Trait and state interoceptive abnormalities are associated with dissociation and seizure frequency in patients with functional seizures, 2020, Koreki

Open access, https://onlinelibrary.wiley.com/doi/full/10.1111/epi.16532

 

whoa, my bullshitometer went right off the scale!

 

They go on to offer what collapses down to a similar view embedded in modern terminology ("predictive coding" is all the rage in cognitive neuroscience now!)

The reference "16" they cite actually endorses the idea of dissociative identity disorder, which most psychologists just scoff at!

Anyway, what they did was to ask their patients to track their heartbeat (count the number of beats they thought their heart made over a short period), and another task where they had to say whether their heart beat was in synch or out of synch with a series of tones. Only the first of these measures differed between patients and a group of healthy controls.

Then they gave them various scales that purport to measure various constructs that may or may not exist (I'm inclined to think they don't, so was not much interested in what these showed, and not much surprised to find that the patients reported more distress and anxiety than happy healthy folks).

Two huge problems imo.

1. What were the patients' and controls' actual heart rates? My guess is you're likely to be better at tracking your heart rate if its slow and regular, than if its fast and racing.

2. (the huge elephant in the room) They compared a chronically ill group to a bunch of healthy people, so there's no way of knowing whether their patients' abnormal scores on some of the tests are something that's common in chronic illness, irrespective of cause, or whether they genuinely point at some sort of "psychological" causation. Its not unreasonable to predict that people with with various sorts of illnesses - especially illnesses with a highly variable course - might be less good at making these kinds of estimations.

A reasonable control group might have been people with epileptic seizures, which has similarities in terms of patient experience (although when epilepsy is properly managed, the seizures are usually nowhere near as frequent), but not believed to be "psychological" in origin.

They would of course say that there's no need to look at another control group, because we already "know" the problem is psychological, that's "well established". It isn't at all, as Ward and Wilshire showed in their review and metanalysis, but the game of medical chinese whispers has a power all of its own.

 

My model goes: woo woo woo woo!

Arbitrary benchmarks be arbitrary. Reminds me of psychics who have this gizmo where if this book jumps up it means a spirit is talking to them. Can we make this a different book? It's all the same anyway. No, of course, must be this book, you know, the one connected to a thing that activates with a buzzer.