Lifting capacity is associated with central sensitization and non-organic signs in patients with chronic back pain, 2020, Echieta et al

Open access, https://www.tandfonline.com/doi/full/10.1080/09638288.2020.1752318

 

As we can see from the use of this 'CSI' there is no attempt to scientifically measure 'Central Sensitization'. From looking at the questions I don't see how this questionnaire could distinguish the supposed CSS diseases from many other significant chronic conditions when untreated/having poor treatment options. For instance, someone with untreated or refractory chronic acid reflux could score quite high on this form. People having to take medications despite side effects could score high.

I think all the number can say is that people who score higher are subjectively sicker - in other words a totally degenerate diagnostic tool.


Here is the paper that first presented the CSI. I browsed through it but there isn't too much to say. It's not a BPS dogma paper. It's just pointless in my opinion. It seems that some BPS people simply happen to have found the terminology appealing and have adapted it to fit their own purposes.
Link to the original paper for the CSI

 

Finally, a BPS questionnaire that I don't win a meaningless diagnosis with.

I'm not sure 'exactly' what my score was (memory problem with keeping a running tally, and I'm far to 'lazy' to use a pen and paper for such a pointless task) but I think it was low 30's, definitely not above 40

 

I guess they don't want to admit they screwed up in their choice of measures.

This is the study in question:
https://www.ncbi.nlm.nih.gov/pubmed/24806467

The "54.8% participants were correctly identified as not having CSS." claim refers to other psychological disorders.

As such, it was not compared to other medical illnesses, but it is quite clear that given the above study that this questionnaire has poor discriminant validity.

One issue that many researchers fail to consider/discuss is that tests of discriminant validity can easily be biased by the social contexts of the study - how the participants are recruited, their knowledge of the study (Hawthorne effects and the like) as well as the wider societal social contexts that bias the questionnaire answering behaviour of the groups in question.

 

It doesn't seem to make much sense to lump in say, ME, IBS, and chronic 'functional' pain as being part of the same 'central sensitization'. There is no necessary overlap in the core symptoms of these syndromes.

Maybe there is some meaningfully similar underlying process, but we would need the actual physiological mechanism(s). It reminds me of the Cell Danger Response. A unifying biological-sounding theory that is just a speculative combination of words and arrows on paper hoping for some biology to back up the concepts. Sounds backwards to me, too.

 

Step 1: put stuff in a box
Step 2: slap a label on the box
Step 3: marvel at the fact that you "discovered" that the stuff is labeled, thus confirming your labeling of said stuff

One remarkable thing is that this questionnaire essentially asks people to rate their frequency (not severity though, apparently that's not important) of illness, and equates it as meaning this is proof they are differently sick. Or something. It's all so damn random. Grinding your teeth? The hell would that even have with the concept of CSS even if it were true? Dry skin? Childhood trauma?

Honestly if this were deliberate satire of bad science nobody could tell the difference. These people are completely delusional.

They "controlled" for sex but not for mass? There is a huge range of lifting capacity depending on body mass. And of course individual pain level is likely the single biggest factor and it's impossible to measure so can't be controlled for. Come on, this isn't serious. Freaking amateurs.