Paul Garner has just made a closed post of this paper.
https://twitter.com/user/status/1840037361821863991
https://twitter.com/user/status/1840037361821863991
Garner on Twitter said:causal link with peripheral pathophysiology like muscle cell function/mitoch likely to reveal little
A wild speculation by someone who haven't got a foggiest idea what PEM is. If he asked MECFS patients in early stage why they describe PEM as happening "with no rhyme or reason", he wouldn't have made this kind of speculation. That is not an unusual description of PEM when the patient doesn't have experience with PEM or pacing. Or ask someone with lots of experience like me who keeps pushing the envelope and still can't predict accurately when PEM will or will not happen.However, if PEM is a consequence of too dominant a priori-expectations,
But PEM is from exertion. I'm assuming you mean immediate PEM-type symptoms?
Wyller said:If confirmed that PEM are best understood as a functional brain aberration, the clinical implications are large.
o wow they are determined to get their money's worth out of that same old material
This is basically just trying to say PEM is a false belief
maybe with adding in that real nonsense theory about 'the expectation effect'.
Of course I think that the perfect paper that debunks the suggestions of the expectation effect is actually that same old one that has Knoop as part of it, Heins et al (2013):
The process of cognitive behaviour therapy for chronic fatigue syndrome: Which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue? - ScienceDirect
Thread here: The process of CBT for CFS: Which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue?, 2013, Knoop et al. | Science for ME (s4me.info)
The thread initially focuses on the part of the paper where there are graphs showing the objective activity and perceived activity.
Basically the various pseudophil ramblings in this try and put some spiel around people think that CBT 'made them less fatigue' based on it making them think they'd done more, when they hadn't. So they were surprised they weren't as tired - but only because they'd metaphorically actually only walked 1 mile and not 2, and thought this CBT must have therefore solved some specific type of fatigue 'response' to the 2miles.
But the graphs (and it gets a bit more complicated than this, as they have 'fast responders and slow responders' to the CBT separated out) show that everyone ended up at the same place with objective activity. No amount of thinking your way around it over the 4 time periods. Which are in essence measuring the 'ME/CFS' impact of this ie the fact you can't just 'increase' activity and still feel OK. Putting aside the PEM in between that may or may not have happened.
I'll underline that's them conning the medical profession, funders and patients into pretending they've fixed something when they instead brainwashed people into losing their calibration of what they'd done, to their advantage.
I can't help but emphasise that this same 'school' ie biopsychosocial then moved to decide to remove reporting any of the objective measures anymore. Papers since came up with every weak excuse under the sun as to why they chose poor subjective measures in unblinded trials (when that would be one of the only ways to make it near triangulated to be accurate), but really this shows that it is because there is no objective effect.
I can only assume because they found they could use this 'CBT tool' to programme in discrepancies in what people subjectively report (because they've been misled into thinking they've done more) instead, because they've brainwashed them or used social pressure/bias so that is higher than reality/objective measures.
It's basically fraudulent isn't it? except they get away with it because they are using the patient sample as the 'vessel' through which to insert this lie into their research - and you can't blame the patients for the fraud because they've been brainwashed/coerced/conned.
I also note that the patients targeted and situations created have always begun with those most vulnerable, and indeed the biggest power differential - hence the coercion being solidly involved. It hardly ever escapes me that the two areas of ME, where people have been actively campaigned against to be maligned, and soldiers who once enlisted are under more control than other citizens must be two of the most obviously vulnerable groups, and noone is picking up on it being sus/weird and that those who are attracted to such groups need to be viewed with extra oversight given other historical things we now look back and on and realise 'how did we not see that the wrong types would be attracted to places where vulnerable x, y, z are'. It is a potential huge ethical scandal to me so I'm always shocked outsiders don't pick up on this.
I knew that post-guideline certain individuals would try and attack the concept of PEM. And this new article is just the same blather with an 'insert a different word' really. I can't believe they'll use this and try and pretend it isn't just fancy words for 'hysterical woman/drama queen/hypochondriac' ie their attitude problem disguised, a sociology paper in them expounding what is behind the bigotry/mis-thinking rather than some sort of medical or scientific observation. Pure propaganda by literally hooking tropes together in sequence and one big claim, but it is all non-sequitur?
It's extremely Dunning-Kruger.
I presume you mean in the ironic way since the Dunning Kruger effect is a statistical artefact, as an example of experts overestimating their flawed knowledge. (the same graphs can be produced from random noise due to self-correlation combined with floor and ceiling effects)