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Psychological Trauma and Functional Somatic Syndromes: A Systematic Review and Meta-Analysis

Bob

Senior Member
Messages
16,455
Location
England (south coast)
Psychological Trauma and Functional Somatic Syndromes: A Systematic Review and Meta-Analysis
Niloofar Afari, Sandra M. Ahumada, Lisa Johnson Wright, Sheeva Mostoufi, Golnaz Golnari, Veronica Reis, and Jessica Gundy Cuneo.
Psychosomatic Medicine December 12, 2013 PSY.0000000000000010
Published online before print December 12, 2013
doi: 10.1097/PSY.0000000000000010
http://www.psychosomaticmedicine.org/content/early/2013/12/11/PSY.0000000000000010.abstract
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
Please don't shoot the messenger! :nervous: * (Disclaimer: Based on analysis of previous similar research I'm certain that this study will prove to be weak and meaningless on close inspection especially in terms of studying CFS/ME.)

One minor** flaw in the study is that CFS (as opposed to chronic fatigue) is not a Functional Somatic Syndrome: It has an immunological pathology with neurological symptoms, and is categorised as neurological by the WHO.

I haven't got access to the full paper. Perhaps it might be useful to study some of the detail: i.e. How is CFS mostly defined (e.g. Oxford, Fukuda)? What sort of trauma is most associated with CFS (e.g. physical or psychological trauma)? Is it all just an utter load of nonsense?


* I know you won't :)
** When I say 'minor' I mean 'major'.
 
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biophile

Places I'd rather be.
Messages
8,977
@Bob. I am betting that the evidence base for CFS primarily involves research which was retrospective and/or did not medically evaluate patients, two obvious major flaws in such research. I would like to know how the association for CFS can be "robust" if comprised from poor quality research:

Results: Individuals who reported exposure to trauma were 2.7 (95% confidence interval = 2.27–3.10) times more likely to have a functional somatic syndrome. This association was robust against both publication bias and the generally low quality of the literature. The magnitude of the association with PTSD was significantly larger than that with sexual or physical abuse. Chronic fatigue syndrome had a larger association with reported trauma than did either irritable bowel syndrome or fibromyalgia. Studies using nonvalidated questionnaires or self-report of trauma reported larger associations than did those using validated questionnaires.

Retrospective research is notorious for producing suspicious positives, particularly when people are suffering now, which may distort memories of previous suffering. In chronic pain, there is a tendency for the research to show associations when retrospective but not prospective. One study had both measures on the same people and found a retrospective but not prospective association, which questions the presumed association, although there may be limitations with that study IIRC.

I think the association between trauma and CFS is a combination of poor research artifact, misdiagnoses, real effects of stress on physiology (often exaggerated and overgeneralized but still plausible), and perhaps an early warning system that something is going wrong biologically e.g. as an example for this I often draw a parallel to the increased rates of pre-morbid depression in those who later develop Parkinson's disease.

Chronic fatigue syndrome had a larger association with reported trauma than did either irritable bowel syndrome or fibromyalgia.

I bet that part comes from the CDC studies using the notorious Reeves et al operationalization of CDC criteria which saw a sudden 10 fold increase in prevalence figures and an unhelpful overlap with depression.

Well-conducted prospective research on medically diagnosed ME/CFS or GTFO!?
 
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Ambrosia_angel

Senior Member
Messages
544
Location
England
Please don't shoot the messenger! :nervous: *

One minor flaw in the study is that CFS (as opposed to chronic fatigue) is not a Functional Somatic Syndrome: It has an immunological pathology with neurological symptoms, and is categorised as neurological by the WHO.

I haven't got access to the full paper. Perhaps it might be interesting to study some of the detail: i.e. How is CFS mostly defined (e.g. Oxford, Fukuda)? What sort of trauma is most associated with CFS (e.g. physical or psychological trauma)? Is it all just an utter load of nonsense?


* I know you won't :)
Well unless I've had trauma or have had physically or sexually abuse that I really can't remember then this clearly doesn't apply to me then. I must be in the 5% that never experienced trauma. I was pretty normal. Not always happy but very very normal. Normal for the Uk standard of a ambitious teenage. I never had any serious problems in life which I look back on as very grateful.
 

SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
Ahem. Allow me to summarize:

Idiots reach idiotic conclusions based on idiotic assumptions. The End.

"Arrogant mental masturbation by pretentious arseholes", hm? ;)

do these scumbags ever bother like TALKING TO THE PATIENTS?!

Despite the crap in my life, I never was depressed until I had THIS illness for over six years!
With one odd exception: bug going around that I got, wasn't very bad but I recall for couple of days feeling way out of sorts, mentally. Pretty sure it was "depression" I just didn't have the experience to categorize it at the time, which leads to an obvious conclusion....
 

A.B.

Senior Member
Messages
3,780
Science by questionnaire isn't science. Patients adjust themselves to the expectations of others. When these others believe in a causal relationship between psychological trauma and illness, then patients will be more likely to see things in that way too.

I remember very well how initially I felt guilty about being ill because the opinion of others around me was that I should feel guilty.

Psychosomatic medicine is quacky and superstitious and not interested in reality.
 

Snowdrop

Rebel without a biscuit
Messages
2,933
Science by questionnaire isn't science. Patients adjust themselves to the expectations of others. When these others believe in a causal relationship between psychological trauma and illness, then patients will be more likely to see things in that way too.

I remember very well how initially I felt guilty about being ill because the opinion of others around me was that I should feel guilty.

Psychosomatic medicine is quacky and superstitious and not interested in reality.

Agreed. The whole genre of pyschosomatic medicine would make an excellent pate.
Crackers anyone. . .