Alegria says: CFS is a "Neurasthenia Spectrum Disorder" (2012)!

[justinreilly]

My response:

"Jennie,
You are saying this statement she co-authored in the Neurasthenia paper leaves doubt that she equates CFS with neurasthenia?

N.B. that she explicitly calls CFS a “neurasthenia spectrum disorder” and the cited paper calls CFS both a “neurasthenia spectrum disorder” and a “neurasthenia category.” (the cited paper’s hypothesis was that CFS might describe Idiopathic Chronic Fatigue in India)

“Likewise, further research is needed to examine the concordance of neurasthenia spectrum disorders (e.g., ICD-10 neurasthenia, CFS, CCMD-2 and CCMD-3 [these last two are the two Chinese Criteria] for neurasthenia) across non-clinical, population-based samples across cultural contexts [cf. 21, 23].”

http://forums.phoenixrising.me/inde...impairment-among-a-nationally-represen.27105/

 

[justinreilly]

Just from these two papers (this one and the one on somatization) and skimming thru others, not only does Alegria have serious biases, but she thinks illogically and her work is sloppy, which are all not great qualities for someone redefining your disease!

The somatization paper (see my other thread), is just absolutely insane, piling gross illogic upon itself into one big stinking turd. This paper is more subtle, if you could call it that, but still very odd.

Just the idea of making such a big study of neurasthenia and saying we must study it further as though it were useful to dredge up an antiquated diagnosis, some of whose problems were, as Angela points out, visible and troubling even at the turn of the last century, is bizarre

I understand that the diagnosis survived much longer in China than it has here, but from what I have read, the diagnosis has been fading out even in the East for decades with the long effort that has and is being made to reconcile and standardize Western medical diagnoses throughout the world.

The papers that do talk about it as a diagnosis in the East all seem to conclude, though I just skimmed through a number of papers, that neurasthenia was an unscientific relic that just lingered because it provided a semi-medical seeming diagnosis for doctors to use who didn't want to burden their patients with the stigma of mental illness, which is really what they had (at least according to these papers)

So, there is no really useful medical/psychological reason to study neurasthenia in the general population in the US. And Alegria doesn't give one, which is really weird. You'd think someone writing about such an irrelevant topic would provide a reason in the paper.

So, that just leads me to believe that she is in league with the Wessely school to revive neurasthenia for the sole reason of making ME seem to be psychiatric. Is there any other plausible reason?

 

[justinreilly]

I am distressed that Jennie Spotila is not taking a completely firm stance against Alegria.

First, Alegria fails to mention that she has spoken and written on neurasthenia in several papers. Then that she says CFS is a 'neurasthenia spectrum disorder', which, according to her is somatization disorder. Then she turns out this absolutely insane paper on what she thinks somatization is!

These two papers prove that, not only does she think CFS is psychiatric, but that she also has incredible difficulty thinking logically (which is a detriment being a scientist on our disease definition panel) especially about our disease and related issues.

Alegria absolutely must not be allowed anywhere near our definition!

 

[justinreilly]

And neither can Mulrow, who writes that CBT and GET are the only effective therapies for ME; and that conclusion regarding GET is based ENTIRELY on OXFORD definition studies! In her paper, she rated OXFORD definition studies HIGHER than FUKUDA studies!!

And she didn't disclose she had ever worked on CFS before, much less headed the official AHRQ (part of HHS) committee on CFS treatments!

These are the type of highly incompetent, illogical, and specifically biased people IoM are trying to sneak by us to ruin our definition and thus our health and lives for years!

We can't have any tolerance for this bad faith destruction of our health! This contract MUST be cancelled- there's more proof of that then ever!

 

[Ecoclimber]

I am distressed that Jennie Spotila is not taking a completely firm stance against Alegria.

First, Alegria fails to mention that she has spoken and written on neurasthenia in several papers. Then that she says CFS is a 'neurasthenia spectrum disorder', which, according to her is somatization disorder. Then she turns out this absolutely insane paper on what she thinks somatization is!

These two papers prove that, not only does she think CFS is psychiatric, but that she also has incredible difficulty thinking logically (which is a detriment being a scientist on our disease definition panel) especially about our disease and related issues.

Alegria absolutely must not be allowed anywhere near our definition!

Logic doesn't really play a part in psychology. They just pull labels out of thin air and attach symptoms to them without any scientific evidence nut which they require from the medical side. Their theories involving sickness behavior eerily resembles Mary Baker Eddy and Christian Science. Religion which could be used against them.

 

[alex3619]

Psychiatry is often internally quite rational, but it goes around in logical circles. It does not often ground out in objective evidence. So its not testable. Which is how it got the label nonscience. Claiming such things are science then qualifies for the label pseudoscience.

Its not the logic that is at fault, syllogism by syllogism. Its the chain of reasoning and the unproven, and often unprovable assertions that are not questioned that are the problem. Its very Pythonesque (for those Monty Python fans out there).

[Satire] Somatization involves three symptoms? In psychogenic medicine we often see it quoted that ME patients are afraid of the stigma of a mental illness so reject claims of psychogenic causation. That has never been demonstrated, and no study is ever cited, it also doesn't match any patients I ever met, so its clearly delusional. Symptom 1: delusional beliefs about patients.

Psychogenic proponents believe that their beliefs must be true, without evidence. We can't prove we have ME, we lack evidence (in their eyes) so they must be right that we have a psychogenic disease, even though they lack evidence. Inability to deal with this contradiction is yet another sign of delusional and irrational thinking. Symptom 2. This is of course closely tied to the fallacy that if an illness is medically unexplained, then it must be psychogenic. Yet psychogenic illnesses are medically unexplained, there are only unproven and typically unprovable hypotheses.

Some authors in psychogenic medicine claim their conclusions are evidence based. They imply by that a high standard of evidence, whereas any medical evidence is evidence based. Their claim goes to what level of evidence it is ranked at, or to a claim of best evidence. Yet psychogenic studies (e.g. the PACE trial) cannot be double blinded, use subjective measures that are known to give results contrary to similar studies using objective outcome measures, involve the use of questionnaires measuring attitude and consider this unproblematic when in fact patients are taught to modify their attitude, and often base their dubious, controversial or highly heterogeneous patient cohorts. No psychogenic diagnosis has EVER been validated, and at least dozens of such claims have been disproved. Clearly these proponents are not capable of reason or dealing with contrary objective evidence. So their symptom is an inability to deal with facts, whereby they prefer the delusion that their methods are based on sound evidence to actually engaging in debate, and mostly keep their discussion to the in-crowd to avoid being proven wrong. That's symptom 3.

Three symptoms centered around irrational and delusional thinking. Three is enough for somatization? Oh, they must be somatizers!

Oh wait, darn, somatization is for physical symptoms! So what is the corresponding equivalent for mental symptoms? [End Satire]

 

[SilverbladeTE]

Wessely is obviously employed by the Ministry of Silly Walks

 

[Snow Leopard]

Back the paper at hand, basically they have shown that there is an association between either diagnosis of depressive/anxiety disorders or use of a mental health service with the reporting of physical symptoms.

The simplest explanation is that those suffering such disorders are simply more likely to report those symptoms to their doctor than the general population.

While Occams Razor is not strictly a scientific principle, if someone wants to propose an alternative link, such as the idea that the reported symptoms are due to somatization then they have to demonstrate that scientifically. For example, design an experiment of biological parameters that predict the physical symptom, as well as the mental disorder, but not any other physical disorder. Unless this is done with high specificity, the concept of somatization will continue to be merely a hypothesis at best and pseudoscience at worst.

 

[taniaaust1]

Of course, to build consensus, she is the lowest common bigoted member on the panel concerning ME/CFS. A definite plant. What can one do but file an objection on 3-ply provided by HHS for a major flush?

I think Ive been sick for too long.. Im constantly thinking about conspiratory strageties which could be coming from the other site...those who want to keep this illness buried.

Seeing one obviously plant onto this panel isnt surprising, in fact they made the panel look better then what I'd been expecting. I suspect there is more then one as surely they must of known there would be an outcry about having Alegria on the panel with her past publishcations...

They could end up removing her just to make it look like they are being very good and fair to us (eg we did this and that for the ME/CFS people, we were extremely fair with the contract etc).. and having most of the attention focused on her and getting her off the panel.. could be allowing other psych field non believers of real ME to go onto the panel with less attention drawn to those.

My inner red lights are screaming.. to watch out for the unobvious. Who's the obvious taking the attention away from.....

As its also a consensus panel.. all they need is only just one set in the views that this illness isnt a real one (ready to stick to the poor psych studies and claim they are good evidence due to not looking deeply enough at them) and that is all which is needed to stop consensus for a good definition to be formed. Hence why I so hate the idea of OMI and of it not having it ALL ME/CFS experts. There is no other illness as important as ME/CFS due to its complexity, so needs to be all experts on the panel...

There is no way that this study is going to end up being as good as the canadian consensus definition..., the non experts just waters the down the knowledge of the experts and introduces into it the failings of the past and misleading things which have been put out which you need to be an expert in the illness to be able to deciper the wrong from the right.

 

[Sing]

I think at one stage Freud believed neurasthenia was caused by too much masturbation and was curable with cocaine.

If only that was true!

What I read was that Freud believed neurasthenia was caused by masturbation and curable by clitoridectomy--female castration. Further, he believed that females who complained of sexual abuse by their male relatives had not experienced this in reality but only wished for it from their fathers! Talk about male fear of female sexuality--fear of females in general.

 

[SilverbladeTE]

Sing
they merely project their neurosis, manias and crap onto their "patients"....

 

[Cheshire]

Back the paper at hand, basically they have shown that there is an association between either diagnosis of depressive/anxiety disorders or use of a mental health service with the reporting of physical symptoms.

The simplest explanation is that those suffering such disorders are simply more likely to report those symptoms to their doctor than the general population.

It reminds me that study showing that women using sunscreen cream were more likely to develop cancer than others, which didn't meant sunscreen were carcinogen but that women who often went under sun used more cream.

 

[Izola]

Snorting coke and jacking off...damn that would explain the lunatics in Parliament!

Maybe something like that would explain certain governmental officials in Arizona but any snorting would have to be by live stock or of gunpowder.

 

[alex3619]

@Izola, as a kid I used to make my own fireworks. Trust me, you don't want to be snorting gunpowder, its not nice in the nose. Indeed a big nosefull of it had me stop making fireworks.

 

[Izola]

@Izola, as a kid I used to make my own fireworks. Trust me, you don't want to be snorting gunpowder, its not nice in the nose. Indeed a big nosefull of it had me stop making fireworks.

Hey Alex: Did it blow your nose?

You're supposed to be resting!

You sound like my baby brother Monte Blair. He blew himself across the room, twice, when he was 2 & 3, experimenting with the electrical outlets & god knows what else. When he got older he entertained himself with math problems and reading huge tomes that I couldn't even lift much less read. He was the best friend anybody could ever have. He's now one of the spirits who visit me in dreams.

Grandma called what she had & I have, a gift. Yes, I know it sounds loony. But the dreams aren't like the usual ones. I foresaw so many things as a kid before I logiced the whole notion of it out of me. So if being a little loony keeps me sane, why not?

Me? I don't snort anything. Guess you are too far away to hear about the crazy politicians in SW USA. They live and breath guns and crazy initiatives. The Sheriff makes arrestees live in tents in 118 degree heat--BEFORE TRIAL. He brags that he spends more per capita on food for his dogs than the pretrial detainees who get plain bologna sandwiches. If you are of Mexican heritage, watch out. I think Amnesty International was checking things out. I don't know what came of that. Oh and then there are the militias with guns along the border.

Take care, Alex. Wishing you the best. Iz

 

[SilverbladeTE]

Sherrif Arpio? (spelling?)
Dear God, there was another sick ignorant internet meme praising that bozo's vicious treatment!
His treatment of prisoners would get you done under a War Crime if it occurred in combat, and many are only on remand, not even convicted, but hey, being mean to folk is soooooooooo easy when you have power and people bay for blood....which is how Dachau was let happen...and we know what that led to.
Wheels of history every turn, cycles ever repeat.
Anyone thinks that's crazy I'll go dig up a list of the horrendous abuses and injuries inflicted on those in detainment under his leadership.
Most prisoners AIN'T hard core scumbags, and even that tiny number, if you treat 'em bad, those who do it get warped by such heinous actions....evil spreads like a disease. This is another reason why you must treat people, even those you hate, humanely.
I may loathe "Weasel #1" but I want him exposed and tried honestly and fairly, or not at all.


Never had dreams about those who'd passed over, but did get precognizant ones a hell of a lot, very very odd, yeah unlike normal dreams.
have a cousin who could see spirits of folk who died in places, sacred hell out of him.
life's a wee bit more mysterious than "ABC"

 

[alex3619]

Many places I see major failures in science that are entrenched in the establishment, and involve diagnoses, I see consensus panels. These are not reliable, and even hard core EBM guidelines seem to fail, they are as subject to bias and influence as the rest of it.

Papers have to be rated in a panel by multiple panelists. If several with scientific biases rate the same paper it may be rated wrongly, and this does not matter if its a good paper or a bad paper, its still a distortion of the process.

I would give every single psychogenic paper a very bad rating due to the huge diagnostic uncertainty, and probable non-validity of most if not all psychogenic diagnoses. That is my bias, though I can explicit as to why I do this. A psychogenic disease proponent will often rate such papers highly, based I suspect mostly on technical points.

We need at least one science based reviewer for every paper, and this cannot be anyone who is publishing on psychogenic-related illnesses like neurasthenia.

 

[Izola]

Sherrif Arpio? (spelling?)
Dear God, there was another sick ignorant internet meme praising that bozo's vicious treatment!
His treatment of prisoners would get you done under a War Crime if it occurred in combat, and many are only on remand, not even convicted, but hey, being mean to folk is soooooooooo easy when you have power and people bay for blood....which is how Dachau was let happen...and we know what that led to.
Wheels of history every turn, cycles ever repeat.
Anyone thinks that's crazy I'll go dig up a list of the horrendous abuses and injuries inflicted on those in detainment under his leadership.
Most prisoners AIN'T hard core scumbags, and even that tiny number, if you treat 'em bad, those who do it get warped by such heinous actions....evil spreads like a disease. This is another reason why you must treat people, even those you hate, humanely.
I may loathe "Weasel #1" but I want him exposed and tried honestly and fairly, or not at all.

Never had dreams about those who'd passed over, but did get precognizant ones a hell of a lot, very very odd, yeah unlike normal dreams.

have a cousin who could see spirits of folk who died in places, sacred hell out of him.
life's a wee bit more mysterious than "ABC"

Silverblade: Yes, Joe Arpaio. Its down right scary how many people think he is great. Many of the prisoners in tent city are awaiting trial. They haven't had their day in court. ". . . Sentence first, trial later. . . Off with their heads. . ." [fr: Alice in Wonderland] Most on lookers don't seem to mind the lack of due process.

I agree with you, most in Arpaio's tent city aren't hard core criminals or even truly criminals. Long ago a prosecutor friend said, "You know, these people we put in and get out of jail aren't really criminals at all. They're just F . . Ups. ,

Hard core or not, everyone has a right to due process. And prosecutors have a duty, not necessarily to win, but to see that justice is served. I don't deny there are some really scary criminals. I wish them due processed all the way to prison including the Weasel.

We are, as a society heading down a scary path. "Evidence Based Medicine" are words opposite to the meaning underlying them. We all read George Orwell and Aldous Huxley. They warned us about what to look for and here we are, as "civilized societies" averting our glances, pretending not to notice. So, we get EBM and Soma. And IOM

 

[Izola]

Many places I see major failures in science that are entrenched in the establishment, and involve diagnoses, I see consensus panels. These are not reliable, and even hard core EBM guidelines seem to fail, they are as subject to bias and influence as the rest of it.

Papers have to be rated in a panel by multiple panelists. If several with scientific biases rate the same paper it may be rated wrongly, and this does not matter if its a good paper or a bad paper, its still a distortion of the process.

I would give every single psychogenic paper a very bad rating due to the huge diagnostic uncertainty, and probable non-validity of most if not all psychogenic diagnoses. That is my bias, though I can explicit as to why I do this. A psychogenic disease proponent will often rate such papers highly, based I suspect mostly on technical points.

We need at least one science based reviewer for every paper, and this cannot be anyone who is publishing on psychogenic-related illnesses like neurasthenia.

Alex: You must be part Energizer Bunny. I Just read the Psychology Today article on EBM. Its a good article, esp for dummies like me. I really get it now. Its not just here and there, its a tsunami.

Sleep well. Iz

 

[Izola]

Just from these two papers (this one and the one on somatization) and skimming thru others, not only does Alegria have serious biases, but she thinks illogically and her work is sloppy, which are all not great qualities for someone redefining your disease!

The somatization paper (see my other thread), is just absolutely insane, piling gross illogic upon itself into one big stinking turd. This paper is more subtle, if you could call it that, but still very odd.

Just the idea of making such a big study of neurasthenia and saying we must study it further as though it were useful to dredge up an antiquated diagnosis, some of whose problems were, as Angela points out, visible and troubling even at the turn of the last century, is bizarre

I understand that the diagnosis survived much longer in China than it has here, but from what I have read, the diagnosis has been fading out even in the East for decades with the long effort that has and is being made to reconcile and standardize Western medical diagnoses throughout the world.

The papers that do talk about it as a diagnosis in the East all seem to conclude, though I just skimmed through a number of papers, that neurasthenia was an unscientific relic that just lingered because it provided a semi-medical seeming diagnosis for doctors to use who didn't want to burden their patients with the stigma of mental illness, which is really what they had (at least according to these papers)

So, there is no really useful medical/psychological reason to study neurasthenia in the general population in the US. And Alegria doesn't give one, which is really weird. You'd think someone writing about such an irrelevant topic would provide a reason in the paper.

So, that just leads me to believe that she is in league with the Wessely school to revive neurasthenia for the sole reason of making ME seem to be psychiatric. Is there any other plausible reason?

JR: In answer to your last question, Nope. Iz