By David Tuller, DrPH
UPDATE POSTED AN HOUR LATER: Shortly after posting this blog, I learned that Volker Köllner, the senior co-author of the chapter in question, had posted a few hours earlier on LinkedIn that the culprit responsible for the “falsified version” that had appeared was German psychiatrist Michael Linden. As “responsible editor” for the relevant project, Linden apparently inserted the since-removed language without running it by the authors. (This posting seems to have occurred overnight in the US, so I missed it this morning.)
This disturbing acknowledgement raises questions about the integrity of the entire series. How often has this happened under Linden’s purview? Do other series editors routinely take such liberties? What is Springer Nature’s stance on this practice? What further actions will be taken regarding Linden’s actions?
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A month after publishing a German-language article about chronic fatigue syndrome as part of a larger project, Springer Nature has removed a passage portraying “some patients with fatigue” as being “combative and reproachful toward health care providers,” engaging in “dysfunctional illness behavior,” and exhibiting “a hypochondriacal disorder.” [All translations from German have been automatically generated.]
But the publisher has failed to explain clearly how the language got inserted in the first place. According to an erratum published on October 7th, it was all just a little mix-up for which no one in particular is responsible. Here’s the erratum:
“The originally published version of this chapter contained statements that were not authored by Alexa Kupferschmitt and Volker Köllner, did not reflect their therapeutic approach, and were not their responsibility. Unfortunately, the final corrections were not communicated to the authors before publication. Consequently, an unauthorized version of the chapter was published…The chapter has since been revised and now reflects the original version approved by the authors.”
Oops!
Let’s back up a bit. On August 29th, for a series called “Verhaltenstherapiemanual – Erwachsene” [Behavioral Therapy Manual – Adults], Springer Nature published a chapter specifically on “Chronisches Fatigue-Syndrom” [“Chronic Fatigue Syndrome”]. The two co-authors, psychotherapist Alexa A. Kupferschmitt and physician Volker Köllner, are researchers in “psychosomatic medicine” at Charite-University Medicine Berlin.
Both Kupferschmitt and Köllner are proponents of the rehabilitative paradigm in this domain. Last year, they co-wrote an article for Psychotherapists Journal (a German-language publication) called “The Post-COVID Syndrome—Overview of Bio-Psycho-Social Explanatory Models.”
The new chapter on chronic fatigue syndrome is full of the standard propaganda about the purported benefits of cognitive behavior therapy (CBT) and forms of graded exercise therapy and so on. The text is stuffed with problematic statements and arguments. But even among the expected verbiage, one passage popped out as, like, whoa!
Here it is:
“A striking characteristic of some patients with fatigue is a combative and reproachful attitude toward healthcare providers who do not share the patient’s own diagnostic assumptions. Another feature may be dysfunctional illness behavior, characterized by self-harming patterns of rest and avoidance, increased self-monitoring, and involvement of the patient’s social environment, which, irrespective of the primary etiology, may fulfill the criteria for a hypochondriacal disorder.”
Well, that passage sure seems to present a core component of the “biopsychosocial” ideology in a nutshell. It’s just unusual to see these prejudicial, biased and creepy notions about a group of people desperate for medical care so directly expressed as if they were facts. Of course, it is not “dysfunctional illness behavior” for people with ME/CFS to pace themselves so they avoid exacerbating their symptoms.
The chapter, and that passage, received significant pushback, and not only from patients. A “joint statement from healthcare providers and scientists” countering the overall thrust of the chapter currently has around 100 signatories. The statement specifically addressed the denigrating characterization of patients as hostile:
“Such sweeping statements condense individual negative experiences into a supposed peculiarity of this patient group, while our experience in practice and research provides no basis for this whatsoever. Such portrayals can foster unfounded mistrust of those affected, encourage a premature psychologization of physical symptoms, and contribute to a lack of impartiality in medical assessments. This further complicates the already inadequate care provided to people with ME/CFS.”
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That was where things stood until Springer Nature published the opaque erratum—acknowledging error without offering accountability. The authors deny all knowledge. So who inserted what the publisher refers to as “the final corrections”? And why would anyone insert such a passage without the knowledge of the authors? To its discredit, Springer Nature appears to have zero interest in this question and makes no mention of any further inquiries into the matter.
Unfortunately for Springer Nature, simply absolving the authors of responsibility and leaving it at that does not wash. If the publisher expects anyone to take seriously the claim that the authors have nothing to do with the matter, it will have to do a better job of identifying the responsible individual or individuals and explaining how this happened. Absent such an explanation, it is hard to assess whether this is an isolated incident or a larger pattern of behavior that threatens the integrity of the scientific literature.
The appearance of the erratum triggered much online consternation and commentary, extending the uproar over the chapter itself. Not many people seemed convinced by the skimpy, detail-free narrative being pushed by Springer Nature. From Daniel Loy, a lawyer on X who comments frequently on ME/CFS:
“Who actually authored these statements or prompted their inclusion? The editors? The publisher’s editorial department? Other involved parties?…If scientific texts can be substantively altered after author approval without the authors’ knowledge, then a central safeguard of the integrity of scientific publications has been undermined.”
Springer Nature has a lot of answering to do here. The erratum provides no insight whatsoever. Let’s hope that is not the last official word on this bizarre matter.