Funding award: Novel approaches to the investigation of psychobiological mechanisms in functional neurological disorder, Chalder, Pick and Hotopf

Andy

Andy

Retired committee member
Funder
  • MRC Medical Research Council

    Collaborative project - lead institution: King's College London

    Total value of award to all partners: £1,370,533

    Value of award to King´s: £1,370,533

https://kclpure.kcl.ac.uk/portal/en...er(409f2487-5595-446f-a8eb-7e11278e195a).html

More at https://gtr.ukri.org/projects?ref=MR/V032771/1

"On the basis of research evidence, I recently proposed that stronger emotional reactions could trigger or worsen FND symptoms, because of a greater physical 'fight or flight' response ('autonomic arousal') (Pick et al., 2019). This could be due to abnormalities in communication between emotional brain systems and brain areas involved in other important functions, such as movement, sensation and self/body awareness (e.g., knowledge of one's own bodily or emotional states). My findings have recently suggested that a psychological process called 'dissociation' might directly trigger FND symptoms (Pick et al., 2017; 2020). Dissociation broadly refers to a disconnection between different aspects of a person's experience (e.g., feeling detached from one's emotions or the outside world, feeling in less control over one's body) and often occurs in response to stressful experiences and strong emotional reactions. Dissociation could therefore potentially explain the connection between emotional abnormalities and FND symptoms.

The primary aim of the proposed research is to investigate factors that trigger or worsen FND symptoms, with a focus on emotional responses, autonomic arousal and dissociation. A second aim is to assess whether these processes are linked to differences in brain functioning. Patients with different types of FND (i.e., seizures or movement symptoms) will be included and compared to people with common mental health symptoms (depression) and people with no significant mental or physical health disorders, to examine potential similarities and differences to these groups. A variety of relevant features will be measured, including participants' subjective 'in-the-moment' experiences (emotions, dissociation), physical measures of arousal (e.g., heart rate), and FND symptoms. Some measures will be taken in both laboratory and real-life settings, to assess whether findings are consistent. Brain structure and functioning will also be assessed in a scanner.

The results of the research will provide more information about the interaction between biological and psychological factors in FND and will have considerable implications for improving or developing new treatments, which are much needed. It is hoped that the research will provide a basis for a more integrated approach to studying and treating this complex disorder, combining both physical and mental health perspectives."
 
BrightCandle said:
I figured Chalder would be hopping off BPS as it got ridiculed and onto FND as it rose.
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I am not sure this group ever had any interest in specific conditions rather the belief that whatever it is it can be cured by exercise and psychological intervention. The work on ME was never about understanding it, rather about disregarding the specifics of the condition and enforcing their preferred intervention strategy.

It is illustrated by the need to lump things together as in the PACE era confabulation of ME/CFS and chronic fatigue. And now the FND bandwagon represents the ultimate lumping together, as everyone even if they have an identified biomedical condition are seen as in need of psychological intervention and exercise therapy for their functional aspects.
 
The paper said:
This could be due to abnormalities in communication between emotional brain systems and brain areas involved in other important functions, such as movement, sensation and self/body awareness
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This is basically the new "chemical imbalance". Bank it. Actually I'm pretty sure the same nonsense in depression, also highly heterogeneous, will be used for a while and all the vague definitions blurred into a giant blurry mass, depending on how psychiatry will secretly hold on to it or not.

It's amazing how healthcare authorities clearly could not care less about the outcome of their work. All this talk of "novel" when it's the same recycled crap that's literally the current standard, and pretending that "new research" is the basis for claims that have been made for over a century. Just because they're being a little more descriptive in describing the emperor's hat doesn't change that this is still the endless quest for the mythical conversion disorder. It's all it is.

Also clearly everyone is moving away from ME or fatigue and onto the most purely vague constructs of FND and MUS. All this does is expose how fully generic this pseudoscience is, but it could go on for many years. This mindless obsession is clearly infinite, it can't be walked back.
BrightCandle said:
I figured Chalder would be hopping off BPS as it got ridiculed and onto FND as it rose.
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It's the same thing for all intents and purposes. They're all just labels with no substance, they can move between them as they please, clearly no one cares about definitions here, it's as vague as possible, which actually shows how truly vague is not a real concern, despite the BS about our symptoms being vague is just that, BS. This stuff is as vague as it gets. We are in terrible, terrible hands.
 
Abstract said:
A variety of relevant features will be measured, including participants' subjective 'in-the-moment' experiences (emotions, dissociation), physical measures of arousal (e.g., heart rate), and FND symptoms. Some measures will be taken in both laboratory and real-life settings, to assess whether findings are consistent. Brain structure and functioning will also be assessed in a scanner.
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Endless scope for cherry picking, not to mention selection bias in the people who are participants in the study, and the huge potential for researchers to influence subjective reports of 'in the moment' experiences.

It's truly bizarre and deeply sad that the Medical Research Council thought that this poorly defined study was worth nearly 1.4 million pounds.

Milo said:
How to warn every patients not to participate in this study?
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Indeed. Is there anything we can do to stop this ongoing rubbish?
 
Hutan said:
Indeed. Is there anything we can do to stop this ongoing rubbish?
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it's very difficult - there's a sense that because it's "science" and even more so "medicine" it must be sacrosanct so neither politicians (I've tried !) nor civic institutions want to put their heads above the parapet and call out the gravy train for what it is. Involving the UK media is a Devil's bargain, there's lots of academic work that the most bigotted sections would like to habitually attack and setting those dogs loose might well come back to bite us.
 
Abstract said:
My findings have recently suggested that a psychological process called 'dissociation' might directly trigger FND symptoms (Pick et al., 2017; 2020).
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That seems to be Susannah Pick writing that - and here's the link to our thread on that referenced 2020 paper:
Dissociation and interoception in functional neurological disorder, 2020, Pick et al

It's exactly as you might imagine, that paper (at least as far as the abstract goes) does not provide evidence for dissociation triggering FND symptoms.
 
Last edited:
Andy said:
Funder
  • MRC Medical Research Council

    Collaborative project - lead institution: King's College London

    Total value of award to all partners: £1,370,533

    Value of award to King´s: £1,370,533

https://kclpure.kcl.ac.uk/portal/en...er(409f2487-5595-446f-a8eb-7e11278e195a).html

More at https://gtr.ukri.org/projects?ref=MR/V032771/1

"On the basis of research evidence, I recently proposed that stronger emotional reactions could trigger or worsen FND symptoms, because of a greater physical 'fight or flight' response ('autonomic arousal') (Pick et al., 2019). This could be due to abnormalities in communication between emotional brain systems and brain areas involved in other important functions, such as movement, sensation and self/body awareness (e.g., knowledge of one's own bodily or emotional states). My findings have recently suggested that a psychological process called 'dissociation' might directly trigger FND symptoms (Pick et al., 2017; 2020). Dissociation broadly refers to a disconnection between different aspects of a person's experience (e.g., feeling detached from one's emotions or the outside world, feeling in less control over one's body) and often occurs in response to stressful experiences and strong emotional reactions. Dissociation could therefore potentially explain the connection between emotional abnormalities and FND symptoms.

The primary aim of the proposed research is to investigate factors that trigger or worsen FND symptoms, with a focus on emotional responses, autonomic arousal and dissociation. A second aim is to assess whether these processes are linked to differences in brain functioning. Patients with different types of FND (i.e., seizures or movement symptoms) will be included and compared to people with common mental health symptoms (depression) and people with no significant mental or physical health disorders, to examine potential similarities and differences to these groups. A variety of relevant features will be measured, including participants' subjective 'in-the-moment' experiences (emotions, dissociation), physical measures of arousal (e.g., heart rate), and FND symptoms. Some measures will be taken in both laboratory and real-life settings, to assess whether findings are consistent. Brain structure and functioning will also be assessed in a scanner.

The results of the research will provide more information about the interaction between biological and psychological factors in FND and will have considerable implications for improving or developing new treatments, which are much needed. It is hoped that the research will provide a basis for a more integrated approach to studying and treating this complex disorder, combining both physical and mental health perspectives."
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These people shouldn't be getting funding. Nevermind MRC - and I note they seem to be doing so by applying with projects in FND rather than CFS but the ideology and methodology is still just as suspect. SO why are they getting it?
 
bobbler said:
These people shouldn't be getting funding. Nevermind MRC - and I note they seem to be doing so by applying with projects in FND rather than CFS but the ideology and methodology is still just as suspect. SO why are they getting it?
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Presumably, given now NICE has defined ME/CFS in terms of PEM it is harder to justify such research into this condition without acknowledging the possibility that their interventions might make it worse, however FND is by definition a psychological condition so you don’t need to allow for the possibility of making it worse and also it is a potentially much bigger patient pool.

Of course no one must question whether FND exists or not. And so far the patients are not being as bolshy as those dreadful ME activists.
 
Hutan said:
That seems to be Susannah Pick writing that - and here's the link to our thread on that referenced 2020 paper:
Dissociation and interoception in functional neurological disorder, 2020, Pick et al

It's exactly as you might imagine, that paper (at least as far as the abstract goes) does not provide evidence for dissociation triggering FND symptoms.
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Dissociation is clearly, oh so clearly, a neurological process. Common in LC, I've seen so much of it. Rarely talked in other communities but common with brain fog and I think common with us, too. It seems to be an immunological response.

If neurology could make serious progress and end most of this nonsense it would be revolutionary, but at their current pace it's likely we get commercial nuclear fusion first, something people are actually motivated to do.
 
bobbler said:
These people shouldn't be getting funding. Nevermind MRC - and I note they seem to be doing so by applying with projects in FND rather than CFS but the ideology and methodology is still just as suspect. SO why are they getting it?
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They're exploiting the same loophole that allowed hundreds of nearly identical studies to be funded, even though normally redundant studies should not be funded unless they add something or do something different. Also helped by the fact that funders clearly don't check for similar studies elsewhere, to avoid uselessly redundant research from being done.

But distinctions are all it takes, that's what made it possible to do the same thing hundreds of times over, so doing the exact same things with FND instead of CFS is OK. It's the exact same thing but with a different hat. It's abuse and should not be allowed but the entire field is repetitive so it seems that no one cares.

This could seriously go on for decades if the pace of science and technology allowed it. Which thankfully it won't, but it will never end until this is all made obsolete, it's a jobs program with lifetime job security, and way too easy to abuse. It's as corrupt as politics, people vote for each other and keep the scam going, it's all publicly-funded so they don't care. As long as the money is flowing it'll keep doing the same things in loops indefinitely.
 
Milo said:
Very ironic considering that the James Lind Alliance just determined what the research priorities were for ME- While the project above does not mention ME by name, there seems to be a go-around by calling it something else.
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even more sinister I think the splitting the spectrum of ME/CFS was used in order that mild/moderate was handed to behavioural rehab as 'fatigue' and then once severe (often caused by such bad treatment, but conveniently when you are made worse then 'they don't deal with that, so it isn't on their books as outcomes') it's off to neurologists for them to pretend it isn't worsening/an extreme level of said illness, but has suddenly come on and is so 'very strange'.

That way all these neuropyschiatrists can infer to the population it is like someone just suddenly one day couldn't wake up, move and had all these horrendous symptoms and so maybe it is something 'in their head' given how extreme it is - whereas the truth is that no serious condition to this level would ever be treated so badly for so long as the clinics are doing - and this is brutalised people, the cast-offs from a health system hell-bent on destroying people's health (whilst claiming that harmful treatment 'helps') and then once destroyed pretending it is a different illness in order that the oversight never says 'what the hell are you guys doing, you are killing and maiming people who were somewhat disabled into never ever recover'.

It's like is someone did a cancer centre where those with earlier stages were left and told to work hard and do a short course, and then when they hit stage 4 they were shifted off to a different dept to change diagnosis to pretend it is a new and differnet illness and no responsibiltiy re: the outcomes for the first. Outrageous but really happening. No wonder what they write about these things is such BS and obvious weirdo nonsense. They've a lot of illogical behaviour they have to cover up and try and make look logical.

How do you keep up feigning something is neuresthenia when it starts killing people or making them that ill - well you ship em off to somewhere that is prepared to relabel as a write-off with 'something different of their own cause ' which as we know does things like take people with CJD and give them an FND label and noone calls them on it.
 
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