Psychological Treatment for Rheumatoid Arthritis Works: Now We Need to Know What Elements Are Most Effective and for Whom
Bibliographic record
Abstract
In this issue of The Journal , Shadick and colleagues1 conduct a proof-of-concept study investigating the efficacy of a novel psychosocial intervention for patients with rheumatoid arthritis (RA): Internal Family Systems-based Psychotherapy (IFS). IFS has not previously been the subject of randomized controlled trials (RCT) and therefore its potential efficacy is unknown. Group differences favoring the IFS group over a group receiving routine care were found for pain severity and physical function at posttreatment, and for joint function (self-assessed), depression, and self-compassion at 1 year followup. Hence, this trial has established proof of concept for the potential efficacy of IFS in RA. But what is IFS and how is it related to existing evidence-based treatments? Internal family systems therapy was developed and articulated by Schwartz2, and his book indicates that much of the influence for IFS has come from work in family therapy3,4. However, IFS is not a form of family therapy per se , because patients were seen in groups without other members of their family present. Shadick, et al 1 described the processes: (a) IFS “teaches patients to attend to and interact mindfully” with their internal experiences; and (b) IFS “recruits self-compassion and conceptualizes parts of a person as subpersonalities, in which they are encouraged to engage in a dialogue with polarized thinking.” According to Shadick, et al 1, patients are encouraged to identify situations with their concomitant thoughts and emotions. Patients are then asked to identify the origin of these experiences, allowing them to change their response and identify compromise positions to allow them to behave differently. From this description, it is clear that IFS shares overlap with numerous other models of psychotherapy, many of which have been previously used in RA. It is important to determine the … Address correspondence to L. Sharpe. E-mail: louises{at}psych.usyd.edu.au
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.038 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.004 | 0.007 |
| Scholarly communication | 0.014 | 0.013 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.013 | 0.025 |
| Insufficient payload (model declined to judge) | 0.007 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".