Invest in ME Conference 12: First Class in Every Way
OverTheHills wraps up our series of articles on this year's 12th Invest in ME International Conference (IIMEC12) in London with some reflections on her experience as a patient attending the conference for the first time.
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Stress vulnerability in adolescents with CFS: study investigating HRV and skin conductance responses

Discussion in 'Latest ME/CFS Research' started by hixxy, Mar 10, 2017.

  1. hixxy

    hixxy Senior Member

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    J Child Psychol Psychiatry. 2017 Mar 9. doi: 10.1111/jcpp.12711. [Epub ahead of print]

    Stress vulnerability in adolescents with chronic fatigue syndrome: experimental study investigating heart rate variability and skin conductance responses.
    Rimes KA, Lievesley K, Chalder T.

    Abstract

    BACKGROUND:
    Stress vulnerability has been implicated in adolescent chronic fatigue syndrome (CFS), but has rarely been investigated directly. This study compared psychological and physiological responses to a laboratory social performance task in adolescents with CFS with chronic illness (asthma) and healthy control groups.

    METHODS:
    Adolescents with CFS (n = 60), adolescents with asthma (n = 31) and healthy adolescents (n = 78) completed questionnaires before and after a social performance task. Skin conductance responses (SCR; mean SCR and Max-Min) and heart rate variability (low frequency/high frequency; LF/HF and root mean square difference of successive RR intervals; RMSSD) was measured before, during and after the task.

    RESULTS:
    Baseline heart rate variability (HRV) (RMSSD) was significantly lower in the CFS and Asthma groups than the HC. During the speech, the CFS and Asthma groups had higher HRV (LF/HF) than the HC, adjusting for baseline LF/HF. Although the asthma group showed a subsequent reduction in HRV during recovery, the CFS group did not. Similarly, during recovery after the task, the CFS group showed a continued increase in skin conductance (Min-Max), unlike the Asthma and HC groups. Compared to control groups, adolescents with CFS expected to find the task more difficult, were more anxious beforehand and afterwards, rated it as more difficult, evaluated their performance more negatively and had lower observer ratings of performance. Parents of adolescents with CFS expected that their child would perform less well in the task than parents of control participants.

    CONCLUSIONS:
    Adolescents with CFS showed autonomic nervous system responses that are consistent with chronic stress vulnerability, difficulty coping with acute stress and slower recovery after acute stress. Self-report measures also indicated greater trait, pre- and posttask anxiety in the CFS group.

    © 2017 Association for Child and Adolescent Mental Health.

    KEYWORDS:
    Chronic fatigue syndrome; adolescence; autonomic nervous system; fatigue; myalgic encephalomyelitis; stress

    https://www.ncbi.nlm.nih.gov/pubmed/28276066
    http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12711/abstract
     
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  2. MEMum

    MEMum Senior Member

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    Is it surprising that adolescents with ME experience more "acute stress and slower recovery afterwards" in their dealings with psychologists? (In comparison to healthy controls or those with a "medically understood" disease)
    Given the psychs view of ME and the repercussions of their stranglehold on UK treatment of ME, this is not unexpected.
     
  3. UKmum

    UKmum

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    ??? This smacks of child abuse. Who would put their child knowingly in this position. Why do you need a study to find out a child with CFS would be acutely stressed and take longer to recover from this kind of experiment. If you could have tested them before they got ill then it might make sense. These more negative ratings don't result from personal traits but from knowledge and intimate experience of the illness. Grrr
     
  4. Mohawk1995

    Mohawk1995 Senior Member

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    Yes ME/CFS is a "Beast of a task master" giving little forgiveness for "stepping out of line". It trains everyone well to avoid exertion, stressful situations or anything that drains more energy from the body. My description is of the physiologic behavior of the disease and not the psychological behavior of the person.

    Out of ignorance we attempted to push our son in the early stages of his disease. He was diagnosed with "atypical migraines". ME/CFS was something I had heard of maybe once before. We quickly learned as did he, that every time you try to push it you are really just "poking the gorilla" and the results are not good. Maybe research was needed to verify this phenomenon, but there are far better ways to do it than this.

    The same research on Juvenile RA, Juvenile Polymyositis, or any other debilitating childhood disease would give similar results. What it says to me, is that children with ME/CFS and their parents/caregivers should be supported and given permission to listen to the signs.

    Perhaps on at least one note they got something right. That is to support that these changes are autonomic meaning they are not under the control of conscious thought. In other words the ability of adolescents (and adults) to cope well with ME/CFS is severely hampered by the dominant autonomic responses of the child's body. VERY VERY VERY Little control!
     
  5. duncan

    duncan Senior Member

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    There are so many things wrong with this that I do not know where to start.

    First and foremost - in my mind, at least - is that I do not believe the authors have demonstrated ANS involvement. I think they put sick kids in a stressful situation. That elicited the same kind of response (increased HRV and skin responses like sweating) it would in HCs, only it was more pronounced and lasted longer. Go figure.
     
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  6. TiredSam

    TiredSam The wise nematode hibernates

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    Ms Chalder & co hooking kids up to an E-meter, who'd have thought it?

    One of the great things about the recent OMF and Ron Davis threads is that now we have real research to focus on, so drivel like this becomes much easier to disregard because it's no longer the only narrative. Can't even be bothered ranting about it.
     
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  7. John Mac

    John Mac Senior Member

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    Skin conductance testing! Is Chalder actually connecting kids up to a lie detector?
     
  8. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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    Full article (haven't read yet):
    http://sci-hub.cc/10.1111/jcpp.12711

     
  9. RogerBlack

    RogerBlack Senior Member

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    This is important IMO.
    While I question seriously the group in questions motive, this is stuff that should have been done in the 80s or earlier.
    Positives in this study are the use of some objective measures.
    Negatives are the presumable intent to use this paper to support the idea that it's 'simply' stress.

    Understanding and providing useful cognitive and other benchmarks to measure PEM/fatigue is valuable.
    Using it as an excuse to claim it's all stress therefore CBT to ignore the illness - not.
     
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  10. Snow Leopard

    Snow Leopard Hibernating

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    People who confuse cause and effect...


    This is not a "controlled" study as there was no similarly impaired control group.
     
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  11. SamanthaJ

    SamanthaJ Senior Member

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    Did the participants have to stand up to give the speech?
     
  12. TiredSam

    TiredSam The wise nematode hibernates

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    When surveys are done about peoples' most common fears, public speaking usually comes top, ahead of death (I think spiders is no.3). Every semester I have two new classes of students in their twenties, my job is to prepare them for the presentation they have to give in their exam. After giving their first short presentation (less than 5 minutes) in front of the class, some of them sit down in tears. This level of stress is hardly manageable for many adults.

    So here we have sick children being separated from their parents with no warning and having the life scared out of them, then their fear is measured using the same technology used in scientology's E-meters or bioresonance therapy (more on that quackery and their machines here:

    https://en.wikipedia.org/wiki/Bioresonance_therapy)

    and the "results" are considered worthy of publication by Ms. Chalder, who presumably is deluded enough to think that she has now contributed to the literature and "growing evidence base" of whatever. FFS.
     
  13. Snow Leopard

    Snow Leopard Hibernating

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    I fear incompetent doctors and psychiatrists. ;)
     
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  14. Valentijn

    Valentijn Senior Member

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    Full text at http://sci-hub.cc/10.1111/jcpp.12711

    Oxford criteria, so it's the usual irrelevant crap.

    It's not clear if they were sitting or standing, but it did involve giving a speech, which is almost always done standing:
    They used a children's version of the Beck Depression Inventory, which equates physical disability with a mood disorder. The anxiety scale looks at autonomic nervous system arousal, so again, not assessing the actual feeling of anxiety, but symptoms which can have an entirely different cause. It's also a children's version, but not meant to be used with the older age group in the study.

    This doesn't sound unreasonable:
    But of course, as psychobabblers they must go on to conclude that even if depression isn't causing CFS, one factor is causing both CFS and depression. And the treatment is the one and only CBT, for both CFS and anxiety :rolleyes:

    So, another idiotic paper produced by idiots. They apparently lack the intelligence to distinguish between disability and depression, or OI and anxiety. They should not be in academia or interacting with patients, until they can get a better grasp of the basics.
     
    Last edited: Mar 11, 2017
  15. sarah darwins

    sarah darwins I told you I was ill

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    The bottom line, isn't it.

    Anything that starts from the Oxford criteria should just have a thick red line drawn through it. If we could figure out a way to put the Oxford criteria where they belong — in the trash can — most of the bogus research would vanish overnight.
     
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  16. Sean

    Sean Senior Member

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    They should not be allowed to handle a wet tissue without adult supervision.
     
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  17. Hutan

    Hutan Senior Member

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    Pre-illness, I liked public speaking. Now, there are times when chatting to a friend at my kitchen table is more than I can handle. My brain may not work fast enough to understand what is being said, my words might not come out right or I may not be able to think of the words I want. I might have a headache or just desperately want to lie down.

    During the two years when I struggled on with work after becoming ill, preparing for a formal presentation, getting dressed right, getting to the place without getting lost and then the effort of appearing excited about my topic and dealing with questions was utterly exhausting. And knowing that my brain might take an unplanned rest break when I needed it to be working hard was confidence-sapping.

    It's worse for the kids in this study. They probably haven't had much public speaking experience - not much call for it lying in bed. They may believe what they have been told about having poor coping skills and being generally inadequate people. Meanwhile the kids that they are compared to have been out in the world building their self-confidence.

    These researchers clearly don't understand the illness. Their study makes as much sense as having people with broken legs jump up and down and then labelling them as 'anxious' when they are stressed before, during and after the jumping.

    Ha, yeah, I thought the same. And then ranted nonetheless.

    Yep
     
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  18. Dolphin

    Dolphin Senior Member

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    I don't think it says. I imagine there is a good chance they did in which case one has to consider what was measured was partly or wholly orthostatic stress.

     
  19. Dolphin

    Dolphin Senior Member

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    The speech the individuals with CFS gave was marked lower in quality than the other speeches. The researchers don't mention one likely contributing factor to this: the cognitive impairment in CFS.
     
  20. Dolphin

    Dolphin Senior Member

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