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Personality Features and Personality Disorders in Chronic Fatigue Syndrome: A Populat

Discussion in 'Latest ME/CFS Research' started by V99, Jul 28, 2010.

  1. oceanblue

    oceanblue Senior Member

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    a closer look at the claims about personality traits, illlnes & treatment compliance

    Well, I waded through the paper now and have found even more in the text doesn't really stand scrutiny. For example the authors stated that:

    "Among the 5 personality dimensions, the strongest correlations were found between neuroticism and both functional impairment and fatigue in CFS and ISF."

    But given that neuroticism is "the tendency to experience negative affect" this is at least as likely to be cause as effect. If you're ill, you are experiencing negative effect and if you're more ill, then you could expect to experience more negative effect. So the correlation between measured neuroticism and functional impairment/fatigue might well be driven by the effect of being ill on people's experience. Researchers are specifically supposed to consider confounding factors like this, but these researchers did not.

    The authors go on to claim that neuroticism makes people less likely to comply with treatment and more prone to illness:

    "Persons with higher scores in neuroticism are more likely to be noncompliant with treatment suggestions, display unhealthy behavioral strategies, lack a stable social environment and are therefore prone to illness."

    But oddly, this claim is unsubstantiated by any reference. Which is particularly worrying as this assertion is repeated in the conclusion section of the abstract.

    They then add to other personality traits to the mix, agreeableness and conscientiousness:

    "Also, decreased agreeableness and conscientiousness scores were found in CFS. Both personality traits might affect compliance with treatment regimes."

    They presented no evidence that agreeableness affects compliance. Conscientiousness might well affect compliance, but conscientiousness tends to be measured by agreement with statements like "I see things through" and "I get a lot done". Someone with fatigue might well be less likely to agree with these statements than someone who is healthy - not because they are not conscientious but because ill-health makes it more difficult to do things. I'm not sure it's possible to draw any conclusions aobut how well such patients would comply with treatment that is designed to alleviate their illness.

    Overall, they authors don't do anything to substantiate their claim that:

    "The maladaptive personality features that we describe interfere with the ability to follow directions and maintain the selfmotivation needed for cognitive behavioral therapy and graded exercise therapy to be effective."

    If reviewers and editors did their jobs properly then such intellectually sloppy statements would not get published.

    Wouldn't it be great if you read research told you new things about the illness, rather than about the views and shortcomings of the researchers? I know, just a dream.
  2. oceanblue

    oceanblue Senior Member

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    Don't know if this has been covered elsewhere, but I think depressive personality disorder was created in the revision to 2000 revision to DSM-IV. The authors refer to 10 personality disorders listed in DSM-IV and 2 more added in the appendix in DSM-IV TR (as in "ps, we just made up another couple of personality disorders!"). Table 1 in the paper lists 12 personality disorders, presumably 10 + the 2 from the appendix, which I guess includes depressive personality disorder.
  3. Dolphin

    Dolphin Senior Member

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    Good points.
  4. Tammie

    Tammie Senior Member

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    It is in the appendix as a proposal; however, this is what it says about the appendix, "This appendix contains a number of proposals for new categories and axes that were suggested for possible inclusion in DSM-IV. The DSM-IV Task Force and Work Groups subjected each of these proposals to a careful empirical review and invited wide commentary from the field. The Task Force determined that there was insufficient information to warrant inclusion of these proposals as official categories or axes in DSM-IV." (bold and italics are mine)

    so basically, thus far, the experts consulted on the DSM agree that there is no such diagnosis
  5. oceanblue

    oceanblue Senior Member

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    So "Depresseive" PD not a real personality disorder

    re my comment that Depressive PD is included in the appendix of the DSM-IV-TR revisions:

    Thanks, Tammie, that is very revealing. I wonder how Nater and friends can justify using it?
  6. Esther12

    Esther12 Senior Member

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    The paper mentions a Kato twin study as the only evidence of abnormal emotional feature priors to the onset of illness. It's available here:

    http://archpsyc.ama-assn.org/cgi/reprint/63/11/1267.pdf

    I was reading it thinking 'This is actually a solid bit of research' and then I got to the prevalence of chronic fatigue in the sample they studies: 20%.

    ? That's not very useful for us.

    Oh well. I've not finished the paper yet, maybe they'll also provide data on the most seriously disabled by fatigue. I'm not holding my breath though.
  7. Dolphin

    Dolphin Senior Member

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    Related to the point you're making

    One thing to keep in mind is that only a percentage of people with a CFS-like condition have ended up with a CFS diagnosis after medical and psychiatric assessment.

    For example in Jason et al (1999), only 32 (19.28%) out of 166 CFS-like patients had CFS http://archinte.ama-assn.org/cgi/reprint/159/18/2129 (see Table 1).

    In Reeves et al (2003), http://archinte.ama-assn.org/cgi/content/full/163/13/1530, they calculated the prevalence of a CFS-like illness has 1607 per 100,000 and the prevalence of CFS as 235 per 100,000 (14.62%).
  8. Esther12

    Esther12 Senior Member

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    That was mentioned in the paper too.

    I just finished it off, and I quite liked it. It was interesting. It's a shame that this is what they're spending CFS funding on, and it doesn't seem likely to be that useful for us, but it was an interesting paper for understanding how stress, etc and fatigue can interact. Much better than most of the CFS papers about, perhaps because it seemed so uninterested in CFS.

    Funny the new paper was so happy to reference it without making it clear what a different classification of CF was being used.
  9. Tammie

    Tammie Senior Member

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    That's just it.....if they actually had to justify most of what they do, there is just no way they could......the problem is that they haven't been held accountable yet by anyone who has any actual power over them
  10. ixchelkali

    ixchelkali Senior Member

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    Good digging, jspotila! Like you, I find the subtle metomorphosis interesting. How did the conclusion:
    get changed to become:
    Interesting that the earlier version asks "whether personality dispositions are a premorbid risk factor or whether they are a consequence of the chronicity and severity of CFS," without considering that they might not be "personality dispositions" at all, but an artifact of the test instruments. Maybe the fact that that's an obvious next question is the reason they left that out of the final version. Apparently even they were aware that the "chronicity and severity of CFS" might effect their results, but chose not to mention that possibility in publication, even though they originally thought it was an "important question."
  11. George

    George waitin' fer rabbits

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    Hillary Johnson has just immortalized this thread and all of the wonderful people on it! Woof!!!!!!!

    Found by Frickly btw!

    You can't fix stupid..(stone) by Hillary Johnson

    http://oslersweb.com/blog.htm?post=730548
  12. Frickly

    Frickly Senior Member

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    Go Hillary!
  13. JT1024

    JT1024 Senior Member

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    Ditto George and Frickly!
  14. V99

    V99 *****

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    Nice one Frickley, great find. Thank you Hillary. Woof to George
  15. Dolphin

    Dolphin Senior Member

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    For anyone interested, this abstract gives a little more info to the published abstract:

    http://www.psychosomaticmedicine.org/misc/meetingAbstracts.shtml

  16. Esther12

    Esther12 Senior Member

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    I'm pretty lazy.

    I think having CFS makes it more difficult to be lazy (darn it) and I think people with CFS are more likely to hide their laziness in order to avoid stoking the prejudices of others...

    but there's no doubt that I'm a pretty lazy person. My dad's helping me do some DIY stuff today. He's popped out to the shops and I'm playing some silly internet browser game instead of a) helping or b) resting up so I can help later. It made me think of this comment.

    I've read papers caliming that low activity levels are a risk factor for CFS, and that high activity levels are. Personally, I think it's very hard to account for all of the different factors that would throw off these sorts of studies. Right now, I'm off to do some washing up and then rest up.

    It is hard being dependent on other people to help you so much, but also wanting to spend your own time just playing: "Can you do all my chores so that I can spend my limited energy mucking about? Thanks for that."
  17. oceanblue

    oceanblue Senior Member

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    !!! And it's so true for me...
  18. V99

    V99 *****

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    I would be the complete opposite. Not lazy at all. I also hate people doing things for me, but that is not to say I don't let others help when I need it.
  19. Dolphin

    Dolphin Senior Member

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    I sent in the following letter today to the corresponding author:

    Im not sure I should post the reply but basically he has passed the request on to Elizabeth Unger (not one of the authors) as he no longer works in the CDC CFS section and doesn't want to deal with it.
    Anyone else written to him? Wonder is this different treatment for non-academics? This paper has only just been published. I've requested such info before from corresponding authors and never had problems (including with Peter White who probably doesn't like me!) Elizabeth Unger wasn't involved as I said so won't have the info probably.
  20. V99

    V99 *****

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    Is he uncomfortable with his own work?

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