Generalised worry in patients with [CFS] following Cognitive Behavioural Therapy - a prospective cohort study in secondary care, 2022, Chalder et al

They use "generalized anxiety disorder" as if it was a final diagnosis. The FND people do this all the time as well with their statements.

The problem is that it is a description which indicates where they should look at what is going wrong, not just done, dusted and categorised. If you decide a patient has stomach pain you have to discover why they are feeling that pain.

So why are people worried? There are different possibilities for it all with their own solution. If someone has no money, needs help with children or housing or accessing social care that can be dealt with.

Some children are born more nervous and timid than others. If an adult unduly worries is this due to differences in brain chemicals or brain structure, could a drug help, or even, dare I say it, targeted CBT?

When people experience a traumatic event, even as a witness, they worry more because all those things we believe can never happen to us suddenly become possible. That needs a different approach or just a simple discussion group to talk about how to deal with it.

The least useful option is the one they use - stop worrying!

All medicine starts from symptoms and gradually homes in on the problem to decide what can be done. They should have a whip round and buy a book on how to diagnose designed for student doctors or nurses.

 

The study states this about the Penn State Worry Questionnaire: "The PSWQ is considered a valid and reliable measure of problematic worry for patients with CFS.” But this sentence is not referenced. Who considers this scale "valid and reliable" for CFS patients? I found only one study of CFS patients that uses this scale, but it is not an analysis of the scale's validity and reliability. What is Chalder's basis for making this apparently unsupported claim that this scale can be used for a sick rather than a healthy population?

 

yes, but really they can't rule anything in or out with this study, given that it is a single cohort with no comparison group.

 

questionnaires like that are not designed for people with actual limiting disabilities. They are inappropriate here.

 

Yes, yes, yes. And the authors use of them only highlights the naivety and incompetency of the authors and their inability to grasp (or perhaps their blinded denial of) what this disease actually is and how patients are affected by it. This is the starting point of the whole terrible tragedy of what ME/CFS patients have had to put up with for decades on top of their debilitating disease. These people have no business in this field if they are only there to advance and sustain their own careers at the expense of and to the detriment of patients. Yet, they are the proclaimed "experts" blindly followed by others in the medical profession. Their nonsense needs to stop and they need to get out and leave us alone and let the true experts lead the way.

 

These folk should be in advertising, with their gift for leaning heavily on the truth.

 

How do they get around the question of confirmation bias during the peer review?

 

They are reviewed by people who belong to the same "cult" of biopsychosocial disease who publish studies of a similar standard.

Editors also ignore negative comments from reviewers. One paper was allowed to stand even when it was shown to break the journals own rules on publication. The rules fly out the window for ME.

 

I think it might be one step beyond that. I think they might generally review each other's papers. Its probably a review circle. Its those from outside who write the negative comments and get ignored. Generally reviews often come from within the same field. You approve their paper, they approve your paper is possibly a common occurrence.

 

I admit to generalized (and specific worry) every time I see Chalder's name....

 

Trial By Error: CBT for CFS Should Target “Problematic Worry,” Says New Study from Professor Chalder

"Apparently, after 30+ years of promoting cognitive behavior therapy for chronic fatigue syndrome (so-called), Professor Trudie Chalder has discovered something new: Patients worry a lot! And those with worse symptoms tend to have higher worry levels! She believes CBT for CFS can be tweaked to make a difference. She presents this information in a new study, published in the journal Behavior Therapy–yet another in which she and her colleagues disavow the possibility of inferring causality but use causal language anyway."

https://www.virology.ws/2022/01/28/...-worry-says-new-study-from-professor-chalder/

 

@Mithriel

I agree with your post.

WRT the 'research' though I think where people's traits are involved there is the need for a lot more nuance than than any psych questionnaire or indeed experiment can give.

Your use of the terms nervous and timid are normal words for what can also be described (less pejoratively) as cautious. I'm not suggesting that all anxiety can be catagorised as caution either. There is a need for cautious people in the world just as there is a need for risk-takers.

And at present if there is any reason for concern I'd say it exists with regard to how the numbers are skewing and being aided by pyschs and influencers to skew to too many risk takers. This to can be an alternative and I think valid POV.

Risk-taking is not the same as resilience which is I think what is trying to be achieved when psychs talk about 'fixing' anxiety.

 

Yes it is actually very complex I was just trying to get across the point that there could be valuable, useful research to be done by breaking down "worry" which is like saying someone is ill, true but not much useful information.

I wish they would examine the biological underpinnings of why some people feel more anxiety. Onw of my children at 3 year sold said "Why does it have to be me that worries?" He is still the same forty years later.

It is the body's reaction which is the problem not the mind. I know how to walk but most of the time my legs won't do it, same thing.

 

Yes, as I said, I agree I just wanted to point out for my part that they pathologise everything. Sometimes caution gets caught up as worry. And worry isn't a problem unless the person finds it interferes with getting on with things. Being born as someone prone to worry is not primarily a mental thing (as in taught -- nurtured) it is a physical thing that happens to manifest as mental.

*Just a note that I don't think my thinking works well enough to clearly come at this but I am going to try.

This group who likes to be seen as experts in these sorts of situations constantly misunder-stand that it is not primarily about people being all mixed up and confused about life and are afraid. They do not need to be told how to act but that they live according to there natural tendencies gifted to them genetically. It is not for them (BPS psychs) to consider any of these so-called functional categories as appropriate to their domain.

And now there is conflicting information coming from them that what they deal with is physical but can be manipulated with their brand of mental woo. Of course their concern being that technology / advances in medicine (actual science) might offer insights into what is physically happening.

This is not to say there isn't space where people feel they need help psychologically. That is a whole different issue. But people are being catagorised en masse -- against their will and own understanding of themselves as people.

It is this research side of psychology where we find people who have IMO real issues of hatred (fear) of other people. And an agenda to fix them by teaching them not to complain about anything for reasons I have yet to understand.

And I am deeply grateful to those who speak up -- especially when they have nothing particular riding on the outcome but do it because it's the right thing. It does still seems like voices in the wilderness with a few here and there catching on to this ongoing, out in the open atrocity.

Getting this kind of brazenly incorrect and anti-science approach to whole swathes of ill or vulnerable people stopped needs more people gaining a deep understanding of the issue and speaking up.

I sometimes wonder if people think I go too far in how I frame things. I have certainly given it some thought and I just don't think so. I believe in calling a thing what it really is not what it's dressed up to be as pretense. They know they can afford to be bold in their claims. They continue to be funded for what is essentially opinion that cannot be refuted and has nothing to do with science.

I think IMO what's needed is someone who can put all of these studies together and see the big picture and how to proceed (as a group including S4ME but beyond). To me each piece of research like this is in commitment to a larger agenda. For some it may sound conspiratorial but I think this is just normalised business doing what it does.

 

my cousins used to sing a song about me that they called "the worry song" when I was 7 or 8. We all still remember it.

 

Families!

 

Now open access, https://www.sciencedirect.com/science/article/pii/S0005789422000065

 

https://twitter.com/user/status/1562407868380364800

 

From the same twitter thread.
https://twitter.com/user/status/1562535293223243778