Andy
Retired committee member
Paywall, https://www.physiotherapyjournal.com/article/S0031-9406(19)30012-4/fulltext
Not available on Sci-hub at time of post.
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Cognitive factors are associated with disability & pain, but not fatigue among physiotherapy attendees with persistent pain & fatigue, 2019, Antcliff
- Thread starter Andy
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Not available on Sci-hub at time of post.
Hard to tell from just an abstract, but two things spring out at me:
1. They call 'self efficacy' and 'catastrophising' cognitive factors. I though they were psychological factors.
To me cognitive factors are things like short term memory, concentration, etc. ie the ability to think and process information, nothing to do with 'beliefs'.
2. In the results section the say the found an 'association' between 'disability' and 'self efficacy beliefs'.
In the conclusion, this morphs into 'Self-efficacy beliefs appear to be particularly strong determinants of disability'. Yet another case of correlation being used to assume the causation, and to choose the direction of causation to suit the researchers beliefs.
And to compound the felony, they take another leap of logic to suggest that it's possible for 'therapy' to alter this supposed 'determinant' of disability.
Ugh!
1. They call 'self efficacy' and 'catastrophising' cognitive factors. I though they were psychological factors.
To me cognitive factors are things like short term memory, concentration, etc. ie the ability to think and process information, nothing to do with 'beliefs'.
2. In the results section the say the found an 'association' between 'disability' and 'self efficacy beliefs'.
In the conclusion, this morphs into 'Self-efficacy beliefs appear to be particularly strong determinants of disability'. Yet another case of correlation being used to assume the causation, and to choose the direction of causation to suit the researchers beliefs.
And to compound the felony, they take another leap of logic to suggest that it's possible for 'therapy' to alter this supposed 'determinant' of disability.
Ugh!
Jonathan Edwards
Senior Member (Voting Rights)
Well, they are physios, not psychologists.
One of the strange things about PACE is that it suggests that to get better you need a therapist but psychotherapists and physiotherapists are equally good. That seems a bit odd - or at least it suggests that uncle Arthur would probably do just as well.
This study seems to provide evidence that physios do not understand the basics of psychology, rather supporting the uncle Arthur hypothesis.
One of the strange things about PACE is that it suggests that to get better you need a therapist but psychotherapists and physiotherapists are equally good. That seems a bit odd - or at least it suggests that uncle Arthur would probably do just as well.
This study seems to provide evidence that physios do not understand the basics of psychology, rather supporting the uncle Arthur hypothesis.
James Morris-Lent
Senior Member (Voting Rights)
I thought PACE showed that changing reported cognitions to be more 'helpful' didn't reduce objective disability in CFS...
I agree they should probably be sent back to high school to relearn that correlation ≠ causation.
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From the abstract I think I see the point that they're trying to make is that disability is linked to sense of self-efficacy more than it is to fatigue or pain - the implication being that the symptoms can be dialed up or down but what it really boils down to is your mental response to their existence.
The thing is, it looks like all they've done is do math on data from 5 self-report questionnaires. When it comes down to it I would bet that what they've done is simply to find out which pairs of questionnaires happen to be worded and/or scored in such a way as to make a nicer scatterplot compared to other combinations.
I will say it would be somewhat of a win for the questionnaires if 'disability' and 'self-efficacy' were most tightly correlated to each other, because when self-reported they are actually the same thing: self-rated level of ability.
Can anyone find the questionnaires used? It would be interesting, as @James Morris-Lent suggest, to see whether self efficacy and disabilty are asking about the same things, in which case it would be odd if a correlation were not found.
So the main finding from this study is that it's a very bad idea for physios (or anyone else) to take a bundle of questionnaires, stick the numerical results in a stats package, hunt for p values less than 0.05, and interpret them as carrying meaning.
So the main finding from this study is that it's a very bad idea for physios (or anyone else) to take a bundle of questionnaires, stick the numerical results in a stats package, hunt for p values less than 0.05, and interpret them as carrying meaning.
Hoopoe
Senior Member (Voting Rights)
One would think that millions of years of evolution failing to eradicate "negative thoughts" is clear evidence that they are not a flaw.
Negativity is really important. Without it, you risk becoming like these positive psychologists that are so full of positivity they just can't stop believing in ideas that don't work, and so sure of themselves they feel no need to observe the problem they are meant to solve.
Negativity is really important. Without it, you risk becoming like these positive psychologists that are so full of positivity they just can't stop believing in ideas that don't work, and so sure of themselves they feel no need to observe the problem they are meant to solve.
This is just one example of a self-efficacy questionnaire:
Schwarzer - https://cyfar.org/sites/default/files/PsychometricsFiles/General Self-Efficacy Scale (Adolescents, Adults) Schwarzer.pdf p3
Items:
1. I can always manage to solve difficult problems if I try hard enough.
2. If someone opposes me, I can find the means and ways to get what I want.
3. It is easy for me to stick to my aims and accomplish my goals.
4. I am confident that I could deal efficiently with unexpected events.
5. Thanks to my resourcefulness, I know how to handle unforeseen situations.
6. I can solve most problems if I invest the necessary effort.
7. I can remain calm when facing difficulties because I can rely on my coping abilities.
8. When I am confronted with a problem, I can usually find several solutions.
9. If I am in trouble, I can usually think of a solution.
10.I can usually handle whatever comes my
Just another case of inappropriate psychobo---cks they use.
Of course pain and fatigue will impact on your ability to reliably do any of the above.
Schwarzer - https://cyfar.org/sites/default/files/PsychometricsFiles/General Self-Efficacy Scale (Adolescents, Adults) Schwarzer.pdf p3
Items:
1. I can always manage to solve difficult problems if I try hard enough.
2. If someone opposes me, I can find the means and ways to get what I want.
3. It is easy for me to stick to my aims and accomplish my goals.
4. I am confident that I could deal efficiently with unexpected events.
5. Thanks to my resourcefulness, I know how to handle unforeseen situations.
6. I can solve most problems if I invest the necessary effort.
7. I can remain calm when facing difficulties because I can rely on my coping abilities.
8. When I am confronted with a problem, I can usually find several solutions.
9. If I am in trouble, I can usually think of a solution.
10.I can usually handle whatever comes my
Just another case of inappropriate psychobo---cks they use.
Of course pain and fatigue will impact on your ability to reliably do any of the above.
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shak8
Senior Member (Voting Rights)
The Chronic Pain Self-Efficacy questionnaire was developed in 1980 by Nicholas, et al. Basically it is a tool used to evaluate whether someone will return to work and off benefits vs not.
It measures how much a person is able to function in activities of daily life despite their pain. Obviously, it makes no distinction about pain or fatigue levels. And coupled with the other "tools" used, I find the conclusions ridiculous.
If I, with fibro, carried on with a near pre-fibro lifestyle, I would increase my pain 1000-fold and be stuck in neurologic-pain-fatigue hell for months.
So, whatever chronic pain efficacy means, it has no bearing on living with fibro chronic pain.
It measures how much a person is able to function in activities of daily life despite their pain. Obviously, it makes no distinction about pain or fatigue levels. And coupled with the other "tools" used, I find the conclusions ridiculous.
If I, with fibro, carried on with a near pre-fibro lifestyle, I would increase my pain 1000-fold and be stuck in neurologic-pain-fatigue hell for months.
So, whatever chronic pain efficacy means, it has no bearing on living with fibro chronic pain.
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rvallee
Senior Member (Voting Rights)
As always, zero distinction between can't and won't, making it entirely useless other than as a confirmation bias tool.
My healthy former self would answer yes to every question. My current disabled self would answer no to every question. None of which has anything to do with will, it's entirely down to ability in the same sense that sick or healthy, I am unable to dunk a regulation-height basketball.
Complete junk.
If anyone ever asks me to fill in a pain catastrophising questionnaire it will be a catastrophe for them as I will be deploying the full panoply of my vocabulary of swear words.
ETA I’ll probably throw in TRIPE for good measure
ETA I’ll probably throw in TRIPE for good measure
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Snow Leopard
Senior Member (Voting Rights)
Cognitions determine questionnaire answering behaviour, so if 'disability' is measured with a questionnaire, it can be the same underlying factor affecting both scores - it is a meaningless association.
