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Chalder and colleagues: Emotional arousal in CFS

Messages
3,263
Emotional Suppression in Chronic Fatigue Syndrome: Experimental Study
Katharine A. Rimes, Joanna Ashcroft, Lauren Bryan, and Trudie Chalder
In Health Psychology, 2016, Vol. 35, No. 9, 979–986

abstract said:
Objective:
Emotional processing differences in chronic fatigue syndrome (CFS) have been reported but have rarely been investigated experimentally. This study used self-report, observer ratings, and electrodermal responses to test hypotheses about emotion suppression and autonomic reactivity.
Methods:
Eighty adults with CFS and 80 healthy controls (HC) watched a distressing film clip. Half of each group were instructed to suppress their emotions and half were told to express their feelings as they wished. Their reactions were filmed and rated by independent observers. Electrodermal activity (skin conductance response) was used as a measure of sympathetic nervous system arousal.
Results:
CFS participants reported higher anxiety and sadness than the HC, both before and after the film. However, observers rated the CFS group as having lower emotional expression than HC in both emotional suppression and expression choice conditions. Beliefs about the unacceptability of negative emotions were associated with greater self-reported suppression. Electrodermal responses were greater in the CFS group than HC participants. Higher skin conductance responses were associated with larger posttask increases in fatigue in the CFS participants but not in the HC.
Conclusions:
CFS participants had lower observer-rated emotional expression than HC, despite greater distress and higher autonomic arousal. This may have implications for their ability to access social support at times of stress. As the degree of autonomic arousal was associated with short-term increases in fatigue in the CFS participants, this requires further investigation as a contributory factor for this condition.
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
CFS participants had lower observer-rated emotional expression than HC, despite greater distress and higher autonomic arousal.

i can believe that she's got at least this part right. Over the years Ive had much practice at having to hide my distress over my situations eg if you go into a doctors and start crying over your situation no matter how bad it is, they will just thinking automatically that you have depression. You often have to suppress emotions to be taken seriously or listened too.

People who do not understand the condition you are experiencing, so often when talking to them you need to try to "control" yourself emotionally while sharing or they will just think you are being over the top with things.

Some people who have got ME/CFS have been called drama queens, attention seekers or so many other things, is it no wonder they have learnt to hide their emotional distress to a degree

How does Trudie Chalder constantly get funding to continue on with all these crappy studies where others who need the funding for ME/CFS research for things which may really benefit us cant get funding?
 
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3,263
Some quick thoughts:
abstract said:
As the degree of autonomic arousal was associated with short-term increases in fatigue in the CFS participants
This bit is actually quite interesting, and fits with what many of us experience (including me). Of course, the finding will most likely be misused and misintepreted as support for the idea that CFS is "stress related".
abstract said:
Electrodermal responses were greater in the CFS group than HC participants.
Don't read a lot into this. The effect was only just significant, p = .041. And they needed loads of patients to even get this marginal effect (80 in each group).

Also, the CFS and control groups differed in various ways which could affect this quite a bit (e.g., age, ethnicity).
abstract said:
Beliefs about the unacceptability of negative emotions were associated with greater self-reported suppression.
Well, you know, not rocket science, that one.
abstract said:
However, observers rated the CFS group as having lower emotional expression than HC in both emotional suppression and expression choice conditions.
This effect was pretty reliable, but again the differences in the composition of the CFS and control groups could also be a factor here. Ethnicity in particular might be key here.
 
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Countrygirl

Senior Member
Messages
5,368
Location
UK
Oh @Woolie, you tease! You knew I was just pouring my early morning coffee while you were posting this!

So now we are emotionally suppressed little flowers whose emotional abnormalities prevent us accessing support for our distress. Boo hoo! I think I will opt for retaining the White-Chalder militant activist label.

Dear Trudie .........she is so endearing. Don't you just love her?
 

user9876

Senior Member
Messages
4,556
Yes, I am extra vigilant because of the names, but I do feel you have to judge each research piece on its own merits.

There is also a question of whether it is worth the energy to judge a paper.

I was thinking about peer review and the choice of journal and came to the conclusion that it should be used as a signal not to trust a paper but whether it is worth spending the time reading it. When reading anything of real interest you as the reader need to judge the quality of the work, you can't rely on the peer review because its often someone who spends a similar time reading the paper, expressing their bias on the subject and trying to get their own work referenced.

But where people such as White, Chalder and Sharpe have been known to have spun data and cherry picked results (and even persuaded trial committees to allow them to do that) it is not just a case of judging but as a reader you need to also look at the original protocol (if published) and see what has changed. For the outcomes they talk about this amount of time is simply not worth the energy.

But then maybe I am obsessive.
 
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3,263
I was thinking about peer review and the choice of journal and came to the conclusion that it should be used as a signal not to trust a paper but whether it is worth spending the time reading it.
Totally agree there. You can't go just by the outlet and the peer review. Pretty loose standards in psychological medicine in general.

And because I read the paper, it means you guys don't have to! ;) (Unless of course you want to!)
 
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3,263
Come to think of it... 160 participants to look at this, when there are so many other more important questions to address about CFS. Exercise physiologists who are trying to study effects of exertion on CFS could only dream of such a sample.

What a waste of time and resources.
 

sarah darwins

Senior Member
Messages
2,508
Location
Cornwall, UK
I have to admit I laughed out loud when I saw the title of this one. Is that wrong?

I know it's deadly serious and all that, but really, how can you not laugh? It's like watching a meeting of the Flat Earth Society. FFS, Prof. Chalder, enough already.

I very much look forward to the time when we can stop posting threads about these twerps because they've become so utterly irrelevant.
 
Messages
2,158
I'd say this has all the hallmarks of a study dreamed up for a PhD student to do, rather than for any medically valid reason. Nice easy experiment, lots of simple things to measure, lots of vaguely related studies to summarise in the introduction to show you've done your reading research, and a handy supply of dupes in the queue at a couple of psych. based CFS clinics waiting for 'treatment' for their fatigue.

In skimming through the paper, here are a few serious flaws:

1. Ethically questionable:
'Study procedure was approved by a local National Health Service Research Ethics Committee (ref. 09/H0803/80) and participants provided prior informed consent.'

Then the procedure is described, then:

'All participants were fully debriefed and given the opportunity to discuss their reactions. Any remaining distress was reduced through relaxation and positive imagery for those who wanted this. It was used for one participant. None had guessed the purpose of the experiment.'

Huh??? So it's fine to take worried sick people and mess with their heads and say they've given informed consent when you haven't told them the purpose?

2. Choice of 'emotional stimulus:

'Materials and Measures Emotion induction. A 9-min clip from a British Broadcasting Corporation documentary called “Britain’s Homecare Scandal,” originally shown in 2003 as part of the “Panorama” series, was used to elicit an emotional response. It shows scenes of reduced quality of care given to older adults by homecare services. The film clip was piloted on 15 individuals (seven CFS participants and eight healthy control participants). It produced an increase in ratings of emotional distress including anger, sadness, and disgust. This complex emotional response was considered to have appropriate ecological validity.'

Huh???? So you're comparing emotional reactions and suppression of emotions in healthy and sick people and you choose a stimulus that is likely to have much higher emotional resonance with the sick people who may already have encountered difficulties with care services, or be concerned about their care needs in future. How is that a valid comparison.

3. Suppression of emotions is found to be higher in CFS patients.

Huh??? Well of course it is, they've been referred to a psych. based service for an illness they experience as a physical illness. Of course they're going to hide their emotions so as not to be further misdiagnosed. And they don't know the purpose of the experiment...

4. Age difference - the average age of the CFS group was 10 years older than the control group. This alone could account for differences in emotion suppression.

5. The conclusion - 'This is the first evidence from an experimental study of greater emotional suppression in individuals with CFS compared to healthy controls, from both self-report and observer ratings. Preexisting beliefs about the unacceptability of experiencing and expressing negative emotions may be one contributory factor to emotional suppression. The CFS group, and participants randomized to the suppression condition, had higher autonomic arousal in an emotionally distressing task. Higher levels of autonomic arousal were associated with greater increases in posttask fatigue for the CFS participants. Further research is needed into the possibility that increased autonomic arousal, perhaps as a result of greater distress and emotional suppression, contributes to fatigue in people with CFS.'

Huh??? So you give them a task that is likely to have more emotional impact on sick people, then say it's the sickness that causes them to be more emotionally aroused, not the task? For me this totally invalidates an already shaky study.

And you conclude by implying that our fatigue is caused by our emotions. OK, I know it doesn't say that exactly, but it's certainly implied.

:aghhh::aghhh::aghhh::aghhh::aghhh::aghhh::aghhh::aghhh::aghhh:
 

A.B.

Senior Member
Messages
3,780
Junk science.

As already mentioned, showing a film related to the neglect of the elderly is likely to produce more response in a patient group with chronic illness and disability. They already failed at this step, so nothing they did afterwards has any importance as it it impossible to distinguish bias arising from flawed methods from an illness-specific effect.

That there is no discussion on alternative explanations for autonomic arousal (specifically biological explanations) already tells you the authors are not interested in the truth. They just want to promote their paradigm.
 
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sarah darwins

Senior Member
Messages
2,508
Location
Cornwall, UK
And you conclude by implying that our fatigue is caused by our emotions. OK, I know it doesn't say that exactly, but it's certainly implied.

You're right. It's there, even if it's not explicit. All of this guff revolves around a conviction, a certainty, that ME (cfs) must be caused by something going on in our heads. Another day, another junk study borne of the same groundless belief. I'm tired of looking at this stuff, and if it weren't that the purveyors of it had acquired so much influence, mostly by churning out a mountain of similar pap, I'd ignore every last bit of it.
 
Messages
2,158
I wonder whether they would get ethical approval to do the same study on, say, MS patients. And would they be allowed to get away with using a film about poor home care services as the emotional stimulus. And then to get away with suggesting it was something inherent in MS that caused them to react differently to this stimulus than healthy people.

Sorry, I won't go on any more. This is a waste of your time and mine. If I'm going to go on about it, it should be to Chalder et al, not my fellow sufferers, and I've used up all my letter writing 'bashing my head against a brick wall' energy.

Back to Harry Potter. He makes more sense.
 

Ysabelle-S

Highly Vexatious
Messages
524
I'd say this has all the hallmarks of a study dreamed up for a PhD student to do, rather than for any medically valid reason. Nice easy experiment, lots of simple things to measure, lots of vaguely related studies to summarise in the introduction to show you've done your reading research, and a handy supply of dupes in the queue at a couple of psych. based CFS clinics waiting for 'treatment' for their fatigue.

In skimming through the paper, here are a few serious flaws:

1. Ethically questionable:
'Study procedure was approved by a local National Health Service Research Ethics Committee (ref. 09/H0803/80) and participants provided prior informed consent.'

Then the procedure is described, then:

'All participants were fully debriefed and given the opportunity to discuss their reactions. Any remaining distress was reduced through relaxation and positive imagery for those who wanted this. It was used for one participant. None had guessed the purpose of the experiment.'

Huh??? So it's fine to take worried sick people and mess with their heads and say they've given informed consent when you haven't told them the purpose?

2. Choice of 'emotional stimulus:

'Materials and Measures Emotion induction. A 9-min clip from a British Broadcasting Corporation documentary called “Britain’s Homecare Scandal,” originally shown in 2003 as part of the “Panorama” series, was used to elicit an emotional response. It shows scenes of reduced quality of care given to older adults by homecare services. The film clip was piloted on 15 individuals (seven CFS participants and eight healthy control participants). It produced an increase in ratings of emotional distress including anger, sadness, and disgust. This complex emotional response was considered to have appropriate ecological validity.'

Huh???? So you're comparing emotional reactions and suppression of emotions in healthy and sick people and you choose a stimulus that is likely to have much higher emotional resonance with the sick people who may already have encountered difficulties with care services, or be concerned about their care needs in future. How is that a valid comparison.

3. Suppression of emotions is found to be higher in CFS patients.

Huh??? Well of course it is, they've been referred to a psych. based service for an illness they experience as a physical illness. Of course they're going to hide their emotions so as not to be further misdiagnosed. And they don't know the purpose of the experiment...

4. Age difference - the average age of the CFS group was 10 years older than the control group. This alone could account for differences in emotion suppression.

5. The conclusion - 'This is the first evidence from an experimental study of greater emotional suppression in individuals with CFS compared to healthy controls, from both self-report and observer ratings. Preexisting beliefs about the unacceptability of experiencing and expressing negative emotions may be one contributory factor to emotional suppression. The CFS group, and participants randomized to the suppression condition, had higher autonomic arousal in an emotionally distressing task. Higher levels of autonomic arousal were associated with greater increases in posttask fatigue for the CFS participants. Further research is needed into the possibility that increased autonomic arousal, perhaps as a result of greater distress and emotional suppression, contributes to fatigue in people with CFS.'

Huh??? So you give them a task that is likely to have more emotional impact on sick people, then say it's the sickness that causes them to be more emotionally aroused, not the task? For me this totally invalidates an already shaky study.

And you conclude by implying that our fatigue is caused by our emotions. OK, I know it doesn't say that exactly, but it's certainly implied.

:aghhh::aghhh::aghhh::aghhh::aghhh::aghhh::aghhh::aghhh::aghhh:

Excellent summation. Money was wasted on this rubbish too. Money better spent on biomedical research. They might as well be living in a remote station in Antarctica beyond the reach of biomedical research news for all the attention they pay.
 

Gijs

Senior Member
Messages
690
What she finds is autonomic dysfunction, well known in ME/CFS. Low emotional expression don't give overactive sympathetic nervous system, it is the other way around. And yes, emotional expression will give the same abnormal reaction of the ANS as when you exercise. I would like to put White and Chalder e.a. in a MRI and see if their brains are aroused by false interpretation believes or other mental disorders.