Need for Controllability & Predictability questionnaire (NCP-q): psychometric properties & preliminary findings in a clinical sample, 2024, Ramakers

As usual, promoters of the psychosomatic paradigm don't seem to be able to maintain a position of equipoise on cause and effect when the evidence could suggest either, let alone put themselves in the shoes of someone who is sick and consider how that might affect their survey answers.

Perhaps someone's pathological requirement for controllability and predictability really has resulted in them developing a health condition that makes life less adventurous and more predictable.

More likely though, being sick, sometimes feeling very ill indeed and needing to be able to lie down quickly, and especially experiencing PEM has resulted in the person learning that a controlled environment is likely to allow them to maximise their functioning.


It's a shame the researchers didn't include a disease that is clearly physical among the 4 patient groups. It might have shown that pretty much everyone who is sick prefers a controlled and predictable environment - it's sensible and it is what we can see has evolved in mammals as part of sickness behaviour. Because unpredictability and unusual challenges are stressors that make being sick much more demanding.

 

So people who a higher than average need for control might be the sort of people who, when faced with a life-limiting diseases might seek out studies to take part in, to try to understand what is wrong with them?

See that reference to the Keen et al 2022 suggesting that people with CFS and FM have a higher need for control. Perhaps we are going to be seeing this idea pushed more.


Interesting that, when referring to other similar scales they note this:

I'm not really sure what they are saying there, if having a strong opinion in the face of uncertainty is supposed to be a good or bad thing. But, I do think that it is an irony that the authors are so concerned about sick people's need for controllability, while probably the core reason for the psychosomatic paradigm to exist is to fill the gaps of uncertainty, to make the unknown supposedly knowable and controllable by the clinician.


Here's another scale they mention:

And yet another, which would be very problematic if given to people who have undergone CBT

 

Questions
1. I do not like to lose control over my life
2. I like to know what awaits me
3. I like to plan everything in advance, so that I don't get any unexpected surprises

4. I find it necessary to control my surroundings
5. I feel uncomfortable if things don’t go as planned
6. I want to have a hold on what is happening around me

7. I like to have control over the things happening around me
8. I become restless if I lose control
9. I want to have a grip on the situation I find myself in

10. I feel anxious if I can’t predict what is going to happen
11. I have to know what I can expect, otherwise I feel uncomfortable
12. Uncertainty about the future gives me a bad feeling

13. I like to have control over my life
14. I like to know what is going to happen
15. I have a need for control



5-point Likert scale ranging from 1 (not typical) to 5 (very typical). Higher scores on all items reflect higher need for controllability/pre- dictability.

Study 1:

 

I doubt I'll finish reading the paper after I came across this in the introductory section:

To talk of the need for controllability and predictability as a 'personality trait' is ridiculous for pwME. The need to find a way to control our activity by pacing is driven by symptoms and is a physical need to try to prevent harm. It's not a 'personality trait'.

 

What a ridiculous questionnaire. What do you do if you like a mix of predictability and surprises? And what things are they meaning - predictablity of what I have for dinner, predictablity of whether a relationship will last, predictablity of war, predicability of whether my friend wlll like my new dress? It's monstrous to judge people like this.

 

If you ever want an example of how arbitrary and pathological psychologisation can be, this is a good one.

 

It's so context driven, isn't it? Imagine a person with chronic diarrhoea. They would want to know they would be close to a toilet most of the day. But, that says nothing about the level of spontenaity they prefer in other aspects of their life. If you primed the person with discussions about how they planned for trips and so on or even just reminded them of their health condition, they would have that constraint uppermost in their mind as they answered the questions. It surely would affect how they answered.