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Role of psychological aspects in both chronic pain and in daily functioning in CFS

Discussion in 'Latest ME/CFS Research' started by Dolphin, Feb 22, 2012.

  1. Dolphin

    Dolphin Senior Member

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    I was going to wait till I had read this (don't have a copy) before starting this thread, but it was already mentioned in another thread so thought I'd start this thread.

    * I gave each sentence its own paragraph.
     
  2. biophile

    biophile Places I'd rather be.

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    Just copying what I posted on another thread where I suggested this paper could be irresponsible:

    Gives the impression that daily functioning and chronic pain in CFS just depend on psychological characteristics such as depression and "catastrophizing". Didn't even bother to evaluate whether ME/CFS symptoms correlate with daily functioning and catastrophizing, so phrases like "strongest correlations" and "main predictors" are essentially meaningless.
     
  3. charityfundraiser

    charityfundraiser Senior Member

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    Hidden in the discussion is this sentence, "Based on the revealed correlations, the direction of the relation remains unclear." Correlation does not imply causation. However, the fact that the title is "Role of psychological aspects in both chronic pain and in daily function in CFS" rather than "Role of chronic pain and daily function in CFS in psychological aspects", and that they phrase it as catastrophising is a predictor of pain level rather than pain level is a predictor of catastrophising, sort of shows which direction they're trying to imply.
     
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  4. Enid

    Enid Senior Member

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    I cannot go beyond a heading here on the psychos Dolphin - good luck but even more bad luck !!!.
     
  5. justinreilly

    justinreilly Stop the IoM & P2P! Adopt CCC!

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    I wonder why Prof De Meirleir (whose daughter has ME i believe) did this paper. it doesn't look very good from reading the abstract.
     
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  6. Dolphin

    Dolphin Senior Member

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    He has co-authored some similar stuff in the past e.g.
    (there was one letter in reply: http://www.ncbi.nlm.nih.gov/pubmed/19744212.1
    so doesn't mean there has been any particular change in his views recently.
     
  7. Dolphin

    Dolphin Senior Member

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    Finished reading this last night.

    It is generally about self-reported measures correlating with other self-reported measures so it's all a bit frustrating.

    I think it's plausible that *some* people may overstate and other people may understate their pain levels due to their "state of mind"/similar making it difficult to make inferences and come to conclusions about management strategies.
     
  8. Dolphin

    Dolphin Senior Member

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    Use of BDI-II to measure depression

    The BDI-II was used to measure depression

    Recently the following was published:

    The authors themselves acknowledge this. I find it slightly odd this is mentioned i.e. if you knew this, why did you use it (but possibly that is not what happened e.g. a reviewer suggested it). Anyway, good they mention it:

     
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  9. Dolphin

    Dolphin Senior Member

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    Typos - or am I missing something

    I'm thinking of writing to the authors about the following. If anyone can see errors I've made, let me know. Thanks.

    PCS predicts "activity limitations/participation restrictions" in Table 3.
    However, perhaps there was another column "daily functioning" - see next comment.

    I can't see any row for "the amount of habitual daily activity". It looks like they are distinguishing it from activity limitations/participation restrictions. At first, I thought they might be referring to figures at 6-12 months but that is covered later in the results section.

    Seems to be missing saying this is about "activity limitations/participation restrictions".

    Numbers don't match figures in Table 1

    Again, this makes me wonder whether there was a separate "daily functioning"/"habitual activity" measure.

    Says PCS, not depression, in Table 3.

    I don't know what the 23.1% is supposed to refer to. I'm wondering did they mean to say depression wasn't a significant predictor of "activity limitations/participation restrictions" at 6-12 months but was for the baseline figure. This seems to be repeating the last error as it was PCS, not depression.
     
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  10. Dolphin

    Dolphin Senior Member

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    Their "big" theory

    Their "big" theory:

     
  11. Dolphin

    Dolphin Senior Member

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    Thought this was "mildly" interesting:

    I think they are probably right on the variability of the VAS measure - probably doing a test-retest assessment would show this.
     
  12. Dolphin

    Dolphin Senior Member

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    "resting" described as a "passive or maladaptive coping style"

    "resting" described as a "passive or maladaptive coping style"

    Earlier they had said in the introduction:
    I read that those were not good pain coping strategies. But perhaps they meant "negatively" in the correlation sense (slope of line less than 0) and in this case they should be read as being associated with higher functioning?
     
  13. Dolphin

    Dolphin Senior Member

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    Reduced pain after CBT wasn't due to increased activity (on another study)

    Reduced pain after CBT wasn't due to increased activity.
    We knew this with regard to fatigue (Wiborg et al, 2010). Not sure it was well-known with regard to pain?

    "Improvement" may simply be a reporting bias after CBT?
     
  14. Bob

    Bob

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    I've only read the abstract, but it seems like one of those annoying studies that confuses cause and effect, and does not actually carry out any research to shed any light on which is which.

    This is an extract from the abstract:

    "Pain catastrophizing and depression were immediate and long-term main predictors for pain in patients with CFS having chronic widespread musculoskeletal pain. Pain was also correlated to daily functioning, with depression as the main predictor for restrictions in daily functioning at baseline."

    It seems to me that the above extract could be written just as factually as follows, but with very different connotations in terms of the potential conclusions that can be drawn:

    "Pain was an immediate and long-term main predictors for pain catastrophizing and depression in patients with CFS having chronic widespread musculoskeletal pain. They were also correlated to daily functioning, with pain as the main predictor for restrictions in daily functioning at baseline."

    Spot the difference? I've swapped the word 'pain' with 'depression' and/or 'catastrophizing'. And it seems to make much more sense now!

    I haven't read the full paper so I might be missing some important info, but it seems like I've rewritten it in a way that could be equally factual.
     
    Last edited: Sep 14, 2014
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