Trial By Error: CBT Model Of Medically Unexplained Symptoms, Explained; CBT Trial For Q-Fever Fatigue

By David Tuller in Virology Blog.

As I have recently written, four major clinical trials of CBT for so-called MUS have documented the opposite of what the investigators hoped to prove. In fact, the evidence from this research suggests that CBT is not an effective treatment for these conditions. That hasn’t stopped these investigators from claiming otherwise, of course. As my earlier post indicated, they have deployed a range of methodological, statistical and rhetorical strategies to obfuscate or downplay their poor results. Three of these studies were based at King’s College London, and one—the now-discredited PACE trial—at Queen Mary University of London.

2007 article in the journal Clinical Psychology Review“The cognitive behavioural model of medically unexplained symptoms: A theoretical and empirical review”–sheds some light on the background and possible genesis of these various trials. (One of the co-authors of the review was a lead investigator in all four of the MUS clinical trials.) This review outlined the rationale behind the CBT treatment approach to MUS, including specifically chronic fatigue syndrome (CFS) and irritable bowel syndrome (IBS), and suggested that these conditions are essentially self-sustaining. The review also helped clarify–for me—why I get a sense of déjà vu whenever I read another article from this group of investigators. Each one basically says the same thing, except with a change in the targeted condition.

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