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Dutch study: Need to change illness perception and beliefs

Dolphin

Senior Member
Messages
17,567
Regarding this:
Focus on symptoms: We used the somatic complaints subscale of the Symptom Checklist 90 (SCL-90) (Arindell & Ettema, 1986) to assess focusing on symptoms. Following Vercoulen et al. (1998), higher scores on this scale indicate a stronger focus on symptoms.

Not everyone uses this questionnaire in this way. I recall a study which used it to measure physical symptoms (rather than a measure of awareness of symptoms):
Functional incapacity and physical and psychological symptoms: how they interconnect in chronic fatigue syndrome.

Psychopathology. 2008;41(6):339-45. doi: 10.1159/000152375. Epub 2008 Sep 3.
Priebe S, Fakhoury WK, Henningsen P.
Source
Unit for Social and Community Psychiatry, Barts' and the London School of Medicine, Queen Mary University of London, London, UK. s.priebe@qmul.ac.uk

Also, Long Term Improvements in Patients with Chronic Fatigue Syndrome Treated with Ampligen", used 18 questions from the Symptom Checklist 90 (SCL-90) including some from this subscale to measure CFS symptoms.


In the previous week, how much were you bothered by:

1. Headaches
4. Faintness or dizziness
12. Pains in heart or chest
27. Pains in lower back
40. Nausea or upset stomach
42. Soreness of your muscles
48. Trouble getting your breath
49. Hot or cold spells
52. Numbness or tingling in parts of your body
53. A lump in your throat
56. Feeling weak in parts of your body
58. Heavy feelings in your arms or legs

EXTREMELY
QUITE A BIT
MODERATELY
A LITTLE BIT
NOT AT ALL


What Figure 2 shows is that the therapy didn't improve the scores.

They describe that as "not changing focus on symptoms" but others might interpret that as not improving those symptoms.
 

Sea

Senior Member
Messages
1,286
Location
NSW Australia
"In the previous week, how much were you BOTHERED by...?"

I refuse to answer questionnaires that are worded in this way. It's like the question "when did you stop beating your wife?" Impossible to answer without giving the psychs what they want to hear.
 

wdb

Senior Member
Messages
1,392
Location
London
"In the previous week, how much were you BOTHERED by...?"

I refuse to answer questionnaires that are worded in this way. It's like the question "when did you stop beating your wife?" Impossible to answer without giving the psychs what they want to hear.
Yes good point, how bothered you are may change over time regardless of how well you are. If I lost a leg I may become less bothered over time but that doesn't mean it has been growing back. The Chalder fatigue scale is similar in asking about whether symptoms are more or less than than usual.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Perhaps these questions could be answered by "not bothered at all"? I mean in the last week I have been more exhausted and brain fogged, but I am not bothered by it, I have accepted it. Alternatively just write in N/A or leave it blank?

The huge ambiguities in these questionairres make them highly subjective and subject to biased interpretation, as if asking about thoughts isn't subjective enough.
 

Dolphin

Senior Member
Messages
17,567
More on Structural Equation Modelling​
, including a longer video and slides.​
Thanks for this. I just watched it (well, I broke it into smaller bits).

Just an idea that occurred to me, but it may be silly - I don't know enough about Structural Equation Modelling to know whether it is plausible or not)
The bit at around 30 minutes, where one can test whether particular questions might be answered differently due to gender or at different time points, made me think of the PACE Trial, and other similar trials. One might have a concept of severity and the scores at baseline could be a function of various variables. One could perhaps then test the hypothesis that such functions don't work well after CBT or GET. For example, the fact that there was no difference on the six minute walking test between CBT+SMC vs SMC alone, but CBT recorded a big increase in a lot of the questionnaire scores. If SMC at time two answered the questions in a similar way to baseline in terms of overall severity (they might not do), but CBT+SMC didn't, this could be interesting.