Patterns of control beliefs in chronic fatigue syndrome: results of a population-based survey

[Dolphin]

Free full text: http://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-017-0174-3

Patterns of control beliefs in chronic fatigue syndrome: results of a population-based survey

• Johanna M. Doerr†,
• Daniela S. Jopp†,
• Michael Chajewski and
• Urs M. NaterEmail author

†Contributed equally
BMC PsychologyBMC series – open, inclusive and trusted
20175:6
DOI: 10.1186/s40359-017-0174-3

© The Author(s). 2017

Received: 13 November 2015

Accepted: 21 February 2017

Published: 6 March 2017

Open Peer Review reports

Abstract
Background
Chronic fatigue syndrome (CFS) represents a unique clinical challenge for patients and health care providers due to unclear etiology and lack of specific treatment. Characteristic patterns of behavior and cognitions might be related to how CFS patients respond to management strategies.

Methods
This study investigates control beliefs in a population-based sample of 113 CFS patients, 264 individuals with insufficient symptoms or fatigue for CFS diagnosis (ISF), and 124 well individuals.

Results
Controlling for personality and coping, individuals with low confidence in their problem-solving capacity were almost 8 times more likely to be classified as ISF and 5 times more likely to be classified as CFS compared to being classified as well. However there was a wide distribution within groups and individuals with “low confidence” scores were found in 31.7% of Well individuals. Individuals with low levels of anxiety and who were more outgoing were less likely to be classified as ISF or CFS.

Conclusions
These findings suggest that fostering control beliefs could be an important focus for developing behavioral management strategies in CFS and other chronic conditions.

Keywords
Chronic fatigue syndrome Control beliefs Personality Coping

 

[Dolphin]

Open Peer Review reports
http://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-017-0174-3/open-peer-review

 

[Dolphin]

This study used the so-called empiric criteria (Reeves et al., 2005) that cover 2.54% of the population. I would argue these are probably the worst criteria.

 

[A.B.]

This study used the so-called empiric criteria (Reeves et al., 2005) that cover 2.54% of the population. I would argue these are probably the worst criteria.

It sounds like these were not broad enough:

subjects classified as ISF had to meet at least one, but not all CFS criteria (not limited to fatigue)

Sounds like one didn't have to be fatigued to qualify. I'm not sure I've seen anyone butcher case definitions like this. This is more inconsistent than the Oxford criteria.

The sample of the current analysis included 501 individuals: 113 were classified as CFS, 264 individuals were classified as not meeting full criteria for CFS but reporting at least one of the CFS defining symptoms (insufficient symptoms or fatigue, termed as ISF), and 124 were classified as Well.

Wow did they REALLY come up with a definition met by more than half of a random population sample? I can't seem to find an explanation for how they picked 501 individuals from the larger (random) sample.

 

[Hajnalka]

Although these preliminary findings are promising, more research about the role of control beliefs in CFS is needed.

 

[Hajnalka]

Received: 13 November 2015
Accepted: 21 February 2017

Is this normal (15 months) or does it mean the paper was too bad to be accepted faster?

 

[Denise]

General beliefs about controllability, or ‘control beliefs’ may be of importance in CFS. Individuals differ with respect to how much they feel in charge of their lives (i.e. self-efficacy) and how much they feel dominated by external forces (e.g. by chance or powerful others) [23, 41].

I haven't told anyone this before but I believe I control the rising and setting of the sun.
In so doing, not only do I control my life but the lives of everyone else!
I guess I have nothing to do with "cfs"....
ETA - I am just kidding. (Though I don't have anything to do with cfs but rather with ME.)

@Dolphin posted "Getting to Know You...Urs Nater" about Nater (a couple of days ago) --- how prescient of you @Dolphin.

 

[Dolphin]

Is this normal (15 months) or does it mean the paper was too bad to be accepted faster?

There were quite a few rounds of peer-review, more than a lot of papers:

Open Peer Review reports
http://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-017-0174-3/open-peer-review

 

[Dolphin]

The sample of the current analysis included 501 individuals: 113 were classified as CFS, 264 individuals were classified as not meeting full criteria for CFS but reporting at least one of the CFS defining symptoms (insufficient symptoms or fatigue, termed as ISF), and 124 were classified as Well.

Wow did they REALLY come up with a definition met by more than half of a random population sample? I can't seem to find an explanation for how they picked 501 individuals from the larger (random) sample.

No, they only invited some of the healthy people in.

Prevalence of chronic fatigue syndrome in metropolitan, urban, and rural Georgia
https://pophealthmetrics.biomedcentral.com/articles/10.1186/1478-7954-5-5

 

[alex3619]

The broadness of the criteria mean that the results cannot be applied to ME or even CFS patients. They can only be applied to Empiric CFS patients. Even then its not clear that there is anything much worth discussing. Even the conclusion is a bit vague, with two qualifiers - "suggest" and "could be'. Keeping that in mind this should be considered at best a pilot study. I hope any follow-up study has a much better design.

 

[Barry53]

Conclusions
These findings suggest that fostering control beliefs could be an important focus for developing behavioral management strategies in CFS and other chronic conditions.

So am I right in thinking this is simply about determining disease coping strategies on an individual basis, according to a person's underlying personality traits? And seeing as it states "and other chronic conditions", what is the point of highlighting CFS?

 

[Hajnalka]

Grrrrrr, just realized that Urs and his gang are all German psychiatrists working at a German university. This paper shows the mainstream German idea of CFS (the term ME doesn't exist).

Urs and his crew are infamous, because they twice tried to trick patients in a German CFS-forum into participating in their studies by claiming they were bio-medical (in a psychiatry department ).

 

[Hajnalka]

The same group made a press release about two weeks ago, that somatoform disorders like CFS or IBS can now be officially linked to childhood traumata.

 

[Hajnalka]

So sorry to be a little OT, I know this thread is not about me or Germany, but I have to share what I just read: Urs Nater is married to a colleague in his research group, whom I used to know quite well.

In our first years of university she was very (very) socially awkward and I was the relaxed, outgoing one. Since I last saw her, she apparently got two doctorate degrees and married, while I spent most of the years in bed and had to move back in with my parents. And now she and her husband make a living of claiming CFS is a somatoform disorder from bad coping and childhood trauma.

If somebody had told me this story in my first years of university when I knew her, I would have never believed how all of this could possibly ever happen. I'm not competitive or ambitious at all, but sometimes it's just too much, what everybody else made of their lives (partner, kids, home, work, degrees, harassing CFS sufferers) while I missed out on most of my 20ies and 30ies. And it's so strange to be told by someone whose talents were rather in other fields than social interactions, that we lack problem-solving capacity and coping-skills. Sorry, don't want to be so bitter, but sometimes can't help it.

 

[BruceInOz]

Keeping that in mind this should be considered at best a pilot study. I hope any follow-up study has a much better design.

Don't encourage them Alex.

 

[Diwi9]

So sorry to be a little OT, I know this thread is not about me or Germany, but I have to share what I just read: Urs Nater is married to a colleague in his research group, whom I used to know quite well.

In our first years of university she was very (very) socially awkward and I was the relaxed, outgoing one. Since I last saw her, she apparently got two doctorate degrees and married, while I spent most of the years in bed and had to move back in with my parents. And now she and her husband make a living of claiming CFS is a somatoform disorder from bad coping and childhood trauma.

If somebody had told me this story in my first years of university when I knew her, I would have never believed how all of this could possibly ever happen. I'm not competitive or ambitious at all, but sometimes it's just too much, what everybody else made of their lives (partner, kids, home, work, degrees, harassing CFS sufferers) while I missed out on most of my 20ies and 30ies. And it's so strange to be told by someone whose talents were rather in other fields than social interactions, that we lack problem-solving capacity and coping-skills. Sorry, don't want to be so bitter, but sometimes can't help it.

Actually, this is on topic, it's great to document the back story of any research study. Context is always important.

 

[alex3619]

Don't encourage them Alex.

Sadly, this paper can only be considered a positioning paper for further study, and they are probably thinking about it. It has no value otherwise. If I were on any grant approval board they would move to the bottom of the list for consideration, unless of course there were even worse proposals.

I would like to encourage all medical researchers to stop using extremely poor methodology with major and obvious flaws. Ditto for reviewers, editors and grant panel members - don't let low quality research through.

 

[Techs]

Personally, based on my own experience, I think it's possible that chronic severe stress (for example) may play a triggering role for some of us who are already predisposed to illness. In my case I think of the stress not as "behavioral" but as "environmental." I had various symptoms going back many years earlier, but I can't say for sure whether the on/off switch would have flipped me from routine poor health into the realm of unequivocal debilitation had my decade of stress not occurred.

Regardless, where I think all these behavioral researchers misstep is in assuming that the road to wellness is simply to reverse any triggers. That's like thinking you can repair a car that blew a rod after being driven fast on no oil simply by filling the crankcase with oil and driving more slowly.

 

[Snow Leopard]

More questionnaire based garbage.

 

[Snowdrop]

Personally, based on my own experience, I think it's possible that chronic severe stress (for example) may play a triggering role for some of us who are already predisposed to illness. In my case I think of the stress not as "behavioral" but as "environmental." I had various symptoms going back many years earlier, but I can't say for sure whether the on/off switch would have flipped me from routine poor health into the realm of unequivocal debilitation had my decade of stress not occurred.

Regardless, where I think all these behavioral researchers misstep is in assuming that the road to wellness is simply to reverse any triggers. That's like thinking you can repair a car that blew a rod after being driven fast on no oil simply by filling the crankcase with oil and driving more slowly.

Or another way to look at it is that you were already ill at a level that may not have had large symptoms (the kind that can be easily recognised as such) but the disease process had taken hold at the cellular level and it was making it harder to do the things a healthy person would not have had issues with. Therefore the disease caused the stress you experienced not the other way round. Just as one can have cancer and (particularly in the early stages) you may not be aware you have a life altering illness.