The 12th Invest in ME Research Conference June, 2017, Part 2
MEMum presents the second article in a series of three about the recent 12th Invest In ME International Conference (IIMEC12) in London.
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Personality change associated with chronic diseases: pooled analysis of four prospective cohort stud

Discussion in 'Other Health News and Research' started by Esther12, Mar 6, 2014.

  1. Esther12

    Esther12 Senior Member

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    Unsurprising findings that may still be useful for a reference:

    http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9179341


    Abstract

    Background Common chronic conditions, such as heart disease and cancer, are associated with increased psychological distress, functional limitations and shortened life expectancy, but whether these diseases alter aspects of personality remains unclear.

    Method To examine whether the onset of heart disease, stroke, diabetes, cancer, hypertension, arthritis and respiratory disease is associated with subsequent changes in personality traits of the five-factor model, we pooled data from the Health and Retirement Study, the Midlife in the United States Survey, and the graduate and sibling samples of the Wisconsin Longitudinal Study for an individual-participant meta-analysis (total n = 17 493; mean age at baseline 55.8 years).

    Results After adjustment for age, we observed consistent decreases in extraversion [−0.25 T-scores per one disease; 95% confidence interval (CI) −0.40 to −0.10], emotional stability (−0.40, 95% CI −0.61 to −0.19), conscientiousness (−0.44, 95% CI −0.57 to −0.30) and openness to experience (−0.25, 95% CI −0.37 to −0.13) but not in agreeableness (−0.05, 95% CI −0.19 to 0.08) after the onset of chronic diseases. The onset of each additional chronic disease accelerated the average age-related personality change by 2.5 years in decreasing extraversion, 5.5 years in decreasing conscientiousness, and 1.6 years in decreasing openness to experience, and attenuated the increasing levels of emotional stability by 1.9 years. Co-morbid conditions were associated with larger changes than single diseases, suggesting a dose–response association between morbidity and personality change.

    Conclusions These results support the hypothesis that chronic diseases influence personality development in adulthood.
     
    Last edited: Mar 7, 2014
  2. Esther12

    Esther12 Senior Member

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    I haven't read the full paper, but just from the abstract, did not think that they were arguing that these changes should be pathologised.
     
  3. Ren

    Ren .

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    Would be interesting to know if they had difficulty getting people to participate in such studies. Perhaps it varies according to culture, but to me, this seems like some kind of psychiatric voyeurism - and little more actually than repeatedly poking a sick dog with a stick and noting the different growls or whimpers he makes.

    Is nothing sacred? Does every moment of human experience have to be documented, measured, evaluated, critiqued, etc. and judged according to these individuals as in need of their "treatment" or not? Traits and signs of narcissism: difficulty with empathy, loss of boundaries, using other people without considering the cost of doing so, pretending to be more important than they really are, claiming to be an "expert" at many things... Hmmm.
     
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  4. alex3619

    alex3619 Senior Member

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    Or in other words, its not the age its the milage?
     
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  5. Valentijn

    Valentijn Senior Member

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    Did they say what questionnaires were used? There's usually quite a few where stuff like "I don't go out and party" are assumed to be a psychological trait, even when the reason is entirely physiological.
     
  6. Ambrosia_angel

    Ambrosia_angel Senior Member

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    That's so true. If I could go out and party every weekend I would but I obviously can't so these questionnaires aren't really worth it imo. I don't think it's a point of choosing to change personalities to adapt to a new lifestyle but being forced to change. Your forced into an introverted lifestyle but deep down inside lives a extroverted person/personality.
     
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  7. Hip

    Hip Senior Member

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    I strongly suspect the mechanism by which people with chronic diseases such as heart disease, stroke, diabetes, cancer, hypertension, arthritis and respiratory disease end up with changes in their personality traits is through the effects of an infectious pathogen.

    All the above chronic diseases are associated with chronic infection, and as many of us here who contracted a respiratory virus and developed ME/CFS know, chronic infection can dramatically affect the brain.
     
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  8. Hip

    Hip Senior Member

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    If the world we live in were sacred and under the auspices of some benign deity, one imagines there would be perfection, with no disease and no need for research and medical science.

    However, in the world we actually live in, there is all manner of disease, both physical and mental, and a lot of suffering and privation that goes with it. Hence the need for scientific inquiry into these diseases, and hopefully one day, technological cure.
     
  9. Esther12

    Esther12 Senior Member

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    From what I've seen of personality questionnaires, it seems quite likely that actually people's 'personalities' don't really change much (depending upon how you define 'personality'), but rather their situation does, and so how they answer the questions used to assess their personality does too.

    At the moment, I don't think it's sensible to assume that our personality questionnaires are measuring what they claim to be measuring.
     
  10. Hip

    Hip Senior Member

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    Why?


    Did you every read about the famous Eysenck Personality Questionnaire (EPQ) that assessed various personality traits of an individual? Eysenck was a formidable, and very hard-nose psychologist.

    The EPQ was introduced in 1975, and it was soon criticized for providing no objective measurement of personality outside the answers to the questions. The implication of this criticism was that the EPQ questionnaire did not measure anything objective.

    To counter this criticism, Eysenck developed the lemon juice test: he found that the amount of saliva secreted by introverts (as determined by the EPQ questions) in response to a measured quantity lemon juice placed on their tongue was greater than the amount saliva secreted by extraverts (again, as determined by the EPQ questions). Eysenck suggested that the introvert–extravert dimension of personality was underpinned by an individual variability in cortical arousal, which the lemon test measured.

    Thus the lemon test proved that the EPQ questions were measuring something objective. At the time, it was a brilliant demonstration.
     
    Last edited: Mar 7, 2014
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  11. Esther12

    Esther12 Senior Member

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    I'm sure that there's more I could learn, but I did end up digging into some questionnaires a fair bit, and entered into a relatively lengthy correspondence with a psychologist who had moved from academia to work with personality tests for job placements. There is a real lack of evidence that personality questionnaires are reliably measuring what they purport to be measuring.

    re lemon test: An association for something like that would not be terribly surprising (depending upon how reliably the personality test was able to identify which individuals produced more or less saliva), or challenge my concerns. People do have different traits, and some of that will be the result of their own biological mechanisms... but I don't think that a test like this serves to validate any of the various personality questionnaires floating around, particularly not for their ability to assess the personalities of individuals who are facing very different external challenges and opportunities.

    It would be interesting to see if 'introverts' with health problems produced the same amount of saliva as 'introverts' without health problems.
     
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  12. alex3619

    alex3619 Senior Member

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    Many of those using these questionnaires fall foul of the psychologists fallacy. They measure something, and reason that in normal people this something must be indicative of particular mental traits. They do not consider individual differences or circumstances, or that these factors they are measuring may be abnormally generated by those individual circumstances, and how they respond to those circumstances.
     
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  13. SOC

    SOC

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    In other words, pure speculation that the objective measure had anything to do with the personality factor.

    Yes, something objective. No evidence it measured the personality characteristic he was claiming it measured.

    Not that brilliant, imo.
     
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  14. Hip

    Hip Senior Member

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    There was a correspondence between saliva secretion and the questionnaire measured introvert-extravert dimension. So the lemon test could be indeed be used to measure whether you were an introvert or extravert.
     
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  15. Hip

    Hip Senior Member

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    It says here that: "the psychologist's fallacy is a fallacy that occurs when an observer assumes that his/her subjective experience reflects the true nature of an event."

    However, in the case of a questionnaire, provided you set objective questions rather than subjective questions, you can easily avoid the psychologist's fallacy, because the person answering the questions (the observer) is not asked for his own subjective opinions of himself, but is only asked for objective facts.

    Yes, sure, but when you have large numbers of patients in your study, such individual circumstances are ironed out by the averaging process. That is precisely why N=1 studies carry little weight, but N=100 or more studies carry much more weight. All scientific studies are like this: large numbers are employed to iron out the individual circumstances, as I am sure you appreciate.
     
    Last edited: Mar 7, 2014
  16. SOC

    SOC

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    Correspondance is not proof of accuracy of the questionnaire. The most logical conclusion from his demonstration is that his questionnaire selects people who salivate more/less with lemon juice, not that it selects introverts/extroverts. Where exactly is there any evidence that the questionnaire selects introverts from extroverts?

    And then there's the circular logic. "Our questionnaire says you're an extrovert. You secrete less saliva with lemon juice. So extroverts excrete less saliva with lemon juice. That proves our questionnaire shows you're an extrovert" o_O

    All his demonstration proved was that the people that answered a certain way on his questionnaire also secrete less saliva with lemon juice. He speculated that cortisol arousal was at the root of both. He didn't even have evidence that cortisol arousal is at the root of introversion or extroversion, he just suggested it.

    Typical psych "research" -- circular logic and speculation passed off as scientific evidence.
     
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  17. alex3619

    alex3619 Senior Member

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    The psychologists fallacy arises when the personal subjective experiences filter the interpretation of a patient's experiences. Its very hard to set objective questions that cannot be misinterpreted. If I took your argument to be correct, then I would have to decide that the CBT/GET crowd are right. The SF-36 uses "objective" criteria, such as what you are physicallly able to do. Its still a subjective questionnaire though.

    So when a psychologist fails to allow for the patient's abnormal responses to be (rationally or otherwise) derived from abnormal circumstances, its fallacious reasoning.

    Similarly the argument about N=1 vs. N=100 is flawed. If this were a random homogeneous population, it might have some validity, on pragmatic grounds. Even then it is wrong. Statistical findings tell you the likelihood something is not due to chance. It does not tell you why - that requires reasoning, and is subject to error. A biased outcome, due to methodological bias or interpretative bias, might not be due to chance either ... but the conclusion is still not valid unless you use good reasoning. That is not, in the final analysis, about statistics. This is why statistics can lie. Interpreted situations (the measurements, even objective ones) are translated to math, and then the math results are translated back to the real world. This translation is a source of error. Its also why reasoning fails sometimes ... perfectly valid reasoning can give erroneous conclusions due to the translation to the reasoning framework and back again.

    The presumption made in the argument about individual differences being ironed out is that such differences are random. I would argue you have to be sure they are random. If you took 100 ME patients, and ran some of the psychological questionnaires, there would be non-random results that look very much like a psychiatric or psychological problem. We don't go out. (Depression). We are worried about the impact even minor activity can have. (Anxiety). We don't trust doctor's claims. (Refusal of authority etc.) These would appear to be uniform throughout the population, and hence would appear to support issues with depression, anxiety and distrust. Yet its the psychologist's fallacy.

    Here is why. The circumstances, which are non-random, which give rise to each of these responses are widespread in the ME population. We don't go out because of pain, lack of energy, and orthostatic issues. It exhausts us, and can impact very badly on our symptoms. Its not depression. We are worried about activity because we pace ourselves (eventually, it can take a long long time to learn to do that) and know, even if we feel OK about it, that excessive activity leads to worsened symptoms. We have to learn that by experience, its counter-intuitive. Finally we don't trust doctors because they guess, speculate, lie to us, don't know much about the condition, and in general can't help us much (unless we have an exceptional doctor, and even then the help is often limited).

    Hard data can be objective. Interpreting that data in a psychological framework rests on assumptions that may not be valid, and can be distorted by bias. Care is always required.

    From the Wikipedia entry already cited:
    This is the problem. There are presumptions about the patient circumstances that are not investigated. What I am saying is that:
    (My addition bolded)

    Those circumstances are often not investigated, and not considered important.

    I am not saying this fallacy always occurs, I am saying that it needs to be accounted for with good methodological design.
     
    Last edited: Mar 8, 2014
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  18. Hip

    Hip Senior Member

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    @SOC @alex3619
    It seems that you have a knee-jerk antagonism to psychology, presumably as a result of the school of psychologists who portray ME/CFS as psychogenic or psychosomatic. But there is no need to hold a negative perspective on the whole field just because of one very small school of psychologists.

    Traits such as introversion and extroversion are defined by behavioral characteristics. If you want to know what those behavioral characteristics are, go read some psychology. In the questionnaire you ask about behaviors. Then if the answers indicate more extravert behaviors than introvert behaviors, you score that person as an extravert, and vice versa. It is a very straightforward process. There is no circular logic at all.

    Certainly psychology is not the most precise of sciences, but it still works reasonably well; and anyway, it is all we've got, so unless you can come up with a better system...
     
  19. Valentijn

    Valentijn Senior Member

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    Personality traits are defined by behavior? If so, it's a best an approximation, and only for lack of a better option. Someone who is in solitary confinement is not necessarily an introvert just because they don't mingle with other people. Similarly, I am not depressed or anxious just because my options to behave "normally" are drastically reduced.
     
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  20. alex3619

    alex3619 Senior Member

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    I have a dislike of irrational claims, irrational "science" (pseudoscience) and such practices causing harm.
    In the case of ME I have a vested interest in insuring good science and good outcomes. I have studied psychology myself, though not much of it, and neuroscience, though not much of it. The entire field is resting on fallacies for the most part, but not entirely. Psychosomatic medicine on the other hand is entirely based on fallacies. It has no firm rational footing.

    The circular logic argument refers specifically to the lemon example. Its not even bad science, the way you described it, it doesn't qualify for that.

    As for developing a better way to do things, wait for my book if I am ever able to complete it. That is a huge focus: how to remove the fallacies and bad practices and enhance psychological and psychiatric research and practice. I think it can be done, I also think most of the profession will resist change, but not everyone. Further, the same issues pervade the medical profession. I want to see a paradigm shift, and by that a major change in how issues are thought about throughout the medical world.
     
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