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Densham et al: Enhanced psychological flexibility and improved quality of life in CFS

Discussion in 'Latest ME/CFS Research' started by mango, Jul 29, 2016.

  1. mango

    mango Senior Member

    Enhanced psychological flexibility and improved quality of life in chronic fatigue syndrome/myalgic encephalomyelitis

    Sarah Densham, Deborah Williams, Anne Johnson, Julie M. Turner-Cobb

    Journal of Psychosomatic Research September 2016 Volume 88, Pages 42–47
    Published Online: July 19, 2016

    * Interdisciplinary group treatment may improve quality of life in CFS/ME.
    * Psychological Flexibility (PF) has applied utility in the treatment of CFS/ME.
    * Changes in PF activity/occupational engagement suggest greatest benefit in CFS/ME.


    Psychological Flexibility (PF) is a relatively new concept in physical health. It can be defined as an overarching process of being able to accept the presence of wanted/unwanted experiences, choosing whether to change or persist in behaviour in response to those experiences.

    Associations between processes of PF and quality of life (QoL) have been found in long-term health conditions such as chronic pain, PF has not yet been applied to Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME).

    Changes in PF, fatigue severity and QoL were examined in one hundred and sixty-five patients with CFS/ME engaged in a six-week outpatient interdisciplinary group treatment programme. Participants were assessed using a series of self-report measures at the start of the start (T1) and end of a six-week programme (T2) and at six months follow up (T3).

    Significant changes in PF and QoL were observed from pre-treatment (T1) to post treatment follow-up (T2 and T3); changes in fatigue severity were observed from T1 to T3 only. Controlling for fatigue severity, changes in the PF dimension of activity/occupational engagement were associated with improvement in QoL at six month follow up (T3) but not at six weeks post programme (T2).

    Findings indicate an interdisciplinary group treatment approach for people with CFS/ME may be associated with improved QoL, processes of PF and fatigue severity, supporting a link between PF and long term health conditions. Results highlight links between PF and patient QoL in CFS/ME and the value of interdisciplinary treatment approaches in this patient population.
    Esther12 likes this.
  2. Research 1st

    Research 1st Severe ME, POTS & MCAS.

    This thought insertion idea of overcoming CFS disabilities by restructuring cognitive processes by Densham et al, reads somewhat like religious text, because the treatment outcome proposed is based on a belief, by the therapist, that it works (there are no objective measures)!

    So irrespective if you name a therapy for CFS: PF, or CBT, or GET, or Xyz, the outcome will be the same. Still, lets go through this quickly, regarding this 'new' idea of PF, based on a client ''accepting'' symptoms and thus altering their behavioral responses to it:

    Using the logic in the text box above, if you punch yourself in the face (not advised), it doesn't hurt because pain is just an experience you can chose to reject if you so wish. Pain in CFS is common, and so the pain in CFS (using PF) can also be ignored and clients no longer need to take Lyrica or have a morphine pump for their neurological disorders, that come with having CFS.

    If this was true, boxing would be a non contact sport and we can safely administer hershey bars to diabetic sufferers, knowing that by not testing their blood glucose, it is safe to do so and to recommend this as an effetive therapy. Except that's not allowed for obvious reasons.

    With CFS, there is should be no difference when it comes to therapeutic interventions based on faith (relgion of BPS). No one know what core disease CFS is, but they do no many with CFS have multiple co-morbid disorders. Ergo, even if CFS was psychological, the proposed therapy of 'Psychological Flexibility' FP, would not work, due to these other disorders (that CFS sufferers have), not responding to them.


    Chronic Migraine
    Chronic dizzyness/vertigo
    Endocrine disorders
    Heart failure
    Liver/Kidney problems
    Chronic infections and inflammation.

    This is the problem of psychology proposing therapies as being effective for CFS (with no objective scientific robust evidence), when inside CFS are many crippling chronic disorders, never mind the core disease itself (ME CFS), which is yet to be adequately researched, defined or aided with a single evidence based treatment.

    A simple analogy would be this, even if CFS was entirely psychological no one could or would respond to the psychological therapies as the other disorders patients suffer with, aren't psychological and are often highly disabling.

    Thus the proposed tool of PF, does NOT and could NOT treat CFS effectively, thus, the idea is silly and silliness should be associated to Science which is why Science, not psychology, requires hard evidence of a 'thing' actually being one, not an imagined one that might be one, because we think it is, without showing it is.

    L'engle, AndyPR, ahmo and 2 others like this.
  3. Invisible Woman

    Invisible Woman Senior Member

    Another fine waste of resources.
    AndyPR and ahmo like this.
  4. adreno

    adreno PR activist

    Sigh. Does it ever end.
  5. ahmo

    ahmo Senior Member

    Northcoast NSW, Australia
    :bang-head: As if we're not daily dealing w/ psychological flexibility to yield reasonable Quality of Life.:mad:

    OK, speak for myself: It's a rare day that I'm not stretching my psychological flexibility. For example, to not get into a state reading what idiots like this spend their time and someone's money on. Or, not going into disappointment that I can't go for a walk, again today, and fear that yes, my bones are probably dissolving because I can't exercise enough. And no, it never ends. That's why we don't all just top ourselves.
  6. Luther Blissett

    Luther Blissett Senior Member

    Yorkshire, England
    New except for any mystical religion I have ever read about.
  7. Snow Leopard

    Snow Leopard Hibernating

    South Australia
    People who have more "psychological flexibility" answer more optimistically on self-report questionnaires...
    Webdog, Invisible Woman and Esther12 like this.
  8. Dolphin

    Dolphin Senior Member


  9. Dolphin

    Dolphin Senior Member

    From the cited paper:

    Last edited: Feb 18, 2017
    Webdog likes this.
  10. Dolphin

    Dolphin Senior Member

    As the authors acknowledge in the limitations, this is an uncontrolled study so one doesn't know how what the results would have been for a group that did not receive any therapy.


    Here are the results on the conventional outcome measures. I'm not so familiar with the quality of life scale (particularly the scoring system used here) but the change in fatigue severity scores does not seem particularly impressive.

    Last edited: Feb 18, 2017
  11. Dolphin

    Dolphin Senior Member

    Here are details of the therapy programme
    As they say in the paper, they didn't specifically target "psychological flexibility".
  12. ash0787

    ash0787 Senior Member

    " Psychological Flexibility (PF) is a relatively new concept in physical health. "

    Is it though ? or is it related to the concept of neuroplasticity ? which is possibly a facet of IQ,
    the ability of the person to learn a variety of completely different skills, I mean there may be other factors
    meaning people don't get the opportunity to try different things because they are tied to one job or possible social factors etc but perhaps its what separates geniuses from simple craftsman and merchants ?

    If you think of a skill that you can't do and then what separates you from doing it, whats the difference in thought process / ability between someone that is successful at that skill and someone who isn't ... whats their exact methodology etc

    For example I tried to learn how to draw and I found that I can copy something perfectly but trying to draw from imagination was very difficult, so I started to try and look for geometrical patterns in the things I wanted to draw, which might be useful, but I noticed that in general after a while I was naturally paying more attention to the shapes of objects and patterns in everything that I did, so in that sense the mind is reprogrammed temporarily.

    So I guess in essence these researchers are questioning our IQ ? what grounds they think they have to do so, I don't know ... shall we compare talents with them ? based on the papers they produce I am not very intimidated ...

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