Comforting factors that influence the severity of fatigue and other somatic symptoms from the perspective of CFS, 2020, Overgaauw

[Dolphin]

Source: Utrecht University Date: June 2, 2020 URL: https://dspace.library.uu.nl/handle/1874/397594

https://dspace.library.uu.nl/bitstream/handle/1874/397594/Overgaauw (4297776) thesis.pdf

Comforting factors that influence the severity of fatigue and other somatic symptoms from the perspective of individuals with chronic fatigue syndrome: A concept mapping study
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Eefje Overgaauw - Faculty of Social and Behavioural Sciences Theses, Utrecht University, The Netherlands

Abstract

Objective To broaden the clinical focus beyond suffering in individuals with chronic fatigue syndrome (CFS), it is important to focus on personal sources of strength and resilience in these individuals. The main aim of this study was to identify and examine the underlying hierarchical structure of soothing influences on somatic symptoms from the perspective of individuals with CFS.

Methods Online interviews yielded a comprehensive overview of 40 soothing influences that were sorted in a card sorting task according to meaning and importance by 73 individuals with chronic somatic symptoms, including seven individuals with CFS. Moreover, the participants completed the PHQ-15 to assess somatic symptom severity. A hierarchical cluster analysis (squared Euclidean distances, Ward's method) was used to obtain the underlying hierarchical structure of soothing influences. The relative importance of each soothing cluster was assessed by a repeated measure analysis of variance, whereas a linear regression analysis was computed to assess associations between soothing clusters and somatic symptom severity. \

Results Hierarchical cluster analysis revealed four overarching categories of soothing influences: ‗Social support', ‗Medical Support', 'Adjustment', and 'Self-management'. These domains comprised 10 clusters. There were no significant differences in the perceived importance of soothing clusters according to seven individuals with CFS, although there was a wide range of individual differences. Adjustment was related to somatic symptom severity, whereas there was no association between social support, medical support, or self-management, and somatic symptom severity.

Conclusions This study revealed an encompassing hierarchical structure of soothing influences based on individuals with chronic somatic symptoms, including patients with CFS. This structure will guide the development of personalized treatment of individuals with CFS.

Keywords: Chronic fatigue syndrome; concept mapping

 

[Trish]

I've tried to read this, but it's so full of assumptions without basis, leaps of logic and nonsense I can't take it seriously.

 

[Cheshire]

Conclusions This study revealed an encompassing hierarchical structure of soothing influences based on individuals with chronic somatic symptoms, including patients with CFS.

They themselves had to admit that there was no association between symptoms and the so-called "factors", but they nonetheless continue to call them "factors" and talk about their "soothing influences".

 

[dave30th]

"This study revealed an encompassing hierarchical structure of soothing influences based on individuals with chronic somatic symptoms, including patients with CFS."

is this ancient Aramaic? Can someone translate it into English for me?

 

[Trish]

Here's my translation of the whole thing:

'We sorted stuff patients said into obvious categories using completely unnecessary fancy stats, then, despite the fact that none of them showed any association with symptom severity, we concluded our favoured therapies would be helpful.'

 

[Jonathan Edwards]

"This study revealed an encompassing hierarchical structure of soothing influences based on individuals with chronic somatic symptoms, including patients with CFS."

is this ancient Aramaic? Can someone translate it into English for me?

You are not trying hard enough, @dave30th. Think of an Italian ice cream store. Sort the soothing influences into cone size, chocolatey and other toffeeish ones, pink ones, green ones and white ones. Then build a hierarchy on your cone and coloured scoops and eat it before it all drips on the pavement (sidewalk).

 

[chrisb]

Seeing the source of the paper I could not get past the memory of Professor Jan van Strabismus whom God preserve of Utrecht.

I cannot imagine why.

 

[rvallee]

 

[rvallee]

Alternatively, this is the dick in a box model of scientific research.

It goes like this:

1. Cut a hole in a box
2. Put your junk in that box
3. Open that box

From that point you are free to argue whichever preferred explanation: dicks come in boxes, or, boxes come with dicks. Decades of vigorous drunken debates can ensue. If you simply ignore causation or context, you can argue anything you want. Does it really matter that you put it there in the box? Not really, it's there anyway and isn't that all that really counts in the end?

 

[dave30th]

Think of an Italian ice cream store

Thanks, Jo. Given current restrictions, I can imagine that while masked looking at the ice cream flavors in my local corner store. I'll do that, then try reading the sentence again.

 

[NelliePledge]

The standard of translation of some of these alleged scientific papers appears to be as shoddy as the science. At least I’m assuming this terminology - soothing factors - is due to poor translation rather than a term that’s actually used by academics. But even as I write I’m realising I could be totally wrong. After all these people use words in the most bizarre ways.

 

[Hutan]

I've tried to read this, but it's so full of assumptions without basis, leaps of logic and nonsense I can't take it seriously.

Indeed. To illustrate. here's just part of one paragraph:

... Whereas the exact cause of CFS remains unknown, there is evidence that physiological and psychological factors play a role. For example, it has been suggested that CFS involves immune system disorders, cardiovascular abnormalities as well as central nervous system disorders (Estévez- López et al., 2018).

What evidence is there for psychological factors? The example of the evidence is that someone has suggested that CFS 'involves immune system disorders, cardiovascular abnormalities as well as central nervous system disorders'. Someone suggesting something isn't evidence. Furthermore, 'immune system disorders, cardiovascular abnormalities and central nervous system disorders' aren't evidence of 'psychological factors playing a role', at least not without further explanation.

Besides, it has been revealed that somatoform disorders, which may have some overlap with CFS, involve deficits in affect regulation (Waller & Scheidt, 2004).

So, in that single sentence, there are the questionable assumptions that:
1. somatoform disorders exist;
2. that somatoform disorders involve deficits in affect regulation ( the ability of an individual to modulate their emotional state in order to adaptively meet the demands of their environment);
3. somatoform disorders may have some (unspecified) overlap with CFS;
4. therefore people with CFS have deficits in affect regulation.

In accordance, Pinto et al. (2019) propose, based on Gilbert‘s model of affect regulation (Gilbert, 2016), that fibromyalgia is the result of an imbalance between an overactive threat-detection system and a deficient soothing system. Given the overlap between CFS and fibromyalgia,Gilbert‘s model (2016), which makes a distinction between three affect regulation systems (threat, drive, and soothing), is considered to better understand and treat CFS as these systems seem to modulate neural activity of somatic symptoms.

Having made those heroic assumptions, the author continues:
1. There are three affect regulation systems (threat, drive and soothing);
2. Fibromyalgia is the result of an over-active threat-detection system and a deficient soothing system;
3. CFS and Fibromyalgia overlap;
4. Therefore, considering these affect regulation systems will lead to better understanding and treatment of CFS;
5. This is because these affect regulation systems 'seem to modulate neural activity of somatic symptoms' - whatever that actually means.

 

[dave30th]

whatever that actually means.

I don't think much of it means anything at all.

 

[Amw66]

Indeed. To illustrate. here's just part of one paragraph:


What evidence is there for psychological factors? The example of the evidence is that someone has suggested that CFS 'involves immune system disorders, cardiovascular abnormalities as well as central nervous system disorders'. Someone suggesting something isn't evidence. Furthermore, 'immune system disorders, cardiovascular abnormalities and central nervous system disorders' aren't evidence of 'psychological factors playing a role', at least not without further explanation.


So, in that single sentence, there are the questionable assumptions that:
1. somatoform disorders exist;
2. that somatoform disorders involve deficits in affect regulation ( the ability of an individual to modulate their emotional state in order to adaptively meet the demands of their environment);
3. somatoform disorders may have some (unspecified) overlap with CFS;
4. therefore people with CFS have deficits in affect regulation.


Having made those heroic assumptions, the author continues:
1. There are three affect regulation systems (threat, drive and soothing);
2. Fibromyalgia is the result of an over-active threat-detection system and a deficient soothing system;
3. CFS and Fibromyalgia overlap;
4. Therefore, considering these affect regulation systems will lead to better understanding and treatment of CFS;
5. This is because these affect regulation systems 'seem to modulate neural activity of somatic symptoms' - whatever that actually means.

I like ice cream. This is more like a really shit pizza.
The type of flavour combinations that only a pregnant woman could conjure up.

 

[Hutan]

So, they did a survey of 701 people with chronic symptoms according to self-report - they had all sorts of diseases. Answers from the survey produced a list of things that people found helpful for 'soothing'. There was quite a bit of manipulation of the results by the researchers e.g. if something was specific to just women or old people, it didn't make it onto the list.

Second, it had to apply to the entire group (e.g., soothers that only concerned women or old people were deleted).

In total 701 people participated in the online interview. The participants form Europa came from the Netherlands (n = 404, Belgium (n =51), Cyprus (n = 18), Greece (n = 30), and Portugal (n = 29). The participants from Latin-America came from Brazil (n = 109), Peru (n =20), and other countries (n =40). 73 Dutch participants were included in the card sorting task and the subsequent hierarchical cluster analyses that yielded the dendrogram (organization of clusters). Seven of these participants were diagnosed with chronic fatigue syndrome and reported on average a medium to high somatic symptom severity as measured with the PHQ- 15, M = 14.83 (9-18). These participants were used in subsequent analyses.

Then 7 (yes!) people with CFS picked out things out of the list that they found helpful.

Concerning to the 40 separate statements, the following influences were experienced as most soothing: 'having the freedom to do something in the way I want to do it myself', 'sleeping', 'understanding my disease', and ' a calm surrounding such as nature, one‘s own house, pleasurable sound and light'.

Somehow this supports the author's desire for us to be fixed by mindfulness and listening to music:

These results do relate to the expected categories and are in line with the scientific literature that underlines the soothing effect of mind-body therapies, included in the category ̳self- management‘, social support, and music included in the category ̳adjustment‘ in patients suffering from CFS

So, yeah. It would be laughable except people are coming out of education systems with Masters degrees for producing this kind of prejudiced waffle.

 

[ME/CFS Skeptic]

Am I correct that this is a master thesis that tried to examine a hierarchical structure of 'soothing factors' in CFS patients, while only having data for 7 CFS patients? That would mean that probably more patients responded in this thread than in the actual study.

 

[NelliePledge]

Am I correct that this is a master thesis that tried to examine a hierarchical structure of 'soothing factors' in CFS patients, while only having data for 7 CFS patients? That would mean that probably more patients responded in this thread than in the actual study.

Thanks Michiel you made me laugh.

They would have done better to just cut out the ‘research’ and post their questions straight on here.

 

[Trish]

Am I correct that this is a master thesis that tried to examine a hierarchical structure of 'soothing factors' in CFS patients, while only having data for 7 CFS patients? That would mean that probably more patients responded in this thread than in the actual study.

I suspect it was a study allocated to a group of Masters' degree students, with each being allocated one condition to focus on.

73 individuals with chronic somatic symptoms, including seven individuals with CFS

This poor mug got allocated the CFS subgroup which turned out to only get 7 participants and had to try to make something out of it in order to be awarded their degree.

 

[Wonko]

On a personal level (N-1) I would find a having few million quid quite soothing.

It would certainly help relieve some of the stressors in my life, a lot of which are caused by my not having a few million quid.

A lot of the other stressor, not all, but a lot. could be reduced by having a few million quid, to pay people to help me do things, or to do things for me.

There exists a possibility I may find this 'comforting'.

So...if another study into things that sooth people with chronic illness is to be conducted.....

 

[shak8]

Poor copy editing of the manuscript or note taking. The fibromyalgia-threat detection concept is not from 2016. The book referenced is Paul Gilbert's Human Nature and Suffering, published in 1996, not 2016.

Poor quality research paper, indeed. Maybe author is missing some soothing attention to detail.

(Concept was of interest to me, as I made a reference to noise being 'threatening' in a post about PEM.)

Edit note: British publication of referenced book was 1989 per Wikipedia bio. US publication found for 1996.