Health-threatening interpretation of ambiguity early on: risk or protective factor? Comparing CFS/ME

[Dolphin]

http://www.ehps2015.org/files/EHPS2015_Conference_Abstracts_27082015.pdf

29th Conference of the European Health Psychology Society

Poster Presentation Abstracts
Health-threatening interpretation of ambiguity early on: risk or protective factor? Comparing CFS/ME and healthy individuals

I. Alexeeva , M. Martin 1

1 University of Oxford, United Kingdom

Background

A cognitive account of the persistence of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis
(CFS/ME) proposes biased interpretation may distort symptom perception and undermine recovery.
Interpretation of somatic information that favours health-threatening meaning may lead to negative
and maladaptive illness cognitions and prolonged suffering.

The study aimed to measure an online
interpretive bias in CFS/ME, the interpretations made at the moment of encounter of ambiguous
information at an early stage of information processing.

Methods
33 CFS/ME and 33 healthy matched controls completed a lexical decision task that measured
preferences in the interpretation of ambiguity.

Findings
CFS/ME individuals did not have an interpretive bias towards health-threatening meaning following
presentation of ambiguous information F (6, 384) = .662, p = .680, ηp2 = .010.

Healthy participants
showed a bias towards Illness prime threat compared with the neutral primes, t (32) = 2.54, p = .016.

Discussion
The experiment showed an absence of interpretation biases in the early stages of information
processing among CFS/ME individuals, but suggested that healthy individuals may be susceptible to
the potentially threatening meaning of the ambiguous illness prime.

 

[Scarecrow]

The language is a bit on the complex side for me but am I right in thinking that the hypothesis was not confirmed? That it was the healthy individuals who behaved in the manner expected of the pwME/CFS but that the patients did not?

 

[Marco]

Ooops. Time to confront the illness beliefs of those healthies.

Kudos to you Tom for wading through these little gems.

 

[lansbergen]

The language is a bit on the complex side for me but am I right in thinking that the hypothesis was not confirmed? That it was the healthy individuals who behaved in the manner expected of the pwME/CFS but that the patients did not?

That is how I read it too.

 

[Bob]

Are they trying to insinuate that ME patients are at fault because (even though they don't have an interpretation bias now) they were once healthy people who had an "interpretive bias towards health-threatening meaning" (which therefore may have triggered the illness)? Or is my cynical brain reading too much into their 'discussion' section?

 

[whodathunkit]

At a glance, not really a great thing going on here. They will probably spin this to mean that CFS patients are inherently inclined to ignore symptoms in the early stages (possibly some form of "self-delusion"), thus allowing themselves to get sick.

 

[Effi]

Or is my cynical brain reading too much into their 'discussion' section?

My brain immediately went into that same direction! But it looks like they came to the conclusion that PWME don't go into an irrational fit while processing health related information. In other words: they FINALLY checked their baseless theory with reality and guess what, it turns out to be BS. I'm so surprised.

 

[Dolphin]

These names are new to me (going just from memory).
They are not well-known psychobabblers (to me) (with regard to ME/CFS). They could be fair/good (some psychologists who study the illness have it themselves)

 

[Effi]

Iana Alexeeva

DPHIL STUDENT
My research is focused on health psychology, behavioural medicine, and information processing in individuals with chronic conditions. The aims of the research include improving quality of life and lifting the burden of disease, development of health promotion and illness prevention strategies.

I investigate cognitive and behavioural aspects of chronic conditions, such as M.E./Chronic Fatigue Syndrome, asthma and cancer. I am looking at how people perceive their health or illness and how they choose to cope with their symptoms and treatment side effects. My special interest is in fatigue and activity/recovery cycle. I investigate whether a particular perception of your body, symptoms, and exertion is associated with a particular pattern of symptoms and illness duration, and with particular methods of coping. In terms of application, the understanding how patterns of symptoms and coping styles fit together helps in the development of strategies that reduce the impact of risk factors and promote resilience.

Our current project is a collaboration with the University of Leiden (the Netherlands). We are conducting a multinational study on Chronic Fatigue Syndrome/M.E. Our research goal is to compare the experiences of British, Dutch, Portuguese, Canadian, and French individuals in how the severity and duration of CFS/M.E. and its symptoms affect their impairment, physical disability, mental state and quality of life.

Maryanne Martin

MA DPhil
PROFESSOR OF ABNORMAL PSYCHOLOGY
My research aims to increase our understanding of cognitive and emotional processes, and in particular of the ways in which the two areas interact. This focus has been explored within the field of Health Psychology, especially with regard to aspects of chronic illness (for example, within the contexts of Irritable Bowel Syndrome and of Asthma), and may bear on differences among individuals in their resilience to the effects of illness. A similar approach has been adopted in exploring fields such as choice among objects, laterality and economic decision-making.

Our latest project is a cross-cultural study of Chronic Fatigue Syndrome / ME, conducted in conjunction with the University of Leiden.

You gotta love her title: Professor of ABNORMAL Psychology

 

[A.B.]

My brain immediately went into that same direction! But it looks like they came to the conclusion that PWME don't go into an irrational fit while processing health related information. In other words: they FINALLY checked their baseless theory with reality and guess what, it turns out to be BS. I'm so surprised.

I doubt it will change anything. Years ago someone did a study using actimetry to check if boom and bust behaviour is actually real. The failed to find episodes of markedly increased activity though.

I think that to propose these illness models one must have some form of mental illness that causes a lack of interest in reality. It's like they have contempt for objectively measuring things.

 

[Effi]

I doubt it will change anything.

Yeah it all depends on how they interpret this. We all know they have twisted and turned results until it fit into their little box.

 

[A.B.]

Also there is another ME/CFS study right after:

Attentional bias for health - threat in CFS/ME following depressed mood I.
Alexeeva 1 , M. Martin 2 1 University of Oxford, United Kingdom 2 University of Oxfprd, United Kingdom

Background
A cognitive account of the persistence of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) proposes amplified attention towards somatic information may distort symptom perception and maintain symptoms. Negative mood may further affect cognitive processing by dwelling on health - threat further amplifying attention to symptoms. The study aims to measure an attentional bias towards health - threat in CFS/ME following a depressed or neutral mood induction.

Methods
16 CFS/ME and 34 healthy and 29 asthma participants completed an attentional task that measured allocation and shifting of attention in response to health - threat or neutral information.

Findings
CFS group similar to healthy controls, but unlike asthma, is showing an atten tional bias towards healththreat F (2, 61) = 4.06, p = .022, ηp2 = .118. Against the prediction, the negative mood appears to decrease the magnitude of the attentional bias in CFS participants.

Discussion
Attentional bias manifests under the higher mental load for CFS/ME and healthy individuals, but not for asthma. Depressed mood decreases the bias, against the expectation that it would amplify the focus on somatic symptoms.

So according to these findings, depression is protective against CFS. Maybe patients will snap out of their CFS if they are just sufficiently depressed?

Or maybe this study is a total waste of time.

 

[Dolphin]

Also there is another ME/CFS study right after:
Attentional bias for health - threat in CFS/ME following depressed mood

For what it's worth, I've just set up a new thread on this: http://forums.phoenixrising.me/inde...epressed-mood-alexeeva-martin-abstract.39611/

 

[Woolie]

(First study, at the top): Looks like they used words that have two possible meanings, one of which is related to health threat (e.g., "operate" could mean surgery, or something was less medical).

It looks like what they did is provide a word before this ambiguous word that was either related to the "health threatening" meaning (e.g., surgery - operate), or to the neutral meaning (machinery - operate). I think they wanted to see if the PWMEs would be more "primed" by the threatening meaning. Suggesting it could be more at the front of their minds.

There was some sort of control condition too (judging from the numbers in brackets in the stats), but not clear from the abstract what that was.

Anyway, controls and PWMEs didn't behave differently across these various conditions.

Putting aside the content, its a not a good abstract, as it doesn't provide much information about what was actually done and found (the most important part of any study). It seems this field of research doesn't demand very high standards.

 

[Cheshire]

I doubt it will change anything. Years ago someone did a study using actimetry to check if boom and bust behaviour is actually real. The failed to find episodes of markedly increased activity though.

I think that to propose these illness models one must have some form of mental illness that causes a lack of interest in reality. It's like they have contempt for objectively measuring things.

Do you have a reference?

 

[Dolphin]

Do you have a reference?

One study is:

Arch Phys Med Rehabil. 2011 Nov;92(11):1820-6. doi: 10.1016/j.apmr.2011.06.023.
Symptom fluctuations and daily physical activity in patients with chronic fatigue syndrome: a case-control study.
Meeus M1, van Eupen I, van Baarle E, De Boeck V, Luyckx A, Kos D, Nijs J.

Post on it: http://forums.phoenixrising.me/inde...ty-in-cfs-meeus-et-al-2011.13139/#post-221658

CFS activity levels don't fluctuate any more than controls within a day or day-to-day

The present study is the first to compare the fluctuations in daily
physical activity between patients with CFS and healthy sedentary
controls. We hypothesized that patients with CFS would present a
more fluctuating activity pattern, with greater variations and a bad
staggering of activities during the day. Concerning the staggering
of activities during the day, we found higher ratios (peak activity
on average activity) in patients with CFS (not statistically significant - see next sentence). So, they tended to
concentrate their activities more in peaks (probably on their better
moments), instead of dispersing them, but the difference was not
statistically significant. Additionally, the fluctuations in the activity
pattern during the complete registration period were not significantly
different between patients and controls.
[..] the present study was not able to confirm the hypothesis of a more fluctuating
activity pattern in patients with CFS, nor during the day, nor
during the registration period.

"during the day" means within any one day.

Note, van der Werf found something similar on daily changes:

"there were no significant group, gender or interaction effects for the number of absolute large or relatively large day-to-day fluctuations (Table 2 and Table 3)." "The day-to-day fluctuation measures were based on somewhat arbitrary criteria (1 S.D. and 33% activity change). However, when we post hoc tested alternative criteria (50% or 66% activity change), again no significant group differences between controls and CFS patients emerged."

van der Werf SP, Prins JB, Vercoulen JH, van der Meer JW, Bleijenberg G. Identifying physical activity patterns in chronic fatigue syndrome using actigraphic assessment. J Psychosom Res. 2000 Nov;49(5):373-9.

This is interesting because part of the rationale of many behavioural interventions in CFS patients is said to be to reduce "boom and bust" (Deary & Chalder). However, it may be the case that the frequency of this activity pattern in CFS has been exaggerated. [ref: Deary V, Chalder T: Chapter 11, "Conceptualisation in Chronic Fatigue Syndrome" in Formulation and Treatment in Clinical Health Psychology Edited by Ana V. Nikcevic, Andrzej R. Kuczmierczyk, Michael Bruch]

 

[Cheshire]

@Dolphin thanks!