Association between child maltreatment and central sensitivity syndromes: a systematic review protocol, 2019, Chandan et al

Andy

Andy

Retired committee member
Abstract
Introduction A growing body of evidence is identifying the link between a history of child maltreatment and a variety of adverse health outcomes ultimately leading to significant social and healthcare burden. Initial work has identified a potential association between child maltreatment and the development of a selection of somatic and visceral central sensitivity syndromes: fibromyalgia, chronic fatigue syndrome, temporomandibular joint disorder, chronic lower back pain, chronic neck pain, chronic pelvic pain, interstitial cystitis, vulvodynia, chronic prostatitis, tension-type headache, migraine, myofascial pain syndrome, irritable bowel syndrome and restless legs syndrome.

Methods and analysis Primary electronic searches will be performed in the Embase, MEDLINE, PubMed, Scopus, PyscINFO, CINAHL and Cochrane Library databases and a number of Grey Literature sources including child protection and paediatric conference proceedings. Following independent screening of studies by two review authors, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses template will be used to aid extraction. A meta-analysis will be conducted on the included case-control and cohort studies. The Newcastle-Ottawa grading system will be used to assess the quality of included studies. Results will be expressed as pooled ORs for binary data and mean differences for continuous data.

Ethics and dissemination Ethics approval will not be required. The final results of the review and meta-analysis will be submitted for peer-review publication and also disseminated at relevant conference presentations.
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Open access at https://bmjopen.bmj.com/content/9/2/e025436

Also already mentioned here in this thread about central sensitisation, https://s4me.info/threads/central-sensitization-a-matter-of-concern.5346/page-4#post-145868
 
Do these researchers ever define what they mean by 'central sensitivity' or do they have a way of actually measuring it?

At present it seems to me a circular definition, certain conditions are presumed to reflect 'central sensitivity' and the existence of 'central sensitivity' is evidenced by people having one of those conditions. The use of the phrase 'a selection of somatic and visceral central sensitivity syndromes' presupposes a level of understanding that simply does not exist, these are a set of symptoms and syndromes that are being prejudged on the basis of researcher beliefs rather than scientific evaluation of their clinical presentation.

Is it me or are these sections of medicine/psychiatry operating on a theoretical level that has not progressed beyond nineteenth century Psychoanalasis, just using different terms for their psuedoscience?
 
I agree completely. They talk about " fibromyalgia, chronic fatigue syndrome, temporomandibular joint disorder, chronic lower back pain, chronic neck pain, chronic pelvic pain, interstitial cystitis, vulvodynia, chronic prostatitis, tension-type headache, migraine, myofascial pain syndrome, irritable bowel syndrome and restless legs syndrome." but there seems to be no common thread to them except that they are all seen as "somatic syndromes" with very little evidence except that doctors do not know how to treat them - possibly because there is no research done into them because they are classed as somatic syndromes.

Tension type headaches must be almost universal and chronic lower back pain is widespread so anyone with childhood adversity would stand a good chance of having them without the adversity being important.

Children who are constantly stressed do stand a fair chance of having their health impacted but not in this woolly BPS way which deems that they grow up neurotic.

In my less sick days I did some volunteer work which led me to read widely on child abuse and I became frustrated that no one ever acknowledged physical health problems, even the obvious such as pregnancy and sexual infections. It was all about mental health things. At first glance things look improved, but it is just that they now have a set of physical problems they believe are caused by "thoughts".

The true physical consequences such as lack of growth hormone because of damaged sleep and the effects of continuous high stress hormones are not properly researched. The obvious things such as dealing with injuries are ignored.
 
In another study, childhood trauma and maltreatment was present in 33% of individuals presenting with chronic fatigue syndrome.26 Although unable to provide a pooled risk ratio, a narrative systematic review of 31 studies examining the relationship of chronic fatigue syndrome/fibromyalgia and child maltreatment identified strong association between the two conditions.27
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26 is Childhood trauma in chronic fatigue syndrome: focus on personality disorders and psychopathology by Spanish researchers including Castro Marrero.
27 is Childhood stressors in the development of fatigue syndromes: a review of the past 20 years of research by Chalder and Pariante.
 
I haven't looked at these studies yet (is it even worth it?) but I'm expecting the usual methodological holes that allow all sorts of biases to influence the results. An expert might just be a person that is good at making the same mistake every time...
 
another confounding factor would be inter-generational poverty

low income families -> financial stressors, less able to afford safe clean housing, warm clothes, healthy food, medical care, child care, transport, education.
longer work hours, less recreation, lesser satisfaction in their work roles & poor job security, &c. risk of emotional distress & violence.
less opportunity for children to escape the poverty trap, because can't afford expensive education to join a high-income profession.

those factors are likely to affect the whole family, and continue for generations.
 
Hey, if at first you don't succeed, try again 100 times or so over several decades.

One day, for sure, they will show that the cancer personalities do exist and it is your shitty attitude that killed you. One day, you'll see, you'll see!

(The year is 2459, Crawleybot#782 publishes the 99,999th in a series of identical trials that show possible connections, if you squint hard enough, between bad breath, feelings of inadequacy in early childhood, and the development of the now long-discredited fictitious diagnosis of chronic fatigueity, the sixth iteration in the alternative disease model for fatigue-related MUS, a long-forgotten medical error that disappeared thanks to the relentless pursuit of dedicated researchers.)
 
Peter Trewhitt said:
Do these researchers ever define what they mean by 'central sensitivity' or do they have a way of actually measuring it?
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Explaining made-up ideas usually takes the magic out of them. And when you need the magic part to support your work, trying to explain is usually not recommended.

When demons and mysmia went out of fashion, it's been a struggle ever since to invent fictitious explanations that superficially sound convincing but will deflect people's pesky, inconvenient, demands to show your work. It works for a few years, then you have to adapt, sometimes mix-and-match, combining different discredited ideas in a "novel" treatment or fine-tuning the precise steps angels need to dance on the hairpin for the magic to run its course.

The worst part is that relying on childhood trauma for BS explanations will actually end up hurting people who did experience it, by wasting away time from professionals who could help them. This hurts everyone in the process, the only beneficiaries are mediocre researchers who couldn't make it in research if they worked on real problems instead of making them up.
 
What is overlooked, as @pteropus said are the issues of poverty, food insecurity, lack of adequate medical care, crime, poor education, lack of affordable and secure housing, etc. However, more effectively addressing these means government commitment to increase spending in these areas. Taking a psychological, rather than an effective practical tack regarding these problems, frees governments from this responsibility.
 
From the footnotes:

Funding This systematic review was supported by the Sandwell and West Birmingham, ’Sandwell Medication Education Centre Trustee' grant for junior doctors. Open access fees will be provided by the University of Birmingham.

So we know who to thank for more GIGO.
 
Adrian said:
I assume there will be a problem with this work in that many of the papers look back at past events and try to interpret and blame illness on previous events. Simply by asking people bias can be introduced.
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Yes, how many have been told over and over by authority figures that all their problems are due to child maltreatment? How many have been looking back to their personal history trying to find some clues or events that could give some meaning to what's happening to them before the trial had even started? Only prospective studies can avoid those bias.
 
This, sadly, is what informs decision making. Dressed in the " respectability" of academia , spouting buzzwords that reinforce a group perception. Telling people what they want to hear.

Even though so clearly tying itself in knots, this type of stuff does a lot of damage.
 
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