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Prevalence of DSM-IV Personality Disorders in Patients with Chronic Fatigue Syndrome: A Controlled S

Discussion in 'Latest ME/CFS Research' started by Bob, Oct 18, 2012.

  1. Firestormm

    Firestormm Guest

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    Ok. I confess. I was about to ask you "Why the hell are you of all people posting another psychological paper?" until I saw the results. :)

    Nice job Mr Bob :thumbsup:

    edit:

    Of course I could say, 'Well, this only relates to CFS patients in the study, and not that ME lot of nutters' but I won't of course :rofl: :D
     
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  2. user9876

    user9876 Senior Member

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    So 16% of the population have personality disorders.It makes me wonder when does someone with a personality that a pscyhiatrist doesn't like become disordered.
     
  3. Esther12

    Esther12 Senior Member

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    The fact that exaggerating the extent to which cognitive and behavioural interventions can control an abnormal 'condition' will serve to increase the stigmatisation which surrounds those with this condition - it was true for homosexuality, and it's true for CFS. That those taking money for the provision of psychosocial care have forgotten to account for this social aspect to their approach reveals them to be utterly incompetent or else intentionally dishonest.

    It was my typo... and I'd just realised I could touch type! That was the first time I ever typed while reading what I was typing up: it was a bit of a thrill.
     
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  4. Esther12

    Esther12 Senior Member

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    This is an interesting and depressing topic. It seems that it is a quacky as you might expect (and figures higher than 16% are often used).
     
  5. Bob

    Bob

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    It also makes me wonder how many psychiatrists have personality disorders!

    That would be an interesting study!

    The control group could be ME patients. Let's see which group has a higher proportion of personality disorders!
     
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  6. Marco

    Marco Old blackguard

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    When I was a psych undergrad (confession time) it was generally assumed that anyone progressing on to clinical psychology were drawn to it for 'personal' reasons.

    Which of course, if not a malicious slur, is at least a gross overgeneralisation;)
     
  7. SOC

    SOC Senior Member

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    I once heard a psychologist say something to the effect that mathematicians and engineers were "almost by definition" asperger's or near-asperger's because of their preference for orderliness and logic. In fact, she said that any child exhibiting a preference for these areas should be considered "at the functional end of the autism spectrum". :eek:

    I probably don't need to mention that this particular person was very much the flighty, touchy-feely, it's-all-about-emotions type of therapist. Clearly, people not like her have to be disordered, right? :rolleyes:
     
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  8. Sing

    Sing Senior Member

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    I was surprised when I read this study to find that it concurs with my own experience. I expected to find a biased attack and psych labelling, reversion to psych cause and categorization. But, after many years of ME/CFS plus aging challenges piling on, I do seem to function more in a rut of petty physical management in order to cope. I like to be functional and competent, but with this illness, I have to do a lot of managing even to function at the low end, much less to convey the appearance of functionality during brief appearances, so to speak, with more normal people. It is not my personality to be a petty manager (OCD behavior), but, functions that were once automatic, or are still automatic for healthy people my age, have broken down into many small steps which I have to do consciously, intentionally. As a result of this focus on a lot of petty management and all the limitations and physical issues, I do feel a tendency towards a depressed outlook. I drop this many times a day too, to focus on my other tendencies--towards interest, joy and humor. I feel that many other people have a hard time too in life, and that we are all in this together. Lightening the burden by sharing humor, encouragement and fun, when possible, gives to me as well as to others. Also being willing to take what responsibility I can to help where help is needed--this also gives back as I am doing the giving.

    So, yeah, I know this stuff. But honestly I think that a psych test would show overall what this one did--that I am not "crazy" (Axis II), but veer somewhat towards OCD behavior and depressive features than the healthy do. I do think that if their study design compared us to other ill people, such as those with MS or Parkinsons, responses such as depressive and OCD features would fall into a natural context of both struggle and coping behavior.
     
  9. Esther12

    Esther12 Senior Member

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    Sorry to continue with an OT, when maybe I should start a new thread, but I was just reading the wikipedia article on the researcher mentioned here:

    This seems interesting:

    There's an awful lot of quackery and politics here. I was going to read her papers, but I'm not sure if there's any need now, as the details don't seem that important. It would be quite funny to test CFS 'experts' on their ability to distinguish the profiles of CFS and (for example) MS patients. The history of the debate about viewing homosexuality as a mental health issue is interesting and terrifying.

    Another article mentions this:

    http://www.psychologicalscience.org...hology-yesterday-and-today-evelyn-hooker.html

    It would be difficult to imagine psychological testing of 'personality' or similar which did not tend to elicit some different responses from gay and straight men in this period, as they would tend to face quite different circumstances. And the same is true with CFS patients and healthy controls.
     
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  10. Esther12

    Esther12 Senior Member

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    Generally, I think that these would be seen as confounding factors in the diagnosis of personality disorders, and this is one of the problems with these sorts of diagnoses. eg: If someone needs to be very controlled because of a health condition, take care with their diet, medication, what they do, etc, then this should not mean that they are more likely to be diagnosed as having an OC personality disorder - although they almost certainly would be. This is one of the reasons why I think it's really important to have an appropriate control group for these sorts of studies, but those who have undue faith in the nature of these diagnoses will be less concerned.
     
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  11. Holmsey

    Holmsey Senior Member

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    With respect to other illnesses, clearly not, there's no need when the pathology of those illnesses is already understood. Whether we like it or not the reason all avenues are still explored is that there is no clear understanding of our condition. We have a growing evidence base for the physical but again, many of those studies throw up physical symptoms which are also seen in psychological conditions so often they're not a clear win. We also get subjected to the same criticism we throw at psychological studies, that the cohort may contain various different illness, so a failure on selection criteria.

    But if we're to genuinely hold the view that this is not a psychological illness then we shouldn't fear these studies, as long as we ensure they are impartially performed and accurately reported then they can only help build the evidence base for our viewpoint. Of course where they divert funds from reciprocal physical studies that's something we should vigorously oppose.

    Given this study in particular, for the main test criteria we are seen as entirely normal, for DE we're elevated but I doubt it's lost on anyone reading this that most likely this is a symptomatic of long term debilitating illness and it's impact on general mental well being. As to the OC, I'm not sure where that leads but we shouldn't fear it, not if what we ultimately want is honest understanding.

    Best regards, Zee.
     
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  12. Bob

    Bob

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    Yes, well, "impartially performed" and "accurately reported" is a bit of a sticking point for us, isn't it?!?

    Another major issue.
     
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  13. Esther12

    Esther12 Senior Member

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    That's not quite right. The biopsychosocial approach to medicine has affected other areas. eg: James Coyne has been writing a lot of critical analysis of those claiming that emotional and personality factors can be routinely medicalised and managed to improve the life expectancy of cancer patients - he seems to think that there's a lot of quackery in this area, and much of it seems very similar to that which we've seen with CFS. This sort of BPS stuff does tend to be of a different nature with conditions like cancer, than conditions like CFS though.

    I cannot imagine that any subsection of society facing abnormal experiences could be lumped together, and have these sorts of psychological studies done so relentlessly, without some abnormalities coming to light. If the group is one people already wish to view dismissively, then these abnormalities will be used to justify their mistreatment, as they have been in the past.

    If there was really clear and good evidence that almost all CFS patients suffered from consistently diagnosable personality disorders, then this would be a line of research worth continuing. Instead we've had two decades worth of studies producing minor and conflicting results - the only impact of which has been to justify bigotry and quackery. I think that we should be afraid of this research, just as gay people, people of minority ethnicity, and many other groups should be.

    I'm sympathetic to your viewpoint, and it was one I shared prior to looking more closely at exactly how this research is done, the tools which are used to assess personality, and so on. This whole area is way more quacky than one would assume. Think about it: how would you design a way of assessing people's personality? It's really difficult, and the techniques used are generally no better than the questionnaires one finds in the back of magazines: 'What season suits your personality best?'
     
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  14. Valentijn

    Valentijn Activity Level: 3

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    But most psych papers aren't impartially performed. They usually begin by stating an unsupported hypothesis as fact, and go on to base their own hypothesis on that unsupported hypothesis. Then they don't use a proper selection of ME/CFS patients, base all of their observations on purely subjective measurements, and create a conclusion that depends on external and unproven assumptions such as personality types.

    This paper is far better than most, yet still throws in the tidbit that their results are consistent with the "maladaptive or self-critical perfectionism" supposedly demonstrated in other studies. Unlike many psych papers, this one actually cites other papers to support that claim, but there is still the basic assumption that those results are trustworthy or meaningful in regards to personality traits, and that it has an effect on our behavior and illness.
     
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  15. Kelly

    Kelly

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    Actually they do do these kinds of studies in other biological diseases - the difference is that they don't use it as a reason to not do biomedical studies. As for why they did this study on personality disorders in CFS, other studies have found that personality disorders are often found more often in individuals with psychosomatic disorders. So this study either shows that theory is incorrect or that CFS is not a psychosomatic disorder as that theory doesn't apply.
     
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  16. Marlène

    Marlène Senior Member

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    Anyone looked at the names of the writers? Indeed, Van Houdenhove, good old advisor of the social security, belgian government and insurers. He is supposed to be retired but his disciples are paid again to solve the "conflicting findings".

    When are going to get paid for their misdiagnosis of existing conditions?
     
  17. Bob

    Bob

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    The latest edition of ME Research UK's Breakthrough magazine has an interesting article about this paper.

    The magazine is not online yet, so I've typed up this section, myself...

    This is the bit that I found interesting, taken from the above quote:

    "The interesting thing is that both of these 'negative' investigations used the ADP-IV questionnaire to assess personality disorder, whereas other 'positive' studies (reporting moderate differences between ME/CFS patients and controls) have tended to use the PDQ questionnaire which, as the authors point out, gives high rates of false positives and overestimates the prevalence of personality disorder."



    There is plenty of other interesting research news in the Breakthrough magazine, but the magazine is not online yet.
    You'll find the full magazine here, when it's placed online:
    http://www.meresearch.org.uk/information/breakthrough/
     
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  18. Bob

    Bob

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  19. Esther12

    Esther12 Senior Member

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    Sorry for weird OT post, but I just stumbled upon this from a 2001 Sports Medicine Report on CFS, and thought that it might be of interest, and need to get off the PC...

    http://aula.acemefide.org/cursos/ph...edicine__Feb2001__Vol._31_Issue_3__p167__.pdf
     
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  20. alex3619

    alex3619 Senior Member

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    Higher levels of depression? Can they tell the difference between unhappy and depressed? Are they unaware that chronic disease and loss of lifestyle make people unhappy? Sure some of us get depressed, so what?

    OCD? When my brain is not working the only way I can function is by picking a task and performing it with serious focus, excluding everything else. OCD? No. When my memory fails me I sometimes have to check things several times. OCD? No.
     
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