Thread by @sunsweptforest

Friends. Welcome to my ZedTalk(TM). Today I want to speak about “effort preference,” because that is the termite-infested foundation on which the Paper-Which-Shall-Not-Be-Named is constructed. Effort preference in this paper is defined as “how much effort a person
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subjectively wants to exert.” The authors warn us that, “as fatigue develops, failure can occur because of...an unfavorable preference.”
But how do they measure this remarkable concept, so key to their ground-breaking analysis? They use the Effort-Expenditure for Rewards Task
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(EEfRT), an instrument designed to explore effort-based decision making in people suffering from Major Depressive Disorder (MDD), anhedonic subtype (Treadway et al 2009). The anhedonic subtype of MDD is characterised by “aberrant motivation and reward responsivity”--ie,
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a lack of “willingness to expend effort for rewards” due to “decreased motivation for and sensitivity to rewarding experiences.” Anhedonia is used to distinguish MDD from other psychiatric disorders.
But wait! Surely ME isn’t...MDD? No indeed. In fact, the authors of The Paper
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carefully (rigorously!) screened out participants who had additional diagnoses that could confuse the results of the study.
This is not unlike taking an instrument designed to measure Fear of Swimming--as a subset of Fear of Water--and asking people who’ve been pre-screened
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and found *not* to suffer from Fear of Water to complete it...then using the results to claim they suffer from Fear of Swimming whilst also deliberately ignoring the fact that these people are all wearing casts bc they have broken limbs, so their behavior during the exercise
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will reflect the fact that they cannot currently swim.

It is patently, flagrantly absurd.

To be very clear, the authors selected people to study who are very sick and then deliberately applied an inappropriate tool that assumes *low motivation* and *lack of appreciation of
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rewards* leads to less effort. Results of the activity are interpreted accordingly. (Amusing in context of ME, where ppl are more likely to behave like the Black Knight--continuing to push thru even as their life blood drains away--than a couch potato.)
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Anyway, the whole paper is constructed around this, and it’s actually totally irrelevant to ME.

The authors even run regressions on the EEfRT results and attempt to correlate all the biophysical findings with this very particular key trait of MDD, piling a
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statistical disaster on top of the dumpsterfire they made of research design.
The way they discuss the findings also tacitly implies some causality (suggesting that effort preference for non-effort leads to deconditioning over time leads to, you guessed it, disability),
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although they are careful to say they can’t make causal claims.
As anything other than a joke or a teaching tool (perfect for undergrad methods classes!), this paper is an outrage.
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https://twitter.com/sunsopeningband/status/1760277547072557565

So, outrage thread to follow.
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