Personality Features and Personality Disorders in Chronic Fatigue Syndrome: A Populat

ixchelkali

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#@!&!! &%#@!+?! bleeping blank blank bleep!

What I really think about this garbage is unprintable in a family forum.

These people put the babble in psychobabble. Reputable psychiatrists, the ones whose goal is to actually help people with mental illness, should be outraged by this kind of sloppy thinking and sloppy research, because it discredits their whole profession.

Its clear they dont know their post from their ergo. They suffer from serious causal fallacies. Answers to true/false statements like "I am in just as good physical health as most of my friends," "I can work about as well as before," or "I feel like I cannot get going" might indicate psychopathology if answered by a person with no somatic illness. But taken in the context of someone with ME/CFS, say, or post-polio syndrome, MS, late-stage AIDS, congestive heart disease, rheumatoid arthritis, or other serious illness, the responses would be perfectly appropriate. I have seen nothing that would indicate that the Personality Diagnostic Questionnaire 4 has been demonstrated to have validity when administered to people with a serious illness. On the contrary, the Personality Diagnostic Questionnaire 4 has been shown to have a high rate of false positives.

My favorite line was Since maladaptive personality is not specific to CFS, it might be associated with illness per se rather than with a specific condition.

Let us not forget how inaccurate their assessment of who has CFS is. I suppose we could say theyve done us a favor by showing that they are studying people with depression rather than ME/CFS. Unfortunately, it doesnt really matter if its not a good study or that its not in a prestigious journal; it will still be cited as evidence that those people are crazy by people who have an interest in discounting and discrediting anything we say. For that matter, even insisting we are sane can be used as evidence of personality disorders. From the Merck manual People with a personality disorder are unaware that their thought or behavior patterns are inappropriate. And of course, thinking that someone might want to construe the study this way can be used as evidence of a paranoid personality.
 

CBS

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I have just pulled the three articles cited in the short passage I posted from the 2003 article by Taillefera, et. al.:
we expected CFS patients to score higher than the MS patients on the Neuroticism scale of the NEO-FFI. Consistent with two other studies comparing personality of CFS and MS patients [20,29], we did not find any difference between the two diagnostic groups.
Moreover, consistent with the findings that levels of neuroticism increase after the onset of a chronic illness [19], both diagnostic groups scored higher than the general population on neuroticism. However, only the more depressed CFS patients had higher scores on neuroticism; the less depressed group of CFS sufferers had lower scores on neuroticism compared to those of the general population. These results point to the possible heterogeneity of our CFS sample and suggest the existence of two subgroups differing in terms of personality.
After a brief review, I have confirmed that all four articles are referenced in the 2010 CDC article.

The other three citations in the 2010 CDC article are as follows:

CDC 2010:
“The role of maladaptive personality as a risk factor for developing CFS, as a factor contributing to its morbidity, pursuit of and responsiveness to treatment, or as a consequence of this chronic complex illness has been poorly explored. Published studies have reported around 40% of persons with CFS as having personality disorders, a relatively high occurrence [7–10]”

[FONT=&quot][10] PERSONALITY DIMENSIONS IN THE CHRONIC FATIGUE SYNDROME: A COMPARISON WITH MULTIPLE SCLEROSIS AND DEPRESSION[/FONT]
[FONT=&quot]SUSAN K. JOHNSON, JOHN DeLUCA and BENJAMIN H. NATELSON[/FONT]
[FONT=&quot]J p~vchiat. Res., [/FONT][FONT=&quot]Vol. 30, No. I, pp. 9 20, 1996[/FONT]

[FONT=&quot]Summary-This study investigated the relative rates of personality disturbance in chronic fatigue syndrome (CFS). Individuals who met the CDC criteria for CFS were compared to two other fatiguing illness groups, mild multiple sclerosis and depression, as well as sedentary healthy controls. Subjects were administered a structured psychiatric interview to determine Axis I psychiatric disorders and two self-report instruments to assess Axis II personality disorders and the personality trait of neuroticism. The depressed group had significantly more personality disorders and elevated neuroticism scores compared with the other three groups. The CFS and MS subjects had intermediary personality scores which were significantly higher than healthy controls. The CFS group with concurrent depressive disorder (34% of the CFS group) was found to account for most of the personality pathology in the CFS sample. The results are discussed in the context of the relationship between personality variables and fatiguing illness.[/FONT]



[FONT=&quot]CDC 2010:[/FONT]
[FONT=&quot][/FONT]In general, a positive association between neuroticism and fatigue has been found [14], with CFS patients showing higher levels compared to healthy controls [15]…[FONT=&quot][/FONT]

[FONT=&quot][15] PERSONALITY DIMENSIONS IN CHRONIC FATIGUE SYNDROME AND DEPRESSION [/FONT]
[FONT=&quot]LUCY BUCKLEY, SIOBHAN M. M[/FONT][FONT=&quot]ac[/FONT][FONT=&quot]HALE, JONATHAN T. O. CAVANAGH, MICHAEL SHARPE, IAN J. DEARY and STEPHEN M. LAWRIE*[/FONT]
[FONT=&quot]Journal of Psychosomatic Research, [/FONT][FONT=&quot]Vol. 46, No. 4, pp. 395–400, 1999[/FONT]

[FONT=&quot]Abstract[/FONT][FONT=&quot]—Chronic fatigue syndrome (CFS) is a poorly understood condition. Possible etiological factors include infectious agents, psychiatric disorders, and personality characteristics. We examined personality dimensions in 30 nondepressed patients with CFS, 20 patients with major depressive disorder (MDD), and 15 healthy controls. On the NEO-FFI, patients with CFS scored significantly lower than healthy controls on the extroversion subscale. On the neuroticism dimension of the Eysenck Personality Questionnaire (EPQ), patients with MDD scored higher than those with CFS, who in turn scored significantly higher than the healthy controls. CFS patients rated themselves as higher on neuroticism and less extroverted when ill than when they were well. Our results suggest that high scores on neuroticism and low scores on extroversion in CFS could be a reaction to chronic illness.[/FONT]

[FONT=&quot]Discussion[/FONT]
[FONT=&quot]“The retrospective self-reports of increased postmorbid neuroticism and introversion in CFS suggest that personality may have changed as a result of the illness. Raised neuroticism and introversion could be a feature of any chronic illness, as levels of neuroticism [16] and personality disorder [32] in CFS and multiple sclerosis are between those in healthy and depressed controls.”[/FONT]


[FONT=&quot]CDC 2010:[/FONT]
[FONT=&quot][/FONT]While some authors have raised the possibility that personality alterations are merely sequelae of the illness itself [25], a recent study in a population-based sample of twins found that
emotional instability assessed 25 years earlier was predictive of a later diagnosis of chronic fatigue [23] . Although that study did not evaluate CFS, its finding is still relevant for the understanding of the relationship between personality and CFS because its use of a prospective, longitudinal design allows strong inferences to be made regarding the potentially causative contribution of personality to the development of fatiguing illness.[FONT=&quot][/FONT]

[FONT=&quot]Can I insert an editorial comment – what a load! I’m quite sure that at this very moment, Reeves is looking for prospective longitudinal studies to arrive at strong inferences about MS.[/FONT]

[FONT=&quot][25] EXAMINATION OF CLONINGER’S BASIC DIMENSIONS OF PERSONALITY IN FATIGUING ILLNESS: CHRONIC FATIGUE SYNDROME AND MULTIPLE SCLEROSIS [/FONT]
[FONT=&quot]CHRISTOPHER CHRISTODOULOU,*† JOHN DELUCA,*† SUSAN K. JOHNSON,‡ GUDRUN LANGE,*† ELIZABETH A. GAUDINO*† and BENJAMIN H. NATELSON*[/FONT]
[FONT=&quot]Journal of Psychosomatic Research, [/FONT][FONT=&quot]Vol. 47, No. 6, pp. 597–607, 1999[/FONT]

[FONT=&quot]Abstract[/FONT][FONT=&quot]—Relatively few studies have examined the personality characteristics of patients with chronic fatigue syndrome (CFS). The personality profiles of 38 CFS subjects were compared with 40 healthy controls and 40 subjects with multiple sclerosis (MS), a chronic illness that shares many symptoms with CFS (e.g., fatigue), but has a known neurological substrate. Subjects were examined within Cloninger’s biosocial theory of personality, which delineates basic dimensions of temperament. Both illness groups displayed similarly elevated levels of Harm Avoidance, and lower levels of Reward Dependence as compared with healthy controls. The MS group showed a lower level of Persistence than controls and CFS subjects. Implications for the relationship between chronic illness and personality are discussed.[/FONT]
 

ixchelkali

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All the versions of these 5 type tests that I've seen have questions whose answers would be directly affected by having a disability, rather than just personality type.

I'm not sure if I can be bothered though. What repulsive quacky bullshit. This is what they spend CFS research money on?
Exactly. "Repulsive quacky bullshit" sums it up pretty well.

Of course, we then have to visit doctors whose view of us has been polluted by this repulsive quacky bullshit, which has a direct adverse effect on the quality of medical care we receive.
 
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There is a measurable factor that is wide spread among those with several personality disorders. Persons with these PD's can not take responsibility for their actions or the consequences there of. Their coping mechanism is to see others as having the same issue that they actually have. This is often called projection, or blaming the victim. For example, Reeves inability to see the symptoms he has: breaks from reality, avoidance of any other perspectives, lack of empathy, extreme arrogance, retaliation when critically questioned. I don't think any Mental Health Clinician would conflate an affective disorder such as Clinical depression (which is mostly an imbalance of vital neurotransmitters in the brain), with a personality disorder.

Note the need of some the personality disordered to retaliate. They spare nothing in this pursuit. The further along the scale of the PD, Narcissism, the greater the chance of those so afflicted to have no ability to relate to others as human beings. Thus they can cause the death of others without conscience. Thus we have Reeves, et al, producing this paper. I'm just sayin'.
 

ixchelkali

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They invented a personality disorder for this, too.....there is no such thing as depressive personality disorder in the DSM!!
The Merck manual lists "depressive personality," as a personality type but says that it is not considered a disorder. Merck describes it as
Depressive Personality: This personality type is characterized by chronic moroseness, worry, and self-consciousness. People have a pessimistic outlook, which impairs their initiative and disheartens others. To them, satisfaction seems undeserved and sinful. They may unconsciously believe their suffering is a badge of merit needed to earn the love or admiration of others.
Sorry, I don't qualify; it's my optimism that tends to get on people's nerves. Pollyanna, and all that. Little Merry Sunshine. I try to temper it. :rolleyes:
 

SOC

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Published studies have reported around 40% of persons with CFS as having personality disorders, a relatively high occurrence [7–10]
Sorry if this is a dumb question -- I'm having focus problems following CBS' content-dense post -- but does anyone know if those references [7-10] actually do report "40% of persons with CFS as having personality disorders"? Or is the CDC interpreting them incorrectly?

Also, aren't personality disorders distinct from and more severe (and difficult to treat) than, say, depression, OCD, and other neurotic-type illnesses? I'm not up to speed on psychology. I'm trying to ask if the CDC is even using the term "personality disorder" appropriately.
 

SOC

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The Merck manual lists "depressive personality," as a personality type but says that it is not considered a disorder. Merck describes it as

Depressive Personality: This personality type is characterized by chronic moroseness, worry, and self-consciousness. People have a pessimistic outlook, which impairs their initiative and disheartens others. To them, satisfaction seems undeserved and sinful. They may unconsciously believe their suffering is a badge of merit needed to earn the love or admiration of others.
Sorry, I don't qualify; it's my optimism that tends to get on people's nerves. Pollyanna, and all that. Little Merry Sunshine. I try to temper it. :rolleyes:
LOL! I don't qualify, either. Good grief, that is so not me its' laughable.

Okay, who publishes this garbage? Who peer reviews it? Surely they should know the CDC is making up their "psychology" as they go...?
 

Dolphin

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And keep in mind that the 2003 study references three other studies of which the CDC should have been aware: Two showing no difference between MS and CFS and one showing elevated values for patients with chronic illness. This is getting written up and sent to the editors of Psychotherapy and Psychosomatics and other interested/responsible parties.
Are you talking about a proper letter to the editor or just something quicker? Maybe some of us could work on something to submit. By chance, around a month ago I submitted a letter to the editor of this journal - no word yet but I have a good record so far in getting published (could be said to be 100% or close to it - I once sent off an angry quick message which just contained one reference and was pretty lazy as I was angry at an article. It wasn't tight at all. But whenever I've tried to do a tight letter, I've had them published).

Journal has a 500 word limit for letters which gives quite a lot of scope.

None of my letters have been on personality disorders. Other people are probably more au fait with this area than me.
 

CBS

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Sorry if this is a dumb question -- I'm having focus problems following CBS' content-dense post -- but does anyone know if those references [7-10] actually do report "40% of persons with CFS as having personality disorders"? Or is the CDC interpreting them incorrectly?

Also, aren't personality disorders distinct from and more severe (and difficult to treat) than, say, depression, OCD, and other neurotic-type illnesses? I'm not up to speed on psychology. I'm trying to ask if the CDC is even using the term "personality disorder" appropriately.
From the Johnson study:

A total of 45% of CFS subjects met criteria for a concurrent Axis I diagnosis, and 37% met PDQ-R criteria for at least one Axis 11 personality disorder (PD).
Sixteen per cent of the MS group had concurrent Axis I and 41% met criteria for PD [personality disorder].
The majority of Axis I diagnoses observed were of major depressive disorder, with 34% of the CFS and 11% of the MS group diagnosed with major depression.
By inclusion-exclusion criteria no healthy subjects had Axis I disorder, but 11% met criteria for PD.
By inclusion-exclusion criteria I00% of the DEP [depressed] had current Axis I and 88% of these also met criteria for PD.
Note that in total, 37% of the CFS group met criterai for a personality disorder (I agree that this term is being used inappropriately - I would suggest that much of this is an adjustment disorder) while 41% of MS patients met the same criteria.
 

CBS

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Are you talking about a proper letter to the editor or just something quicker? Maybe some of us could work on something to submit. By chance, around a month ago I submitted a letter to the editor of this journal - no word yet but I have a good record so far in getting published (could be said to be 100% or close to it - I once sent off an angry quick message which just contained one reference and was pretty lazy as I was angry at an article. It wasn't tight at all. But whenever I've tried to do a tight letter, I've had them published).

Journal has a 500 word limit for letters which gives quite a lot of scope.

None of my letters have been on personality disorders. Other people are probably more au fait with this area than me.
Hi Dolphin,

I am talking about a proper letter to be published as a commentary. Let's talk. And anyone else who is interested.
 

Dolphin

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Empiric criteria (Reeves, 2005) were used to select "CFS" patients

Methods: 501 study participants were identified from the general population of Georgia: 113 people with CFS, 264 with unexplained unwellness but not CFS (insufficient fatigue, ISF) and 124 well controls.
Just in case there was ever any doubt: this information is enough to tell one that the empiric criteria (Reeves, 2005) were used to define CFS in this study.

For what it's worth, there's a petition, "CDC CFS research should not involve the empirical definition (2005)" at: http://www.ipetitions.com/petition/empirical_defn_and_cfs_research/index.html
 

CBS

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And while I'm at it, I may just fire off a letter to Reeves' boss about his unhealthy and unbalanced preoccupation/obsession with CFS now that he has been removed from his position as CFS director.
 
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I laughed out loud twice in all of this.

As one can see from the choice for my "screen name," I have, up until I became sick, been the extrovert extreme. My husband used to say that I was one of those who wanted folks over at the house every other day.

And you guys may remember, in my fictitious dialogue, I showed they believe there is a personality type with CFS.

The question, folks, is whether this will be reported in mainstream media. Think of the consequences.

Tina
 

Dolphin

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A previous CFS study which found a rate of 12% (same as controls)

A previous CFS study which found a rate of 12% (same as controls)

Full text free at: http://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind0812C&L=CO-CURE&P=R474&I=-3

Chronic fatigue syndrome and DSM-IV personality disorders

J Psychosom Res. 2009 Jan;66(1):13-20. Epub 2008 Nov 22.

Courjaret J, Schotte CK, Wijnants H, Moorkens G, Cosyns P.

Department of Psychiatry, University Hospital Antwerp, Edegem, Belgium. kim.courjaret@uza.be

Abstract

OBJECTIVE:
Personality is an important factor in the research of the chronic fatigue syndrome (CFS).

Although some studies report a high rate of personality disorders--around the 40% level--in samples of patients with CFS, the generalizability of these findings can be questioned.

The present study evaluates the prevalence of Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) personality disorders in a sample of female CFS patients and in two control groups.

METHOD:
The ADP-IV questionnaire (Assessment of DSM Personality Disorders IV) was used to assess the DSM-IV-TR personality disorders at a dimensional and categorical level in a sample of 50 female CFS patients and in two matched control samples of Flemish civilians (n=50) and psychiatric patients (n=50).

RESULTS:
The results indicate a striking lack of statistical significant differences between the CFS sample and the Flemish control group at the level of dimensional Trait scores, number of criteria, and prevalence rates of personality disorder diagnoses.

Unsurprisingly, higher scores at these levels were obtained within the psychiatric sample.

The prevalence of an Axis II disorder was 12% in the Flemish and CFS samples, whereas the psychiatric sample obtained a prevalence of 54%.

CONCLUSION:
The prominent absence of any significant difference in personality disorder characteristics between the female Flemish general population and the CFS samples seems to suggest only a minor etiological role for personality pathology, as defined by the DSM-IV Axis II, within CFS.
 
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oh, and Esther's first response made me laugh because I had not seen such fire in her before. The normally conciliatory tone disappeared this time. Esther was pushed over the edge this time.

Tina
 

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And the CAA's thoughts on all this would be????

Believe me, they're not going to be happy.

I don't even care what the results are....this is where the CDC is going - this is what they are investing in and that's what important. I asked Kim McCleary 1 1/2 years ago when they went after the CDC full force - what if they ended up destroying the program? What if the CDC decided it was just too much trouble and shut it down? Nancy Klimas was just appalled at the idea of losing a 3 million dollar a year program when so little other research was being done. I felt the same way - no way should we risk losing that program no matter how bad it was at the time.

But Kim said losing it might be the best thing that could happen. She was ready to risk putting half the research done on CFS the US into the tank - knowing it would NEVER come back. At the time I thought it had just gotten personal between her and Dr. Reeves. (It seemed to me that it was getting personal - she's usually pretty good at looking at things in a kind of objective manner but she was just angry...). Maybe she was right...

I am just so sick of those guys! (&(&(%#. (Here I am listening to my beautiful Bach and they're killing him. The CDC is killing Bach...they are going too far....if Bach can't survive them then no one can! Ugh! :))

Lacking a stable social environment
Sorry but they can just kiss my ...whatever.......I used to think, well they're digging down into cortisol - its no big deal - it's never going to fix CFS but at least they're finding something - but they've just bottomed out here. Ugh....

The sexual abuse studies turned the CDC's heads. If they are spending money looking for personality disorders they're lost......this program is lost, lost, lost. They've finally become as bad as everybody's said they are....

We'll see who they chose to lead the program. Watch them choose a mental health expert......Maybe we can start laying down in the streets then.
 

Dolphin

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It would be interesting to compare the methodologies. I wonder if the difference is the diagnostic criteria? The Fukuda Belgium group vs the fat, depressed Empirical Georgia group.
I've gone back and added a link to the full text of the Courjaret et al study.