I don't agree: not only do I not understand how they came to say that they "demonstrated" that "a brain abnormality makes it harder for those with ME/CFS to exert themselves physically or mentally.", but I find the fact that these comments are not the info you get from the paper problematic.
I'm just commenting on this snippet relating to "effort preference" (a quick look at the full article makes it seem like a good one), but what's happening in this snippet is hella weird IMO: to me it reads they're trying to portray the paper's claims in a more palatable-
sounding way, which comes across like they are trying to polish the effort preference turd. (And the question for me is then if they are doing it because they are aware that being honest about their shit would make them look bad, or if they're trying to reshape what they allowed in the paper while not agreeing with it - and either would be bad.)
The remark that when "the brain is telling ME patients" not to make an effort it is not "voluntary" irks me a lot. This is somehow meant to make the effort preference concept sound better, but to me it doesn't; sticking the reason for illness or any other unwanted "deviation" from how you "should be" on disablist/prejudiced notions and then saying that the patient is doing that not on purpose but subconsciously is a boring old trick (you are blind because you subconsciously wanted someone else to be blind, you have spasms because you subconsciously want attention, you are a lesbian because you subconsciously want to be a man, etc, etc, etc). The person it concerns is demoted to being an unreliable narrator about themselves, while the person saying it usually feels entitled to fill in what that subconscious thing
really is, according to their prejudiced preferences.
So personally I consider this is used as a fig leaf, a shield to protect the authors when pointing out that their paper is disablist, and quite the red flag.
Walitt et al says:
About the grip strength it says that
All these sentences imply choice, preference etc - as far as I see it is nowhere stressed or even mentioned that this would even be unvoluntary. The only time the word "unconscious is used in the paper is
when linking "effort preference" to other test results, with a reference [ref 35) to a Knoop & Van der Meer publication that opens its background section in the abstract with "Chronic fatigue syndrome (CFS) is characterized by disabling fatigue, which is suggested to be maintained by dysfunctional beliefs. Fatigue and its maintenance are recently conceptualized as arising from abnormally precise expectations about bodily inputs and from beliefs of diminished control over bodily states, respectively." and concludes "alterations in behavioral choices on effort investment, prefrontal functioning, and supplementary motor area connectivity, with the dorsolateral prefrontal cortex being associated with prior beliefs about physical abilities"
(
@dave30th, you might be interested in this)
