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Dutch CBT manual (from 2003) (Bleijenberg, Prins & Bazelmans)

Discussion in 'Latest ME/CFS Research' started by Dolphin, Oct 13, 2010.

  1. Dolphin

    Dolphin Senior Member

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    http://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind1009C&L=CO-CURE&P=R1774&I=-3

    Ellen Goudsmit PhD critiques this section in her review of the book at: http://freespace.virgin.net/david.axford/bookrev8.htm .

    Gijs Bleijenberg was regularly involved in CDC discussions on CFS in the 2000s (one of the international representatives).
  2. Snow Leopard

    Snow Leopard Senior Member

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    With regards to the deleted post, I thought I'd posted in the wrong thread.

    Anyway, it is interesting that Ellen Goudsmit's point about the difference in the actometer readings being small, was later shown to be correct in the meta review of the Nijmegen CBT articles.

    One point that needs to be discussed more is the fact that CBT can never be 'placebo controlled'. In fact one of its primary objectives of certain schools of thought is 'changing illness beliefs''. Belief of self-efficacy is not the same as actual efficacy. Hence the emphasis by you and others on the importance of objective measures of treatment success, such as the aforementioned actometer readings.
    There may of course be other minor temporary benefits from better pacing of activity, better sleep regulation etc. It is also interesting that when a CBT trial is negative - the 1993 Lloyd et al. trial for example, which also trialed pharmaceutical treatments, certain prominent psychiatrists merely make excuses. To paraphrase - they're doing it wrong (due to poor training, treatment period not long enough and every other excuse you can think of), or comparison to the pharmaceutical treatments prevents magically prevents CBT from working. Or maybe providing the alternative better controls for the placebo effect. Very few psychiatrists seem to discuss why CBT has consistently failed to be proven as curative for a large majority of patients. I guess they don't like talking about their failures.
  3. Berthe

    Berthe Senior Member

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    near Antwerp
    Thank you Andrew. Fascinating! The dubieus and grimy nature of research concerning CBT. (and CFS). I also read the study of the meta-analysis on a dutch forum. It was hillarious. Do you know where this meta-analysis was published? It tought it was made by Roessingh. But I can't find it in the published form. The conlusion was that patients with CFS were moving less than healthy people. Roessingh is now looking for patints who are willing to carry around a actometer, to measure their movements. What I can read from their website is that they try to treat patients from a distance.The patient will get immediate feedback on their movements. A little PDA will advice them what to do (based on healthy controls) to find the right balance.:eek:

    Because this advice is based on healthy controls it will demotivate some patients. Roessingh is therefor studying the norm for movement scientifically:confused:
    They think that improving the norm for movement, will motivate people with CFS to better follow the guidelines for moving.

    This is a brandnew study. It makes me feel sick to my stomach.

    What a waste of money and time. They remain total oblivious for the post-exertional malaise that comes with moving to much.

    Love,
    Berthe

    http://www.onwilliglichaam.blogspot.com
  4. Dolphin

    Dolphin Senior Member

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    I think Andrew1 is referring to this paper:

  5. Berthe

    Berthe Senior Member

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    near Antwerp
    Thank you Dolphin,

    My brain is like Swiss Emmentaler cheese:D
    I actually find the article again on the dutch forum. It is ahead of print, that's probably the reason why I can't find it yet. Well read and weep.

    Clin Rehabil. 2010 Oct 13. [Epub ahead of print]
    Daily physical activity of patients with the chronic fatigue syndrome: a systematic review.
    Evering RM, van Weering MG, Groothuis-Oudshoorn KC, Vollenbroek-Hutten MM.
    Roessingh Research and Development, Enschede, The Netherlands.
    Abstract
    Objective: To give an overview of the physical activity level of patients with chronic fatigue syndrome in comparison with asymptomatic controls. Data sources: MEDLINE, Web of Science, EMBASE, PsycINFO, Picarta, the Cochrane Controlled Trial Register that is included in the Cochrane Library and reference tracking. Review methods: A systematic literature search was conducted focusing on studies concerning physical activity levels of patients with chronic fatigue syndrome compared to controls. A meta-analysis was performed to pool data of the studies. Results: Seventeen studies were included with 22 different comparisons between patients with chronic fatigue syndrome and controls. Fourteen studies, including 18 comparisons, showed lower physical activity levels in patients with chronic fatigue syndrome as compared to controls. Four studies, including four comparisons, showed no differences between both groups. The meta-analysis included seven studies and showed a daily physical activity level in patients with chronic fatigue syndrome of only 68% of the physical activity level observed in control subjects. The pooled mean coefficient of variation in patients with chronic fatigue syndrome was higher as compared to control subjects (34.3% versus 31.5%), but this difference did not reach significance. Conclusion: Patients with chronic fatigue syndrome appear to be less physically active compared with asymptomatic controls. There is no difference in variation of physical activity levels between patients with chronic fatigue syndrome and healthy control subjects, but the validity and reliability of some methods of measuring physical activity is questionable or unknown.
    PMID: 20943713 [PubMed - as supplied by publisher]

    I also love the last sentence after the comma.

    Love,
    Berthe

    http://www.onwilliglichaam.blogspot.com
  6. Snow Leopard

    Snow Leopard Senior Member

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    I have skimed the discussion of the Evering et al. paper and it's definitely weep-worthy.

    This is the last few paragraphs (the worst of it)

    I'm hypothesizing they have zero actual experience in treating our disease.
    http://www.rrd.nl/
    See also: http://www.rrd.nl/publications/posters/Schreurs K - Measuring daily activity in fibromyalgia.pdf

    Someone should write a letter to the editor. :tongue:

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