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The CBT myth

Discussion in 'General ME/CFS News' started by Gerwyn, Jan 30, 2010.

  1. Gerwyn

    Gerwyn Guest

    After looking at the CBT data in depression only 22% of patients experienced remission and less than half that were in remission after a year---some therapy Kellar et al NEJM May 2000-----there is still no data showing that CBT is more effective than a chat and a cup of tea I dont know if there is a CBT thread in existence if so sorry.CBT has never been shown to improve any objectively measurable parameter of any kind all studies that report any benefit use self assessment questionaires which are unblinded and highly contraversial
     
  2. Yes if you tell people enough times (and get them to tell themselves enough times) that they are feeling good, and then you give them a questionnaire to ask whether they are feeling good - what do you get? Oh yes of course, they're feeling good.

    *facepalm*

    Rachel xx
     
  3. V99

    V99 *****

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    CBT, makes you feel good, it just don't improve the amount you can do.
     
  4. Quilp

    Quilp Senior Member

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    Why not hypnotism ? One doesn't hear much about that in relation to M.E but i have always wondered why CBT is promulgated but hypnotism isn't. I'm not suggesting either are effective in treating M.E because i know they are not, but why CBT ? The bottom line perhaps ? Dare i say vested interests who head research and clinics into CBT ( and GET ) are at play here ? Perhaps i'm just cynical; perhaps i'm just right.

    Kind regards Mark
     
  5. Maybe cynicism should be one of the diagnostic criteria for M.E. :eek:)
     
  6. Quilp

    Quilp Senior Member

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    lol@Rachel

    I think i just saved $ 650 on the XMRV test :)
     
  7. Dolphin

    Dolphin Senior Member

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    There is a study that found counselling is as good as CBT in chronic fatigue and in the subgroups with "Chronic Fatigue Syndrome".

    A subgroup analysis was done on the patients with CFS.

    One can see the results in Tables 4a and 4b in the full article, available for free at:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1313894/pdf/11271868.pdf.

    Here's an extract from the text:
    This finding tends to be ignored.
     
  8. Gerwyn

    Gerwyn Guest

    looking at the data the confidence intervals make any subgroup analysis meaningless and even though the authors claim the participants no longer met the(subjective) criterea for fatigue the absolute differences before and after "treatment" are negligable ..They have qoted the sd,s after treatment but not before and they dont look statistically or clinically significant
     
  9. Gerwyn

    Gerwyn Guest

    looking at the data the confidence intervals make any subgroup analysis meaningless and even though the authors claim the participants no longer met the(subjective) criterea for fatigue the absolute differences before and after "treatment" are negligable in absolute terms.They have qoted the sd,s after treatment but not before and they dont look statistically or clinically significant
     
  10. Dolphin

    Dolphin Senior Member

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    Not that I particularly think CBT or Counselling is the answer but just to point out that the Chalder fatigue scale is an 11 question scale scored 0-33 where one scores 1 if one says same as usual. One can work out the average values before treatment using the change scores of course. The point isn't so much that CBT or counselling is the answer but that they had similar effects. I'm not sure I understand your point about subgroup analysis.
     
  11. Gerwyn

    Gerwyn Guest

    there is a "scatter" in the fatigue scores at follow up in both groups why isn,t the scatter quoted at the start it should be according to scientific convention- but here they have only quoted the mean.If the scatter bars for before and after overlap then neither treatment worked or they were as bad as each other.The confidence intervals are a measure of something called the powering of the study and the ability to generalise from it.In an adequately powered study the CI,s should only vary about5% from the mean so this study was never designed to look at a subgroup analysis.Without meaning any disrespect the fatigue scale in itself is subjective and open to abuse in the wrong hands!
     
  12. Gerwyn

    Gerwyn Guest

    Hi I agree with every word--some so called scientific studies involving stats make me want to cry!
     
  13. Gerwyn

    Gerwyn Guest

    Hi Maarten-----I looked at the biochem of mito dysfunction and realised the implications for overall bodily functions particularily neuroendocrine homeostatic control and neurolgical dysfunction I then realised that a whole range of otherwise wholly disparate symptoms could flow from such a "simple" core defect----------My mito's are quite severely damaged and i need daily corrective measures to maintain my current level of physical and cognitive functioning----sorry for my n=1 trial!The symptoms are so similar to known mito disorder that this theory would seem plausible and parsimonious------I agree with your entire post by the way Gerwyn
     
  14. Gerwyn

    Gerwyn Guest

    i couldn,t agree more!
     
  15. Hi Maarten and Gerwyn,

    We are so lucky to have you both on this forum!
    I'm about as good at statistics as I am at my Romberg Test, so it's great to know that we have two statistically astute fellows who can help critique any junk science that gets thrown at us.

    Might you perhaps be interested in helping _kim_ with the wonderful survey that she's building? We definitely need somebody who knows what they are doing to analyse the results to help us figure out which conclusions (if any) we might be able to draw with some degree of mathematical confidence (if that makes any sense).

    And finally...

    I do love your dry sense of humour, Maarten... this made me laugh.

    Rachel xx
     

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