Firestormm
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"symptoms and disability of CFS are perpetuated predominantly by dysfunctional illness beliefs and coping behaviours"
Just checked this, and it's in an early copy of a CBT manual for PACE, for which Wessely is one of the authors. I think that they could have used similar phrasing in the Lancet paper too. I don't know if those are on-line anywhere right now. If you want I could put them up somewhere.
edit: I had a bit of a panic, as google showed I'd posted that quote a while back without having checked it, as it was from someone I considered reliable. Only got around to checking it out just now. Here's the old thread, which I've just edited to attach the documents:
http://forums.phoenixrising.me/inde...nuals-trial-identifier-etc.15109/#post-245972
"The patient is encouraged to think of the illness as "real but reversible by his or her own efforts" rather than (as many patients do) as a fixed unalterable disease."
That one can be found by searching in this book, using Amazon's 'look inside' feature:
http://www.amazon.co.uk/Somatoform-Disorders-Experience-Psychiatry-ebook/dp/B000QCS6FS
I don't think that it's possible to link directly to either of those quotes at the moment.
I have been sent Appendix 2 of the CBT PACE Manual Model from 2002 - a precursor then I presume to what was published alongside the PACE Trial itself.
Authors of this 2002 Appendix: Chalder, Deale, Sharpe and Wessely. Date: 19/06/2002 (though this Appendix and the rest of the Trial papers at this time, all have the hand-written date of 1989 appended to them).
Relevant quote then, in context, reads:
MODEL OF TREATMENT
Cognitive behavioural therapy is based on assessing and changing the patient's thoughts and beliefs about the illness and their situation and helping them to change these where necessary.
The procedure is first, to non-judgementally elicit the patient's own illness model, appraisal of their situation and the ways they cope with these; second to introduce the possibility of alternative beliefs and coping behaviours; third to help the patient choose which beliefs and coping behaviours are most accurate and helpful by conducting behavioural experiments.
The key question for the behavioural experiment is 'is it possible for me to make changes in my behaviour that will allow me to achieve my goals?'
The patient is encouraged to think of the Illness as 'real but reversible by his or her own efforts' rather than (as many patients do) as a fixed unalterable disease. Their ability to make changes is a test of these alternative hypotheses.
Behavioural change is tailored to overcoming obstacles and to achieving specific goals. It does not include aerobic exercise.
I am guessing then that the experiment/model/hypothesis being tested here, the part above in quotes i.e. 'real but reversible by his or her own efforts' might come from a previous paper perhaps.
There were several attached to this manual model, but I can't be arsed to look for something that might not be there, as the quote marks could be used by way of highlight - as per the question appearing above it I suppose.
The papers cited were:
1. Sharpe M, HawtonKE, Simkin S, SurawyC, Hackmann A, Klimes I, Peto T, \Varre!1 D,
Seagroatt V. Cognitive behavioural therapy for the chronic fatigue syndrome: a randomized
controlled trial. BM11996;312:22.-6.
2 Deale A. Chalder T, Marks 1M, Wessely S. Cognitive behaviour therapy for chronic fatigue
syndrome; a randomized controlled trial. Am J Psychiatry 1997~i54:408-14.
3.Sharpe M. Cognitive behavior therapy for functional somatic complaints. The example of
chronic fatigue syndrome. Psychosom 1991;33{4}:356-62.
4. Chalder T, Butler S, Wessely S. In-patient treatment of chronic fatigue syndrome. Behavioural
and Cognitive psychotherapy 1996;24( 4).(pp 35 l-3(5)
5. Surawy C, Hackmann A, Hawton KE, Sharpe M. Chronic fatigue syndrome: a cognitive
approach. Behav Res Ther 1995;33(5):535-44.
6. Joyce J. Hotopf MH, Wessely S. The prognosis of chronic fatigue and chronic fatigue syndrome:
a systematic review. QJM 1997;90(3):223-33.
7. Petrie KJ, Moss-Morris R, Weinman J. The impact of catastrophic beliefs on functioning in
chrome fatigue syndrome. J Psychosom Res 1995;39{l):31~8
8. Deale A, Chalder, T, Wessely S. (i998) Do causal attributions influence outcome m chrome fatigue:
syndrome;. Journal of Psychosomatic Research. 45, 1,71-83
9. Sharpe M, Hawton KC, Seagroatt V, Pasvol G. Patients who present with fatigue: a follow up of
referrals to an infectious diseases clinic 8MJ 1'992;305: 147·52.
10. Ray C, Jefferies S, Weir WR. Coping and other predictors of outcome inchronic fatigue
syndrome: a l-year follow-up. J Psychosom Res 1997;43(4)'405-15.
Thanks to my supplier