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No More Psychological Studies. An editorial, by Mindy Kitei

Discussion in 'Action Alerts and Advocacy' started by Mindy Kitei, Feb 2, 2011.

  1. biophile

    biophile Places I'd rather be.

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    Knowledge gaps and hubris

    Hi pictureofhealth. Indeed. It really is a rabbit hole without end. Recently I was looking at "Functional somatic syndromes" (Barsky & Borus 1999) as well as the reader comments and authors' reply.

    They allow for the possibility of biomedical factors but aren't really interested in them even if they exist, they just care about the alleged psychosocial and cognitive behavioural factors which are given obvious preference. Nor do they seem all that concerned about the looming contradiction of finding biomedical causes and subtle structural damage in "functional" disorders, unless of course what they really mean is a biomedical event "triggered" the psychological maladaptation rather than "cause" it, and at some point there will be an argument over exactly where "functional" ends and structural damage begins. Even then, they state "these same psychosocial factors are operative in illnesses that have a clearly demonstrable medical basis, such as ischemic heart disease".

    I think "functional somatic syndromes" will be renamed to compensate for future biomedical findings while still clinging to the initial psychosocial conceptualisation. Having biomedical research into ME/CFS reveal undeniable evidence of organic pathology and allow for effective treatments, this is really only one side of the story, one part of a victory over a devastating illness and a despicable response to it from society.

    I do believe there are genuine psychological factors in disease but it has been difficult teasing out fact from ideology and cutting through all the overstatement and overgeneralisation. Unfortunately, much of the research degrades into mere psychobabble and assfacts by the time it reaches the public and the medical profession. Angela mentions US and UK as "societies where psychobabble has run rampant without logical and effective critique". Mind over body wishful thinking, illusion/myth of control, and just world theory; these are all common human traits, it may be hard to find any society that isn't affected.

    You mention the knowledge gap. Every generation seems affected by it, and fills in the gaps with speculation. The hubris comes in when this is swallowed as fact and when the previous lessons are ignored because recent progress has set up a false confidence that similar mistakes won't be repeated with the modern methodology.

    The toolset available to researchers has expanded greatly over the last 50 years, but still vulnerable to self-deception via measuring one's own bias. A good example is how some people have been wooed by the "evidence base" of CBT/GET. When I first read the CBT literature it sounded impressive, until I realised it employed flawed hypotheses, flawed criteria, and flawed psychometrics or fatigue scales taken for granted as reliable but don't match what is happening in reality.
  2. biophile

    biophile Places I'd rather be.

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    I re-read Mindy's short editorial on "no more studies" and her comments. I don't feel personally offended at what she said, but I think she underestimates the importance of such critique. The handful of people critiquing the CBSM study may already be hounding government officials anyway. The discussion between Angela and Mindy is between them, but I share Angela's concerns about the serious long term threat of the psycho-juggernaut to ME/CFS and the underestimation of this threat as encouraged by the hope that biomedical research will somehow solve everything.

    One may argue that we don't need it or we can challenge the psychobabble, analyse the psychological research and critique the psychiatric paradigm AFTER the biomedical research is in place first. Some people made reasonable comments to the effect that we should devote ourselves to what we think is best (thankyou), but only a small handful of people actually defended the importance of tackling the psych stuff (thankyou!).

    It is not like a large proportion of the community is dedicated to such analyses and critique, and they should not be discouraged or distracted or told their work is futile, we really need them and I have learned a lot from them. They all generally appear to engage in multiple forms of advocacy as well, so if anyone needs to be criticised for engaging in armchair critique without much advocacy it is people like me.

    But I have decided that the best use of my effort is doing what I am already doing, understand ME/CFS research and issues. I admit I'm slow, may have no immediate effect, and will take several years to get to a decent level of understanding. Frankly, I'm not all that interested in getting involved in other forms of advocacy right now, I investigate these related issues for reasons other than (in addition to) illness, so I probably wouldn't stop it even if I thought this approach was useless for advocacy purposes. If this makes me selfish, so be it.

    Was this entire thread itself just another "diversion", a massive waste of time and effort? Perhaps the hours I spent on this thread could have been better spent elsewhere? I think it was important to respond to what Angela called "anti-analytical sentiment" and the "erroneous belief that counteracting the psychiatric paradigm is futile".

    My only criticism would be, "Unfortunately much of what has been written is embedded and scattered across countless pages of forum discussions and blogs etc. If only this wealth of information and wisdom was more centralised, involved collaboration among multiple authors, and was better targeted towards those who need to see it?"
  3. biophile

    biophile Places I'd rather be.

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    Nielk and Crohn's disease

    Associating personality to disease was all the rage in the early 20th century and continued for several decades. Don't quote me on this but I think I have seen a few reviews of research into psych factors in organic disease which acknowledged the earlier research claiming strong associations was flawed and not confirmed in better designed studies later on. I think the same will be said for ME/CFS.
  4. Cloud

    Cloud Guest

    Well put....thanks Biophile. Cool Avi, btw.

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