a closer look at the claims about personality traits, illlnes & treatment compliance
Well, I waded through the paper now and have found even more in the text doesn't really stand scrutiny. For example the authors stated that:
"Among the 5 personality dimensions, the strongest correlations were found between neuroticism and both functional impairment and fatigue in CFS and ISF."
But given that neuroticism is "the tendency to experience negative affect" this is at least as likely to be cause as effect. If you're ill, you are experiencing negative effect and if you're more ill, then you could expect to experience more negative effect. So the correlation between measured neuroticism and functional impairment/fatigue might well be driven by the effect of being ill on people's experience. Researchers are specifically supposed to consider confounding factors like this, but these researchers did not.
The authors go on to claim that neuroticism makes people less likely to comply with treatment and more prone to illness:
"Persons with higher scores in neuroticism are more likely to be noncompliant with treatment suggestions, display unhealthy behavioral strategies, lack a stable social environment and are therefore prone to illness."
But oddly, this claim is unsubstantiated by any reference. Which is particularly worrying as this assertion is repeated in the conclusion section of the abstract.
They then add to other personality traits to the mix, agreeableness and conscientiousness:
"Also, decreased agreeableness and conscientiousness scores were found in CFS. Both personality traits might affect compliance with treatment regimes."
They presented no evidence that agreeableness affects compliance. Conscientiousness might well affect compliance, but conscientiousness tends to be measured by agreement with statements like "I see things through" and "I get a lot done". Someone with fatigue might well be less likely to agree with these statements than someone who is healthy - not because they are not conscientious but because ill-health makes it more difficult to do things. I'm not sure it's possible to draw any conclusions aobut how well such patients would comply with treatment that is designed to alleviate their illness.
Overall, they authors don't do anything to substantiate their claim that:
"The maladaptive personality features that we describe interfere with the ability to follow directions and maintain the selfmotivation needed for cognitive behavioral therapy and graded exercise therapy to be effective."
If reviewers and editors did their jobs properly then such intellectually sloppy statements would not get published.
Wouldn't it be great if you read research told you new things about the illness, rather than about the views and shortcomings of the researchers? I know, just a dream.
Well, I waded through the paper now and have found even more in the text doesn't really stand scrutiny. For example the authors stated that:
"Among the 5 personality dimensions, the strongest correlations were found between neuroticism and both functional impairment and fatigue in CFS and ISF."
But given that neuroticism is "the tendency to experience negative affect" this is at least as likely to be cause as effect. If you're ill, you are experiencing negative effect and if you're more ill, then you could expect to experience more negative effect. So the correlation between measured neuroticism and functional impairment/fatigue might well be driven by the effect of being ill on people's experience. Researchers are specifically supposed to consider confounding factors like this, but these researchers did not.
The authors go on to claim that neuroticism makes people less likely to comply with treatment and more prone to illness:
"Persons with higher scores in neuroticism are more likely to be noncompliant with treatment suggestions, display unhealthy behavioral strategies, lack a stable social environment and are therefore prone to illness."
But oddly, this claim is unsubstantiated by any reference. Which is particularly worrying as this assertion is repeated in the conclusion section of the abstract.
They then add to other personality traits to the mix, agreeableness and conscientiousness:
"Also, decreased agreeableness and conscientiousness scores were found in CFS. Both personality traits might affect compliance with treatment regimes."
They presented no evidence that agreeableness affects compliance. Conscientiousness might well affect compliance, but conscientiousness tends to be measured by agreement with statements like "I see things through" and "I get a lot done". Someone with fatigue might well be less likely to agree with these statements than someone who is healthy - not because they are not conscientious but because ill-health makes it more difficult to do things. I'm not sure it's possible to draw any conclusions aobut how well such patients would comply with treatment that is designed to alleviate their illness.
Overall, they authors don't do anything to substantiate their claim that:
"The maladaptive personality features that we describe interfere with the ability to follow directions and maintain the selfmotivation needed for cognitive behavioral therapy and graded exercise therapy to be effective."
If reviewers and editors did their jobs properly then such intellectually sloppy statements would not get published.
Wouldn't it be great if you read research told you new things about the illness, rather than about the views and shortcomings of the researchers? I know, just a dream.
