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Cluster randomised controlled trial of training practices in reattribution for medically unexplained symptoms (2007) Richard Morris et al.

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by fivetowns, Nov 12, 2018.

  1. fivetowns

    fivetowns Established Member (Voting Rights)

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    Sorry if this has already been posted somewhere already. (I searched and couldn't find anything). I haven't had time to study the full article in much detail, but I thought it might be worth looking at -the results in particular.

    Full text here, plus doi
    (If any one needs it.)
     
  2. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    Does that mean that telling people fairy tales makes them feel more ill?
     
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  3. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    The strange thing is that it looks as if the one explanation for it not working they did not discuss is that it was the wrong thing to do.
     
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  4. Lidia

    Lidia Senior Member (Voting Rights)

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    I think it means making people believe fairy tales doesn’t make them better...
     
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  5. fivetowns

    fivetowns Established Member (Voting Rights)

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    ...and the prize for funniest unintentional satire in an academic paper goes to...
     
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  6. alktipping

    alktipping Senior Member (Voting Rights)

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    teaching doctors to replace science with bigoted opinions leads to worse health outcomes who would of guessed that .
     
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  7. Sean

    Sean Moderator Staff Member

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    There goes that damn vexatious reality, always getting in the way of nice neat simple ideas. :rolleyes:
     
  8. obeat

    obeat Senior Member (Voting Rights)

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    Came upon a slide presentation by Prof. Matthias of National hospital for Neurology in London. He referred to doctors who diagnose MUS as disbelievingologists. He leads an autonomic disorders unit and includes CFS in the spectrum.
     
  9. Trish

    Trish Moderator Staff Member

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    Just catching up with this one. My goodness, what an irresponsible conclusion - the method doesn't work so we must redouble our efforts to make it work. I agree with everyone else's comments here.

    Why didn't they draw the obvious conclusions -
    1. the method doesn't work so everyone should stop doing it immediately.
    2. the method should never have been used in the first place as it is dishonest and wrong to tell lies to patients to try to make them go away and stop bothering doctors.

    I see this was from 2007. Do we know whether reattribution is still used?
    I guess I can answer my own question - it's what the PACE CBT was based on - changing illness beliefs and as a result changing behaviour. Look how well that works. :arghh:
     
  10. chrisb

    chrisb Senior Member (Voting Rights)

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    Afraid my reading capacity for unknown texts is not good today, so I have not yet read the paper. However the language seems familiar. There are papers in 1991 by Goldberg and 1993 by Abbey (both with interest in somatisation) in which they clearly use the term attribution in connection with dysfunctional cognitions and maladaptive behaviours which lie at the heart of the Wessely and Sharpe enterprise, and it is not hard to believe that they consider CBT and GET to be exercises in reattribution.

    Apologies if this is already clear.
     
  11. fivetowns

    fivetowns Established Member (Voting Rights)

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    Hi I found this guide sheet about MUS from Royal Society of Psychiatrists from 2011. This is the advice it gives on dealing with MUS patients. It cites the paper in the references. This is what it says about reattribution;
    Which is a very positive spin on the results. But what's more interesting is the advice they give on dealing with MUS:

    It's a lot wordier but very similar to the reattribution techniques listed in the paper. I've quoted them here for comparisons;

     

    Attached Files:

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  12. NelliePledge

    NelliePledge Moderator Staff Member

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    Seems to be a word missing in the title after cluster
     
  13. Trish

    Trish Moderator Staff Member

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    I think 'Cluster randomised' refers to the sampling method, where GP surgeries are treated as 'clusters' and allocated randomly to the active and control groups.
     
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  14. NelliePledge

    NelliePledge Moderator Staff Member

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    Sorry for lowering the tone @Trish I was trying to be rude without saying the F word.
     
  15. Trish

    Trish Moderator Staff Member

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    :rofl::rofl::rofl:
    My F word brain cell was having a holiday!
     
  16. rvallee

    rvallee Senior Member (Voting Rights)

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    Wow. It doesn't work, yet it's the standard. So since it's the standard, we'll keep doing what doesn't work.

    Genius.
     

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