The 12th Invest in ME Research Conference June, 2017, Part 2
MEMum presents the second article in a series of three about the recent 12th Invest In ME International Conference (IIMEC12) in London.
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2013: Attention processes in chronic fatigue syndrome: Attentional bias for health-related threat an

Discussion in 'Latest ME/CFS Research' started by Esther12, May 3, 2014.

  1. Esther12

    Esther12 Senior Member

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    http://www.sciencedirect.com/science/article/pii/S0005796713001800

    I've had this abstract open on my PC for ages because it smelt like a spun null result and I've only just got a copy, so am going to post some stuff up. I quote quite a lot from it as I've really not gone through it that carefully, but thought others might be interested. Also, I'm feeling a bit brain dead, and am just knocking this out: low expectations please!

    For a quick summary, skip to the very end where I quote bits from their abstracts and show their results... that's the only really interesting bit imo.

    Also, there was this earlier abstract from a conference which seemed stronger (and has some different authors):

    I'm not entirely clear what analyses were planned and which were post-hoc.


    From the paper:

    They really need some evidence of bias and cognitive distortions to support the way they've treated patients in order to avoid being utter quacks.

    How they looked for attentional bias:

    You would think that this means that they should use controls suffering from ill health?:

    Unsurprisingly, those with CFS tend to be a bit rubbish at testing:

    CFS patients also took nearly twice as long on average to respond to this test.

    'Recovered' PACE participants could have been included [can't resist the dig]:

    Here are their results:

    Attentional bias results.JPG

    They don't seem that interested in the fact that CFS patients classed as having good executive function seem to have a bias against threat words. To me, those results look like a mess indicative of nothing. It looks like there would not be overall evidence of bias from pictures and words, as the 'bias' is going in opposite directions.

    This bit would seem to be more of a problem for them than their abstract acknowledges:


    What they see as the implications (not 'fire the quacks'):

    This is the only bit really worth reading:

    Back to their abstracts:

    And their results:

    Attentional bias results.JPG

    As I said:

    They don't seem that interested in the fact that CFS patients classed as having good executive function seem to have a bias against threat words. To me, those results look like a mess indicative of nothing. It looks like there would not be overall evidence of bias from pictures and words, as the 'bias' is going in opposite directions.​

    Also, I thought I'd post the conclusion from the smaller Moss-Morris study which was positive, and this is a larger follow-up for:

    http://www.jpsychores.com/article/S0022-3999(08)00113-X/abstract

    Shouldn't the conclusion for their larger study have been:

    "The absence of evidence of an AB towards health-threat information in individuals with CFS challenges the models of CFS which underlie cognitive behavior therapy."

    PS: That earlier study is cited by them in this 2013 chapter on CFS I was sure I'd read:

    http://www.sciencedirect.com/science/article/pii/B9780444529015000253

    You can get a lot of it on google: http://books.google.co.uk/books?hl=...aC50M2v2MG1ANXNY32T99djpM#v=onepage&q&f=false

    They cite the article to say "CFS patients also tend to be hypervigilant to illness and symptom information" - the whole chapter is pretty irritating and full of claims built on sand. Okay - night-night!
     
    Last edited: Jun 26, 2016
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  2. Cheshire

    Cheshire Senior Member

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    Thanks a lot Esther 12!
    I was wondering yesterday if there were any study proving the illness belief distortions that we are supposed to have. This study is not the one that is going to prove anything. It is just money waste...

    How can they pretend to have a scientific approach when there is no control group with a disease similar to ME/CFS???

    Do someone know about other studies aiming at proving our cognitive bias?
     
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  3. WillowJ

    WillowJ คภภเє ɠรค๓թєl

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    I agree that they should have used a disease control group.

    I also couldn't find a part where they compared "threat" with "neutral" reaction times. From the data given (unless I missed something), isn't it plausible that people with ME/CFS have slightly more difficulty interpreting pictures than healthy people?
     
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  4. A.B.

    A.B. Senior Member

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    There is no intention to investigate reality. It's about pretending to be scientific just enough to justify intervention. Psychology is pseudoscience. Notice how even with a control group, there would be no way to know whether an allegedly increased attention towards illness has any clinical significance. It is just assumed to have significance. This study is a complete waste of money. I wonder when the house of cards will come crashing down.
     
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  5. Valentijn

    Valentijn Senior Member

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    A good indication of crap results is when the patients are divided into multiple groups based upon a largely arbitrary measurement. In this case, there's only a "significant" difference between a subgroup of patients and the controls, which means they found no difference between controls and the patients as a single group.

    In short, they found nothing, and messed with the data until they could find a correlation. And even then, the correlation only applies to so-called "threat words" but not photos. Their study was a huge failure, and they are engaging in extensive spin to present results which look positive to people who don't know any better.
     
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  6. alex3619

    alex3619 Senior Member

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    Lets presume there really is cognitive bias toward threat-related words, their best-case scenario. What does this tell us?

    If you presume the behavioural models, it tells us this supports their view. If you presume a biomedical model, then being more cogntively impaired means you might be sicker, and so pay more attention. So it supports a fully biomedical model too. When data supports whatever model you choose, using the model as a presumption, then the fallacy of Begging The Question is in play. Its the model driving the interpretation, not the data. Its a methodologically flawed study, with flawed analysis.

    The sad fact is that, yet again, they are conflating association with causation, by implication. This is not merely bad science, its evidence that these people should never get through peer review. In a journal with strict and enforced scientific standards this should not happen.

    Not all psychology is pseudoscience. They just have a slightly larger share of it. Psychiatry has a big share too. Psychogenic psychiatry on the other hand is mostly pseudoscience by every definition of pseudoscience I have so far looked at.

    One current estimate is that half of all psychological findings are wrong. Thats too much for the field to be considered strong science, but then it never has been ... its soft science, an euphemism for not really scientific but trying to be.
     
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  7. alex3619

    alex3619 Senior Member

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    This is just one way results can be spun and twisted to support a view. It has a formal name, but it escapes me at the moment. Its a deeply entrenched and widely used methodological bias that generates oodles of spurious results in the literature.
     
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  8. Bob

    Bob

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    Interesting comments. There's enough material in these comments for a letter to the journal.
     
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  9. biophile

    biophile Places I'd rather be.

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    There is an understandable acknowledgment that poor executive function could contribute to attentional bias, but there seems to be an unjustified assumption that attentional bias is contributing to symptoms via hypervigilance. The results are weak and contradictory, so for all we know, they cannot be confidently extrapolated to paying attention to symptoms.

    Dare I suggest that illness puts the body under chronic biological stress, and as part of legitimate sickness behaviour, the brain is primed to detect possible further threats to homeostasis, including on some level, threatening words and pictures.

    An adequate disease control group would need to experience similar symptom categories and similar levels of stigma. Compared to other chronic conditions, ME/CFS basically has a rare ratio of symptom burden to societal ridicule/dismissal, so finding such controls in a wealthy country where the research is conducted may be rather difficult.

    I wonder if CBT/GET proponents experience attentional bias towards scary threat words such as "actometers", "exercise testing", "letters to the editor", "PubMed Commons", and "patients researching their condition on the internet"?

    Would they click faster on the buzzer in response to the pictures and words in these two videos?
    http://forums.phoenixrising.me/index.php?threads/the-fable-known-as-the-pace-trial.29991/
     
    Last edited: May 4, 2014
  10. Wildcat

    Wildcat

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    .
    The psychosocial research funding gravy train rolls ever onwards; there seems to be some kind of bottomless pot of research funding gold for it.

    Who on earth keeps funding this dross? And how come they have so much money to burn in poverty struck Britain (poverty struck when it comes to healthcare, and useful ME bioresearch, that is)

    .
    When concerned patients and carers wanted to submit evidence to the West of England Research Ethics Service to explain why doing a Lightning Process study on youngsters was not a good idea (Dr Esther Crawleys SMILE Trial)..... it transpired that local Research Ethics Committees only accept evidence from the researcher and the research funders.

    The National Research Ethics Service (NRES) made an exception to receive evidence from patients and carers about Lightning Process, which the NRES passed on to the West of England RES.

    .
    I am not suggesting that this 'An investigation of attention processes in chronic fatigue syndrome: health-threat related attentional biases and attentional control' research is unethical, but that funders and LRES's seem to rubber stamp the same kinds of research by the same researchers decade after decade.
    .

    .
    .
     
    Last edited: May 4, 2014
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  11. peggy-sue

    peggy-sue

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    I'm going to have to have a big think about this - but I reckon they're simply tapping in to areas of cognitive disability and not taking into consideration the actual time taken for the brain to achieve different processes.

    I've only read the first bit and the stuff about health-treat words being recognised before health threat images - but we are slow at getting info. from an image and putting it together and interpreting it.

    Individual common words are instantly recognised by fluent readers, much as an advertising logo can be recognised.
    It's a much shorter processing time.

    (Attentional processes were someting I specialised in a bit at uni.)
     
    Last edited: May 4, 2014
  12. peggy-sue

    peggy-sue

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    I wrote that before reading the rest of the thread, before I forgot.
    I am confirming Willow's suspicion - the reality of how the brain works backs it up. :thumbsup:

    Normal/control subjects would have paid more attention to health threat words/images too.
     
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  13. Esther12

    Esther12 Senior Member

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    People seem more interested in this than I expected.

    To me, the fact that the CFS group 'with good executive function' had a significant bias against threat words (as opposed to what was hypothesised), and their disinterest in commenting upon this, seems particularly amusing.

    (There was a recent prospective study which had predicted children with lower IQ would be more likely to develop CFS, but...: "We found an association between higher cognitive ability and self-reported CFS/ME, which was in contrast to our hypothesis. Since the association was only found when additionally adjusting for psychological symptoms and since it was rather small, we might consider this as a chance finding." http://forums.phoenixrising.me/inde...ldhood-cognitive-ability-and-somatic-s.26753/ )

    I think that is what the main results are - comparing responses to threat words/images with responses to non-threat words/images.

    Just opened the paper up to get some quotes:

    Also thought I'd post results for the combined scores:

    Table 2

    Also - here are their hypotheses.

    1:

    Hypothesis 2, that patients with CFS would perform less well in testing, was just right.

    3:

    They seem to avoid deciding whether they think that their data supports hypothesis 3 or not:

     
    Last edited: May 4, 2014
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  14. peggy-sue

    peggy-sue

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    I'm never keen on using ANOVA - it's only use is for ascertaining you actually do have a realistic graph drawn and that the points do fit on it, rather than it being a plot on top of a spread of points.

    Paired t-tests would have been far more suitable and informative.

    BTW - have they got any evidence for their measuring "executive function"?
    Are they using this term from a "cognitive" point of view - ie, it is an assumed bit of "software of the mind", :vomit:

    or have they got realistic biological underpinnings of what they consider it to be in terms of real brain function?
     
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  15. peggy-sue

    peggy-sue

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    PWME have slower reaction times to pressing buttons than normals, for a start.
    It's not just our brains that are slower and require more areas to perform oordinary things - we are physically slower to move our arms and fingers too.
    I'm even sure it's been proven in a study, but do not ask me where.

    This is just typical experimental psychology.
    Find a couple of groups of folk, shove them in experimental conditions, make a few measuremennts, change the conditions, make a few more measurements...
    (conditions changing should generate different numbers)

    Apply the great god of ANOVA...

    then off to the ivory towers to fiddle with the all important numbers (this is what makes them a science, you see - they have numbers to fiddle with) and speculate a load of philosphical garbage.
     
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  16. alex3619

    alex3619 Senior Member

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    There are so many ways to stack studies its causing a crisis in psychology. Yet the practices are endemic, and journals and reviewers do not typically look for these issues. This is before you get to the serious biases in psychogenic CFS research.
     
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  17. Esther12

    Esther12 Senior Member

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    re executive function: I think that this was just based on average speed of response. Something like that. If important I could go back and check.

    re ANOVA: Do you fancy doing a 'for dummies' explanation of that? I didn't really follow that section of the paper - don't worry if it's tricky though.
     
  18. peggy-sue

    peggy-sue

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    I seem to remember "executive function" was the big controller of all other "mind" functions in psychology; rather a vague and very assuming sort of thing.

    Oh dear, Esther, I don't think I could do a "for dummies" now.:(

    I did a big sort of exposition on it at uni, for myself, because I didn't trust computers or the SPSS package I was being made to use.
    I like to work a few examples of all stat tests through on my own - to check that the computer does give the same results and to be certain I'd entered all the numbers into the right places on the spread sheets.
    And to find out exactly what the test is doing with my numbers.

    I did a few ANOVAs on paper, but while doing it, was not at all happy about what it was measuring - it does means or averages of differences, and it can't tell you when there are interactions although it claims to, because of the problem of the number of tails. Psychology does not seem to understand that in a living system, a response of "no response" is still a real response.
    .
     
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  19. Esther12

    Esther12 Senior Member

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    No worries peggy-sue. Whenever I try to learn stats stuff I end up forgetting it the following month anyway!
     
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  20. Dolphin

    Dolphin Senior Member

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    I was just coming here to make some points on this but see Esther12 has said what I was going to point out:
    Yes

    (see attachment above) Yes, exactly.
     
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