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Chronic fatigue syndrome/fibromyalgia: a “stress-adaptation” model

Discussion in 'Latest ME/CFS Research' started by Simon, May 31, 2013.

  1. Simon

    Simon

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    Aims to "demonstrate the theoretical and clinical value of a biopsychosocially-oriented ‘stress-adaptation’ model for this multi-symptom illness"

    Chronic fatigue syndrome/fibromyalgia: a “stress-adaptation” model - Fatigue: Biomedicine, Health & Behavior
    Boudewijn Van Houdenhovea*, Patrick Luytenbc & Stefan Kempkeb

    Abstract

    Background: A symptom cluster consisting of ‘medically-unexplained’ chronic fatigue, effort intolerance and widespread pain is a complex and still poorly understood condition.

    Purpose: To demonstrate the theoretical and clinical value of a biopsychosocially-oriented ‘stress-adaptation’ model for this multi-symptom illness.

    Methods: Clinical observation and review of the relevant literature.

    Results: Symptoms and functional limitations of these patients may reflect a loss of normal physical, mental and emotional adaptability, primarily based on stress system dysregulation.

    Conclusions: The proposed stress-adaptation model may facilitate diagnosis, defy dualistic causal thinking, and offer tailor-made treatment options to help patients find a better balance in their lives

    Paywalled.
     
  2. biophile

    biophile Places I'd rather be.

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    It is good to have aims in life. Whether or not they are achieved is another story.
     
  3. Gijs

    Gijs Senior Member

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    ''primarily based on stress system dysregulation''. This mechanisme HPA-as is broken in ME/CVS i think. It can be the key driver. But i don not see any objective markers for this hypothesis. He must proof his concept based on objective markers. I think that this system is physical damaged or disturbed not by mental factors. You can not handel stimuli.
     
    Valentijn likes this.
  4. A.B.

    A.B. Senior Member

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    Sounds a lot like the usual psychological dribble which pathologizes the survivability behavior observed in patients with serious illness.

    Then again, I haven't actually read the paper and the abstract doesn't say a whole lot.
     
    Dolphin and Valentijn like this.
  5. Mithriel

    Mithriel Senior Member

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    Yet another paper that ignores the fact that ME came in EPIDEMICS. Many of us were perfectly well one day, took an infection and became ill with the same disease we still have years later.

    And I bet they call themselves scientists despite ignoring the most important data.

    Mithriel
     
    aimossy, Dolphin, A.B. and 2 others like this.
  6. Enid

    Enid Senior Member

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    Big sigh.
     
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  7. alex3619

    alex3619 Senior Member

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    This is the fault of McEvedy and Beard (1970) who convinced much of the medical world that outbreaks were just mass hysteria. Actually Speight wrote about this here, in a Saudi Arabian medical journal:

    http://www.sjmms.net/article.asp?is...me=1;issue=1;spage=11;epage=13;aulast=Speight

    This was very poor medicine and science, but very pursuasive to those who believe in psychogenic illness. I now think that it was McEvedy and Beard who set the world up for dismissal of cluster outbreaks and the creation of the term CFS itself, as well as the rise of modern psychogenic medicine in the form of CBT/GET for CFS. Ramsay apparently wrote about some of this in a book, but I don't have that book yet.
     
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  8. adreno

    adreno 3% neanderthal

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    Tundras of Europa
    Lovely stuff.
     
  9. Richie

    Richie

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    Would like to read the full paper but:
    They will not address HPA probs if they
    a) see all such probs as a disordered response rather than a (somewhat) ordered response to e.g. infection, toxicity etc
    b) if they ignore all pathological inputs apart form the psychological ones.

    But being BIOpsychosocial in outlook, we can rest assured that they will be fully appreciative and knowledgeable of all the biologically based problems in ME/CFS/FM, can't we?
     
  10. alex3619

    alex3619 Senior Member

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    Engel's view of biopsychosocial was put forward as a balanced approach to medicine, and in opposition to biomedicine, based on good ideas from systems theory. However his focus was primarily psychosomatic medicine. So far as I can see much of the biopsychosocial approach is psychosomatic medicine, not at all balanced. It further lends itself to concepts around social engineering, concepts which have historically failed in countries that have tried it.

    We currently see the result of this in the UK with respect to disability politics. Its a disaster. It is estimated (but not proven) that large numbers of the disabled are dying as a result of this, quite often from suicide. Yet the government does not seem to care - and the government opposition is not really opposing it.

    These approaches promise cheap and simple answers, politically popular answers with some demographics. They typically do not work however. Indeed I think they are more expensive, and make the situation even more complex and intractable.

    So don't expect most following the biopsychosocial approach to have anything to do with biomedicine, hard evidence, or reason. This is an ideological movement more than its medicine.

    Richie , I do get that you made a sarcastic comment. I just wanted to add to your point.

    Anyone who is interested in BPS might like to read my blog on the topic:

    http://forums.phoenixrising.me/inde...e-and-fall-of-the-biopsychosocial-model.1075/

    http://forums.phoenixrising.me/index.php?entries/the-fall-of-the-biopsychosocial-model.1081/

    http://forums.phoenixrising.me/index.php?entries/part-three-what-next.1099/
     
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  11. Richie

    Richie

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    No worries Alex
     
  12. Dolphin

    Dolphin Senior Member

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    Here's an extract that I thought was a little bit interesting:


     
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  13. Dolphin

    Dolphin Senior Member

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    Although not as explicit as some of us might like, there is some questioning of CBT/GET in this (although probably not that exciting):
     
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  14. Esther12

    Esther12 Senior Member

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    Thanks for looking at the full paper d.

    Personally, I don't have any interest in an illness theory being presented to me by a doctor. I want to be spoken to honestly and clearly about what the evidence shows, and then left to decide for myself how to respond to the uncertainty that surrounds CFS. Clinicians who want to claim to be 'CFS experts' have far more need of an illness model than patients do, and these models, at least with CFS, tend to cause more harm than good for patients. Just present the limited evidence - don't try to engage me in an empowering therapeutic alliance around a pragmatically constructed narrative of illness - I'll never forgive you if you try.

    Interesting to see that they were aware of, and reported, patient concerns about the way in which 'recovery' is being redefined. That's cheering.
     

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