Hello bio,

You wrote:

Quote Originally Posted by biopsychobabble View Post
Maarten, I also noticed how just like the phrases "multi-disciplined" and "integrative approach", the word "multifactorial" is used differently by biomedical proponents and biopsychosocialists. The former group list several biological aspects and sometimes a psychological component. The latter group usually just list a bunch of different psychosocial, cognitive and behavioural attributes along with their "biological" consequences (eg deconditioning).

Nijmegen (Knoop et al) state "fatigue is perceived as something negative", "CFS is seen as an illness that is difficult to influence" and (dysfunctional) "beliefs about activity and fatigue" as if these are all unreasonable conclusions by patients. No mention whatsoever of any biological factors/components in the abstract. They do not appear to acknowledge or understand the existence of post-exertional symptom exacerbation either. I have little faith in the perspective of anyone who claims exertional symptoms are a "dysfunctional belief" or a merely consequence of misinterpreting ordinary signs of deconditioning. Even the questionable "chronic stress" model of CFS is more respectable than that.

Although Wessely is often seen as the pinnacle of the biopsychosocial approach, he may not necessary be the most hardcore proponent and there are plenty of others who would be willing to pick up the slack even if the entire UK school retired from CFS. We may be witnessing a split of biopsychosocial schools where some will become even more extremist about patient delusions while others will incorporate more biological factors.

+1 to all of that, with the added notes that I personally believe (i) Wessely et al. are playing a conscious clever con-game and (ii) one reason - of very many, very well discussed by Malcolm Hooper (thank you very kindly, sir! GREAT work!) - they are not even decently scientific and fair is that they systematically leave out all or nearly all references to biomedical findings & explanations and (iiii) Wessely is important due to the positions of power he has, and his formal standing. But sure: No doubt quite a few of his kind may replace him and spout the same drivel till their pensions, and even after, to feed the sick twists in their tiny minds.

Maarten.