Telephone-administered versus live group cognitive behavioral stress management for adults with CFS

[deleder2k]

Telephone-administered versus live group cognitive behavioral stress management for adults with CFS

Highlights

• •L-CBSM and T-CBSM both yielded modest effects on perceived stress (PSS).
• •L-CBSM, but not T-CBSM, also demonstrated modest effects on Symptom Severity and Symptom Frequency.
• •Future studies should continue to explore ways to offer benefits of L-CBSM to CFS patients via other remote technologies.

Abstract
Objective
Chronic fatigue syndrome (CFS) symptoms have been shown to be exacerbated by stress and ameliorated by group-based psychosocial interventions such as cognitive behavioral stress management (CBSM). Still, patients may have difficulty attending face-to-face groups. This study compared the effects of a telephone-delivered (T-CBSM) vs a live (L-CBSM) group on perceived stress and symptomology in adults with CFS.

Methods
Intervention data from 100 patients with CFS (mean age 50 years; 90% female) participating in T-CBSM (N = 56) or L-CBSM (N = 44) in previously conducted randomized clinical trials were obtained. Perceived Stress Scale (PSS) and the Centers for Disease Control and Prevention symptom checklist scores were compared with repeated measures analyses of variance in adjusted and unadjusted analyses.

Results
Participants across groups showed no differences in most demographic and illness variables at study entry and had similar session attendance. Both conditions showed significant reductions in PSS scores, with L-CBSM showing a large effect (partial ε2 = 0.16) and T-CBSM a medium effect (partial ε2 = 0.095). For CFS symptom frequency and severity scores, L-CBSM reported large effect size improvements (partial ε2 = 0.19–0.23), while T-CBSM showed no significant changes over time.

Conclusions
Two different formats for delivering group-based CBSM—live and telephone—showed reductions in perceived stress among patients with CFS. However, only the live format was associated with physical symptom improvements, with specific effects on post-exertional malaise, chills, fever, and restful sleep. The added value of the live group format is discussed, along with implications for future technology-facilitated group interventions in this population.



http://www.jpsychores.com/article/S0022-3999(16)30566-9/abstract?cc=y=

 

[slysaint]

From the Journal of Psychosomatic research.:thumbdown:

 

[NL93]

Why is Nancy klimas involved? :thumbdown:

 

[MEisnotMUPS]

So disappointed in Klimas and Fletcher ..... I truely do not understand this.

 

[Wildcat]

.
@MEisnotMUPS wrote 'So disappointed in Klimas and Fletcher ..... I truely do not understand this.'

Agreed.

Shows disregard for the harm that this kind of research has done to ME sufferers. We dont need stress management - we need the removal of the sources of stress. One major source of stress for physically sick people is researchers telling us and the outside world that our physical ME symptoms can be helped by CBT (however its delivered).
.

 

[Valentijn]

The lead author, Daniel L Hall, is an up-and-coming quack. Accordingly, he's producing a lot of useless research to increase his publication count.

Fletcher and Klimas are probably involved due to being the local ME experts at one of the universities the quack is associated with. So there is stuff about it being a neuroimmune disease ... but the disconnect is that the quacks involved understand pretty much nothing about ME/CFS.

 

[Wildcat]

.
This is no time for more self serving, career building, research funding wasting, psychosocial research rubbish.

Where did the funding for this study come from?.. Was the funding from the NIH? .. If not, from where?

And Klimas and Fletcher should have nothing to do with such research, at any level.

.

 

[deleder2k]

Looks like a horrible study. I don't know why Klimas would put her name on this. Fukuda criteria and looks like they don't use objective outcome at all. I don't think they even that that is a major limitation.

Shouldn't they also have had some sort of control group?

 

[A.B.]

Basic logic failure: the study design doesn't allow drawing any conclusions about the effectiveness of these interventions. It can only tell you which of these is better at altering questionnaire responses, which reflects the sum of treatment effect plus a variety of human biases. For all we know the differences may be purely down to bias. Indeed, it seems unlikely that talking would produce changes in physical symptoms such as PEM, fever, chills, etc, and it is likely that it's easier to introduce bias with live CBT than with a telephone CBT.

Why is it so difficult for some researchers to grasp even the basics?

 

[Valentijn]

Shouldn't they also have had some sort of control group?

They think it's controlled because two types of therapies were used

 

[deleder2k]

Basic logic failure: the study design doesn't allow drawing any conclusions about the effectiveness of these interventions. It can only tell you which of these is better at altering questionnaire responses, which reflects the sum of treatment effect plus a variety of human biases. For all we know the differences may be purely down to bias. Indeed, it seems unlikely that talking would produce changes in physical symptoms such as PEM, fever, chills, etc, and it is likely that it's easier to introduce bias with live CBT than with a telephone CBT.

Why is it so difficult for some researchers to grasp even the basics?

How does a study like this get funded? The study design look amateurish (even for a stupid economist like myself)

 

[MEisnotMUPS]

they used data from previous trials

"Data was obtained from two intervention trials that were identical
with respect to principal investigator, intervention material, and geographic
location. The first trial compared approximately 3 months of
L-CBSM to a one-day Live Self-Help psycho-education condition [14].
The second trial compared an approximately 3-month (10 weekly sessions)
T-CBSMto 10weekly sessions of telephone-delivered Health Education."

one of them (reference 14) is this one http://www.jpsychores.com/article/S0022-3999(10)00447-2/abstract (which also involved Klimas and Fletcher_
the second one, no reference given (so never published?/or this paper compared the 2011 old trial with a seperate new / recent T-CBSM trial, not very clear from text )

 

[Large Donner]

So disappointed in Klimas and Fletcher ..... I truely do not understand this.

Why not? She does stuff like this all the time, has done for years.

 

[*GG*]

Cool, so when the Psych starts talking crap, just hang up, sorry, bad connection I am not against all psychiatrist, actually saw one for a couple weeks, when my work would not accommodate me!

GG

 

[Kati]

Michael Antoni is a long time ME/cfs psych study author. He is part of the team that is lead by Dr Klimas. When published these studies are problematic on many levels because it reinforces the need for these kinds of therapies, they usually reference the Pace trial and Pace authors, when what is most needed is bio-medical research.

They are not looking at CBT/group therapy as a curative measure, they have looked at the quality of life, stress reduction, CBT as adjunct therapy, in general. (Not something I am keen to partake in)-

The participation to these studies is voluntary. It means that there are patients signing a consent and engaging in the activities. What I always wonder is how much of 'pleasing your therapist/ doctor' is going on when answering the pre and post questionnaires. The perception of stress is highly suggestive.

 

[Anabel]

.

Where did the funding for this study come from?.. Was the funding from the NIH? .. If not, from where?

And Klimas and Fletcher should have nothing to do with such research, at any level.

.

"Conflicts of interest and source of funding: Michael H. Antoni, the principal investigator of this study, as well as Daniel L. Hall, Emily G. Lattie, Sara Czaja, Mary Ann Fletcher, Nancy Klimas, and Dolores Perdomo received funding for this study through the National Institutes of Health ( 5R01NS055672 ). DLH was subsequently supported by an institutional National Research Service Award ( T32AT000051 ) from the National Center for Complementary and Integrative Health at the National Institutes of Health. The authors report no conflicts of interest.

 

[Valentijn]

They are not looking at CBT/group therapy as a curative measure, they have looked at the quality of life, stress reduction, CBT as adjunct therapy, in general. (Not something I am keen to partake in)-

That's what they claim. Then they also claim that their stress-based CBT reduces PEM and other ME symptoms

 

[deleder2k]

@Kati studies like this is a complete disaster. I just saw a video where Klimas spoke about a Rituximab study application she handed in. How can she do serious studies on Rituximab, and put her name on this?

@Jonathan Edwards, what is your rating of the study based on a scale from one to ten? Are you impressed? To me it looks so bad I want to e-mail dr. Klimas in a gently way and ask her to explain what happened, why she is involved, and what she thinks about the study design.

 

[Solstice]

@Kati studies like this is a complete disaster. I just saw a video where Klimas spoke about a Rituximab study application she handed in. How can she do serious studies on Rituximab, and put her name on this?

@Jonathan Edwards, what is your rating of the study based on a scale from one to ten? Are you impressed? To me it looks so bad I want to e-mail dr. Klimas in a gently way and ask her to explain what happened, why she is involved, and what she thinks about the study design.

Go for it, i'd say.

 

[Jonathan Edwards]

@Kati studies like this is a complete disaster. I just saw a video where Klimas spoke about a Rituximab study application she handed in. How can she do serious studies on Rituximab, and put her name on this?

@Jonathan Edwards, what is your rating of the study based on a scale from one to ten? Are you impressed? To me it looks so bad I want to e-mail dr. Klimas in a gently way and ask her to explain what happened, why she is involved, and what she thinks about the study design.

Somewhere between plus 2 and minus 2 I guess.