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Changes in illness perceptions mediated the effect of CBT in severe functional somatic syndromes

Discussion in 'Latest ME/CFS Research' started by Dolphin, Feb 13, 2017.

  1. Dolphin

    Dolphin Senior Member

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  2. Dolphin

    Dolphin Senior Member

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    No objective measures used in this paper.
     
  3. Dolphin

    Dolphin Senior Member

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    This is a version of the questionnaire they used to look for mediating factors:

     
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  4. A.B.

    A.B. Senior Member

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    If the illness serverity is measured in a way that is highly dependent on perception, and a therapy whose goal is to change perception is applied, is it surprising that the illness seems to improve?

    I would not be surprised if there is some intervention that can change the perception of car engine problems in car owners. Only an idiot would conclude that altered perception is the same as altered physical reality. Yet here they are, doing exactly that.
     
    Last edited: Feb 13, 2017
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  5. Dolphin

    Dolphin Senior Member

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  6. Dolphin

    Dolphin Senior Member

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    Agree. But if somebody could highlight specific connections between the questions used regarding mediating factors and the questions used for the outcome measures, that would be great. Though just for general interest: I'm not sure I will do anything specifically on this at this stage.
     
  7. Snow Leopard

    Snow Leopard Hibernating

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    I was about to say the same thing.

    In the absence of objective measures of functioning, all they have is tautological evidence - the therapy aims to modify illness perceptions, therefore patients report differently on questionnaires. There are of course.many possible biases involved, that could explain such an effect without any change in underlying health or functioning.
     
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  8. Woolie

    Woolie Senior Member

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    I see its our friend Schroder! Wonder if James Coyne might like to have a go at this?
     
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  9. user9876

    user9876 Senior Member

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    I've not read it but I suspect there are assumptions of independence in the mediation and final variables yet they are all derived from questionnaire whose answers will have some common underlying semantics.

    Shouldn't get through a peer review without properly dealing with these issues (i.e. using more objective measures of outcomes).
     
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  10. Dolphin

    Dolphin Senior Member

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  11. This is not Science, there is no measured factual evidence
     
  12. Hutan

    Hutan Senior Member

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    So, presumably the treatment arms had around the same number of people, in which case some 20-odd people did not complete the trial. (I can only see the abstract, so I don't know how many didn't finish the course, but the fact that 'completers' was mentioned suggests that at least some did not complete the course ).

    And is it likely that the non-completers were just like the completers? No, of course not. The non-completers are much more likely to have had worse functionality at the beginning and/or to have deteriorated during the course. That is, they were physically less able to make it to the sessions and were a lot more likely to get mightily pissed off at being told that they are failing to think better and that's why they aren't improving.

    And those recalcitrant sick people have just been swept under the carpet.

    So, we have a set of completers with a higher percentage of people whose illness has improved than the set of controls. And these improved completers have been told that their successful thinking has made them better.

    And of course, if you are physically better, then you feel better. And you also feel that you have more control over your life and you are worrying much less about your illness. Being physically better causes the improved outlook, not the other way around.

    And then of course you have the participants reporting what the researchers want to hear etc etc

    The stupidity apparent in these kinds of papers never fails to amaze me.
     
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  13. Dolphin

    Dolphin Senior Member

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    A reminder that physical health was measured by a questionnaire:
     
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  14. PennyIA

    PennyIA Senior Member

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    What really bugs me (above and beyond what everyone else is reporting)... is that there are people that sometimes have an improvement of symptoms that are spontaneous. We don't KNOW WHY, we DON'T KNOW HOW LONG, but geez... if it happens to occur while you're being given CBT, you can bet they are going to claim it was their treatment.

    UGH
     
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  15. Dolphin

    Dolphin Senior Member

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    And indeed some patients will come to the same conclusion i.e. having more people do CBT can create fans for CBT even when the improvement isn't really down to the CBT.
     
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  16. daisybell

    daisybell Senior Member

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    Is it just me - when I see that there's a new paper in the journal of psychosomatic research, my inner voice just goes
    'Blah, blah, blah, blah, blah.......bleurgh."

    I can't even summon up any energy to feel annoyed. It's just too stupid for wasting more words on.
     
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  17. Valentijn

    Valentijn The Diabolic Logic

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    What a surprise :rolleyes:
     

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