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Jackson: Well-being in CFS: Relationship to Symptoms and Psychological Distress

Discussion in 'Latest ME/CFS Research' started by mango, Oct 16, 2016.

  1. mango

    mango Senior Member

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    Well-being in Chronic Fatigue Syndrome: Relationship to Symptoms and Psychological Distress

    Jackson H 1, MacLeod AK 2.

    Author information

    1 Royal Holloway, University of London, London, UK.
    2 Royal Holloway, University of London, London, UK.

    Clin Psychol Psychother. 2016 Oct 13. doi: 10.1002/cpp.2051. [Epub ahead of print]

    Abstract
    OBJECTIVE:
    There is growing recognition in psychology that wellness is more than the absence of disease and distress. Well-being has been defined in numerous ways. Two dominant models include Diener, Eunkook, Suh, Lucas and Smith's (1999) model of subjective well-being (SWB) and Ryff's (1989) model of psychological well-being (PWB).

    In contrast to the abundance of research investigating negative constructs and psychopathology in chronic fatigue syndrome (CFS), there has been a paucity of positive psychology studies. This study had two aims: to examine PWB and SWB and their relationship to symptoms in CFS and to compare PWB scores in a subgroup of the CFS sample to a matched control group.

    METHOD:
    Chronic fatigue syndrome participants (n = 60) completed self-report scales of PWB, SWB, fatigue, anxiety and depression. PWB scores in a subgroup of the CFS sample (n = 42) were compared with those of a matched nonclinical control group (n = 42).

    RESULTS:
    Correlations between scales of symptoms and well-being were complex. Well-being dimensions were largely independent of physical components of fatigue but strongly related to psychological components of fatigue and psychological distress. Multiple regression indicated that five dimensions of well-being uniquely predicted symptomatology. Compared with the control group, the CFS group scored significantly lower on five of Ryff's six PWB dimensions, with particularly marked deficits in personal growth, environmental mastery and self-acceptance.

    CONCLUSION:
    This multidimensional assessment of well-being advances our understanding of CFS and offers new treatment targets. Future research must investigate whether interventions targeting theses well-being deficits can boost the efficacy of symptom-focused treatments.

    KEY PRACTITIONER MESSAGES:
    Previous psychological research into CFS has largely focused on the identification of negative constructs and CBT, a treatment that targets evidenced-based negative constructs, has demonstrated efficacy in reducing levels of fatigue and disability. However, the majority of people continue to experience psychiatric symptoms and excessive levels of fatigue post-treatment.

    Finding ways to enhance the efficacy of existing treatments is a clinical priority. There is evidence to suggest that in clinical populations, standard CBT is effective at reducing negative affect and thinking but fails to enhance low levels of positive affect and thinking, implying treatments may be more effective if they promote positive functioning alongside a reduction of negative functioning.

    Multidimensional models of well-being suggest that well-being is not a single phenomenon, and different psychological disorders may be characterized by varying well-being deficit profiles.

    Psychological well-being was found to be diminished in CFS participants compared with controls, with particularly marked deficits in personal growth, environmental mastery and self-acceptance, suggesting that these may be particularly important treatment targets.

    Well-being dimensions within the CFS group were largely independent of physical symptoms but strongly related to psychological symptoms, suggesting what may be causing low levels of well-being in CFS is largely psychological factors and the general impact of living with a chronic illness rather than symptom levels per se.

    KEYWORDS:
    Chronic Fatigue Syndrome; Cognitive-behavioural Therapy; Depression; Psychological Well-being; Subjective Well-being

    https://www.ncbi.nlm.nih.gov/pubmed/27739228
     
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  2. Cheesus

    Cheesus Senior Member

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    Or maybe symptomology predicts wellbeing? It's rather blindingly obvious that the sicker you are the lower your psychological wellbeing is likely to be.

    How could it not occur to the authors that the direction of causality might be in the opposite direction? Do they choose to gloss over that possibility or are they genuinely oblivious to it?
     
  3. Effi

    Effi Senior Member

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    Deficits in all three of these areas are a direct result of the burden of our physical symptoms:

    Developing your talents usually involves some sort of physical or mental activity.
    ME/CFS (not sure which one this study is talking about) makes it impossible to get a decent grip on events in our life - we never know what state we'll be in tomorrow, or how events will impact us.
    Self-acceptance - this is a tricky one: I would guess their questionnaires don't take into account the fact that this illness makes life so unbearable sometimes that I can imagine many patients saying things that would be interpreted as a lack of self-acceptance.

    I'm so sick of this kind of backward thinking. :vomit:
     
  4. Cheesus

    Cheesus Senior Member

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    If ME can cause secondary depression (which it obviously can) then you would expect that to impact how a person feels about themselves. That is essentially the nature of depression.
     
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  5. A.B.

    A.B. Senior Member

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    Wow that's a big pile of bullshit they are dropping on the reader here. :confused:

    This is actually offensive to people who suffer from severe unbearable symptoms, such as chronic pain. Somebody with severe physical symptoms is never well. I wonder how they could possibly arrive at these results.
     
    Last edited: Oct 16, 2016
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  6. Cheesus

    Cheesus Senior Member

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    It's actually a bit like saying that a lack of psychological wellbeing is related to a lack of psychological wellbeing.
     
  7. Living Dead

    Living Dead Senior Member

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    Read: we had to do post-hoc data mining.
     
  8. Marky90

    Marky90 Science breeds knowledge, opinion breeds ignorance

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    What a pile of useless blabber.
     
  9. trishrhymes

    trishrhymes Senior Member

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    Oh how I long for the day when ME is universally recognised as a physical illness and we no longer have psychs inflicting this bullshit on us.
    :bang-head:
     
  10. Barry53

    Barry53 Senior Member

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    [My bold]. Maybe, just maybe :rolleyes:, it is because being constantly told your fatigue is all mind over matter, can be immensely depressing and demoralising?

    Ditto. If you feel no one really gives a monkey's, and those who do think it's all your fault anyway, is it really that surprising?
     
  11. trishrhymes

    trishrhymes Senior Member

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    I noticed that too. Are they saying both their fancy constructs were actually measuring the same thing?

    Can't be bothered trying to get my head around that!
     
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  12. Sidney

    Sidney

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    I was extremely puzzled by this study (?), before I'd read any comments; all I could come up with was that they are doing 'an altogether different type of study': instead of 'proving' that the symptoms are caused by high levels of psychological ill-health, now they are attributed to low levels of psychological well-being!
    How inane can these projects be?
     
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  13. Barry53

    Barry53 Senior Member

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    However they say it, the claim is still the same - that it is all in the head.
     
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  14. Ysabelle-S

    Ysabelle-S Highly Vexatious

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    Oh look out, more flying rubbish to duck. They make no effort whatsoever to understand the actual reality of this illness. It's just one intellectually bankrupt study after another.

    What on earth are they being taught at university? Why do they have no ability to analyse previous bad research or question dodgy orthodoxy? Why can't they familiarise themselves with the biomedical research? Because they'd have to find something else to do. I mean it's not like they have anything better to do - it's not like there's a crisis in mental health provision and a shortage of people for patients to see. Obviously real psychological and psychiatric patients are just not good enough for them.

    It's like they come up with crap like this to justify their existence at their institutions. There's a whole industry of people feeding off ME at the patients' expense. This is why I point blank refuse to give any money to UK research.
     
  15. hixxy

    hixxy Senior Member

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    Is there an uptick in psych papers coming out of the UK at the moment? It seems like a response to the challenge to PACE trial.
     
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  16. Sean

    Sean Senior Member

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    I just can't imagine why patients are (apparently) having trouble with self-acceptance, given how wonderfully accepting and supportive the medical profession and whole world has been for us.

    :meh:
     
  17. Snow Leopard

    Snow Leopard Hibernating

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    I would like to point out that the authors are saying that CBT should not be focused on telling patients they are not really fatigued or disabled, but rather trying to improve wellbeing in spite of the underlying illness.

    My major issue with the study is that it entirely focuses on the psychological aspects using questionnaires and ignores other factors, eg social, economic etc?
    Why does bio-psycho-social always translate into bio-psycho-social?
     
  18. RogerBlack

    RogerBlack Senior Member

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    This is work submitted to go along with a much longer thesis.
    https://pure.royalholloway.ac.uk/po...IP_TO_SYMPTOMS_AND_PSYCHOLOGICAL_DISTRESS.pdf - 202 pages.

    Page 20
    43
    interestingly is contrasted with the papers
    Page 116 is interesting,
    I know I have worried about my virtue. :)
    More seriously - though I question the destination - any shift away from symptom reduction is good.
    Page 119, on pacing is also positive in part.
    (here she means control strategies that do not work, I think).

    I really would like to see what the first submitted version of this paper was.
    (quotes retyped and paraphrased in part, copy/paste not working)

    On the more comedy side.
    P183 has the patient information info.
    P199 and on has the data.
     
    Last edited: Oct 16, 2016
  19. Art Vandelay

    Art Vandelay Senior Member

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    What a load of pseudo-scientific nonsense. I think we're getting to the point where even astrology is more scientific than this psychiatry claptrap.
     
    Last edited: Oct 16, 2016
  20. taniaaust1

    taniaaust1

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    maybe it would be interesting to see this researches raw data to see what they had based their conclusions on exactly.
    I think they have upped the studies due to the PACE trial being challenged.. look at where this study came from.. University of London. City of Wessely isnt that? He's probably got all his psych buddy friends now churning out psych papers as quickly as they can to try to wipe out what is going on with the PACE stuff which dirties his hands too seeing that was on his whole ME/CFS field.

    not only do they seem to be upping the psych papers, they also seem to be publishing bolder, before they were being more careful in how they'd put things eg term neuropsychological illness was being used but now they want to be even more deceptive and make it clear that we are mental health patients. WIth this research they couldnt have been any more bolder in making ME/CFS sound like its a recognised mental health illness eg "continue to experience psychiatric symptoms"
     
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