PHD Project: Stress reactivity in people suffering from chronic fatigue, 2019 - 2023

Andy

Andy

Retired committee member
Abstract

During the course of this PhD, the student will examine the relationship between stressful experiences, stress reactivity and symptoms in people suffering from chronic fatigue syndrome (CFS), in comparison with matched non-fatigued control participants. The project will include a systematic review of stress reactivity in fatiguing conditions, a qualitative study of the impact of stress on symptoms in people with CFS and an experimental study using the Trier Social Stress Test (TSST) to compare stress reactivity in CFS participants and controls. We will also consider the potential moderating role of support attempts by close significant others (e.g. spouses or partners) on the response to stress, using a partner support version of the TSST.

https://gtr.ukri.org/projects?ref=studentship-2281613

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I wondered what the Trier Social Stress Test might be and found this from 1993:

https://www.karger.com/Article/Abstract/119004
The ‘Trier Social Stress Test’ – A Tool for Investigating Psychobiological Stress Responses in a Laboratory Setting
Kirschbaum C. · Pirke K.-M. · Hellhammer D.H.

Neuropsychobiology 1993;28:76–81
https://doi.org/10.1159/000119004

Abstract
This paper describes a protocol for induction of moderate psychological stress in a laboratory setting and evaluates its effects on physiological responses. The ‘Trier Social Stress Test’ (TSST) mainly consists of an anticipation period (10 min) and a test period (10 min) in which the subjects have to deliver a free speech and perform mental arithmetic in front of an audience. In six independent studies this protocol has been found to induce considerable changes in the concentration of ACTH, cortisol (serum and saliva), GH, prolactin as well as significant increases in heart rate. As for salivary cortisol levels, the TSST reliably led to 2- to 4-fold elevations above baseline with similar peak cortisol concentrations. Studies are summarized in which TSST-induced cortisol increases elucidated some of the multiple variables contributing to the interindividual variation in adrenocortical stress responses. The results suggest that gender, genetics and nicotine consumption can influence the individual’s stress responsiveness to psychological stress while personality traits showed no correlation with cortisol responses to TSST stimulation. From these data we conclude that the TSST can serve as a tool for psychobiological research.

© 1993 S. Karger AG, Basel

Edit:
I couldn't find anything about the partner support version, but this one looks related:
A friendly version of the trier social stress test does not activate the HPA axis in healthy men and women
 
It is beginning to look like deliberate provocation. All these studies seem to refer to "chronic fatigue" in the title and CFS in the body of the work. It is just about credible that people starting a PhD are unfamiliar with the significance - though it does not auger well if they are. One would expect supervisors to recognise the problems and correct them before damage is done. It immediately casts doubt on the selection criteria.
 
If they are wanting to find out whether ME/CFS is stress related, surely they need to have a control group who are equally disabled by chronic physical disease.

On the other hand if they want to find out whether it is the symptom fatigue that is key to whatever their hypothesis is, they need to test people with a variety of fatiguing conditions.

As someone who was a maths teacher, the idea of having to give a short speech to a few people and do some mental arithmetic would not have been particularly stressful when I was well or when I had mild ME. Now with more physically severe ME, It would be the whole situation of having to organise someone to take me to the test centre with wheelchair, and the physical effort required to sit or stand while speaking for 10 minutes etc would be far more stressful, whether done with family support or not.

The whole project seems daft to me.
 
There is a place for looking at romantic and sexual aspects of ME but doing so from the point of view of the stress involved is a bit skewed. Have a close partner can cause stress but it also takes away stress. Being single because you are so sick is stressful but then it is less stressful than a partner who is disbelieving.

Hopefully she will find some of the truth about the ways ME screws up our lives but we do not need a simple conclusion that stress causes CFS.

And call it ME/CFS for goodness sake. How can you be up to date with the literature if you have never read the NICE guidelines about the disease you are studying!!!
 
Mithriel said:
There is a place for looking at romantic and sexual aspects of ME but doing so from the point of view of the stress involved is a bit skewed. Have a close partner can cause stress but it also takes away stress. Being single because you are so sick is stressful but then it is less stressful than a partner who is disbelieving.

Hopefully she will find some of the truth about the ways ME screws up our lives but we do not need a simple conclusion that stress causes CFS.

And call it ME/CFS for goodness sake. How can you be up to date with the literature if you have never read the NICE guidelines about the disease you are studying!!!
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The Phd award started in 2019 so NICE 2021 wouldn't apply. Still raises the question about whether patients were involved in the study design (I'd bet on No !)

I usually manage to be generous in my thinking to almost any area of study (yes even psych) but this one really irritates me. The way both the MRC brief and and the researcher talk about this gives (perhaps wholly unintentionally) the sense that patients are mere lab rats, whose curious and funny little behaviours are open to being probed and prodded for absolutely no benefit to the rats. Of course participants will go through the usual consent processes but I think we all know the soft sell that will come with recruitment.

It is also a touch perverse to have a brief that says "We will also consider the potential moderating role of support attempts by close significant others (e.g. spouses or partners) on the response to stress ...." for a patient population for which studies that measure attached status consistently suggest only a minority patients are in 'romantic' relationships. This study by Nacul et al gives just 35 partners for 169 patients https://link.springer.com/article/10.1186/s12889-020-09049-x/tables/2 !
 
What will they do with the results? It increases possibilities for social prescribing. Prescribe everyone a partner, or perhaps provide a prescription for a divorce?
 
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