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Mediators of the Effects on Fatigue of Pragmatic Rehabilitation for CFS

Discussion in 'Latest ME/CFS Research' started by Firestormm, Jun 27, 2013.

  1. Esther12

    Esther12 Senior Member

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    This paper made me think of CFS research. FINE was published (considering the amount of money and publicity involved, it had to be), but those who have made their careers on the theories tested by FINE seem keen to avoid acknowledging it as a falsification of their claims:

    Full paper: http://pps.sagepub.com/content/7/6/555.full#aff-2
     
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  2. Dolphin

    Dolphin Senior Member

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  3. Dolphin

    Dolphin Senior Member

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  4. Dolphin

    Dolphin Senior Member

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  5. Dolphin

    Dolphin Senior Member

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  6. Dolphin

    Dolphin Senior Member

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    I don't recall coming across the term common-method variance but believe I understand (roughly) this sentence.
     
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  7. Dolphin

    Dolphin Senior Member

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    Penultimate paragraph:
    The thing is that we don't know for certain the people are actually more active (actometers weren't used). There were no statistically significant difference in the more objective step tests.

    Near the start of the discussion, they did mention about the lack of improvement in the step tests:
     
    Last edited: Oct 30, 2013
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  8. Dolphin

    Dolphin Senior Member

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    A paragraph from the introduction:

    Which most people think is true

    Symptoms can be indicative of relapse. And can certainly indicate something physiological

    Most people won't avoid them totally. It's not like a phobia for example.

    Which is likely due to the illness. Doesn't prove anything about maladaptive avoidance.
    Little evidence that CBT and similar programs reverses this.

    Speculative theory - not sure there's much evidence for it.

    My underlining: where do we have evidence that it's not deleterious.

    Any treatment rationale that sounds like it might work can be reassuring. However, if it doesn't work, it is unlikely to be reassuring anymore.
    And if one finds out one is being giving a treatment rationale which doesn't match the facts, one doesn't even get temporary reassurance. Also, people may feel guilty for not improving. And other people indeed may see them as being guilty of not trying hard enough if they think people could get better if they just tried harder/similar.

    The aim of medicine surely isn't to give people reassuring treatment rationales if they don't work. Any "woo" therapy can also do this. The aim of medicine should be to give accurate descriptions/treatment rationales.
     
  9. Dolphin

    Dolphin Senior Member

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    This is what they say on the main questionnaire that showed mediators:

    The 42 questions can be found in this attachment: http://epubs.surrey.ac.uk/2788/1/506003.pdf (pages 351 & 352) although it doesn't break them down by category.
     
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  10. Dolphin

    Dolphin Senior Member

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    Here are four of the catastrophising questions - somebody may be able to get the others from the link in the last message:

    Questions like:
    seem more like a question about whether one will recover or not. It isn't necessarily a measure of catastrophising to agree with this.
    One could certainly fill somebody up with hope that they would improve but in general it's unclear how useful this really is. (in this study, lower scores in the pragmatic rehabilitation scale at 20 weeks was associated with lower fatigue at 70 weeks but a lower fatigue rating "isn't everything").
     
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