• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

"Experts" embarrass themselves with uncritical praise for CBT schizophrenia study with null results

Dolphin

Senior Member
Messages
17,567
James C. Coyne is a research psychologist who isn't afraid to speak his mind.

Here's a tweet of his today:

I haven't looked at this study myself. And don't have any opinion about the efficacy or otherwise of CBT for schizophrenia. But I thought the odd person might find this of interest given the role the Science Media Centre has played in ME/CFS matters.

e.g.
FEBRUARY 17, 2011
expert reaction to Lancet study looking at treatments for Chronic Fatigue Syndrome/ME

http://www.sciencemediacentre.org/e...reatments-for-chronic-fatigue-syndromeme-2-2/
 

SOC

Senior Member
Messages
7,849
"Oh yes, my particular therapy (for which I am going to charge you lots of money) works magnificently for many and diverse serious illnesses. There is no need for a physical explanation for why it works because I have lots of anecdotal evidence to show that it really works."

Do these people even listen to themselves? :rolleyes:
 

biophile

Places I'd rather be.
Messages
8,977
http://www.sciencemediacentre.org/e...reatments-for-chronic-fatigue-syndromeme-2-2/

Dr Alastair Miller said:
This trial represents the highest grade of clinical evidence – a large randomized clinical trial, carefully designed, rigorously conducted and scrupulously analysed and reported. It provides convincing evidence that GET and CBT are safe and effective and should be widely available for our patients with CFS/ME.

Dr Brian John Angus said:
It was extremely rigorous. It was large and it was randomised. The study was carefully conducted in the manner of a drug intervention study to not only establish the superiority of one treatment over the other but also to carefully report any side effects or harm from those treatments. Since the treatments were therapies and not drugs stringent efforts were made to ensure the ‘purity’ of each treatment and to rapidly report any adverse effects. As a trial this involved a huge amount of checking and cross checking.

Wow, one would think the PACE Trial was a double-blind placebo-control trial or something, one which did not give more optimistic expectations and conditioning to some groups over others, and which actually showed clinically significant improvements in objective measures rather than just subjective measures, and one which did not loosen the goalposts mid-trial and/or post-hoc when the researchers realized it might not pan out as expected or saw the disappointing data.

First class evidence requires first class methodology. The PACE Trial was neither. And LOL at the "huge amount of checking and cross checking". How did all the schoolboy errors and misleading commentaries get through then?
 
Last edited:

biophile

Places I'd rather be.
Messages
8,977
More about the CBT for schizophrenia trial can be found here, including links to the full text:

http://www.thementalelf.net/treatme...ics-for-people-with-schizophrenia-or-does-it/

The trial reports that:

Compared to TAU, cognitive therapy is associated with important treatment signals including a reduction in psychotic experiences such as hearing voices and paranoia and an improvement in day to day social functioning.

Mean PANSS total scores were consistently lower in the cognitive therapy group than in the TAU group, with an estimated between-group treatment effect size of -6·52 (95% CI -10·79 to -2·25; p=0·003).

This equates to a standardised effect size (Cohen’s d) of 0·46.

However:

Can we be sure that the trial results represent more than just natural fluctuation?

Analysis of the effect sizes for CBT vs controls at 9 months reveals no significant differences on PANSS total, PANSS positive or PANSS negative. This finding is consistent with the results of the recent meta-analysis published in the British Journal of Psychiatry (Jauhar et al, 2014)

Furthermore, the baseline and 9 months PANSS data for the unmedicated TAU group show a symptom improvement that is just as large as the CBT group at 18 months. In other words, the end of study finding for CBT is no bigger than the natural levels of fluctuation (improvement) that can be seen in the data for the unmedicated patients.

CBT did not reduce distress at all (for delusions or hallucinations), self-rated recovery, depression or anxiety.
 
Messages
13,774
I had an alert earlier from Science. I haven't read it, but it's about this CBT thing:

5 February 2014

Schizophrenia: Time to Flush the Meds?

Yeah, that's it.

Dodgy headline. I'm really surprised by the way in which people seem to feel so little shame in making hyped claims about treating a condition as serious as schizophrenia. I think I had assumed that the dodginess around CFS was related to the fact that it was seen as a joke condition - maybe not?
 
Last edited:

Bob

Senior Member
Messages
16,455
Location
England (south coast)
The press releases were regurgitated by the BBC today.
e.g:
Schizophrenia: Talking therapies 'effective as drugs'
http://www.bbc.co.uk/news/health-26046228

Two weeks ago BBC news had this headline with reference to a meta analysis which included Keith Laws as a co-author...
Schizophrenia: talking therapy offers 'little benefit'
http://www.bbc.co.uk/news/health-25574773

I wish they'd make up their mind!!!

 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
The press releases were regurgitated by the BBC today.
e.g:
Schizophrenia: Talking therapies 'effective as drugs'
http://www.bbc.co.uk/news/health-26046228

Two weeks ago BBC news had this headline with reference to a meta analysis which included Keith Laws as a co-author...
Schizophrenia: talking therapy offers 'little benefit'
http://www.bbc.co.uk/news/health-25574773

I wish they'd make up their mind!!!

First - I know why I am up at this godawful hour - but I can't be the only Brit who had an argument with the bedroom wall! :)

Second:

I wish they'd make up their mind!!!

Struck me as quite funny, Bob given the topic under discussion. But then I realised I was probably being insensitive or somesuch. But it's so early and I am in pain, so I have forgiven myself :)

I think to be fair the Beeb are only quoting 'experts'. And that's ever the trouble with all science really and medicine. All dependent on opinions and interpretations especially when the evidence base allows for such potential abuse.
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
I think to be fair the Beeb are only quoting 'experts'. And that's ever the trouble with all science really and medicine. All dependent on opinions and interpretations especially when the evidence base allows for such potential abuse.
I don't think we should be fair to the BBC! By blindly regurgitating duff press releases they are discriminating against patients. (And they are supposed to be a public service broadcaster.) When the spotlight is on them (such as with the issue of climate change), then they don't blindly regurgitate vested interests, and they don't promote opinions or small studies as fact.

The BBC should do better journalism, and they shouldn't quote study results out of context, and without interpreting the results. And they should not use stupid misleading headlines. It surely can't be impossible for the BBC (it has thousands of journalists, with an enormous news budget) to have a health editor who is able to carry out a basic interpretation of study results, or who is able to cross-reference with other information, or who is able to seek alternative opinions (from scientists or patient advocates). They can surely afford a health editor who does more than simply regurgitate press releases from the SMC or other vested interests!
 
Last edited:

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia

Bob

Senior Member
Messages
16,455
Location
England (south coast)
Add churnalism to zombie science, public relations, declining education standards, and global monopolies or defacto monopolies ... and democracy, science, and even capitalism are dying.
I like to think that that things aren't quite that bleak (even if I'm deluding myself.)
I think that (overall) democracy, science, and society are improving over time, it's just that they started from a very poor state.

If we think about Europe during the 1800's (i.e. Victorian times), democracy, science and society were far from perfect.

Women didn't have the vote, there was little democracy for the masses, science and medicine were in their infancy, and people were vulnerable to poverty, exploitation and even slavery. Not to mention the fact that Britain had an Empire and was happy to invade countries and oppress the peoples with violence.

(Sorry, slightly off-topic!)
 
Last edited:

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
I don't think the decline is inevitable, only that it is happening. Against this we have a rise in participatory democracy, driven by modern communications. Yet now big business is trying to fight back, by restricting much of the net to a use pays model. Grrrrr .....
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
The BBC should do better journalism, and they shouldn't quote study results out of context, and without interpreting the results. And they should not use stupid misleading headlines. It surely can't be impossible for the BBC (it has thousands of journalists, with an enormous news budget) to have a health editor who is able to carry out a basic interpretation of study results, or who is able to cross-reference with other information, or who is able to seek alternative opinions (from scientists or patient advocates). They can surely afford a health editor who does more than simply regurgitate press releases from the SMC or other vested interests!

Don't be silly - they have more important things to spend money on, like huge salaries for 'celebrities'. :rolleyes:
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
The press releases were regurgitated by the BBC today.
e.g:
Schizophrenia: Talking therapies 'effective as drugs'
http://www.bbc.co.uk/news/health-26046228

Two weeks ago BBC news had this headline with reference to a meta analysis which included Keith Laws as a co-author...
Schizophrenia: talking therapy offers 'little benefit'
http://www.bbc.co.uk/news/health-25574773

I wish they'd make up their mind!!!

Struck me as quite funny, Bob given the topic under discussion.

I'm guessing that you are making the common error of confusing schizophrenia with dual/multiple personality disorder.

As a patient group with another seriously misunderstood and misrepresented illness, I think we should be careful to avoid such misunderstandings.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
I think to be fair the Beeb are only quoting 'experts'. And that's ever the trouble with all science really and medicine. All dependent on opinions and interpretations especially when the evidence base allows for such potential abuse.

I don't think they often get copy from experts. It is commonly provided to them by the notorious Science Media Centre.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
Experts who work for large institutions also have their comments frequently sent by the public relations people, as a press release. These press releases are often hyped up.

I had a little 'war of words' with an academic at my uni who denied that he had ever made certain exaggerated claims about the relevance of his work to a particular illness, when I in fact had cuttings from the uni and/or student magazine and uni annual reports, in which he was quoted as doing precisely that. When I quoted these back to him, he stopped replying, so I don't know whether or not the words had in fact been his.

It was, however, gratifying when the claims were absent from future reports, having been made for years.

It's worth challenging things even when attributed to 'experts'. It's surprising what impact just one challenge can have.
 

Marco

Grrrrrrr!
Messages
2,386
Location
Near Cognac, France
Experts who work for large institutions also have their comments frequently sent by the public relations people, as a press release. These press releases are often hyped up.

Indeed Alex

As someone who used to have to rely on the 'press office' for public pronouncements it paid to keep an eagle eye on them to avoid unsubstantiated 'spin'.