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Reexamination of Cognitive Behavioral Model of CFS: Investigating Cogency of Model’s Behavioral Path

Discussion in 'Latest ME/CFS Research' started by Dolphin, Feb 14, 2017.

  1. Dolphin

    Dolphin Senior Member

    mango, Simon, MEMum and 33 others like this.
  2. SilverbladeTE

    SilverbladeTE Senior Member

    Somewhere near Glasgow, Scotland
    A ray of sunshine in a pond full of cow flop and sat upon by treacherous toads and slimy weasels! ;)

    Always nice to see someone living up to ideals, decency and critical thinking :)
    Such people are going to be needed to rebuild the corrupt House of "Mind Medicine" one day, beyond just helping us.
    AndyPR, Sean, Luther Blissett and 6 others like this.
  3. Jan

    Jan Senior Member

    Devon UK
    :trophy: Bloody brilliant! Give them knight/dame-hoods :trophy:
    MEMum, Luther Blissett, Hutan and 2 others like this.
  4. trishrhymes

    trishrhymes Senior Member

    Wow, this is brilliant. BPS model disproved again! As I understand it, they are saying that it is illness severity that causes impairment, fatigue and low activity level. They show that beliefs have nothing to do with any of these factors.

    Severity of symptoms is not caused by false illness beliefs or by low activity levels. CBT and GET are not appropriate or effective treatments.

    Good to see them clearly demarcating the difference between chronic fatigue syndrome, and chronic fatigue as a symptom caused by depression.

    Another nail in Wessely and PACE's coffins.

    Made my day, especially after Wessely's ghastly self satisfied preening on the radio this morning.

    'these failed replication attempts support patient-expressed concerns about the appropriateness and efficacy of these treatments.'

    Such a contrast to Wessely's talk of being threatened by disgruntled patients.
    Simon, MEMum, Valentijn and 9 others like this.
  5. Hutan

    Hutan Senior Member

    New Zealand
    The whole document is worth a read if you are in to this sort of thing.

    The Vercoulen model (that found that faulty illness beliefs was the problem) is slammed beautifully from page 6:

    Broad inclusion criteria - Oxford definition, just more than 6 months unexplained fatigue

    Measurement selection - I was amazed at how limited the measures of impairment and activity levels used by Vercoulen were. For example for 'Impairment', it seems that they used only two questions:
    • I have given up taking care of personal or household business affairs (e.g., paying bills, banking, working on budget);
    • I am doing less of the regular daily work around the house than I usually do.

    Now, since I and my children became ill I have stopped work and so I actually do more of the household business affairs than I used to. We can't afford a cleaner anymore and my son and I are home virtually all of the time, so there is more housework and food preparation to do and I do more of it than I used to. But I don't do my demanding, satisfying paid work anymore.

    So, using the Vercoulen measure of impairment, I was actually more impaired when I was a busy executive who frequently worked overseas in cultures quite different to my own and could do complex abstract thinking for long periods than I am now, a housewife whose major challenge is getting to the supermarket, remembering what I went there for and getting home again.

    As Sunnquist says:
    It seems to me as though Vercoulen et al specifically picked measures out of a whole range of possibilities that gave them the answer they wanted.

    Sample size: Too small

    Causal claims: Basically, it is all very well finding an association between attribution of illness to a physical cause, low activity levels and fatigue, but that in itself says nothing about causation.

    Sunnquist says:
    That's as far as I have got. But I'm impressed. Well done Madison Sunnquist and thank you.
    Simon, Jan, MEMum and 14 others like this.
  6. barbc56

    barbc56 Senior Member

    Yes! Over the years, DePaul has come out with some good research.

    My rheumatologist in Chicago worked half time in a physician practice and half time research on Fibromyalgia. It would be interesting to fiind out if they've done studies that include both me/cfs and FM.
    trishrhymes and Luther Blissett like this.
  7. Dolphin

    Dolphin Senior Member

    MEMum, Valentijn, mango and 6 others like this.
  8. AndyPR

    AndyPR Senior Member

    That's the important step. At the moment it's nice but not that helpful, get it published and it's much more useful.
    MEMum and trishrhymes like this.
  9. A.B.

    A.B. Senior Member

    They have never made any serious attempt to reject alternative explanations, and typically don't even mention that alternative explanations might exist. The modus operandi appears to be: can I construct a psychosocial narrative from this correlation? Not "is a psychosocial narrative the best fit for the data?"
    Dolphin, Jan, MEMum and 5 others like this.
  10. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits


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