7387","authenticated-orcid":false,"given":"Alexander J.","family":"Hess","sequence":"first","affiliation":[{"name":"Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, 8032 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4193-5203","authenticated-orcid":false,"given":"Dina","family":"von Werder","sequence":"additional","affiliation":[{"name":"Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, 8032 Zurich, Switzerland"},{"name":"Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, 03048 Cottbus, Germany"},{"name":"Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, 82152 Planegg-Martinsried, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0897-7142","authenticated-orcid":false,"given":"Olivia K.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, 8032 Zurich, Switzerland"},{"name":"Department of Psychology, University of Otago, Dunedin 9016, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5228-041X","authenticated-orcid":false,"given":"Jakob","family":"Heinzle","sequence":"additional","affiliation":[{"name":"Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, 8032 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8594-9092","authenticated-orcid":false,"given":"Klaas Enno","family":"Stephan","sequence":"additional","affiliation":[{"name":"Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, 8032 Zurich, Switzerland"},{"name":"Max Planck Institute for Metabolism Research, 50931 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1016\/S0140-6736(04)15794-2","article-title":"Fatigue in neurological disorders","volume":"363","author":"Chaudhuri","year":"2004","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"838","DOI":"10.7326\/0003-4819-134-9_Part_2-200105011-00007","article-title":"Chronic Fatigue: Symptom and Syndrome","volume":"134","author":"Wessely","year":"2001","journal-title":"Ann. 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