1. Patients launch $1.27 million crowdfunding campaign for ME/CFS gut microbiome study.
    Check out the website, Facebook and Twitter. Join in donate and spread the word!
Can You Come for a Visit? My ME/CFS Says No
My daughter and son-in-law just had a baby last week. We are thrilled. But we won't be able to see the baby or hold her any time soon. We won't be able to take over little gifts or help out with housework or babysitting.
Discuss the article on the Forums.

Chalder and Moss-Morris RCTY of CBT for MS

Discussion in 'Other Health News and Research' started by Esther12, Jul 1, 2012.

  1. Esther12

    Esther12 Senior Member

    Messages:
    5,299
    Likes:
    5,619
    May be of interest to some. The abstract makes me suspect that the results were spun somewhat, but I haven't found the full paper yet. Again, no difference on actual impairment.

    CBT being increasingly ineffective over the longer-term was taken to indicate that more money should be spent on CBT. Has anyone ever tried a control group where the patients are just given the same money the CBT cost, and allowed to spend it on whatever they think will help them most?

    A Randomized Controlled Trial of Cognitive Behavioral Therapy (CBT) for Adjusting to Multiple Sclerosis (the saMS Trial): Does CBT Work and for Whom Does It Work?

    By Moss-Morris, Rona; Dennison, Laura; Landau, Sabine; Yardley, Lucy; Silber, Eli; Chalder, Trudie

    Journal of Consulting and Clinical Psychology, Jun 25 , 2012, No Pagination Specified.

    Abstract

    Objective: The aims were (a) to test the effectiveness of a nurse-led cognitive behavioral therapy (CBT) program to assist adjustment in the early stages of multiple sclerosis (MS) and (b) to determine moderators of treatment including baseline distress, social support (SS), and treatment preference. Method: Ninety-four ambulatory people with MS within 10 years of diagnosis were randomized to receive 8 individual sessions of CBT (n = 48) or supportive listening (n = 46), most delivered on the telephone, in a multicenter randomized controlled trial. The primary outcomes were distress and functional impairment. Secondary outcomes included global improvement, acceptance of illness, and dysfunctional cognitions. Assessments were completed at home and were coordinated by a blind assessor. Data were analyzed by intention-to-treat using multilevel models. Results: The CBT group was significantly less distressed at the end of treatment (estimated General Health Questionnaire group difference = 3.2 points, 95% CI 1.1 to 5.4 points) and at the 12-month follow-up (estimated group difference = 2.2 points, 95% CI 0.01 to 4.4 points). There were no differences between the groups on functional impairment. The CBT group also demonstrated significantly greater improvements on secondary outcomes at the end of treatment but not at the 12-month follow-up. CBT participants with poor SS and/or clinically defined levels of distress at baseline showed significantly greater gains on both primary outcomes. Treatment preference did not moderate treatment effects. Conclusion: CBT is more effective than supportive listening in reducing distress in people with MS. CBT appears most effective for patients with poor SS and high levels of distress. The loss of gains in the secondary outcomes by 12 months suggests further follow-up sessions may be warranted. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
     
  2. Enid

    Enid Senior Member

    Messages:
    3,309
    Likes:
    840
    UK
    Can't help noticing a big difference (as opposed to PACE eg) - presumably well defined/diagnosed patients, ADJUSTING to the disease only, for whom does it work etc. Much more cautious than the psychiatrist's involvement at least it seems. But I suspect the usual spin on efficacy.
     
    WillowJ likes this.
  3. biophile

    biophile Places I'd rather be.

    Messages:
    1,389
    Likes:
    4,663
  4. Esther12

    Esther12 Senior Member

    Messages:
    5,299
    Likes:
    5,619
    After having seen how Chalder and Moss-Morris manipulate their results and use of language, I'm not going to make any assumptions about the impact of their CBT here.

    It did remind me of the sort of results, and possibly the sort of spin, that seem to be a part of their trails for CFS.
     
  5. Valentijn

    Valentijn Activity Level: 3

    Messages:
    6,518
    Likes:
    9,659
    Amersfoort, Netherlands
    Give them a few years and they'll have papers published citing this paper as proof that MS really is a psychological (and social) disease after all, and CBT delivered by highly trained nurses is the One True Cure.

    Or maybe I just have no faith in anything involving Chalder :D Though it is interesting to see that she's listed dead last in the list of authors.
     
  6. Enid

    Enid Senior Member

    Messages:
    3,309
    Likes:
    840
    UK
    I suspect they are trying to rehabiltate themselves after the fiasco of PACE. Having experienced the psychos in an A & E (picked up in the street collapsed) and met their "all in the mind" - outrageous when so ill. (And that is the UK). Let's hope their attempt to "brain wash" illnesses they do not understand away is not part of their repetoire now.
     
  7. user9876

    user9876 Senior Member

    Messages:
    771
    Likes:
    1,871
    I'm not convinced that talking theorpies such as CBT do help people adjust to illness. Don't they take a considerable energy in focusing your mind on being ill rather than just doing stuff. Maybe it comes down to different personaility types, I know people who like to analyse themselves and there actions and I could see such approaches helping them but do such theropies help where people are largely focused on activities (albeit quite limited activities)? I note that they don't include a control group within this study.

    Too me the most valuable thing would be for people to help overcome the practical problems of life with disabilities. I can see this reducing stress levels and helping people feel better.

    I have realised that I don't know what CBT is even though I have read a few bits about it.
     
  8. WillowJ

    WillowJ Senior Member

    Messages:
    3,102
    Likes:
    2,729
    WA, USA
    that would be really cool

    I'm think that the normal kind of CBT is supposed to do this to some extent, though I'm not entirely certain.

    ETA: http://freespace.virgin.net/david.axford/cbt-ms.htm
     
  9. Esther12

    Esther12 Senior Member

    Messages:
    5,299
    Likes:
    5,619
    I was just about to start a new thread about this paper, when I realised I'd already made one.

    The improvement in questionnaire scores, rather than disability, was similar to that seen with Chalders work with CFS. And the work of homoeopaths, etc.

     
  10. IreneF

    IreneF Senior Member

    Messages:
    466
    Likes:
    432
    I've experienced CBT in a couple of contexts and I think it can be useful in helping people adjust to a bad situation, but I don't think it has any curative properties. It focuses on alerting you to thinking styles that are counterproductive, stuff like that. It's good for people who catastrophize and worry.
     
  11. SilverbladeTE

    SilverbladeTE Senior Member

    Messages:
    2,143
    Likes:
    1,718
    Somewhere near Glasgow, Scotland
    And instead of this load of "mental masturbation", the same money/effort could have been put into biological treatments for MS! :rolleyes:
    "Nero fiddles with himself while Rome burns" :alien:

    If a house is on fire, you do not sit around offering supportive talk, YOU PUT THE BLOODY FIRE OUT!
    Ye gods...

    Psychological help for severe truama, be it unexpected injury, or the loss of self image/hope etc from chronic illness, is of course, very useful, but far too much of this "official" stuff is ludicrous.
    Instead, ask the patients what helps THEM, stop coming at it from the arrogant, dumbass side of preconcieved notions and pedantry (or worse, phamacological bribery)
    OMG am I sick of such stuff in many quarters (not getting pratical, down on the ground info, first and listening to it), but the psychs have little common sense/easily measured proofs to disuade them from zealotry or plain stupidity.

    I found ta;king to a psychologist very helpful, but the CBT she offered was of no use to me, not what I needed at all.
    Human psychology is mind bogglingly complex, and is affected by biological factors, personal experiences, and the mindset of the person (which can help/hidner enquiry and all other aspects), etc
    CBT is seen by too many in that sphere AND, worse, governance/finances, as a simple "tick box" method to getting folk off welfare, and that's the dirty truth of it.
     
    PhoenixDown and Don Quichotte like this.
  12. Esther12

    Esther12 Senior Member

    Messages:
    5,299
    Likes:
    5,619
    What?!

    This paper has come around again, but now in a new journal?

    Darn it, I spent ages looking for this thread, as I thought it was a new paper, but related to this one. Ah well. Pardon the pointless *bump*.


     

See more popular forum discussions.

Share This Page