Etiology: graphic representations

Simone

Simone

Senior Member (Voting Rights)
Hi brains trust!

I’m looking for a graphic that presents a possible biomedical model of ME/CFS for a project I’m working on. I’ve got this one, from a Maes & Twisk article in 2010, but ideally I’d like something more recent and which isn’t framed as biopsychosocial.

Any thoughts?

Source for this image: https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-8-35
 

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I don't think we have a clear enough picture to want to build a diagram of that sort. Diagrams like that in biomedical science are mostly very dubious and misleading. They are popular because they look as if they mean something but generally don't. People like to draw lots of circuits and loops but most of the time the mathematical basis is unsound. Diagrams really only start to hold water once you know in detail what is going on.
 
That Maes and Twisk one seems to suggest symptoms are perpetuated by psychological stress. The biological bits look speculative. We don't know if they are accurate. So I agree, it's BPS and not useful.
I dont like these sort of diagrams - we see them all over the BPS publications full of nonsense dressed up to look complicated and scientific when they are prejudiced nonsense.
As Jonathan Edwards says, we dont yet know the biological basis of ME, so what would you put in the diagram?
 
If the goal is to show an audience that there is a biological basis to the illness, then the epidemiology and selected findings like the responses to a 2-day CPET could be good.
 
Here's a review article from 2019 by Warren Tate that should give you an overview of the current scientific literature. It doesn't have a diagram so I guess you could make your own and add bits from this review article to it. Of course, it's a bit difficult to have anything conclusive since, like others said, we don't have a clear picture of the disease.
 
Graphic representation of ME/CFS

5471047557_4dc13f5376_n.jpg
 
Yes.
About all we know is
1. Infections(viral, bacterial, amoebic) (or other triggers) sometimes lead to ME/CFS (but some particular infections don't seem to be a trigger)
2. Personality traits (as measured in the Dubbo study) including hypochondria have no meaningful impact on the risk of developing ME/CFS (e.g. the Cvejic 2019 paper)
3. CBT to correct 'faulty thinking' and GET to correct approaches to activity have no meaningful impact on ME/CFS, suggesting that neither faulty thinking, a phobia about activity or deconditioning are causes

Although, some would question whether 'other triggers' really do cause ME/CFS. And many would debate the name. And some still cling to beliefs about personality and behavioural problems. So, Michiel's graphic seems about right.
 
Trish said:
That Maes and Twisk one seems to suggest symptoms are perpetuated by psychological stress. The biological bits look speculative. We don't know if they are accurate. So I agree, it's BPS and not useful.
Click to expand...
Yes, the good thing about that diagram is it clearly shows why it is wrong. The "Psychological stress" feedback loop, apparently able to provoke the same physical characteristics that are shown as perpetuating ME/CFS.

When we know enough about what ME/CFS really is then such diagrams will be very helpful.
 
Jonathan Edwards said:
I don't think we have a clear enough picture to want to build a diagram of that sort. Diagrams like that in biomedical science are mostly very dubious and misleading. They are popular because they look as if they mean something but generally don't. People like to draw lots of circuits and loops but most of the time the mathematical basis is unsound. Diagrams really only start to hold water once you know in detail what is going on.
Click to expand...

I agree. I don’t think we do either, which is partly why I wanted to replace this one (which is currently proposed for this project). The people I’m working with want a nice picture, but I’m leaning towards us just providing a couple of sentences on some of the current hypotheses, to show that nothing is set is stone, but that there are biomedical hypotheses around.
 
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