Chronic Fatigue Syndrome the roles of perfectionism and metacognition in co-morbid depression and anxiety, 2020, Wright (D.Clin.Psy.)

Can be downloaded for free at these links:
https://livrepository.liverpool.ac.uk/3100418/1/201310670_June2020.pdf

https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.815650

 

There are some annoying things there. Not sure how great a reference Kelland is.

Part of this is the survey commented on here (IRAS reference: 253333): https://www.s4me.info/threads/unive...tress-in-chronic-fatigue-syndrome-2019.11049/

 

Poor dear. This piece of new research is going to feel very dated very quick. And it's the fault of her supervisors.

What she clearly doesn't understand is the fury over the fact that this (CBT) is ALL we've been offered for decades along with GET. There really are better things to do than rehash this endlessly.

 

Page 21, (assessment of risk of bias in the systematic review)

Strangely, these selection/participation biases were ignored when it came to discussing her own study.

 

It's really offputting to see psychologists ignoring the impact of the illness on patients and reducing depression and anxiety to a personality problem.

Life destroying illness. Loss of many things that enrich one's life. Uncertainty about the future with a probably bad prognosis. None of these seem to matter, it's a personality problem according to some psychologists.

How about addressing depression and anxiety in ME/CFS by giving patients real hope of a better life, better care and support?

 

What can they deliver e.g. if they've delivered the limited benefit they can then why not try something different? Simon Ponting's GWAS study offers an opportunity to understand the underlying genetic basis for ME. Given that these other approaches don't seem to return people to a normal life then why continue to pursue them?
When I think of the level of disability, of some people with ME, I think the obvious answer is that they have an underlying biochemical illness. Understanding ME might be a journey of discovery e.g. it might indicate the underlying genetic basis for some things currently labelled as personality traits etc. - perfectionism or whatever. However, if we have the tools to improve our understanding (GWAS etc.) then why not apply them?
@Simon M

 

Are there any known examples of "perfectionists" suffering an acute viral illness and not experiencing perpetuation of symptoms? If so, why?

 

Should be

Goudsmit & Gadd, 1991

 

Yes!! Exactly this.

 

In my view, if this person wants to do something constructive they'd better serve by turning their focus on the people who spend their entire careers denying reality.

What type of psychological traits make a person repeat the same interventions over and over, ignore and avoid the evidence of harms over and over.and still show up for work every day to do it all over again.

Why the need to deny reality and try to impose their own wishful thinking on the way things are? Regardless of how many get hurt.

What are these traits? How do they develop? If the field of psychology is as powerful in effect as they seem to believe then why isn't more done to ensure that those who put their own careers and interests above those of patients are not permitted to work with vulnerable people?

If the field as psychology wants to be seen as a grown up sibling from the medical family then why the failure to accept that the ability to cause positive affect when appropriately applied means the ability to cause harm when inappropriately applied? As an adult where there is freedom if choice there is also the responsibility to make the right choices - why does psychology constantly duck it's responsibilities?

 

Just reading this summary, it doesn't sound too bad to me. I'm all for investigating how to better support the mental health of pwME (whilst also acknowledging that this is never going to be a treatment for the ME itself). Maladaptive perfectionism is generally linked to depression and anxiety. For people who have maladaptive perfectionist habits as well as ME, their experience of dealing with ME could be made even worse by their maladaptive perfectionism. How could we help those people improve their maladaptive perfectionism in order to make living wME slightly easier? - this seems like a reasonable question if that's what she's asking.

The bit that references the research into potentially predisposing personality traits worries me a bit - this research is so poor it seems pointless to even engage with it.

It's also a bit disappointing to me that a more accurate description of why patients reject the psychological theory of ME is not given. As Sean says above, it is not that we think that mental illness is not 'real' illness (this is an accusation aimed at us, it is not what we really think). It is the specific model of ME presented by the psychiatrists who have designed the treatments we are offered that we reject. This specific model does not reflect our experiences. As Sean says, we are not 'anti-psych', we are anti-inappropriate-psych'. I feel that it would be important to represent this in a thesis about mental health and ME. (I have only read this summary so I don't know if this is covered in the full paper.)

[Edited for clarity]

 

I agree - this would be very interesting!

 

What is maladaptive perfectionism though?

In the case of a surgeon we would consider perfectionism to be a good thing. Perhaps in other walks of life where budget, time and other restraints are imposed on a person perfectionism might be a handicap.

People will tend to carry over traits from their professional life into their personal life. One of my parents was a healthcare professional. As a kid with one disabled parent I had to do my share of household chores and they were expected to be done to a certain, fairly high standard.

In my career, assessing potential problems and planning ahead to minimise risk and have backup plans in place was a key factor. So there was a degree of perfectionism. When I became sick part of my journey was learning that just because I wasn't at work it didn't mean my house had to be sparkling (though that's how I would like it to be).

I would imagine that for many of us part of our ME journey is that what we unthinkingly expected of ourselves and maybe the people around us had to change. I am far less the perfectionist than I used to be. My house doesn't sparkle and my floors aren't always clean. How do I prove that I have adapted though? If someone levels the accusation of maladaptive perfectionism at me today I have no means of proving I'm not. It's not falsifiable.

I would agree that some of us probably could have done with some psychological support, especially when first ill, because becoming chronically ill with something so debilitating is a huge adjustment. I think that support should be more to with helping people get the most out of their lives and accessing whatever social support and benefits are available to them than assuming character traits that will inevitably be true for a small percentage of people whatever sample size you choose. After all even a stopped clock is right twice a day & worse than useless the rest of the time because it's so misleading.

 

Isn't that the definition of insanity?

 

It's hardly surprising that a lot of ME patients suffer from Anxiety and Depression. It's normal, surely, to be anxious about losing your job - some people will have been in highly paid jobs, and will be worried about how to pay their Mortgage as one instance. I've been seeing a fair number of LongCovid folks on Twitter being told they "only have anxiety" by GPs too. Anxiety isn't an "only" in my view, it's horrible, and it's also not surprising people with LongCovid are anxious, but that attitude is just so horribly dismissive of their suffering.

As to Depression, I've suffered that in the past. It's very different to ME, though there are some overlapping symptoms (never sure if that should be signs or symptoms?). My sleep patterns are rubbish at present, early waking - which is supposed to be a red flag for Depression. While I feel sad over a lot of things at present, that is NOT the same as being Depressed. I feel sad I can't see my GrandKids, and don't know when I'll be able to see them. Which I think is a reasonable way to feel about that, and other stuff in my life currently too.

But I get plenty of laughs in life still too... Latest was just now, "Smothered by a meat pudding" from Barnaby in Midsomer Murders! OK, off topic, but it's strange where you can find a laugh or a smile sometimes! Laughing is good for your health - why don't the psychologists do some research into that instead of messing with our heads? (OK I'm sure some have done research into that, but don't have the energy to look it up right now)

 

Yes Chris Ponting; however, I was thinking of tagging Simon @Simon M The two are linked of course re the GWAS study --- Simon's Gods representative on earth --- or, in this case, Chris's representative on Science 4 ME!
Attempt at a joke in case it's not clear!

I had decided not to tag Simon but instead he's now been tagged twice!