Thanks to
@Sly Saint for that transcript. I've got some notes, but they are very far from comprehensive.
So I’m hoping that when you go away from this lecture and think about me in a few years time it wont be equally as negative.
Hmmm....
I just wanted to start off with, well not right at the very beginning, but the beginning where I thought it took some importance which was working with Professor Isaac Marks who was a psychiatrist, a specialist in cognitive behavioural therapy. And I think to him I owe quite a lot because he set me on my path and really taught me to think very clearly about research and clinical work.
That's Isaac Marks, the aversion therapy researcher:
http://gaynewsarchive.org/tag/isaac-marks/
Okay, well if she still speaks of him like that then that makes a bit more sense of why she thinks she is unfairly criticised.
So in terms of the relationship between common viruses and the development of fatigue we found absolutely no evidence that common viruses delivered fatigue six months later. We recruited people with a virus in general practice and a control, that was someone who didn’t have a virus and followed them up and in six months there was no difference between groups.
This is one of the old studies oceanblue pointed out problems with on PR:
https://forums.phoenixrising.me/thr...-90s-that-keep-cropping-up.10274/#post-183831
Chalder goes on to some risk factor stuff but it's really difficult to fact check anything without knowing what she is citing. My suspicion is that a lot of it is weak/misleading. A lot of the work she seems to like in this area seems to ignore how the severity of the initial infection can confound data on negative expectations, time spent resting, etc.
autonomic disfunctions which I think just means a tendency to feel anxious, or experience physical symptoms predicted a poor outcome
That is an interesting understanding of autonomic dysfunction.
So is it possible to prevent chronic fatigue after these more serious infections? Well we did a smallish study, with Bridgit Camdy who is a great research nurse and Matthew Hotoff and others.
We tested the hypothesis that if you gave people a brief psycheducational intervention asking people not to rest, which is what most people tell them to do, but to gradually get back to their normal activities bearing in mind that they shouldn’t burn the candle at both ends, which is what a lot of young people are doing, after all it’s something that affects younger people than older ones, whether it would help prevent the fatigue later on.
So what we found was even though there was no difference at three months between the two groups; the control group were just given some information about glandular fever, you can see at six months the people who got just some advice that was one face to face sessions plus two telephone follow up calls, that they were less fatigued at six months.
Did she again cite that study and omit the 12 month data with no significant difference between groups (or any of the other many problems with it)?
I've reposted some critical comments about that study here:
https://www.s4me.info/threads/2003-...id-recovery-in-infectious-mononucleosis.8644/
I'm only on page 2 of this transcript and I've already lost the will to take it seriously. I used to be so much more committed to this stuff!
So obviously replication is very important in to have any confidence in results, and I think in Health Psychology and Psychology specifically people are talking a lot these days about the importance of replication. Because so many things are not replicated. But results of two meta analyses show that CBT and graded exercise therapy are promising treatments for chronic fatigue syndrome, but that CBT may be more effective when patients have comorbid anxiety and depression.
That Cochrane? If so, how come there's no mention of the editor's note warning of problems?! Earlier in this very talk she had said "And some people have suggested that CBT only really works on people who have got anxiety and depression but not people who have got fatigue or pain, in fact we found the opposite, that those people with mood disorders did less well."
So then we move on to the PACE trial.
This was carried out with Peter White and Michael Sharpe and many others and was funded by the MRC and the Department of Health.
And? The third funder? A bit controversial? No mention for the DWP?
So why the anger, and the anger by the way continues to this very day with scores and scores of freedom of information requests and what have you.
Well I think it’s because a psychological treatment and even graded exercise therapy in terms of a certain group of people, they feel that it implies that the condition is psychological, it might even imply that the person is lazy which clearly it doesn’t. And if people get better it means that the problem wasn’t real in the first place and it certainly wasn’t organic in nature.
It's possible that Chalder is so blind to the problems with her own work that she genuinely believes this.
After a long discussion on mediation claims from PACE she says:
Interesting with mediation of ?? its very hard to show which thing changed first because we were unable to really show temporal precedence because when you look at the pattern of change in the mediators its changing at the same time as the outcomes. Which means its very hard to say well actually, this changed before that.
So, as Simon McGrath pointed out in his letter about this study:
Although the authors acknowledged that simultaneous change in their study’s outcomes means mediators and outcomes might affect each other reciprocally, the abstract and conclusions unambiguously assert mediation.1 Claims of causal mediation, and the linked assertion that this strengthens the theoretical treatment model, are premature.
https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(15)00085-1.pdf
So much of their work seems to be about trying to create appealing stories for those who won't check the evidence.
Thank you for posting 
