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Childhood stressors in the development of fatigue syndromes: a review of past 20 years of research

Discussion in 'Latest ME/CFS Research' started by Dolphin, Oct 7, 2013.

  1. Dolphin

    Dolphin Senior Member

    This was highlighted elsewhere on PR. I thought I'd give it its own thread so it can be found easier in future (rather than being a big fan of this angle)

  2. Esther12

    Esther12 Senior Member

    I started thinking about this, then decided it wasn't worth cajoling my tired mind over. So much of the research in this area seems really weak and, even if valid, uninteresting, particularly given the nature of CFS as a diagnosis.
    justy likes this.
  3. biophile

    biophile Places I'd rather be.

    Me too Esther. It is disappointing that they did a narrative review not a systematic review. No mention of caveats in the abstract. Recall bias is a major problem in retrospective research on people who are suffering now.

    Some of the CFS stress research was done using the notorious Reeves definition which saw prevalence estimates skyrocket by an order of magnitude.

    There is also research into chronic pain which suggests that the association with stress tends to show up in retrospective research but not prospective research, even in the same group of people being studied.

    CFS and FM are wastebasket diagnoses, and I'm betting this review does not consider issues with defining these entities.
    Valentijn, justy, peggy-sue and 5 others like this.
  4. WillowJ

    WillowJ คภภเє ɠรค๓թєl

    WA, USA
    It's worth having other illness controls and trying to diagnose ME, ME/CFS, or CFS compared to CF/ICF. Which probably most of the articles in that review did neither (educated guess; I didn't look).

    As biophile mentioned, an example from FM:

    Esther12, Valentijn, justy and 2 others like this.
  5. Sean

    Sean Senior Member

    I would like to ban narrative reviews. They are nothing more than an excuse to cherry pick.
  6. peggy-sue


    Abuse in childhood results in a person who suffers from higher levels of stress far more in daily life than those who were not abused - they have had their abilty to trust in people messed around with,

    They don't understand love or what it is. They most certainly don't feel they deserve it.

    They do not know what "normal" is - they have never experienced it, but they spend their lives trying to pretend they are "normal".

    Often, they get their ideas of "normality" from tv shows or books - not very reliable accounts!

    Stress is very bad for ME.

    It's just a double whammy for these folk.:cry:
    Valentijn and biophile like this.
  7. Roy S

    Roy S former DC ME/CFS lobbyist

    Illinois, USA
    Meta-garbage in -- meta-garbage out?

    Did they review this paper by Taylor and Jason?
    "A closer examination of individuals in the chronic fatigue syndrome group revealed that significantly fewer individuals with CFS reported abuse as compared with those who did not."
    alex3619, Valentijn and justy like this.
  8. peggy-sue


    This statement is not exactly clear about how the papers for review were selected - it can be read to mean that they only cherry-picked ones which supported the finding they wanted...

    "In this review, we examined whether multiple forms of childhood stressors are contributing factors to the development of these disorders, and of the associated psychiatric symptoms."
  9. peggy-sue


    I cannot find their references - their "key words" are stated to be;

    • Anxiety;
    • childhood abuse;
    • childhood maltreatment;
    • chronic fatigue syndrome;
    • chronic pain;
    • depression;
    • fibromyalgia;
    • stress
    Pubmed seems to be offline right now - I can't stick the keywords into a search to see if more than 31 papers come up.

    My personal opinion is that all "meta-analyses" should be scrapped.
    They are just garbage-in = garbage-out.
  10. Snow Leopard

    Snow Leopard Hibernating

    South Australia
    Yes they did include the Jason study and they claim it provided positive evidence for the association between childhood stressors and CFS!

    They cite a previous meta-analysis of child abuse in general.

    Only 10 studies were included for CFS and only eight of them were investigating CFS, the other two were investigating Bipolar disorder and Migranes!

    The problem is that there are selection biases for participation in case-control studies (those who have suffered more stress/abuse are more vocal and more likely to want to participate), along with reporting biases. Some patients may falsely attribute childhood stress as a causative factor because it is one of the common narratives in our society and may answer accordingly.
    Some of the prospective/longitudinal cohort studies could control for this, but the cohort studies have massive methodological issues of their own, with self-report diagnoses at best and questionnaire based answers being used as evidence for suffering from "chronic fatigue" at worst.

    Where is Ioannidis when you need him?

    Oh and questionable references eg:

    Yes, that Maes and Twisk paper. "Harvey and Wessely's (bio)psychosocial model versus a bio(psychosocial) model based on inflammatory and oxidative and nitrosative stress pathways."

    They then mention a highly questionable HPA-axis based hypothesis and then go on to claim that the association of childhood stress with fatigue is mediated by cytokines and associated inflammation. (I guess they liked the Maes/Twisk paper after all)

    PS, the word 'bias' was not used in the review at all. They did however mention:

    They finally conclude with.

    So in conclusion, it is a narrative review of questionable validity due to the lack of underlying evidence in all respects.
    Valentijn, WillowJ, biophile and 3 others like this.
  11. SilverbladeTE

    SilverbladeTE Senior Member

    Somewhere near Glasgow, Scotland

    I have to disagree with the way you describe abused kids and how that affects them
    abuse, family backgrounds/culture etc, person's own mental/physical strengths/weaknesses and many other things all have major impacts on outcome
    I wasn't sexually abused, nor was may Dad a cruel or cold blooded person, he'd just have complete psychotic rage breaks at the drop of a hat
    when I was little (4 or 5?) I got a simple sliding bolt lock put on my door, I felt safe, it was my talisman to keep out the bogeyman....until he smashed the door down to get at me.
    yet, as said he not a cruel person in fact he was kind, just very very messed up by awful things he had suffered
    difference is, my mum was very loving and kind, her folks were very warm, full of *good* laughter (at self, enjoyment, not at other people's expense) etc (Dad's sister is a laugh riot, a great person but lives elsewhere, his mum was a cold person, not cruel or unkind just...distanced, but nto surprising again she had suffered)
    that kindess, great friendship, warmth with rest of my folks made a huge difference to me, THAT is what can stop folk becoming utterly broken

    so yes, that and other stuff has left me with real issues, but it wasn't until I had this damn illness bad for years that I got cranky, less compassionate at times, difficulty empathizing, etc.
    as a kid I loved making new friends, yes it was not easy dealing with the constant fear and anxiety, but I was determined not to let it get me down and thank God I was warm hearted person by nature.
    I recall when I was about 8, really getting uptight thinking if I avoid the cracks on the pavement all will be well...and even as a kid I knew this was bad wasn't just silly was a route to a ugly path and fought against that because I wanted peace so bad

    I am a VERY passionate, I both senses of the word. lol it's kind of funny, the bullying I got at school was outrageous. I was very intelligent, logical about some things and gentle, bullies are about finding those who are different, because different = not part of the herd = easy victims
    I have pointed the nickname "Spock" became associated with cruelty and bloody sadism, the ironic thing is the fictional Vulcan race were so stoical because they didn't want to unleash their destructive passions...same with me
    though I enjoyed the emotional spectrum as to cut that out is to no longer be Human, no joy ugh, but I had huge fear/abhorrence of becoming like my Dad, losing control, a rampaging monster
    But when the assholes did inally push me to far, I went bloody berserk on 'em, difference was I could limit it
    hence the "Spock" nomeclature was very apt in the end
    somewhere, someone is laughing at we silly Humans :p

    So I really resent these useless bastards as usual blaming the victim, not doing their damn jobs, not doing their OWN research
    this bastard illness they should have worked on treatments for, has shaken up and unlocked al my "Pandora's boxes" so I keep having to think/deal with shit I had put away years ago. Put away with the good therapy of going fishing, being creative, keeping myself fit etc not their damn crap and pills.
    not saying a GOOD psychologist cannot help, or that some medication doesn't help some folks, as they do help *some*. Merely IMHO, most of psychiatry is absolute bollocks! :p

    I do realize there are folk worse than me, some of you poor souls are bed bound or suffered sadistic abuse as kids etc, but dear God I am so sick and tired of this nightmare, one or other woe would be bad enough but not both
  12. peggy-sue


    Hiya Silverblade!:hug:

    You are perfectly correct to correct me. :p

    How it all works out does depend on the dynamics of the relationships and how each individual reacts.

    And if there are other relatives around who can offer some real unconditional love, the benefits of that cannot be underestimated

    I wasn't sexually abused either - but I had a very weird mother. Total narccissist, alcoholic, and misogynist, I was the "scapegoat". Dad was an alcoholic too - driven to it by her.
    She ruled the roost; we all had to pretend everything was normal and that we didn't even know they drank.
    They sat in two different rooms, watching the same tv programmes.
    Communication sometimes happened when essential, by them leaving notes for each other on the hall table.

    Mother took the credit for anything I ever did achieve, but anything less than perfection and I was derided as being "Your father's daughter, nothing to do with her."

    Love was not unconditional.

    In fact she was weird about that too - she'd get plastered and start staggering around the house wailing and shrieking

    "There is so much love!" and "You hurt me so much when I gave you life."

    She made out she had this overriding misery in her life and it was all my fault.

    I spent my childhood trying to work out what on earth I could have done, or what it was I was doing wrong, how on earth could I solve this problem of mother's dreadful misery?

    I did discover, years later, what her "misery" was.

    Dad wasn't rich enough. She wanted her best friend's husband. (She'd have had him too, if he had co-operated.)
    She wanted a "title".

    I don't want kids. Never have. She wanted me to have a baby to give it to her to look after.

    The first time she met my OH, she took him aside and told him in secret; "She's never been "right", you know."

    Getting the jitters just thinking about her!
    Ritto, SilverbladeTE and Countrygirl like this.
  13. Mij

    Mij Senior Member

    Neglect is also a form of abuse, it actually changes the structure of a developing brain. I watched a program on this and they showed the differences in fMRI's, normal brain and abused brain.

    SilverbladeTE your father sounds like mine. I finally realized later in life that he had a personality disorder from being neglected as a child. My mother's family was like your mother's family, warm, loving etc, I think this is what saved me as a child. My older sister on the other hand also developed a personality disorder.
    SilverbladeTE likes this.
  14. peggy-sue


    It really saddens me to see how globalisation has completely destroyed the reality of the large extended family all living close to each other - lots of aunts and uncles, cousins, grandparents around, for so many.

    It's a very healthy atmosphere to grow up in. Lots of adults to love all the kids - so if one of the adults does fail, there are other to support and take up the slack -or at least to let the child know their parent was wrong.

    Without that, the only source for the child is the failing adult - and a child places total trust in its parents.

    Neglect is a truly vile form of abuse. Sexual abuse is not the only devastating kind.
    But it does make titivating and lurid headlines.:cry:

    :love: I'm still trying to get to grips with the fact that I have been "adopted" by Michael's family - a (nearly-normal, :p) but most importantly, loving and affectionate family. I can't quite believe that my "dream" has finally come true.
    SilverbladeTE likes this.
  15. Roy S

    Roy S former DC ME/CFS lobbyist

    Illinois, USA
    Since fibromyalgia is included in this there is a recent paper with explanations on CBT's for FM on Prohealth showing some very small improvements.
    Effectiveness of Cognitive Behavioral Therapies for Fibromyalgia: A Review

    Perhaps one of the more scientifically respected members would start a new thread? Perhaps with a title like "CBT's -- Honest Analyses
    Esther12 likes this.
  16. kaffiend

    kaffiend Senior Member

    I was neither abused nor neglected as a child yet have CFS. Therefore childhood abuse is neither a necessary nor sufficient condition for the development of CFS.

    As the biological evidence builds, the serious minded researchers will see these meta-analyses for what they are: Junk science.
    peggy-sue, alex3619 and Valentijn like this.
  17. Esther12

    Esther12 Senior Member

    Thanks. That link seemed broken, but this one works:

    I thought that I had seen that discussed on here already, but maybe not.

    You can get the full text free here:
    Roy S likes this.
  18. alex3619

    alex3619 Senior Member

    Logan, Queensland, Australia
    Meta-analyses do not have to be junk science, but often are. If the underlying science is well defined, the evidence is objective, then a meta-analysis improves the statistical examination of the data. Yet if the underlying science is more pseudo- than science, has highly subjective data, aimed to confirm their conclusions without testing them, or based on layers of unproven hypotheses (which the psychiatric pseudoscience known as psychogenic medicine is) then there is nothing substantive to put in the meta-analysis. So GIGO it is. Systemic bias just gets amplified in meta-analyses.
    SilverbladeTE and peggy-sue like this.

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