Lumpers Versus Splitters: Analysing the Effects of Soothers on Fibromyalgia and Chronic Fatigue Syndrome, 2021, Crowe (M.Sc. Thesis)

via Dr. Marc-Alexander Fluks

Source: University Utrecht
Date: May 11, 2021
URL: https://dspace.library.uu.nl/handle/1874/405927

https://dspace.library.uu.nl/bitstream/handle/1874/405927/Crowe (8158479) thesis.pdf


Lumpers Versus Splitters: Analysing the Effects of Soothers on Fibromyalgia and Chronic Fatigue Syndrome

Crowe, C.
(2021) Faculty of Social and Behavioural Sciences Theses
(Master thesis)

Abstract

The ‘Lumpers’ versus ‘Splitters’ debate has been central to the study of Functional somatic syndromes (FSS) for decades.

Fibromyalgia (FM) and Chronic fatigue syndrome (CFS) share similar demographic and clinical characteristics; however, their aetiology and pathophysiology remain undetermined.

Lumpers postulate that FM and CFS are simply different manifestations of a singular FSS, while ‘Splitters’ argue that they are separate FSSs.

This study is part of a group project assessing the impacts of threats, soothers and drives on somatic symptoms.

The current study focuses on the role of the soothing system, and investigates the potential ability of soothers to alleviate FM and CFS symptoms.

Additionally, this study examines the experiential differences between these two FSSs, in order to add to the Lumpers versus Splitters debate.

The sample consisted of FM and CFS patients (n = 804) aged 18 and over.

Participants answered three questionnaires relating to the impact of soothers on their somatic symptoms, mental wellbeing, physical functioning, and how the syndromes affect their quality of life and overall health.

The findings tentatively support the splitters perspective. Results revealed significant differences between CFS and FM regarding fatigue severity (the central symptom of CFS), and also indicated that balancing activities and relaxation was more important within CFS treatment in comparison to FM treatment.

There were also differences in overall symptom severity, with FM patients being the least affected and patients with both FM and CFS being the most affected.

This study highlights the potential utility of soothers within FM and CFS treatment.

The results tentatively indicate that FM and CFS should be considered separate FSSs and provides a platform for future study in this area.

 

Table 1.

List of soothers used for this study

1) Mindfulness (living in the here and now and being non-judgmental)
2) Aids (such as a wheelchair, jug, comfortable matrass or good pillows)
3) Medication that reduces disease activity or symptoms
4) Doing a fun thing with family or friends
5) A leisure activity, such as reading, music, movie, dancing, drawing,
painting or another hobby
6) To be surrounded by lovely people (e.g., friends or family)
7) Warm temperature (for example, bath, shower, infrared lamp, warm
water bag)
8) Having the freedom to do something in the way I want to do it myself
9) Consistency and structure
10) Something that cools me down (e.g., a cold shower, cold wind,
cooling gels)
11) Getting help from other people, such as kins or specialists
12) Understanding my disease
13) Getting a massage
14) Supplements (vitamins, proteins, and so on)
15) A calm surrounding such as nature, one’s own house, pleasurable
sound and light
16) A good balance between activities and relaxation
17) Having a good or positive conversation
18) Healthy or good nutrition
19) An alternative medicine such as osteopathy and reiki
20) Seeing that people in my environment are happy and healthy
21) A relaxation or breathing exercise such as yoga or meditation
22) To take a rest or a break
23) Intimacy
24) Having a positive mindset (e.g., positive thinking, acceptance,
being thankful)
25) Talking to and sharing experiences with fellow sufferers
26) Receiving physical affection such as being caressed or getting a hug
27) Being accompanied by or caring for pets (e.g., horse, dogs, cats)
28) Expressing myself to others and knowing that I’m not alone in all of
this
29) Professional help (for instance from physical therapists or
psychologists)
30) Taking a comfortable posture
31) Being in a good mood
32) A physical activity such as walking or cycling, gardening, Tai Chi
or Qigong
33) To be in a secure and trusted environment
34) To remain within my limits or boundaries (e.g., saying ‘no’, or
asking for help)
35) Nice weather
36) Sleeping
37) Feeling recognized, understood, respected, loved, liked or important
38) Drinking a yummy beverage (such as tea, cola or alcoholic drink),
eating a treat (such as chocolate or sweets) or smoking a cigarette
39) An activity in water (e.g., being in a pool, floating, hot tub)
40) Performing a spiritual or religious activity such as going to church
of praying.

 

I love that list of nice things.
I don’t rate any else about this study.

In fact I feel a little more nauseous than soothed..

 

Calling that list of things "soothers" is demeaning, and the language used in it is appalling e.g. "Drinking a yummy beverage". Babies need soothing, not older sick people. Why doesn't the author suggest patting people on the head, stroking their hair, and saying "There, there, everything is going to be fine" in the tone of voice you would use with a baby?

 

Yes, I wondered that too, after I'd posted.

 

How on Earth can this simultaneously arbitrary and patronising list be regarded as containing related items? This study is yet another pointless exercise in deciding in advance what you want to conclude and then twisting your data to achieve that?

How does having appropriate clinical intervention, symptom control through activity management, avoiding things that do you harm, ordering the world the way you like it, receiving emotional support and doing things you enjoy in anyway represent an homogenous list?

This is basically a list of a lot of things the participants do, but also missing out many equally important things such as going to the toilet, personal hygiene, getting shopping, etc. What one person regards as a ‘soother’ another may regard as torture, for example dancing or having a warm bath, and many activities combine both ‘soothers’ and torture in equal measure, for example enjoying that your room is being cleaned whilst having to endure the sensory overload of the noise of a vacuum cleaner, that can trigger a worsening of your condition.

(An aside - am I the only person that really struggles to read a long list of short sentences each equally spaced from each other and each approximately the same length, I find this as impenetrable as a large unbroken block of text? In the case of the abstract to this article, though I appreciate the effort put into trying to make it easier to read, I found the original single block less problematic than the long list of spaced single sentences here.

People seem to be increasingly using long lists of equal length short sentences rather than short paragraphs and/or sentences of varying length. I assume it is to help people understand the posts better, but for me it has the opposite result. It is not the list format that I struggle with, as numbered lists cause me no problems, it is the lack of any visual clue to help me orient myself on what becomes a very large undifferentiated visual field, with a distractingly/distressingly large amount of blank space.

My personal preference is for short paragraphs of varying lengths, that avoid over dense blocks of text, but also provide a visual landscape to help navigate the page, still maintain the use of some juxtapositioning to elucidate relationships between sentences and avoid large amounts of blank page.)

 

I don’t know.
I came to a rather different conclusion.

I clicked on this thread, My curiosity all aroused. One thought in my head. My Fibromyalgia is in need.

What is a ‘Soother’ and where can I buy one?

Followed by some practical consideration.

Will I need a ‘Splitter’ and a ‘Lumper’ to make it work?

Will the various components of this set up become cost prohibitive?

Slight dampening of my enthusiasm


The realisation that there are also bound to be ongoing maintenance costs.

I am feeling sad now.

I simply can’t afford this advanced cutting edge pain zapping technology.

 

On a different tack, I find the issue of ‘lumpers’ and ‘splitters’ an important one. If we are to effectively interact with the world we need to distinguish appropriately between many things, for example it might be essential for survival to distinguish between domestic cats and big cats such as lions and tiggers.

Though the authors start from the assumption that ME/CFS and Fibro are both functional somatic disorders they looked to their lists of ‘soothers’ to support the notion it is clinically meaningful to distinguish them. However I am not sure why they find this necessary, as though there is overlap, regardless of your beliefs about aetiology they present with different symptoms in the first place.

In order to appropriately manage and hopefully in the future effectively treat we need appropriate/meaningful diagnostic categories, but I am not sure what this arbitrary confection of niceness adds to our understanding. Though ‘niceness’ makes the world a more pleasant place, I would much prefer effective management/intervention to being jollied along. In general I feel we should be leaving it up to individuals to decide themselves how to squeeze what pleasure they can out our restricted condition.

In a wider sense we are seeing ‘lumpers’ on steroids with the ever increasing BPS catch all diagnoses of MUS and FND, that seek to block meaningful clinical assessment of individual conditions, with potentially fatal consequences.

 

Ah, another text in the "Youth in Asia" series, where people don't understand the question and make weird stuff up instead.

The standards in this field are an absolute joke, all they do is project and talk about whatever they project.

 

I havent read further than the OP & the list. What i can say is that if i were able to access even say 75% of the things on that list, instead of just 7/40... my life would be transformed! They have no clue.

 

Soother is a synonym to “binkie”- i am utterly insulted.

 

i find it startling that this meaningless waffle is supposedly a masters thesis . that tripe should fail the first reading from any scientifically literate examiner .

 

Very scientific.

 

Master’s degree thesis recommending cigarette smoking…

‘Yummy beverage’ - infantilization