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The 3Ps model
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==Perpetuating factors == Perpetuating or maintaining factors are hypothesized to be: *[[kinesiophobia]] - phobia or fear of exercise that is not based on a realistic understanding of the illness *[[deconditioning]], meaning lack of fitness due to inactive *[[excessive rest]] *[[boom and bust activity cycle]] of doing too much on a good day, and too little on a bad day The 3Ps model is based on a hypothesis of a '''vicious cycle''' that keeps the illness going - without perpetuating factors there would be nothing to keep the illness continuing... according to this theory there is [[illness without disease|no underlying disease]] and full recovery can be achieved by psychological and behavioral changes only - meaning that ME/CFS is considered fully curable through [[cognitive behavioral therapy]] and/or [[graded exercise therapy]]. This vicious model holds the patient fully responsible for recovery, which can lead to negative outcomes, such as: *assuming that ME/CFS is not a serious or [[Causes of death|dangerous illness]] even when severe - leading to [[medical neglect and abuse]] *[[patient blaming]] when patients do not recover *assuming that patients are physically well enough to fully follow a recovery program *assuming that not following a recovery plan fully is due to psychological factors only, e.g., lack of motivation, presumed [[secondary gain]], not wanting to recover, which can lead to removal of essential support *clinicians fully accepting a hypothesis such as the 3Ps model can then assuming that a clinical trial testing the associated treatments '''''must''''' have successful outcomes - a significant [[Research bias|bias]] that occurred in the [[FINE trial]] and the [[PACE trial]] *[[psychologization]] *[[medical gaslighting]] *patient coercion instead of [[informed consent]]
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