The ‘cognitive behavioural model’ of chronic fatigue syndrome: Critique of a flawed model, 2019, Geraghty et al

Roy S said:
The response could be interesting.
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Take your pick:

Have you read the paper?
If yes:

You obviously haven't understood the paper.
If you have:

These points have all been comprehensively addressed before.
If that doesn't work:

Your view is due to (insert malevolent motive here).

I'm prepared to be corrected, but I think that's all they've been able to come up with for the last few decades, so I'll be amazed if they come up with anything different now. Perhaps "You are now blocked" - does that count as a response?
 
IMO, and I may be wrong, I'm happy, though not really, to be proved wrong, all of the responses given to any criticism amount to

"Wibble!!!"

Admittedly with the emphasis on different syllables from time to time.

Not the most constructive post I've ever made, or even today, and I've apparently made some stinkers today, but, it's my point of view.
 
I finally managed to read the whole thing. Late to the party.

I too felt it was at times a bit quick in jumping from one thing to another.

The biomedical abnormalities were a bit too overstated?

PEM is an important part why CBT and GET do not work. That wasn't too well explained? Maybe I missed that bit. Fried brain.

That being said the paper clearly shows that the model does not fit with the patients experience of the disease at all. That the whole thing is just eminence based, based on some ideas of a group of psychiatrists and psychologists. Their little fantasy.

That devalidation of our experience is the most valuable of this paper. You really feel they went of the rails and it had nothing to do with the disease and its patients community.

So in all a great job. Awesome paper to share everywhere
 
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It's a bit of a nit-picky point but as there is now some good discussion on the divide between the biological and P-S model I'd like to see more discussion around the social aspect of BPS.

All three of these components have some validity for illness (just not in the ways twisted by it's current proponents). The social aspect gets pretty much ignored for the most part as the BPS people get so excited about the shame and blame part (although they've developed a whole new way of phrasing this to soften the blow and /or disguise the intent and/or fool themselves).

ETA: Apologies if this goes away from main topic.
 
I think read this comment with a lot of scepticism. It related to the so-called "empiric" CDC CFS criteria which were a very odd set of criteria as the paper itself explains.
Jason et al. (2009) found that 38 per cent of patients with major depressive disorder were misclassified as having CFS.

Jason LA, Najar N, Porter N, et al. (2009) Evaluating the centers for disease control’s empirical chronic fatigue syndrome case definition. Journal of Disability Policy Studies 20: 93–100.
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I recently found this is Stephen Strauss's 1988 paper

While already yielding a tantalizing series of observations, future immunologic studies of patients with chronic fatigue need to be undertaken in a more orderly fashion, and patients who are physically deconditioned or clinically depressed should be included as additional control subjects.

The Chronic Mononucleosis Syndrome
Stephen E. Straus
The Journal of Infectious Diseases, Volume 157, Issue 3, March 1988, Pages 405–412, https://doi.org/10.1093/infdis/157.3.405

https://sci-hub.se/10.1093/infdis/157.3.405

It seems rather odd that the idea of a deconditioned control group was not taken up and tested before Wessely et al decided in 1989 that deconditioning was a fundamental and treatable part of the illness.



 
It forwards a hypothesis that the illness may begin after an infection or stressful life event; that certain individuals are more susceptible, those with a previous history of trauma, abuse or depression/anxiety; and that the illness is perpetuated by sufferers’ holding on to beliefs that they have a physical illness or that they ‘irrationally’ avoid exercise.
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This sounds like the author thinks ME is a type of mass hysteria and that it is perpetuated by online information saying that it is a physical illness perpetuated by viruses. If that were true than CBT should have a very high effectiveness rate. All you should have to do is to convince patients to stop avoiding exercise and they would normalize. Treatment should be very easy. However we know this isn't the case.

“Most people are not cured by CBT/GET and few find benefit while some find these interventions worsen symptoms and lead to deterioration.”
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https://www.meassociation.org.uk/20...in-me-cfs-by-dr-keith-geraghty-27-april-2019/


The limitations post-ME initiation are all too real even when one forces oneself to exercise vigorously. There are cases of atheletes getting ME who were at a very high level of conditioning. Also of professionals and scholars no longer being able to think at a high creative level. This hypothesis is rubbish.
 
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AllenJB said:
What does BPS stand for?
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Biopsychosocial. The BPS model of ME/CFS is the model used by the likes of Simon Wessely, Michael Sharpe, etc in the UK and others elsewhere. Hence the PACE trial etc. The model is basically that ME and/or CFS is caused by fear of exercise after being ill with an infection, leading to deconditioning. Hence their idea the we should all be cured by graded exercise therapy etc etc. All rubbish.
 
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