Psychology & Health: Perfectionism and beliefs about emotions in adolescents with chronic fatigue syndrome and their parents (2019) Chalder et al.

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Eagles

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Psychology & Health: Perfectionism and beliefs about emotions in adolescents with chronic fatigue syndrome and their parents: a preliminary investigation in a case control study nested within a cohort

Maria E. Loades, Katharine A. Rimes, Kate Lievesley, Sheila Ali & Trudie Chalder

Received 18 May 2018, Accepted 07 Dec 2018, Published online: 01 Mar 2019

https://www.tandfonline.com/doi/full/10.1080/08870446.2019.1579331

Objectives: To investigate perfectionism and beliefs about emotions in adolescents with chronic fatigue syndrome (CFS) and their parents.

Design: Case-control comparing adolescents (age 11–18) with CFS (N = 121), asthma (N = 27) and healthy controls (N = 78) with a 3-month follow up for CFS participants…
 
Results: Adolescents with CFS did not consistently report higher levels of perfectionism and unhelpful beliefs about emotions than adolescents with asthma or healthy adolescents. Mothers’ and adolescents’ beliefs about emotions and unhelpful perfectionism were significantly associated (p = .007). Linear regression found that neither adolescent perfectionism nor beliefs about emotions accounted for variance in subsequent fatigue or physical functioning.

Conclusion: Parental perfectionism and emotion regulation style may contribute to perfectionism in adolescents with CFS. Parental representations could contribute to fatigue maintenance.
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Can someone explain how these unconclusive results end up in this conclusion?

"neither adolescent perfectionism nor beliefs about emotions accounted for variance in subsequent fatigue or physical functioning" but nonetheless "Parental representations could contribute to fatigue maintenance."
This is insane.
 
Cheshire said:
Can someone explain how these unconclusive results end up in this conclusion?

"neither adolescent perfectionism nor beliefs about emotions accounted for variance in subsequent fatigue or physical functioning" but nonetheless "Parental representations could contribute to fatigue maintenance."
This is insane.
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ah it's not the children now, it's the parents:confused:.........this is going to make the FII accusations situation worse.

eta: they are going to start suggesting CBT for perfectionist parents of sick children next (if they are not already)
 
The parental associations are likely due to participation biases, namely demanding parents are more likely to have children participating in such studies because they want answers. The noteworthy part is the bias applies to the parents, compared to biases of patient participation and response as would be the case in studies of adults.
 
Cheshire said:
Can someone explain how these unconclusive results end up in this conclusion?

"neither adolescent perfectionism nor beliefs about emotions accounted for variance in subsequent fatigue or physical functioning" but nonetheless "Parental representations could contribute to fatigue maintenance."
This is insane.
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When encouraged to just make stuff up for years, people continue making stuff up until they're stopped. Hell, they're getting participation trophies for doing meaningless research so full throttle on the psychobabble.

This is a parody of science.
 
WTF is emotion regulation style? How does anyone determine what style of emotion regulation one has and how does one measure that style in a scientific way that can have application to medicine? How does one decide what perfectionism is? This is the same fundamental issue as with fatigue: what do you mean by that? How do you remove the subjective framing of what perfectionism mean for one person and make a standard measurement?

How does any of this has any relevance to a disease? This is refrigerator mothers and cancer personalities rolled up all in one. These people have truly lost all attachment with reality, who keeps giving ethical approval and chooses to waste money on this crap? This is money that could be spent on real research! Why are they just burning it away on stupid ideological circlejerks?! Why do they keep doing the same 2 trials over and over again with slight variations?!
 
How fully informed are these parents about the aims of this study? Or parents in any of these types of studies for that matter? If the aim is to find out if they're causing their children's "cfs" why would parents engage in this study?

As long as this disease remains viewed by a significant number of the more powerful as a psychological condition, blame will be assigned to someone for it.
 
Sci Hub, https://sci-hub.tw/https://www.tandfonline.com/doi/full/10.1080/08870446.2019.1579331, for those who want to put themselves through the whole paper.

All I could find on selection criteria used
Chronic fatigue syndrome (CFS) is diagnosed when ongoing, medically unexplained fatigue, which may be accompanied by other symptoms, does not remit with rest (NICE, 2007).
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CFS participants. This group was recruited from consecutive attenders at two specialist CFS units. Recruitment commenced in August 2010 and continued until January 2017. The additional eligibility criterion for this group was a clinician-confirmed diagnosis of CFS.
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Lots of great stuff like this..
A conceptual model of CFS in adolescents contends that psychological processes may make an individual more prone to developing fatigue following an acute infection or significant life event, and may also contribute to the maintenance of fatigue following onset (Lievesley, Rimes, & Chalder, 2014). These processes include perfectionism and beliefs about emotions (Lievesley et al., 2014).
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Those darned "psychological processes"!

The faulty concept of personality types causing diseases, e.g. type A personality causing "cfs" gives practitioners license to blame and mistreat patients.

I was quite taken aback by the attitude of the practitioner I consulted who said my type A personality had caused my "cfs". This was one of my first encounters with a professional who seemed to think it perfectly fine to be nasty to a paying customer based on some ridiculous theory about personality causing diseases.
 
I come to wonder about the purpose of an abstract. This one provides no useful information and generates nothing but questions that need answering.

I remember more thorough write ups from high school. Why is this considered a write up that belongs in a journal? I can't see the full paper but anyone could literally make stuff up in a matter of hours and submit and nobody would be the wiser.

I doubt the full paper does any justice either. How were the parents assessed apart from a silly questionnaire? Were they seen by the trial authors at all? It's not even clear if both parents were administered the questionnaire separately (not that it would be in any way meaningful if they were).

And you do wonder as Dokagirl says if the parents were told the true nature of the study. I fear too many people are willing to swallow silly answers simply because they are given by an authority and because the people themselves feel out of their depth with whatever is going on.

It's been eye opening being ill like this and being exposed to the truly ludicrous nature of subjective twaddle that passes itself off as psychological understanding.

What a steaming turd.

And as an additional bonus thought-- what if one of the parents is a surgeon or a air traffic controller or any of a number of other jobs that require perfection. Are these jobs to be avoided as people overcome their perfectionism so their kids don't get sick? One could be forgiven for thinking that many psychologists are not just not perfectionist but anti-competent as well.
 
gee, they're really nailing the patient blaming. so not having perfectionism is bad too?

A study of adults with CFS found that perfectionism post-diagnosis was not significantly different from healthy adults but their reports of premorbid perfectionism were significantly higher (Brooks et al., 2017). It is possible that people are forced to modify their perfectionism as a result of disabling CFS symptoms or that they choose to do so. In the present study, socially prescribed perfectionism, including perceived parental criticism and parental expectations, tended to be lower in the CFS group than in healthy controls. It may be that significant others have lowered their expectations in response to the CFS symptoms and impact, or this pattern may have been present premorbidly. Potentially, lower expectations could be an impediment to encouraging the processes that facilitate recovery from CFS, such as gradually and incrementally engaging in activities.
 
The scale used to measure perfectionism has two parts - one relating to one's own standards and one relating to the standards imposed by others:
The Child and Adolescent Perfectionism Scale (Flett et al., 2016) is a 22-item scale, which measures two factors which are considered to be maladaptive; self-oriented per- fectionism (i.e. holding extremely high personal standards and being excessively driven to achieve these) and other-oriented or socially prescribed perfectionism (i.e. believing that others demand extremely high standards of the self). Self-oriented per- fectionism is composed of 12 items, with scores ranging from 12 to 60. Other-oriented perfectionism is composed of 10 items, with scores ranging from 10 to 50. The CAPS has been found to be valid and reliable in adolescents
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The three groups (CFS, asthma, healthy controls) weren't statistically different on either part. There was a non-significant trend to the CFS participants being less concerned about standards imposed by others.
The groups were not significantly different from each other on the CAPS-self ori- ented perfectionism scale, nor on the organisation, personal standards, or maladaptive perfectionism subscales of the FMPS (see Table 2). There was a non-significant trend towards a group difference on the CAPS-other oriented perfectionism scale (F 1⁄4 3.60, p= .029); CFS participants scored lower (M1⁄422.6, SD = 8.8) than healthy controls (M1⁄426.0, SD = 8.4), whilst asthma participants were not different from either group
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So, the study found that young people with CFS were not more perfectionistic than healthy controls.

This was despite recruiting patients over a really long time period (more than 6 years) potentially allowing for cherry picking. And having a very loose definition of CFS. And recruiting a couple of healthy controls from the children of staff of the clinic.

So, what to do if you are certain that there's something wrong with the attitudes of people with CFS?

Kalliope said:
so not having perfectionism is bad too?
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I have read this part four times but still don't grasp what is being said here..

Holding unhelpful beliefs about emotions did not differ significantly across groups either, which was also contrary to expectations. This is different to findings in adults with CFS (Rimes et al., 2016; Rimes & Chalder, 2010), with unhelpful beliefs about emotions likely to lead to maladaptive emotion regulation strategies such as emotional suppression and somatising. However it has previously been found that adults with CFS report significantly more negative beliefs prior to CFS onset than after diagnosis (Brooks et al., 2017). Developing CFS may mean that an individual has to experience negative emotions from others (e.g. disappointment), which may have previously been avoided. This may lead to modification of their pre-existing beliefs about negative emotions being unacceptable or leading to rejection from others. The current study did not ask adolescents to rate their beliefs about emotions before CFS onset but this could be investigated in future research.
 
Sly Saint said:
eta: they are going to start suggesting CBT for perfectionist parents of sick children next (if they are not already)
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The findings of this study also indicate the potential importance of a familybased approach to treatment (Lloyd, Chalder, & Rimes, 2012), given that it is other-oriented perfectionism which seems to be different in CFS, rather than self-oriented perfectionism. Furthermore, involving both mothers and fathers in treatment could be important, as different aspects of maternal perfectionism and beliefs about emotions, but paternal affective style were related to perfectionism in adolescents.
 
Kalliope said:
I have read this part four times but still don't grasp what is being said here..

Holding unhelpful beliefs about emotions did not differ significantly across groups either, which was also contrary to expectations. This is different to findings in adults with CFS (Rimes et al., 2016; Rimes & Chalder, 2010), with unhelpful beliefs about emotions likely to lead to maladaptive emotion regulation strategies such as emotional suppression and somatising. However it has previously been found that adults with CFS report significantly more negative beliefs prior to CFS onset than after diagnosis (Brooks et al., 2017). Developing CFS may mean that an individual has to experience negative emotions from others (e.g. disappointment), which may have previously been avoided. This may lead to modification of their pre-existing beliefs about negative emotions being unacceptable or leading to rejection from others. The current study did not ask adolescents to rate their beliefs about emotions before CFS onset but this could be investigated in future research.
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Something along the lines of "We've got another idea for yet another really useless study that won't actually help anybody with ME but will keep us in a job"?
 
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