Article: A Hitch in its Step: PACE Trial Indicates CBT/GET No Cure For CFS, 60% of Patients Show No


Posted on Co-Cure:
Alison Hunter Memorial Foundation

It is important to make very clear the PACE Trials use of Cognitive Behavioural Therapy (CBT).
It is commonly reported by many, both medical practitioners and ME advocates, "as with other medical conditions" in reference
to CBT for ME. It is most emphatically not.

CBT with other medical conditions may be offered alongside the primary medical management-

Asthma- medication preventers, ventolin inhalers antibiotictherapy etc

Diabetes- insulin, dietary restrictions, etc

Cardiac disease - medications for BP, angina, bypass surgery[Chris Hunter] , pacemaker etc.

in all cases CBT means strategies important to manage the condition,such as
proper adherence to drug therapies,dietary regimes, lifestyle advice etc )

However, CBT for ME/CFS per Lancet PACE Trial extract page 5 "CBT was done on the basis of fear avoidance theory
of chronic fatigue syndrome. This theory regards chronic fatigue syndrome as reversible and that cognitive responses
(fear of engaging in activity) and behavioural responses (avoidance of activity) are linked and interact with physiological processes
to perpetuate fatigue. The aim of treatment was to change the behavioural and cognitive factors assumed
to be responsible for perpetuation of the participant's symptoms and disability" .

ie CBT treatment for ME is based on "avoidance theory" and "factors assumed".

My Concise Oxford Dictionary agrees with me!

1. theory n. "Supposition or system of ideas explaining something, based on general principles, independent of the facts"

2. assuming v. "taking much upon oneself, arrogant"

Chris Hunter
Alison Hunter Memorial Foundation
+ 61 2 9958 6285
I just got this.

I'm afraid I won't have time to look at the blogs but maybe other people will look at one or more.

If you're not on Facebook, the links would hopefully work if you knock off the Facebook bit right up till the part of the URL that has a .com in it (not the .com beside Facebook).

ME/CFS Blogger Army: PACE isn't for ME " sent you a message on Facebook

Subject: PACE Isn't For ME - Complete List of Participating Blogs

PACE Isn't for ME's aim was to launch accurate information on PACE into cyberspace and counteract all the recent 'space junk' produced by vested-interest groups aligned with the lead researchers of the trial. The campaign relied on bloggers posting about PACE (and ME/CFS) and on those blogs being shared, viewed and commented on.

Although PACE Isn't for ME has come to a close, there is still a way you can help. Below is a list of the participating blogs - if you would visit each one in turn and leave a comment, this will help raise the blog's profile on Google, which in turn will increase its public visibility.

There is also another way you can help. By entering Google and typing PACE into the search window you will be presented with the top ranking PACE articles. Find the ones that have published positive and accurate information and leave a comment. In future, you might want to consider not leaving a comment when you read a negative 'blog' article. Visiting and commenting on some of the obvious attention-seeking blogs (ie those that bate sufferers with a view to increasing hits), only raises their profile, which we want to avoid. Commenting on online news media sites is a good thing, especially if the information they provide is inaccurate. It's a good opportunity to put the record straight and your comment is likely to be read by a larger audience.

If you enjoyed participating in XMRV Bloggerama Day and PACE Isn't for ME consider joining the newly created blog ring ME/CFS Blogger Nation. This will be an ongoing initiative aimed at growing a dedicated network and community of patient writers.

PACE trial: vague criteria and poor assessment

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PACE Trial - A Strong Smell of Fish

Rocky Works Hard: a Good News/Bad News Story Inspired by the PACE Trial

CBT & GET: The Studies, the Science and the Pseudoscience

PACE Tripe…sorry I mean Trial

The PACE Trial: “This is not a good day for people with ME/CFS”

Not Exactly Medical Journalism

Fighting the PACE

PACE Trial Results are Out: ME is Caused by an Oncogenic Virus

PACE Trial: What's fear got to do with it?

Keep on blogging!
How valid is the model behind cognitive behavior therapy

Hi, on the PACE trial results:


B. Stouten 1*, PhD
Ellen M. Goudsmit 2, PhD FBPsS


The cognitive behavior therapy (CBT) program studied by Prins et al. is based on a model of chronic fatigue syndrome that posits that fatigue and functional impairment are perpetuated by physical inactivity, somatic attributions, focusing on bodily symptoms and a low sense of control. A recent analysis of the data from three trials based on a model devised by Vercoulen et al. concluded that the effect of CBT on fatigue could not be attributed to a persistent increase in physical activity. We therefore examined the effect of treatment on the remaining three variables in the model using data from one of the trials, available in the public domain. The results from the groups given CBT, Guided Support and treatment as usual revealed that CBT had no significant impact on somatic attributions and focusing on bodily symptoms, and that in line with established guidelines, these two variables were not mediating factors. The only variable in the model showing an effect of CBT was sense of control. We submit that there is now sufficient evidence to warrant a review of CFS guidelines which advocate interventions aimed particularly at increasing physical activity and challenging somatic attributions, and that more flexible programs which address loss of control deserve further consideration and evaluation.


ps This was originally announced on Co-Cure but I deleted the entry and so can't credit it. The above information comes directly from the iacfsme site.