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Cumulative life stress in chronic fatigue syndrome - Nater et al ('11) (CDC research)

Discussion in 'Latest ME/CFS Research' started by Dolphin, Dec 26, 2011.

  1. Dolphin

    Dolphin Senior Member

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    I've just read the following CDC study which involved, among other others, Bill Reeves:

    *I've given each sentence its own paragraph
  2. Dolphin

    Dolphin Senior Member

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    It uses the Reeves et al. (2005) "empiric" criteria, although readers would have no real way of knowing from it alone (e.g. the 2005 paper isn't referenced at all).

    Here's an extract which shows it isn't clear:

    The Reeves et al. (2005) paper shows there were 43 with that ("empiric") criteria: http://www.biomedcentral.com/content/pdf/1741-7015-3-19.pdf

    This paper which explicitly says it used the Reeves et al. (2005) criteria:
    --
    --
    Says there were 36 Female/7 male, average age 50.6, 3 non-white, all the same as the Nater et al. (2011) study.

    The CDC (and others) need to be clear about what criteria are being used.
  3. Dolphin

    Dolphin Senior Member

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    I generally think empiric criteria studies are virtually meaningless for what I suffer from. But for what it's worth, here are the details:

    This is what was measured by these scales:
    Regarding PTSD:
    Using the threshold of >40, the percentages were 26.8% vs 9.3% i.e. even using this definition, 73.2% of "CFS" patients wouldn't have been classified as having possible PTSD using Davidson Trauma Scale.
    Using Diagnostic Interview Schedule (DIS), the figures were only 9.3% vs 1.7% i.e. 90.7% of "CFS" patients wouldn't have been classified as having possible PTSD using Diagnostic Interview Schedule (DIS).
  4. Dolphin

    Dolphin Senior Member

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    Figures taken *after* people ill

    (Again, I don't find empiric criteria studies of much use but might as well see this through)

    The figures that were significant generally relate to after people were ill.
    However, people could be traumatised and/or under stress, not because of how they are themselves, but how others are reacting to them - the help (or otherwise) they are getting for governmental and non-governmental agencies, the health system/doctors, their family and friends, etc.

    As the authors say themselves:
  5. LaurelW

    LaurelW Senior Member

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    I think they've got their chickens and eggs mixed up.
    justinreilly, Enid and Dolphin like this.
  6. Esther12

    Esther12 Senior Member

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    So is this retrospective, and without a control group with a comparable illness?

    I'd feel silly even asking that if it wasn't Nater. Thanks for the posts.
  7. Dolphin

    Dolphin Senior Member

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    Yes.
    From 2011 paper
    Nonfatigued means they weren't in the ISF group - one could be in the ISF group if one had fatigue or some of the other symptoms that might be part of CFS.

    One can get more info from the Nater et al. (2006) and Reeves et al (2005) papers although it's probably not worth trying to follow all the details.
    Here's a quote from 2006 paper:
  8. Dolphin

    Dolphin Senior Member

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    Authors use study to plug CBT (and GET)

    Final paragraph:

    The thing is that stress management isn't really a big part of CBT programs that are based on graded increases in activity.
    And people can certainly be taught stress management without requiring them to have graded increases in activity.
    justinreilly likes this.
  9. alex3619

    alex3619 Senior Member

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    I am all for the teaching of stress management techniques. These are good, they can only help provided they are of a nature that the specific patient can implement them.

    The vast majority of all the stress in my life is post-ME, either as a consequence of limitations imposed by ME, or as a consequence of how others have treated me because I have ME. I wonder if this whole paper could be more accurately summed up as "CFS causes stress"? They could post that on twitter and not have to go to all this rigmarole.

    The CDC empiric definition is a joke. Any paper that uses it I don't take seriously. We don't know who they are studying, and neither do they, so we don't know who it applies to. The most that could be said is that a whole group of people with unknown or undiagnosed health problems involving fatigue are involved.

    Bye, Alex
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  10. Enid

    Enid Senior Member

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    Presumably there is no definition for "cumulative life stress" except the psyches totting up "experiences" and making 2 + 2 = 5. QED.
  11. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    We are stressed i guess, either trying to hold onto our jobs or going through the process of getting disability payments or even trying to survive off disability payments is going to be stressful. Maybe if they gave more assistance to people with cfs/me then this stressfullness would be alot lower. i think this stress happens with all chronic illnesses just like how they mention depression, its a symptom of a chronic illness, not the cause. they really are trying hard to make cfs/me a psychosomatic illness. Common Norway prove these buggers wrong!!

    cheers!!!
    Dolphin likes this.
  12. gracenote

    gracenote All shall be well . . .

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    Thank you, Dolphin.

    Is the full paper posted anywhere?
  13. Dolphin

    Dolphin Senior Member

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    Not that I'm aware of.
  14. eric_s

    eric_s Senior Member

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    They study a group of people of which many probably don't have CFS (the "CFS" that actually means something).

    Then they find these unwell people are more stressed than others.

    Then they jump to the conclusion that stress leads to CFS.

    And if that was not enough yet... they even get paid for that... plus some people will actually buy it and cause us even more trouble... then we will be stressed... :rolleyes:

    The only thing we can do is to stay cool and do whatever we can so there will be more real, good quality research and refuse everything that's based on this type of crap research. And do that in as united a way as possible.
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  15. sianrecovery

    sianrecovery Senior Member

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    It sounds like a flawed study, and I intensely dislike the attempt to control ME by the psych establishment, but it also seems plausible to me that the experience of trauma, with its long term consequences for the endocrine system (another poorly understood phenomenon) may run alongside the later development of ME for some - and personally and and ancedotally among my ME friends I would say that there is an association. Not that that means a causal relationship obviously
  16. Snow Leopard

    Snow Leopard Senior Member

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    It might not be a causal relationship, but if they want to prove that their is a link, then they are going to have to do the longitudinal (and biochemical) research, otherwise their result may merely be due to a variety of other biases (such as participation bias - those who are stressed are more likely to want to report their stress in such studies). In the mean time, we can't conclude either way.
  17. sianrecovery

    sianrecovery Senior Member

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    yes, absolutely
  18. eric_s

    eric_s Senior Member

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    I think such an association has been reported for other diseases (don't remember if what i read was about cancer) as well. It might exist, but the problem is that some people draw the wrong conclusions about the nature of the disease and about what treatment approaches are appropriate. I usually don't even read that kind of studies, feels like wading through ... It's also quite amazing how this can coexist with the developments in Norway and with other studies, such as the ones that have shown that infections can lead to ME/CFS or that there is abnormal gene expression after exercise, that we do much worse on the second day of a repeated exercise challenge, etc. I guess many people just work in their field, and will do so until it's absolutely impossible to keep their position and then they will stop altogether (instead of exploring different leads).
  19. eric_s

    eric_s Senior Member

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    I mean, just as a small example, not that it's very scientific. Yesterday at night, i was feeling quite alright. Because i'm leaving here tomorrow, i went to play billard with some friends. I like to play billard and i also like to hang out with my friends. Today, after waking up, i feel ill and have a headache. This is what i and probably many others experiece again and again. If you feel these things yourself, you know where your problem lies and would not waste your time with the crazy ideas of some of these researchers. [If you were a researcher yourself and your goal was to try to find a cause and a solution. I'm not talking about people on this thread here, but about the authors of these studies, just realized that what i've said might sound that way.]

    Edit: Also ME/CFS often has a sudden onset. And once you have it, it does not just go away again after leading an easy life for some time, at least not usually. This just does not sound like a reaction to stress, maybe apart from stress weakening you and making you more vulnerable to developping this and many other illnesses.
    Snow Leopard likes this.
  20. sianrecovery

    sianrecovery Senior Member

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    plus if you took any patient group -heart disease for example - and tried to make a connection between childhood abuse and its incidence you could probably manage it, because the statistical size of those reporting child abuse is a relatively significant one in the population at large, and its associated with worse health outcomes per se. Completely with you on the billards Eric, even pleasurable activites we enjoy can mess us up - its not about lack of motivation or avoidance

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