“When my mind hurts, my body hurts”: Complex PTSD and chronic physical health conditions—A qualitative study exploring... 2025 Blackett et al

Andy

Retired committee member
Full title: “When my mind hurts, my body hurts”: Complex PTSD and chronic physical health conditions—A qualitative study exploring the factors contributing to their relationship

Abstract

Objectives
Complex PTSD (cPTSD) has a high comorbidity rate with chronic physical health conditions. This is the first qualitative study to investigate what factors might be contributing to this relationship.

Methods
Twelve participants with cPTSD and chronic physical health conditions were recruited from mental health services across London. Semi-structured interviews were completed. A reflexive thematic analysis was conducted.

Results
Four themes were identified: Negative Health Behaviours; Mind–Body Link; Negative Core Beliefs about Self, Others and Health; and Negative Impact of Conditions on Wellbeing. The reciprocal relationship between cPTSD and chronic physical health conditions was highlighted: one condition was found to perpetuate or trigger the other, either directly (e.g., pain triggering flashbacks) or indirectly (interfering with treatment). Various factors were found to contribute to the relationship, including cognitive difficulties, sleep difficulties, and reduced social support.

Conclusions
The importance of recognizing mind–body links and targeting factors maintaining both cPTSD and physical health conditions is highlighted.

Practitioner points
  • Highlights maintaining factors of cPTSD and chronic physical health conditions.
  • Makes recommendations for cPTSD treatment targets when there is chronic physical health comorbidity.
  • Advances existing research models by highlighting the reciprocal relationship between cPTSD and physical health conditions.
  • Identifies the role of Disturbance in Self Organization symptoms which have not been considered by previous models.
Open access
 
"The role of anxiety sensitivity and avoidance is incorporated with five other components that are proposed to contribute to both PTSD and chronic pain in The Mutual Maintenance model (Sharp & Harvey, 2001); these are:
  1. Anxiety sensitivity (e.g. viewing events as potentially catastrophic)
  2. Physical pain as a reminder of the trauma
  3. Attentional biases that increase hypervigilance to threat and pain
  4. Avoidance coping behaviours
  5. Fatigue that drives depression
  6. Worries common to both disorders
  7. The overwhelming cognitive demands of both conditions limit one's ability to problem solve or use coping skills
This model explains all seven processes that underlie and maintain PTSD and chronic pain, with the cognitive, affective, and behavioural components of pain maintaining and exacerbating the physiological, affective, and behavioural components of PTSD, and vice versa (Asmundson & Katz, 2009)."
 
So biopsychosocial theory promoters looking for academic funding have switched from saying all unexplained disease is somatisation to saying verifiable PTSD causes somatisation (if you cherry pick twelve traumatised people who also have comorbidities).

I suppose that is less insane than the previous made up dogma behind PACE designed to align with prejudice rather than dispelling it but its still not necessarily true and in the pursuit of science you have to prove it. I don't think "semi-structured interviews" really qualify as empirical evidence. If you make the Venn diagram of groups of all people with PTSD and all people with unxplained morbidity there is going to be an intersection, but the intersection is a minority in both cases, association does not prove causation, or provide the rule for treating either group.

Sorry @Andy I just cannot bring myself to like those two posts, though I appreciate you bringing the 'publication' to our attention, as we should remain aware of what the next generation of psycho-fictionalists are up to.
 
When im involved in occasional social activities with friends sometimes photos get taken. At the time Im enjoying myself and absolutely not focusing on my ME/CFS symptoms. Nevertheless I regularly find that the photo shows a group of people smiling and me with something of a frown. This isn’t because I am just naturally grumpy because why would I bother making the effort of meeting people.

I know from my Auntie who has Fibromyalgia that she frowns when she’s in pain, sometimes she hasn’t taken her next dose of painkillers, and that’s what I see in myself in those pictures.
 
Four themes were identified: Negative Health Behaviours; Mind–Body Link; Negative Core Beliefs about Self, Others and Health; and Negative Impact of Conditions on Wellbeing
"Identified". Sure thing, boss. "And then they broke out in coordinated song-and-dance, doing the new corporate anthem, totally unprompted, and then only spoke using quotes from the corporate brochure, I swears, boss! They love the new campaign, this product will sell like hot buns straight from the oven!"

I don't know who the audience for this drivel is. It's laughable that anyone takes bullshit like this seriously. It's basically a perfect example of how not to do science, how easily people can simply throw stuff on the ground, then pretend, all surprised, like they found the thing they put there on the ground for them to find. Total surprise!

There's a funny thing in the history of forensics "science", which should be more accurately called forensics shmience. Some of it is legitimate, but most of it is bunk, and has been debunked. But this, here, is what a world would look like if no one cared about legitimate outcomes, and, say, polygraphs ("lie detectors") were not only routinely used, but were considered objective evidence in themselves in a court of law. But, instead, forensics shmience has been mostly discredited.

Not only that, but it's widely known just how poor memory recall is. Even for simple events. Which multiple people witnessed. Even right after it happened. Details can change completely. The color of the car. How many people were right in front of them. Was there a gun? It doesn't take hundreds of details to get lost, just a dozen or so will do. Recall is generally terrible, and for this reason is never considered reliable evidence. Not just years later, as is the case here, even mere hours is enough.

And this, here, is made entirely of some recall-polygraph combination, mixed with an extreme of biased profiling, and probably a few calipers. And people pretend like it's any legitimate. No, they pretend that it's scientific.

So what else does it say about all the other things they call scientific? Because when you sit behind a desk, under a banner that says "this person always tells the truth" and that person states an obvious lie, even a white one, then the person on the other side of the desk should have confidence that the sign on the wall is itself a lie in giant letters.

They just never think of what it means to tell the truth out of one corner of their mouths and make up ridiculous lies out the other. They think people should take everything out of their mouths as the truth. Even when they tell lies so obvious that even a child will know not to bother with that person.
 
This was a PhD project by a psychology student with the participants reporting their physical conditions that included fibromyalgia, asthma, diabletes, HIV, chronic pain etc. No medical doctor input.

At a quick glance through, I don't think anything useful was found from the interviews - just unsurprising things that show it's tough coping with life with PTSD as well as one or more chronic physical conditions.

I don't like this sort of research. It feels like exploitation to me, just so someone can write up a project full of jargon and theorising and get themselves a doctorate.
 
Complex PTSD (cPTSD) has a high comorbidity rate with chronic physical health conditions. This is the first qualitative study to investigate what factors might be contributing to this relationship.
It is impossible to assess contributions with this methodology. It is shocking that this passed any kind of assessments for a PhD.
 
I don't like this sort of research. It feels like exploitation to me, just so someone can write up a project full of jargon and theorising and get themselves a doctorate.

Shades of McEvedy and Catch Me If You Can, make stuff up which people will believe and devil take the hindmost.

e.g. What does "Mind–Body Link" mean if it is not BPS baloney trying to make a comeback?
What does "one condition was found to perpetuate or trigger the other" if it is not asserting PTSD causes physical comorbidity, with what proof?

What is "The Mutual Maintenance model" if not opining on the BPS paradigm, again without proof?
We have argued that chronic pain and PTSD can be conceptualized as mutually maintaining conditions.
https://www.sciencedirect.com/science/article/abs/pii/S0272735800000714?via=ihub

Of course some people with PTSD also have chronic pain, because trauma often involves physical accidents or battlefield injury, just because they occur together does not mean they are mutually maintained, that is unjustifiable sophistry comprising an insurance company legal argument for reducing costs of therapy and care i.e. its a blag.
 
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