The problem with these studies is that they are based on a convenience sample, and given that most people know they're talking to a psychologist etc, it biases towards people who may believe in the hypothesis and may explicitly or implicitly bias their responses to favor the hypothesis...
If we were inactive because we have false beliefs about our capacity to be active, then CBT or GET would surely change that and lead to an increase in activity.
Direct activity measures is the best way to confirm or eliminate that hypothesis.
There have been a lot of genetic false positives, but a high quality GWAS provides some confidence in the results. Certainly worth funding much research targeting these loci and seeing how they lead to depression.
I bet $200 to be given to a legitimate ME or CFS charity, that this treatment will not be found to be effective in a well designed and sufficiently large randomised controlled (double blinded) study.
Note, $200 is a lot of money for me right now, but would be a trivial amount of money if we...
The 2 day exercise test results, namely the unusual lower performance (and it is due to lower metabolic efficiency) at the ventilatory threshold on the 2nd day suggests that any sensitisation/maladaptive signaling is necessarily happening at the cellular/peripheral level too.
From the manuscript:
Notice the language used: "assume" "possible" "perhaps" "could".
The simplest conclusion is that there is no long term effect of CBT on chronic fatigue, regardless of the underlying cause.
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