Thesis Exploring overcontrolled personality traits in individuals with fibromyalgia and chronic fatigue syndrome, 2023, Horton

Dolphin

Dolphin

Senior Member (Voting Rights)
From: Dr. Marc-Alexander Fluks


Source: Royal Holloway, University of London
Date: September 2022 and March 22, 2023
URL:
https://pure.royalholloway.ac.uk//files/50888929/2023hortonephd.docx

https://pure.royalholloway.ac.uk/en/publications/ffb6e196-f6e2-4897-9289-29696651d703

https://pure.royalholloway.ac.uk/en...lled-personality-traits-in-individuals-with-f


Exploring overcontrolled personality traits in individuals with fibromyalgia and chronic fatigue syndrome
---------------------------------------------------------------
Eleanor Horton
- Department of Psychology, Royal Holloway, University of London, UK


Abstract

Fibromyalgia (FM) is a long-term health condition affecting around 2% of
the UK population. Symptoms of FM include widespread muscular pain,
tiredness, fatigue, increased pain sensitivity, sleep problems, poor
memory, and headaches. Research has also shown that individuals with FM
may also be likely to experience mental health difficulties such as
anxiety, depression, and personality disorders. As a result,
psychological interventions or therapies have been recommended as a
treatment option for individuals with FM. One psychological therapy that
has been shown to have a positive impact on pain and other FM symptoms
is cognitive behavioural therapy (CBT). However, some individuals with
FM do not appear to benefit from CBT and other individuals may find that
their symptoms only improve in the short-term. There is an increasing
emphasis in the healthcare system to provide better support for
individuals with long-term health conditions, particularly those who
also experience mental health conditions. This has led to more research
exploring how other psychological interventions may be effective in
managing FM, therefore it is important to have an updated review of the
literature.

This updated systematic review of the literature aimed to understand how
effective a range of psychological interventions are for psychological
outcomes such as anxiety, depression, and sleep quality in individuals
with FM. The current review aimed to provide an update on previous
reviews about psychological interventions for FM by including studies
published from 2017 onwards. Three electronic databases were searched
for FM-based studies that used a randomised controlled (RCT) design to
compare at least one psychological intervention to at least one
comparative intervention, for example a waitlist control group. The
studies included in the review had to include at least one psychological
outcome such as a measure of depression or anxiety. Ten studies were
included.

It was found that:
* A range of psychological interventions were used; CBTs, personal
construct therapy (PCT), internet-delivered exposure therapy (iExp),
attachment-based compassion therapy (ABCT), mindfulness-based stress
reduction (MBSR) and multicomponent interventions that include more than
one approach combined.
* All interventions showed improvements in at least one psychological
outcome.
* The number of different psychological outcomes and interventions that
were measured across the studies made it challenging to make meaningful
comparisons across the studies.
* Overall, the findings were promising but further research is needed to
understand if these improvements remain longer-term.

The findings of the systematic review show that psychological
interventions can be useful for FM and the empirical study showed that
coping styles and individual personality characteristics may be
important to understand further, potentially to tailor treatments to
better meet the needs of individuals with conditions such as FM and CFS.
However, this may need further exploration, and it is hoped that other
clinicians or researchers may be encouraged to explore overcontrolled
coping in other groups. It is hoped that the systematic review and
empirical study encourage further research into further understanding
these conditions and highlights that there is still much we may need to
understand further about how improvements are maintained or not and any
factors that may impact this.

In the future, research would likely benefit from recruiting more
participants from a range of different backgrounds, along with
addressing the limitations discussed in this study. To maximise the
reach of the study, findings will be shared with participants,
organisations that assisted with advertising on social media. Findings
will also be presented and potentially published in an academic journal.

--------
(c) 2022, 2023 Royal Holloway, University of London
 
The lay summary of the thesis makes the study clearer.

First there was a systematic review that looked at 10 recent FM studies specifically to see whether psych. interventions helped with anxiety or depression.

Then there was a new study based on questionnaires.
Here's the lay summary of that study:


The empirical study hoped to build upon the systematic review as research has also found FM is linked to higher rates of personality characteristics such as perfectionism and alexithymia (a term used to describe a lack of emotional expression). These characteristics are part of an overcontrolled coping style, whereby a person’s biological temperament combined with environmental, cultural, or familial experiences, predisposes them to coping with challenges through rigid patterns of avoiding uncertainty or novelty, perfectionism, distancing from others and not expressing emotions (alexithymia).

Research suggests overcontrolled traits and coping are more prevalent in certain conditions that may be resistant to treatment, such as personality disorders which as stated, can co-occur frequently in FM. These overcontrolled traits are also found in chronic fatigue syndrome (CFS), another long-term health condition characterised by disabling fatigue and other symptoms that overlap with FM, such as sleep problems, muscle ache, depression, and personality disorders. As there are high rates of overlap and comorbidity between FM and CFS, both conditions were explored in the study.

The study aimed to explore whether overcontrolled traits and coping is higher in individuals with FM and CFS compared to individuals without these conditions. It was hoped that this may improve our understanding about personality and temperament and support the potential use of more personality-tailored treatment interventions for these client groups to improve the efficacy of current interventions.

The study used an online survey design with 129 individuals taking part. 40 reported diagnoses of FM and/or CFS, forming the clinical group. 89 individuals without these conditions formed the non-clinical control group. Participants were recruited online through advertising on social media and through Fibromyalgia Action UK. Participants completed a number or questionnaires about their health, broad overcontrol traits plus overcontrolled traits such as alexithymia, experiential avoidance, personal need for structure, sense of social safeness, and loneliness.

It was found that:

The two groups could not be considered significantly different from each other across the measures. This was due to mixed findings whereby the non-clinical group had higher levels of broad overcontrol than the clinical group, but the groups did not differ on personal need for structure, alexithymia, or emotional loneliness. The clinical group showed higher levels of experiential avoidance, social safeness, total and social loneliness.

Data from the two groups was therefore pooled together to run further analysis.

Overcontrolled traits were related to personal need for structure and loneliness but was not correlated with experiential avoidance or overall alexithymia. Alexithymia, need for structure and social safeness significantly contributed to the model that predicted experiential avoidance, but overcontrol did not. Only social safeness significantly contributed to the model predicting loneliness.

The findings of the systematic review show that psychological interventions can be useful for FM and the empirical study showed that coping styles and individual personality characteristics may be important to understand further, potentially to tailor treatments to better meet the needs of individuals with conditions such as FM and CFS.
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my bolding

I've cut off the bit at the end that goes on about further research being needed.
 
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So it looks to me from the bits I've bolded in the lay summary that in fact the control group had higher levels of overcontrol than the patient group. And the only differences were things that relate to being socially isolated due to being sick, not anything to do with personality types. (Checked the data and that's correct)

The author does her best to explain away the unexpected(to her) results and still say that personality characteristics contribute to FM and ME/CFS and need to be addressed by therapy.
 
I'm not sure if it would read any different if you just swapped most of the terms here with codes. Just numbers, like ASCII codes. Swap "fatigue" for 7837 and anxiety for 0034, or whatever. They don't seem to actually mean anything, are simply placeholders for ideas that have no depth whatsoever. Then they do BS statistical stuff on fake numbers and how they relate to other codes through their fake numbers.

A decades-long loop of "promising" research that needs more research. For decades. And it never ends, funding is always there because clearly no one gives a damn about the people this affects.
 
since when is there any evidence that personality disorders are more common in FM or CFS? I have seen them try to say anxiety/depresion but not personality disorders, have i missed something. In fact i never came across a person with ME who had a PD, although i'm sure there will be some just as there will be some people with CFS/FM who have MS/RA/broken limbs/cancer etc etc
 
 
SNT Gatchaman said:
The supporting references are given as —

Trying to be perfect in an imperfect world: A person-centred test of perfectionism and health in fibromyalgia patients versus healthy controls (2019)
Psychological therapies for chronic widespread pain and fibromyalgia syndrome (2019)
Recent advances in understanding physical health problems in personality disorders (2018)
A systematic review of personality disorders and health outcomes (2018)
Pain experience in Fibromyalgia Syndrome: The role of alexithymia and psychological distress (2017)
Prevalence of personality disorders in patients with fibromyalgia: a brief review (2017)
Personality and Fibromyalgia Syndrome (2012)
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the poor so and sos with this condition. It really isn't on anymore for dodgy sections of certain subjects to be allowed to continue with made-up personality terms just to slight people with certain conditions. These really are inventions as per psychology with things like 'perfectionism' not being internally consistent at all and so any right-minded research claiming to use these isn't really on and should as per the subject I think be being questioned as to whether they are weaponising 'pretend labels'. You quickly learn how much of the personality nonsense is just inconsistent rambling tripe, given teh Big 5 was invented to see 'how close' any general terms could get to describing anything. Even Type A is doubted now (but it did apply to that demographic that might be heard of course).

If there really was something underneath it they'd be using those specifics - tending to not stop doing a piece of work until it is finished, and not 'tropes' which mean nothing. But then what would that actually mean with regard whatever they are trying to push? There are so many factors involved just in that which could be external and situational.

Silly, silly researching to be basically still thinking just for a nice job area they can take an illness and suggest 'if only these people weren't the way they were they wouldn't be ill' isn't as transparent as it is. I just don't get why the area isn't labelled for what it actually is and sits under when it is down this end of the reliability and accuracy scale.

HIlariously it isn't even like they've got a cure or treatment for it, because they can't define what it is reliably anyway. It's just a layperson's label used by a pretty poor area. So it's a one-liner added as an association and lable meaning nothing and down to individual interpretation of whatever therapist to just say 'have you thought of not being perfectionist' - what a ruse.

How mad would you drive an ill person who is having an awful life with pain already to force them to spend years being kidded it's because they like pretty pens or were too much of a goody two-shoes in school, I mean it might have the benefit for the business offering these courses, and in distracting the patients from hassling those who commission them but what misery-mongering when/if it ever hits or worse if it doesn't and you've just convinced someone to go around the rest of their their 'taking responsibility for their awful plight because they are who they are - which someone unreliably claimed was 'flawed''?
 
My two cents:

If I were to express my feelings regularly about my FM condition (the overwhelm, confusion, pain, exhaustion and almost PEM-like incapacity cognitively), I would be even more ignored as nuts than I already am by most family members, and others.

The research about PwFM having personality disorders at greater frequency, and of having had abusive childhoods more than non FMers...I'm sure holes can poked in the cited research reports because they are never based on huge numbers of representative samples. Rather, it is who shows up for care in tertiary settings (specialized medical care settings).

Old and tiresome tropes.
 
shak8 said:
My two cents:

If I were to express my feelings regularly about my FM condition (the overwhelm, confusion, pain, exhaustion and almost PEM-like incapacity cognitively), I would be even more ignored as nuts than I already am by most family members, and others.

The research about PwFM having personality disorders at greater frequency, and of having had abusive childhoods more than non FMers...I'm sure holes can poked in the cited research reports because they are never based on huge numbers of representative samples. Rather, it is who shows up for care in tertiary settings (specialized medical care settings).

Old and tiresome tropes.
Click to expand...


Things like this all need to be forcibly consigned to a research assessment unit (ie subject under research funding terms) called ‘troping studies’ just so people are at least aware and funding given at least as much to decent psychologist and those who study the impact of such propaganda to study why someone would do this.

The only useful thing from these, which can’t stand as research rather than manifestos due to their poor quality (only hidden in plain sight by getting others in the same category to be as bad in order to pretend that’s ‘normal’) is the insight into the faulty thinking of those wrote wrote them these give which one day hopefully might help save others from using troping to destroy lives, health, relationships etc and hide it behind weaponising labels. Which is actually really important.
 
Overall, the findings were promising but further research is needed to understand if these improvements remain longer-term.

After thirty-five years of dominance the psycho-behavioural approach has yet to deliver anything more than 'promising findings that need further research (funds)'.

Enough is enough.

Give the money to physiology research. All of it.
 
When I was early in my diagnosis journey and search for treatments I came into contact with an internist who asked me whether I was abused as a child. These papers and in this case, the thesis that are defended in front of academics of ‘reputable’ universities, they still make their ways in search engines, in pubmed, and seep through in disease treatment guidelines.
 
The information about the thesis says it's part of the student's work to complete a doctorate in clinical psychology. The rest of the degree is probably based on their clinical learning and practice.

This is not the first bit of crap research for such a PhD we've seen based on two tasks:
1. A review article of published papers on a particular psychological aspect of ME/CFS or FM written up in the style of a published review article with a long list of references.
2. A piece of 'original research' based on using existing questionnaires and aimed to test a series of hypotheses about some aspect of our supposed psychology gleaned from the review article. They use the internet to find their participants, advertising through patient charities and social media. Then they write up the results in the style of a published paper, with lots of stats analyses using computer packages and discussions and conclusions and limitations etc. And it always ends up with the conclusion that more research is needed, and that they have identified an area of our psychology that is going wrong and is amenable to therapy.

They never look under the lid at what the questionniares are actually asking and whether it makes any sense in terms of a physical illness, whether the outcomes are a cause or an effect of the illness, or what the participants think the questions mean or think of the conclusions. In other words they never do any real research, they are just using us as convenient generators of meaningless numbers to fulfil the requirements for their degree.

If they are lucky they get two published papers out of this process, and their supervisor gets more publications to add to their tally too.

They never need to meet a real sufferer of the illness. And they probably have no intention of meeting any of us - the other example I'm thinking of where I had some correspondence with the researcher told me so openly - he wasn't interested in learning about or treating pwME, we are just a means to their end of getting the qualification that will help towards promotion to higher level positions in clinical psychology by having a doctorate.
 
Milo said:
When I was early in my diagnosis journey and search for treatments I came into contact with an internist who asked me whether I was abused as a child. These papers and in this case, the thesis that are defended in front of academics of ‘reputable’ universities, they still make their ways in search engines, in pubmed, and seep through in disease treatment guidelines.
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For 'comedic' effect, this is what the governmental healthcare informational website says about the causes of CFS in Hungary, even today:

Google translate:

Causes of chronic fatigue syndrome

The root causes of chronic fatigue syndrome and the process of its development are extremely complex, but their details are still unknown. A dysfunction of the immune system or adrenal gland, genetic background, or even childhood trauma can most likely contribute to it.


Presumed root causes:

viral infections (e.g. viral meningitis),
bacterial infections (e.g. pneumonia),
problems related to the immune system,
hormonal imbalance (e.g. thyroid disease),
anemia,
cancerous lesion,
mental problems (stress, emotional trauma, childhood abuse),
hereditary tendency.


Chronic fatigue syndrome can also develop after contracting COVID-19.
Click to expand...

Written by someone who has no freaking idea of what this disease is but has read a couple of these weird chronic fatigue papers circulating on the internet written by people who also have no idea of what they are talking about.
 
Trish said:
They never need to meet a real sufferer of the illness. And they probably have no intention of meeting any of us - the other example I'm thinking of where I had some correspondence with the researcher told me so openly - he wasn't interested in learning about or treating pwME, we are just a means to their end of getting the qualification that will help towards promotion to higher level positions in clinical psychology by having a doctorate.
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Just another easy PhD. Nothing's changed since then, if anything this mindset has taken control of everything. Validity is of no concern, rejecting reality and substituting their own is the actual paradigm.

But truly the fact that this is considered PhD worthy is absurd. This is not what PhDs are about. There is no new knowledge here, nothing is actually being researched. At best it's a Master's thesis, summarizing the current dominant paradigm. And a bad one at that, relying on old debunked and nonsensical tropes.

But this isn't research at all. I follow AI research intensely, it's what I would be working on if I wasn't disabled, and the contrast is just extreme. To call this research is an insult to science. AI makes more progress every single month than the entire BPS ideology has managed in over a century.
 
Thanks for explaining, @Sid. While I can accept that the thesis part will be smaller and less time consuming than a PhD thesis, I can’t accept that this justifies bad science. It may be smaller in quantity, but should still be high quality.

That it's considered acceptable to so abuse the trust of sick people who participate in such research thinking they are helping to provide better understanding of their disease seems to me completely unethical.

Basing conclusions on data collected using flawed and inappropriate questionnaires without ever needing to understand anything about the disease or listen to a single patient is crazy. This sort of low quality research becomes the basis for inappropriate and potentially harmful 'therapy'. It's not victim free research.

I think I might write to the author.
 
Trish said:
I can’t accept that this justifies bad science. It may be smaller in quantity, but should still be high quality.
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Agreed. I’ve been railing against these people being allowed to call themselves Dr for years. I’ve seen clinical psych doctorates (in non-ME/CFS areas) that were literally based on 10 people interviewed in a focus group. It’s really harmful. It’s especially irritating when I think back on the ordeal I went through to get an actual PhD.
 
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