The role of high expectations of self and social desirability in emotional processing in IBS

[Luther Blissett]

I think it's more like:

Patient expresses much emotion > hysterical
Patient expresses little emotion > suppressed emotions
Patient expresses mixed emotions > therapist thinks patient is too normal > hiding something under the surface
Patient thinks this is all BS > proves patient is indeed guilty (too defensive)
Patient agrees > We told you so.

Patient making lists > obsessive

 

[Woolie]

http://www.sciencedirect.com/science/article/pii/S0005796712000447

Development and preliminary evaluation of a psychosocial intervention for modifying psychosocial risk factors associated with foot re-ulceration in diabetes

This one really cracked me up, @chipmunk1!

- Only 8 people underwent the intervention (5 in the control group)
- NO DATA about foot ulceration rates either before or after intervention!
- The only formal measures were psychological. Means were presented, but no stats AT ALL.

The paper mainly consists of a bunch of the best statements patients made about how 'helpful' they found the intervention.

It reads like a marketing brochure. Which I suppose is what its intended to be.

 

[Woolie]

This is one of the more reasonable in principle conditions where it might matter.

I do take your more general point that its good to provide support to patients to help encourage good illness management practice.

But there's nothing new about this,

Also:
- The support offered should be positive. We should never try to pathologise those that don't behave in the desired manner. This paper pathologises. That's a form of patient blaming.

- If you want to publish a study about some new and magical intervention that improves health practices, you absolutely need to show that it leads to measurable changes in the relevant health outcomes. This paper only reports on psychological measures (but no actual stats).

 

[Valentijn]

There is very clear link between prompt treatment of issues and bad blood-sugar control with worse disease.

Ah it all makes sense now. Since CBT can improve subjective outcomes, it's okay to actively discourage Type 2 diabetics from monitoring blood sugar And yes, that discouragement is actually policy, because otherwise the NHS has to pay for testing strips.

 

[Skycloud]

I'm really not convinced that CBT itself is that effective compared with regular support from a good clinic nurse to improve patient self-management of health conditions like diabetes. I can see that where a patient has mood issues that affect their life including health management there might be a case.

 

[trishrhymes]

I'm really not convinced that CBT itself is that effective compared with regular support from a good clinic nurse to improve patient self-management of health conditions like diabetes. I can see that where a patient has mood issues that affect their life including health management there might be a case.

I agree, and the nurse can pick up when medical help is needed, whereas the therapist is likely to be ignorant of the warning signs.