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Coping strategies in chronic fatigue syndrome: outcomes over time

Discussion in 'Latest ME/CFS Research' started by Dolphin, Jun 18, 2011.

  1. Dolphin

    Dolphin Senior Member

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    * I gave each line its own paragraph
     
  2. Dolphin

    Dolphin Senior Member

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    I think they haven't adjusted for multiple comparisons.

    It looks to me that they looked at 64 comparisons and found one that was significant at the threshold of p<0.05. However, unusual things can happen by chance if you look enough times e.g. toss enough coins 10 times, you may find one set where you get 10 heads or 10 tails but you can't be sure that that particular coin is biased - it could simply be due to chance.

    They looked at 15 of the 16 coping styles measured by COPE:
    So one can see that people would generally use more than one method.

    and neuroticism:
    They checked whether it had an effect on for outcome measures:
    CFS symptom severity (9 symptoms incl. fatigue)
    and three of the SF-36 subscales: physical functioning, vitality, and physical role functioning.

    Out of these 64 possible cases where one coping strategy/personality trait (neuroticism) could be associated with an outcome measure, there was only one case it was:
     
  3. Dolphin

    Dolphin Senior Member

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    Discussion section:
    I'd be suspicious of these psychologists in future. It is my impression that some psychologists can be sympathetic and see patients as human beings facing challenges with possible ways to improve things (e.g. Leonard Jason and his team); while others seem to see patients more as generally dysfunctional.
    ----
    The paper doesn't mention at all the literature that people can use different coping strategies and different times within the illness e.g. the first few months after diagnosis might be different from years later. Leonard Jason and his team have looked at that in some papers e.g. on the Fennell scale.
     
  4. illsince1977

    illsince1977 A shadow of my former self

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    I wish I could rationally discuss this, but I just can't get past my anger. I have the utmost respect for anyone, like you, Dolphin, who has the wherewithal to actually read these presumably scientific papers in detail. Hats off to you! Kudos! :victory:

    I understand that I'm not serving our cause by my avoidance and reflexive condemnation of this nonsense, and that no reasoned rebuttal to this narrow-minded, uncompassionate, wrong-headed view of illness is possible without acquainting myself with the literature, but I'm just not up to it!

    Sorry for the rant.
     
  5. Snow Leopard

    Snow Leopard Hibernating

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    I don't see how reducing social support will improve outcomes.

    It would have been nice if they would actually do other tests on the data to explore this. For example, were those who sought social support and didn't improve more likely to have had lower baseline SF-36 scores, or longer illness duration for example.

    Or in terms if information-seeking behaviour, perhaps this is associated with patients who are more realistic/less biased in the way they answer self report questionnaires (eg less blind optimism). As a consequence, hypotheses about information seeking behaviour and outcomes need to be tested against more robust measures, such as employment status or actometer measurements at long term followups and controlled for in terms of baseline measurements.
     
  6. 5150

    5150 Senior Member

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    people who "seek social support" are those who are ill to the point of their daily functioning being affected; that's generally when someone looks for help, when their lives take a nosedive due to the progressive, cascade of symptoms. And yes, when we are so ill as to seek social support, such as by using on-line forums, the outcome is worse than than those who aren't sick enough to yet look for help. Why? because _there is no cure_ and we only get worse... notwithstanding the occasional case of reported temporary improvement(although at some point these are followed by relapse).

    but what the heck is so revealing about this? it's only common sense! for psych-babblers to present this as significant is twisted. they want to keep their piece of the $$ action.

    my blood pressure goes up re this kind of study. grrrrr
     
  7. Enid

    Enid Senior Member

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    Grrrrr - too - 5150 !.
     
  8. WillowJ

    WillowJ คภภเє ɠรค๓թєl

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    Only after they made statistical adjustments, did they find anything significant (that they cared to report)... that's what they are saying here, yes?

    And what factors? Attribution to a physical cause? "Somatization" (or worse degree of ME/CFS-type symptoms, such as weak limbs and difficulty breathing)? It could hardly be membership in a support group since that is what they are testing.

    So, they negate the differences between those who say, "I have a physical disease, probably related to a virus--it all started with a case of the flu that just wouldn't go away" and those who say, "I have a psychiatric-classified disease" and those who say "I have an emotional problem or burnout".

    They negate the differences between those who say "I have weak legs and am unable to do things" and those who say "I feel sleepy, tired, or not motivated".

    Only then do they try to figure out whether seeking assistance is related to worse outcomes.

    Confounding factors, anyone? :b
     
  9. Dolphin

    Dolphin Senior Member

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    Here's how they defined somatic attribution:
     
  10. WillowJ

    WillowJ คภภเє ɠรค๓թєl

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    so somatization and attribution to a physical cause is one and the same in this particular study. Thanks for the info. :)

    Still, they do statistical gymnastics to negate the difference between those who say, "I have a physical disease with physical symptoms" (such as weak legs, difficulty breathing) and those who say, "I have a psychiatric-classified disease" or "I have an emotional problem or burnout".

    Then and only then, do they test coping mechanisms.

    The differences they have controlled for, are confounding factors.
     
  11. Snow Leopard

    Snow Leopard Hibernating

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    No, somatization was not discussed in this study at all. That measurement came under the title "Attribution for CFS."

    Here is a quote from the "Statistical Analysis" section:
     
  12. Sean

    Sean Senior Member

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    Yes, I would love to see robust evidence that reducing social support (ie increasing social adversity) improves general outcomes, in any group of people.
     

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