rvallee
Senior Member (Voting Rights)
As defined by this study. Regardless, I agree this is far more significant in itself than whatever causative rabbit they are fetching out of this hat.
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Association of adverse childhood experiences with the development of multiple sclerosis, 2022, Eid et al
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rvallee
Senior Member (Voting Rights)
I'll scream this until my throat is a lump of bloody raw meat, but I am 100% certain this is the real placebo/nocebo effect: imprecision from non-measurement. Everything else is either unaccounted for or an artifact like a random correlation. Once clinical psychology stops messing out as if fuzzy maths accounted for large compounding imprecision, all this silliness will go down as an embarrassment worse than even phrenology was.
Substituting a temperature scale for a subjective rating equivalent (e.g. cold, warm, hot) would yield similar manipulation of outcomes. When there is no right answer, there is no wrong answer either. Especially since more psychometric questionnaires use weird and ambiguous questions, no doubt on purpose as this is one way to manifest the -cebo. Asking simple, direct questions would not yield that.
The recent UngData found that 20% of adolescents experienced abuse "for the first time" during the first months/year of the pandemic. That also got into a lot of headlines despite being similar to previous years and likely not a "pandemic effect". Also "abuse" in this context include things like having been called silly (this was not explicit in most of the newspaper articles covering the topic). 
I haven't read the abstract, or comments, and my blood sugar may be a bit low from a (too) long delayed meal but this statement is stunning: "
Association of adverse childhood experiences with the development of multiple sclerosis, 2022, Eid et al"
What idiot would write this/publish it, oh it was published in the BMJ. Any of these folks reflected on the fact that a recent study identified EBV as a cause of MS?
Reminds me of the local guy who phoned up the official in his pigeon club to tell him that his pigeon had just arrived back in the loft - winning the race. Quite an achievement since the birds weren't released on time owing to bad weather in France. He resigned and I think was sued by those who had purchased "winning" birds --- no such ignominy awaits these guys --- probably some award or other for "valuable" research!
Someone should have a go at BMJ - surely this deserves to be challenged.
Association of adverse childhood experiences with the development of multiple sclerosis, 2022, Eid et al"
What idiot would write this/publish it, oh it was published in the BMJ. Any of these folks reflected on the fact that a recent study identified EBV as a cause of MS?
Reminds me of the local guy who phoned up the official in his pigeon club to tell him that his pigeon had just arrived back in the loft - winning the race. Quite an achievement since the birds weren't released on time owing to bad weather in France. He resigned and I think was sued by those who had purchased "winning" birds --- no such ignominy awaits these guys --- probably some award or other for "valuable" research!
Someone should have a go at BMJ - surely this deserves to be challenged.
While it's true that Table 2 shows that an association between sexual abuse and MS was significant, I thought it was fair to say that the paper in its entirety doesn't constitute evidence of an association between childhood abuse and MS as claimed by the authors:
this paper said:
This is because
1. the other three other types of abuse are not significant
2. the combined 'any type of abuse' which includes sexual abuse is not significant
3. the proposed biological mechanism for an association should apply to any major childhood stressor, not just sexual abuse
4. there is no good reason for excluding the women who had already developed MS at the time of the survey from the analysis. When they are included (in Supplementary Table 2), the association between childhood sexual abuse and MS is only just significant and the confidence interval is very wide, indicating an inconsistent effect. The total number of women with MS reporting sexual abuse in this study is small, making the estimate of impact more questionable and more likely to be due to chance.
5. there is scope for bias in the decisions made about whether a woman's MS diagnosis was accepted as valid or not
6. details about adjustments made for confounders are not given and adjustments made for the woman's birth year (on the basis that levels of childhood abuse have changed over time) are poorly justified
7. there is inadequate accounting for likely correlations between childhood abuse and other factors for which there is probably more evidence of being relevant to incidence of MS (e.g. lack of sun exposure during the Norwegian winter; parental smoking; diet; childhood infections)
8. the authors are not in a state of equipoise, given that they uncritically refer to evidence in favour of psychosomatic effects
9. the body of other evidence does not provide consistent support for childhood abuse causing MS (From the paper: "Few have studied the association between childhood abuse and MS, and these studies were not prospective and arrived at different conclusions.")
hibiscuswahine
Senior Member (Voting Rights)
Sadly I am not surprised by the level of abuse found having spent my psychiatric career dealing with the outcomes. There are many modifying factors (for instance - genetics, age, severity, social support, early intervention etc) to why an individual who has experienced abuse (of any form) will go on to have a psychological effects. The literature is still emerging around brain inflammation and permanent damage to neural pathways and networks which then may require psychiatric input.
In Norway the level of childhood abuse and neglect in an adolescent sample found in 2019 can be read here.
https://www.nkvts.no/english/report...-norwegian-adolescents-12-to-16-years-of-age/
In NZ, (which has a higher rate of child abuse than Norway, https://www.oecd.org/els/soc/SF3_4_Family_violence_Jan2013.pdf)
A recent cross-sectional study has shown an increased rate of family violence due to the pandemic. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241658
In Norway the level of childhood abuse and neglect in an adolescent sample found in 2019 can be read here.
https://www.nkvts.no/english/report...-norwegian-adolescents-12-to-16-years-of-age/
In NZ, (which has a higher rate of child abuse than Norway, https://www.oecd.org/els/soc/SF3_4_Family_violence_Jan2013.pdf)
A recent cross-sectional study has shown an increased rate of family violence due to the pandemic. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241658
This is indeed a paper that keeps on giving. Yes, for Table 2, all of the percentages for reports of various childhood abuses are wrong
Table 2 - total 300 women
Emotional abuse 56/300 = 18.7% not 20%
Humiliation 48/300 = 16.0% not 17%
Threat 20/300 = 6.7% not 8%
Sexual abuse 34/300 =11.3% not 13%
Physical abuse 22/300 = 7.3% not 9%
The percentages in the Supplementary Table 2 are also wrong
Supplementary Table 2 -total 397 women
Emotional abuse 71/397 = 17.9% not 19%
Humiliation 60/397 = 15.1% not 16%
Threat 26/397 = 6.5% not 8%
Sexual abuse 39/397 =9.8% not 11%
Physical abuse 28/397 = 7.1% not 8%
It's not just a matter of changing the denominator to another number i.e. changing the total of 397 women to 374 women produces the reported 19% for emotional abuse, but most of the other percentages are still wrong. There seems to be a significantly different denominator used for each abuse category e.g. 374 for Emotional Abuse and 355 for Sexual Abuse.
I can't think of a reason for that to be other than there has been a series of post hoc adjustments and the authors ended up quite muddled.
Is there any evidence for childhood abuse causing brain inflammation that stands up better to scrutiny than this study?
hibiscuswahine
Senior Member (Voting Rights)
No. There is a lot of different lines of research going on into trauma and it’s mental health effects especially in the area of depression, psychosis and PTSD, all have methodological problems and major limitations.
If interested here is review article of the current findings on a small area of this research. https://www.sciencedirect.com/science/article/pii/S2666354622000084
Sounds like these authors (like some well known others) are more in a state of equinoise.
Jonathan Edwards
Senior Member (Voting Rights)
To a one time inflammation scientist that looks like complete nonsense to be honest.
The author is not very good at English either.
edit: I see that she is a great expert in fact - a first year part-time Phd student!
And she works for Carmine Pariente at King's.
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Snow Leopard
Senior Member (Voting Rights)
It also suggests that the editors and peer reviewers aren't doing their job properly.
A problem for me with a lot of this litterature (that I've read at least) is that what is considered abuse or an adverse event has been decided in advance, and someone who has experienced the "wrong" type of abuse or adversity is not recognized.
hibiscuswahine
Senior Member (Voting Rights)
Yes, lots of psychiatrists, psychologists, government policy makers, the wellness industry and lots of the public here are are pretty sold on this, I am not. Many psychiatrists, especially in the private sector are getting very excited and claiming a variety of psychotropics can treat the “inflammation of trauma” mainly via histaminergic effects etc and neuroplasticity etc, not convinced.
Diseases can have more than one predisposing factor, so I don't see the point of your comment.
The point here, as others have said, is that in this case the research seems to be flawed.
I wonder whether there was incomplete filling in of questionnaires, so they used as denominator the number for each question who filled in that question.
That could be one reason. But, it suggests that a lot of the participants only answered in a very patchy sort of way. There's no mention of large scale patchiness in the answering of the individual abuse questions.
They do say
So, only 0.8% of those who answered the week 30 questionnaire did not answer all of the 4 abuse questions.
Working with Supplementary Table 2, they report that 397 women had or went on to develop MS.
Here are the required numbers of women answering to give the percentages they report:
Emotional abuse 374
Humiliation 375
Threat 325
Sexual abuse 355
Physical abuse 350
Emotional Abuse is the amalgamation of the Humiliation and Threat responses. If only 325 women answered the Threat question, how could there be 374 complete responses to the amalgamated Emotional Abuse category? It isn't possible.
I've double checked the calculations. The authors report 26 women with MS experienced Threat and they constituted 8% of the women with MS. But 26 out of 397 is 6.5%. To be 8% of the total, the total has to be 325.
Another too late meal - poor organisation skills!
I remain entirely baffled --- EBV is strongly linked to MS (large study of US army personnel) and presumably if a sufficiently large population were available, who had post (EBV) viral onset, then pre-disposing genes could be identified. Why anyone would wonder off that path into psychological/trauma territory isn't at all clear to me. Probably sums these folks up the answer to all is psychological/trauma ---
rvallee
Senior Member (Voting Rights)
Depends. If the job is to publish papers, as many papers as possible, they're doing their job. And it is.
I think it's fair to say that academic publishing is about publishing papers and nothing else. Whether they are any useful, or accurate, is not anyone's actual job. Even when errors are found out and pointed to an editor, we've seen this many times, they're basically puzzled and respond with "well, what do you want me to do here?". This happened to Tuller many times.
I remember at one point Sharpe responded to someone about how PACE had harmed him. He said he doesn't know the person (as if this changes anything) and that his job is to write clear papers, or something close to that. To write "clear papers". That's it.
He writes papers. The papers get published. This gets him more funding to publishe more useless papers. The editors skim the papers and hit the publish button, even if half the peer reviewers admit they didn't even read the paper. That's the job. Science has taken a back seat, it no longer even matters since the job is simply to publish papers, even worthless ones.
It's a cultural problem, the damn Iron law of institutions. Academic medicine has basically become the Catholic church to Galileo, it exists to preserve a power structure, everything else is secondary. Marketing above knowledge, reputation far above outcomes.