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Processing of Emotions in Functional Movement Disorder: An Exploratory fMRI Study, 2019, Sojka et al

Discussion in 'Other psychosomatic news and research' started by Andy, Sep 3, 2019.

  1. Andy

    Andy Committee Member

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    Open access at https://www.frontiersin.org/articles/10.3389/fneur.2019.00861/full
     
    JohnM, Barry and Peter Trewhitt like this.
  2. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    This might be potentially interesting.

    For example I have recently been trying to get my head around why brain fog varies between cognitive tasks, and wondering if stress or distressing factors are significant issues in determining how hard different cognitive tasks feel.

    However I am afraid I did not bother to read the article as I anticipate from the abstract the authors are looking for grossly over simplified answers in very complex situations. In such an example association tells us very little about causation.

    Also any unquestioning acceptance of a ‘functional’ label is always very worrying.
     
    alktipping, oldtimer, JaneL and 6 others like this.
  3. Hutan

    Hutan Moderator Staff Member

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    The authors clutch at straws.

    Sample size 15 with a 'functional movement disorder', 15 healthy controls. Functional movement disorder covered a wide range of things from 'right hand tremor', to 'gait disturbance', 'non-epileptic seizures' and 'spasms'.

    Turns out the groups didn't differ on ability to recognise their emotions. Self-reported measures of anxiety and depression came out a bit higher in patients. But despite including 4 patients with diagnosed depression (one of which also had diagnosed panic attacks and one of which had an anxiety disorder) only the anxiety scores were significantly higher - and then only just with a P value of 0.04.

    They had three tasks related to looking at pictures - for each they had to report the strength of negative affect on a scale of 1 to 4
    1. negative picture - look without emotional regulation
    2. negative picture - try to regulate emotion
    3. neutral picture - look without emotional regulation

    Patients and controls didn't differ with the strength of negative affect or the strategies used to control emotions.

    With respect to the imaging, the planned statistical analysis was
    It doesn't look as though any finding of differences between patients and controls met that threshold. The authors do refer to uncorrected differences, so they have something to talk about.

    Now, I don't know whether the stats approach was appropriate, but the study looks to me as though it didn't find anything very much.

    But read the conclusion...

    Well no, it doesn't.

    There was no low emotional awareness problem - the mean of both the patients and controls in the TAS-20 was well below the 61 score required to diagnose alexithymia. The authors said as much in the results section.
    (low alexithymia is a good thing, the opposite of low emotional awareness)​

    And of course a null result just means that more studies are needed.
    It's another one of these studies where the authors appear to have written the conclusion ahead of the experiment - and then, when the results don't fit, they just paste in the conclusion anyway. I despair.
     
    Last edited: Sep 3, 2019
  4. Amw66

    Amw66 Senior Member (Voting Rights)

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    worth someone tweeting this?
     
  5. Mithriel

    Mithriel Senior Member (Voting Rights)

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    Aberrant movements are not a bodily emotional regulation process. There are many genetic movement disorders which are caused by ion channel dysfunction. There are also movement disorders caused by autoimmune problems due to certain cancers.

    :banghead::banghead::banghead:
     
  6. rvallee

    rvallee Senior Member (Voting Rights)

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    So many of the concepts used are vague and any conclusions depend on interaction between those vague, unquantifiable, concepts. In addition to functional disorders being vague and a complete black box made from the god of the gaps.

    Based on what definition of normal? We have neither the resolution nor the understanding to define those beyond vague concepts.

    Pretty obvious that it's a conclusion seeking evidence.
     
  7. Hutan

    Hutan Moderator Staff Member

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    Actually, I think a published review of papers like this could be warranted- there's a few of them now, trying to find imaging and other evidence for this theory that FMD is the result of suppressed emotions/alexithymia. I think the problems are blatant enough that they could be easily pointed out.

    @Carolyn Wilshire
     
  8. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    Discussion could be: Our findings may implicate areas associated with self-referential processing in knowing that you are patient in the study rather than a control.

    It has certain psychological implications I suspect - which might even show on brain scans.
     

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