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New paper from the Netherlands: the treatment of CFS

GracieJ

Senior Member
Messages
773
Location
Utah
Have not read the paper, do not want to, very entertained by the comments, except when they just make me want to cry for the victims.

So... the flip side would be that if you are not believed for years, beaten up emotionally regularly, neglected in every way possible, you should be completely well, right?? So... I should have been completely healed years ago. Decades ago. :cautious:

Do I have it right??
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Did the phone call trigger your Oppositional Defiance Disorder?
This little issue is what potentially makes all this nonscience. If you agree with them you have a psych disorder. If you don't you have a psych disorder. As I have said before, you have to prove you do not have a psych disorder, and they wont look at the published science, you can't have any tests done, and if you do have tests done they will dismiss them. Its a lot like the Inquisition. Of course not all psychs will fall into this trap, but enough do to create a big issue.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Do I have it right??
Only if you have CBT. This is about response to therapy.

So, in theory, you are so desperate from your situation that you have the highest chance of response. Which from PACE is about thirty percent responders or thereabouts. Less half due to controls. Oh and the response size is clinically of little value. Oh, and it might all be bias, all this is within a reasonable bias range, and without any objective confirmation.

So your circumstances might improve with CBT if its not all due to bias, you are one of the lucky ones, and you live in a tower in a remote castle protected by a dragon and with a large moat. Oh, I might have got carried away there, just like this claim about CBT.
 

biophile

Places I'd rather be.
Messages
8,977
Was there any attempt at addressing the direction of causation? Solicitous responses from the partner could simply have been a result of more severe illness in the patient which may or may not show up on simplistic symptom questionnaires.

Note that 3 authors (including the first and last) are from the Expert Centre for Chronic Fatigue, Radboud University Medical Centre, Nijmegen, The Netherlands. This group have a negative reputation among the patient community for heavily spinning results on CBT/GET in their favour beyond the evidence.

Two of the authors, Bleijenberg & Knoop, commented on the PACE trial in ways which significantly question their credibility. In their own previous research they regarded the PACE threshold for normal physical function to be severe impairment, but when writing an editorial for the Lancet to accompany the 2011 PACE paper, they suddenly claimed it was a strict criterion for recovery based on healthy scores (which was demonstrably incorrect for multiple reasons). When the editorial was subject to a complaint to the Press Complaints Commission, they stood by their comment despite the PACE authors themselves confirming that recovery was not reported in that paper (note that lead PACE author White personally approved the editorial and the correction was only published because of intense criticism rather than PACE taking issue with the editorial). Unless they publicly renounce or correct their statement on the PACE trial, many of us will have difficulty trusting anything Bleijenberg & Knoop have to say about interpreting the results of CBT/GET.
 
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Sean

Senior Member
Messages
7,378
Ian Duncan-Smith, meanwhile, was reported yesterday as saying withdrawing peoples' benefits was a 'compassionate' act by the Tory government. The UK is certainly a scary place to live if you are sick.
Australia is now rapidly heading that exact same way. Our current government describes workers being sacked due to the company closing down, because of changes to government policy, as being "liberated" to pursue other options. :grumpy:

Through unemployment to freedom.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
I was just reading a commentary on an old paper, by Renaud and Estess, 1961, Life history interviews with one hundred normal American males: "Pathogenicity" of childhood, American Journal of Orthopsychiatry, 31, 796-802. There were grounds for deciding most of them has the kinds of issues in their childhood that at the time would have led to a psych diagnosis.

Psych is dominantly confirmatory, its a huge problem, if you might have a psych disorder then you do. I think this confirmatory bias, verificationism in research settings, is a huge issue and a major cause of where they go wrong.
 

Hutan

Senior Member
Messages
1,099
Location
New Zealand
Yes, we have the research issues here in Australia too. My son and I were recently invited to take part in a study at the Royal Children's Hospital in Melbourne. It's called 'Understanding CFS'. Of course it is just a survey, but we thought helping to ensure the doctors understand the impact of the illness might be help a little.

But no, most of the questions to the child/adolescent seem to be aiming to prove that the child has a psychological issue or poor sleep hygiene (eg 'Do you repeat words or numbers over and over to stop bad things happening?'; 'Are you afraid of the dark'; 'Do you chew or smoke tobacco within an hour of bedtime?'). And the questions to the parent seem to be aiming to prove that the parent is encouraging the child to be sick (eg 'Do you give your child treats when they are sick in bed?). And there are no questions on post-exertion malaise. None.

When I explained in an email these and other concerns to the researcher, I got no reply. I followed up a month later and she said 'I understand your concerns. If you wish to talk about them further, talk to the Director of Ethics'. I spoke to the Director of Ethics and explained that because the survey (title 'Understanding CFS') doesn't actually cover the symptoms of CFS, the researchers can't be sure that the respondents actually have CFS - and they can't stratify the results according to gradual or acute viral onset and so on. So they could have respondents who are fatigued for a whole range of reasons, making the data useless. The Director, after discussing with the researcher, reported back that if they need to stratify, they can look at the medical records. I did not recall giving permission for them to access the medical records and indeed the Director agreed it was a problem that the 'agreement to participate' form did not include permission to access medical records and that they would fix that.

So, we don't know whether to stick with the project (the surveys will be repeated a few times over the next two years) and ensure that there is at least one respondent who does not repeat words over and over to stop bad things happening or have a problem with bed wetting. Or to pull out of the survey and not give these people any encouragement.

Of course, the researchers might actually be wanting to prove that young CFS patients aren't in fact neurotic and coddled by doing this survey. But they refuse to tell us the aims of the project while we remain part of it in case that influences our answers, so we don't know.
 
Messages
4
Location
Sunshine Coast
This is insane. Ive had CFS since i was 17, was officially diagnosed at the age of 24. When diagnosed i had been with my partner for 3 years, its now been 5 years. I had cfs when i was single, and i still have it now im in a relationship. When i was first diagnosed it took a while before my partner acknowledged it and realised i wasnt just a hypochondriac. When he didnt seem to take me seriously it didnt change my symptoms, just upset me. Now he is very sympathetic, yet again, my symtoms dont change.
 

GracieJ

Senior Member
Messages
773
Location
Utah
@alex3619 It is time to don your Dr. Seuss mode and write a story, maybe something about stars upon thars, only it is a stamp on the forehead, "CBT," with the other group hiding within the castle walls, peeking through the crenellations from time to time... you just did such a great job with wight here, wight now.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
Have not read the paper, do not want to, very entertained by the comments, except when they just make me want to cry for the victims.

So... the flip side would be that if you are not believed for years, beaten up emotionally regularly, neglected in every way possible, you should be completely well, right?? So... I should have been completely healed years ago. Decades ago. :cautious:

Do I have it right??

Didn't you know - in order to get well you need to want to get well. So if you're not getting well, it's because you don't want to, or are not trying hard enough - as with the Lightning Process.

It's a bit like fairies - they won't exist unless you believe in them really really hard.

:lol::cry:
 

jimells

Senior Member
Messages
2,009
Location
northern Maine
I did not recall giving permission for them to access the medical records and indeed the Director agreed it was a problem that the 'agreement to participate' form did not include permission to access medical records and that they would fix that.

They are "fixing" access to records by changing the consent form after folks sign it?
 

Iquitos

Senior Member
Messages
513
Location
Colorado
Too bad they haven't enlightened the whole HIV/AIDS scene with this stunning "knowledge." The whole world could have saved so much money on the research and treatment of AIDS by just prescribing CBT for those patients.

Maybe their next "cure" will be for Ebola, eh?:meh:
 

GracieJ

Senior Member
Messages
773
Location
Utah
I believe in fairies, I believe in fairies... (For @MeSci )

What I do NOT believe in is sarcasm, having lived with it to my detriment. The root word means "to take a bite out of," hence sarcoma shares the same root. I work hard to keep sarcasm out of my speech.

Until it comes to this nonsense... then it comes out, alive and well.

Can we add some fairies to the story?

And can we get pancakes?? :devil: :p
 

Hutan

Senior Member
Messages
1,099
Location
New Zealand
Valentijn, you have nailed it. I don't think the researchers foresaw a need to have more information (eg core symptoms) in addition to the questions that help them prove their hypothesis. Jimelis, the Director suggested that they might have to get respondents to sign a revised participation agreement that allows access to medical records. I'll post here if they bother to do that.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Castles, fairies, pancakes, tall order. It would of course have to highlight the magical thinking of the psychs who do this kind of thing. Maybe something based on the famous tale of King Canute.

In one version Canute tried to hold back the ocean, he was a King after all, and got wet.

In a better version he did this deliberately, to show his court and others that even Kings have their limitations, and the world does not care what people think about what is, only about what is.
 

Countrygirl

Senior Member
Messages
5,479
Location
UK
Australia is now rapidly heading that exact same way. Our current government describes workers being sacked due to the company closing down, because of changes to government policy, as being "liberated" to pursue other options. :grumpy:

Through unemployment to freedom.

This reminds me of the terrible pictures of thousands upon thousands of persecuted Jews being herded to their death while the mocking giant metal sign over the high gates saying Albeit Macht Frei cast on ominous shadow over those sentenced to starvation, hard labour and torture by the German government. The mentality and ethics of our present governments seem to be emulating the terrible behaviour that characterised National Socialism in the 30s.
 
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MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
This reminds me of the terrible pictures of thousands upon thousands of persecuted Jews being herded to their death while the mocking giant metal saying Albeit Macht Frei cast on ominous shadow over those sentenced to starvation, hard labour and torture by the German government. The mentality and ethics of our present governments seem to be emulating the terrible behaviour that characterised National Socialism in the 30s.

Well, 'Arbeit' does sometimes make disabled people 'Frei' from their mortal coils...