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I don't think they've misunderstood at all. They're playing games.

Jenkins' chapter for the special issue of British Medical Bulletin 1991 issue 4 seems to be a shortened version of her intro to the book. Whole issue is here: https://academic.oup.com/bmb/issue/47/4

I haven't seen the Wessely, Hotopf, Sharpe book, but I agree they have misquoted Jenkins. As you say, she was carefully outlining Acheson's argument, and it needs to be taken in the context of that whole section of the Introduction. That makes me so cross. The number of times that Wessely and...

I think it looks more like regression to the mean. If they looked at the control group in the same way, they should see exactly the same, although without the 'treatment' effect the increases/decreases on each side would be more balanced (those below the mean would increase by about the same...

Ah - OK. There are two different types of ceiling effect. One could be in the scale itself - as you say, starting at 90 when 100 is the max. But there's also a treatment ceiling effect, whereby a treatment is acknowledged as only able to produce, say, a 10-point improvement. I read it as a...

It's a certainty if they subgroup the data like that! Those with low scores will tend to improve; those with high scores will tend to get worse (before any treatment effects). They don't seem to have selected on PF this time, but that will have happened to a certain extent anyway, by nature of...

I'm trying to get my head round why this makes a difference. Surely the difference in the increases between the subgroups is an indication of regression to the mean, in addition to any ceiling effect? I guess I'm not clear what they are trying to say and why this is a problem. This is from the...

Just to clarify, @Trish, the words in square brackets are mine, to explain what the "issues" were. The previous paragraphs refered to the tendency of patients to attribute their symptoms to external causes, not that 'orthodox medicine' was making those attributions per se.

I found his chapter hard to read without feeling very angry and frustrated by what he was proposing. Some things of course may well make sense, but others, like this, are highly prejudicial. At the end of the section on Attributions (part of A New Model of PVFS), he says: On its own, it seems...

Re: DoH - I liked this disclaimer...

OK. I've now had a chance to have a more detailed look at the book: Post-viral fatigue syndrome (Myalgic Encephalomyelitis) - edited by Rachel Jenkins and James Mowbray (Wiley, 1991). On the whole, support groups, where named, are mentioned favourably. However, this is not always the case...

Post has just arrived. Seems I've got the copy that Prof Mowbray gave to St Mary's Hospital med school library!

This post on the ME Association's Facebook page caught my eye this morning. Over the past few days, I've been looking into the history of research into ME/CFS/PVFS in the late 80s/early 90s (in relation to support groups). But one item mentioned hyperventilation [Rosen et al 1988], so I thought...

Another book I'd like to get my hands on is the Ciba Foundation Symposium 173 monograph on CFS (1993). I suspect that some of the chapters will be similar to those in the book @chrisb and I currently have on order, but it is the discussions between chapters that are likely to be most revealing...

You only have to glance at the Eisenberg reference [available here: pdf] to see that's *exactly* what they are doing. "My argument will consist of four theses. First, that all scientific concepts are inventions of the imagination. Second, that the human sciences are beset by a paradox: what is...

Well that's been a very interesting day. All I can say is that they are experts at laying down the tracks and letting everyone else come to their own conclusions. They themselves tread a very cautious path and are very careful NOT to say that "being in support groups leads to a poor outcome"...

Aha - might have guessed I would get closer by looking at Wessely's contribution:

The whole section of that part of the overview is quite revealing: The Eisenberg reference is available here: pdf I wondered whether there was anything in Sharpe's contribution, and found this (again, not explicit): The ToC for the whole issue is here.

Ha! Me too!

OK. I did a search for the 1991 Wessely book chapter, and this 1989 paper came up instead: Wessely S, David A, Butler S, Chalder T. Management of chronic (post-viral) fatigue syndrome. J R Coll Gen Pract 1989;39(318):26-9. [Commentary here: pdf] But it doesn't explicitly blame support groups...