1. Patients launch a $1.27 million crowdfunding campaign for ME/CFS gut microbiome study.
    Check out the website, Facebook and Twitter. Join in donate and spread the word!
Leptin
Andrew Gladman reflects upon the recent IACFS/ME conference and the buzz surrounding a small molecule, leptin.
Discuss the article on the Forums.

Moderators of the treatment response to guided self-instruction for chronic fatigue syndrome

Discussion in 'Latest ME/CFS Research' started by Dolphin, Mar 11, 2014.

  1. Dolphin

    Dolphin Senior Member

    Messages:
    6,472
    Likes:
    4,754
    (Not an exciting paper, IMHO)
    *I gave each sentence its own paragraph
    Valentijn, barbc56 and Esther12 like this.
  2. Dolphin

    Dolphin Senior Member

    Messages:
    6,472
    Likes:
    4,754
    (these comments aren't that exciting but I thought I'd post them as I put myself through reading the paper)

    The two sets of data they use are:
    This is from the Nijmegen group who could be described as huge fans of CBT for CFS. As with lots of their papers (and many other CBT papers from other countries) it would have been more interesting if objective measures had been used. Here neither the dependent variable (fatigue) nor the possible moderators are objective. Somebody could report improved fatigue after CBT and still be quite ill. With CBT (and presumably the guided self-instruction intervention),
    Adopting this sort of attitude could easily lower the quantity of fatigue one reports.

    ---
    This is how "avoidance of activity" was measured:
    Last edited: Mar 11, 2014
    WillowJ, Simon, Valentijn and 2 others like this.
  3. Dolphin

    Dolphin Senior Member

    Messages:
    6,472
    Likes:
    4,754
    They also investigated other potential moderators:
    (This quote refers to liner regression, where fatigue is measured on a continuous scale.)

    Similar results were found with regard to logistic regression. This involves dividing the outcome into two groups, "successful" and "unsuccessful" (my wording):

    Similar results were found with regard to linear regression. However, physical functioning (SF-36 PF) was p=0.06 so I think that should be considered a borderline result so I don't think they should have tried to make the big distinction they did between SF-36 PF and SIP:

    Also, talking about it as "in a previous trial performed in a tertiary treatment centre" seems to me a bit weird: the current paper is looking at the data from paper 9, plus another study.
    Valentijn and Esther12 like this.
  4. Esther12

    Esther12 Senior Member

    Messages:
    5,105
    Likes:
    4,904
    Thanks D.

    Interesting that those who were most depressed reported benefiting least from self-instruction -I could cheekily suggest that's depressive realism counter-acting response bias!

    Also, those who reported avoiding activity reported benefiting least from self-instruction designed to discourage people from avoiding activity... shouldn't it be the other way around? Shouldn't these be the people most likely to have the cognitive problems being targeted by the intervention? Did they say what they'd predicted at the start of the trial?
  5. barbc56

    barbc56 Senior Member

    Messages:
    1,256
    Likes:
    636
    Sigh.:mad:
    Valentijn likes this.
  6. Dolphin

    Dolphin Senior Member

    Messages:
    6,472
    Likes:
    4,754
    They described it as a post-hoc analysis and didn't mention any specific predictions, as I recall.

    This is the introduction which lists previously findings:
    Valentijn and Esther12 like this.
  7. A.B.

    A.B. Senior Member

    Messages:
    425
    Likes:
    1,059
    Regarding the definition of "avoidance of activity":

    Isn't this normal behavior for people suffering from fatigue? Patients with severe fatiguing illness such as cancer and MS will probably adopt the exact same behaviour, and anything else would be self harm. Who are the authors to decide that this is suddenly unhealthy pathological behavior?

    In other words, the more fatigued people were, the less this form of CBT worked.
    Last edited: Mar 12, 2014

See more popular forum discussions.

Share This Page