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Cognitive and behavioural responses to symptoms in adolescents with CFS: A case-control study nested within a cohort, 2019, Loades et al

Discussion in 'PsychoSocial ME/CFS Research' started by Andy, Mar 23, 2019.

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  1. Andy

    Andy Committee Member & Outreach

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    Paywalled at https://journals.sagepub.com/doi/abs/10.1177/1359104519835583?journalCode=ccpa
    Alt at https://sci-hub.se/https://journals.sagepub.com/doi/abs/10.1177/1359104519835583?journalCode=ccpa
     
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  2. Cheshire

    Cheshire Moderator Staff Member

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    That speaks volume. Kids saying "doing too much doesn't help" is translated in "beliefs about activity contribute to the exacerbation of their CFS symptoms". NO, this is not a proof that the belief is driving the symptoms. None of the things they quote proves there's a causality between a behaviour or a belief and symptoms. To demonstrate a causality, you'd have to have a way more complex process than just putting two things together and say one causes the other.

    Once again, correlation is not causation.

    This should be written in big red letters in every psychology university.
     
  3. strategist

    strategist Senior Member (Voting Rights)

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    That there is a correlation between thinking the illness is bad and lower functioning some time later is entirely consistent with the illness actually being bad. Chalder of course interprets this as these thoughts being a self fulfilling prophecy that causes worsening of the illness.
     
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  4. strategist

    strategist Senior Member (Voting Rights)

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    It's also unsurprising that CFS patients score worse on these questionnaires than asthma patients. They are much sicker.
     
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  5. wdb

    wdb Senior Member (Voting Rights)

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    That CBRQ questionnaire is so biased and terrible it's unbelievable (found a link (p.450-2) on this thread)

    These are some of the questions that they presumably think indicate 'Unhelpful cognitive and behavioural responses' rather than someone who legitimately might just experience PEM as a symptom.
    • I am afraid that my daughter will make her symptoms worse if she exercises
    • Physical activity makes my daughter’s symptoms worse
    • My daughter should avoid exercise when she has symptoms
    • My daughter’s illness is awful and I feel that it overwhelms her
    • When my daughter experiences symptoms, she rests.
    • My daughter tends to avoid activities that make her symptoms worse
    • My daughter tends to do a lot on a good day and rest on a bad day
    • My daughter avoids making social arrangements in case she is not up to it
    • My daughter avoids stressful situations
     
  6. chrisb

    chrisb Senior Member (Voting Rights)

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    Chalder must be a slow learner. Thirty years and still doesn't get the basics.

    And how can one assess whether cognitive and behavioural responses are helpful or unhelpful. It all depends upon the criteria for assessment. The bases for selecting those criteria are subjective.
     
  7. Amw66

    Amw66 Senior Member (Voting Rights)

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    There seems to be a deluge if such research at the moment.
    I hope that our NICE representatives and advisors can translate the cognitive dissonance into plain english for all to see.
     
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  8. Roy S

    Roy S Senior Member (Voting Rights)

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    "fatigue maintenance"?

    Is this new terminology? A google search doesn't return anything.


    ETA- I use the word "terminology" loosely.
     
  9. Londinium

    Londinium Senior Member (Voting Rights)

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    'Could' is doing so much work in this sentence it's probably a breach of EU labour law.
     
  10. Roy S

    Roy S Senior Member (Voting Rights)

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  11. Andy

    Andy Committee Member & Outreach

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    Hahaha, brilliant, thanks for the laugh. :rofl::thumbup:
     
  12. obeat

    obeat Senior Member (Voting Rights)

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    The children have more insight than the researchers.
     
  13. Cinders66

    Cinders66 Senior Member (Voting Rights)

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    Sharpe recently asserted that he believes CFS has a biological basis. I’ve never seen anything from his colleague chalder to show that she does, in fact the opposite, plus she only ever studies fatigue. It’s laughable.
     
  14. Trish

    Trish Moderator Staff Member

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    So the logical conclusion of that should be:
    We've got our model upside down all these years. Those responses of avoiding activity that make you sicker are actually helpful, not unhelpful. These children are sick, and pushing to do more makes them sicker.
    Aaaaaaaaaaaagh :banghead:

    It's so dispiriting that whole new generations of psychologists and psychotherapists are being taught this upside down nonsense.
     
  15. chrisb

    chrisb Senior Member (Voting Rights)

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    Surely it's membership of the MEA that is the determining factor, and probably not many of the children are members.
     
  16. roller*

    roller* Senior Member (Voting Rights)

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    are the tests they did available online ?

    is GET and CBT available as online training ?
     
    Last edited: Mar 23, 2019
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  17. Cinders66

    Cinders66 Senior Member (Voting Rights)

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    I suppose comparing CFS with asthma was supppsed to show kids with CFS had excessive fears and such, not that there’s an agenda
     
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  18. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    It is interesting that they recognise boom and bust as a problem. If the disability is perpetuated by unhelpful beliefs there would be no bust. 'Overdoing it' would just make the children fitter, surely.
     
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  19. chrisb

    chrisb Senior Member (Voting Rights)

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    I am sure this was recognised by others in 1989 which makes me wonder just how much communication they had with doctors outside their own little cult before describing their new condition. I am sure that that is in part what led to the belief that if, this is what they were seeing in patients, their patients were dissimilar to those who were previously diagnosed. this they have, of course always denied. But one or other of their propositions has to give.
     
  20. Esther12

    Esther12 Senior Member (Voting Rights)

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    It could be that unhelpful belief gets in the way of patients building up over time, but that there's some reason for patients not being able to rapidly increase their activity levels (physiological, or based on fear-anxiety that needs to be gradually assuaged through GET). There's no real evidence for that, but that sort of model could explain their use of 'boom and bust'.
     

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