Are Sexual Assaults Related to Functional Somatic Disorders? A Cross-Sectional Study 2023 Jacobsen et al

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by Sly Saint, Oct 27, 2023.

  1. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    Abstract
    An increasing number of sexual assaults (SAs) are being reported. This study investigated associations between SA and FSD, conceptualized as bodily distress syndrome (BDS), and five functional somatic syndromes (FSSs): chronic widespread pain (CWP), irritable bowel (IB), chronic fatigue (CF), multiple chemical sensitivity (MCS), and whiplash-associated disorder (WAD).

    Participants (n = 7493) from the population-based cohort Danish Study of Functional Disorders (DanFunD) completed questionnaires on FSD, emotional distress, SA, and sociodemographics. Risk ratios (RRs) for each FSD and emotional distress were calculated in nine models with SA as the primary exposure using generalized linear models with binomial family and log link and were adjusted for other potential risk factors.

    The results showed that SA was associated with single-organ FSD (RR = 1.51; 95% CI = 1.22–1.87), multi-organ FSD (RR = 3.51; 95% CI = 1.89–6.49), CWP (RR = 1.28; 95% CI = 0.83–1.98), IB (RR = 2.00; 95% CI = 1.30–3.07), CF (RR = 1.81; 95% CI = 1.42–2.32), WAD (RR = 2.62; 95% CI = 1.37–5.03), MCS (RR = 3.04; 95% CI = 1.79–5.17), emotional distress (RR = 1.75; 95% CI = 1.21–2.54), and health anxiety (RR = 1.65; 95% CI = 1.10–2.46).

    Overall, SA victims experienced significantly more somatic symptoms than individuals not exposed to SA. Adjusting for physical and emotional abuse did not change the observed associations. Our results suggest a large impact of SA on the overall somatic and mental health of SA victims. Due to the cross-sectional study design, further studies are required.

    https://www.mdpi.com/1660-4601/20/20/6947
     
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  2. Arvo

    Arvo Senior Member (Voting Rights)

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    Pure evil.

    Patients become victims of their perpetrators twice: first when it happened, and then when it's weaponized against then to dismiss their physical illness, framing it as somatization.

    (For the record, PTSD can come with periods of overwhelming exhaustion, but that's completely different than "chronic fatigue" or physical ailments.)
     
  3. Hoopoe

    Hoopoe Senior Member (Voting Rights)

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    My pet hypothesis is that these illnesses can start at a young age and remain below the treshold where they are perceived as illness and diagnosed, while subtly harming sufferers. For example, by making them less able to resist various kinds of mistreatments and neglect.

    Fast forward 10-20 years and the person now has a story of mistreatment, abuse or neglect and gets finally diagnosed by a very slow medical system who is eager to absolve itself of responsibility and uses an history of mistreatment and neglect of patients against them.
     
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  4. Ash

    Ash Senior Member (Voting Rights)

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    Yes @Arvo, sums it up.

    And @Hoopoe, could be? Disabled people are more likely to be victims of violence including sexual assault.

    A fact that is often spun around, to come out in the form of a perverse ‘expert’ opinion that you’re disabled because you didn’t toughen up and get over being assaulted, which may have happened after you became disabled. But never mind that.
     
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  5. LarsSG

    LarsSG Senior Member (Voting Rights)

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    Being a victim of sexual assault is also associated with heart disease, hypertension, diabetes and all kinds of negative health outcomes that definitely aren't functional.
     
  6. Ash

    Ash Senior Member (Voting Rights)

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    Almost like it’s an assault on the body or something.
     
  7. Sean

    Sean Moderator Staff Member

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    I think this is one of the biggest technical questions about ME: Is there a prodromal phase, where the disease process is in place and actively affecting patients' lives, but is still at the relatively mild end of the spectrum, and the symptom expression is not yet sufficiently distinct to allow accurate diagnosis?

    You can see how that situation could lead to all sorts of misdiagnoses, particularly psych ones.
     
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  8. Kitty

    Kitty Senior Member (Voting Rights)

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    So many people have been sexually assaulted that, depending on the definition, it's possible any associations simply reflect general population trends.

    I don't know about men, but it's a pretty normal experience among women of my generation. The majority don't involve rape or significant violence, but it doesn't mean they're not sexual assaults and it doesn't mean they don't affect the women subjected to them.

    The nature of assaults may have changed over time, I guess, but it wouldn't surprise me if it's still common.
     
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  9. NelliePledge

    NelliePledge Moderator Staff Member

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    Yeah it’s called gradual onset ME and quite a substantial % have this type of onset. I can’t quote a source but I have 1/3 in my head from somewhere. I guess where people have acute onset individuals and medic’s don’t look back in the same depth at the history as when it has gradually become worse over a decade or more.
     
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  10. Ash

    Ash Senior Member (Voting Rights)

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    Yeah. I think it’s still very common. According to statistics in UK rates were getting higher and higher over time. One hopeful explanation for this is that people are less ashamed and more confident about reporting. That’s considered certain to account for some of the rise. But less hopefully not necessarily all of it. In any case most people don’t report so, yeah very common.

    I think it’s more difficult for boys and men to report. So whatever these numbers are there won’t be so much to work with if tempted to try to associate an experience sexual assault with men’s symptoms.
     
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  11. Hutan

    Hutan Moderator Staff Member

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    This problem alone invalidates the study. People who are willing to bear the label 'Functional Disorder' are much more likely to buy into the idea of past trauma being responsible for their current physical health. If you have persistent symptoms and you've had a fairly trouble-free life, you are going to be much more likely to reject that labelling and reject the concept of functional disorder. Your privileged life (and I don't primarily mean in socioeconomic terms, but that probably applies too) probably makes you better able to be assertive and resist coercive brainwashing, and less likely to want to blame family and others you have encountered for your disease.

    People who have gone through treatment for functional disorder will probably be much more likely than healthy people to have sifted through their memories for incidents that might qualify as the abuse they are told must be there. For the healthy person, a sexual assault at the milder end of the scale, might not even be remembered when filling out the survey (certainly for a woman of my generation). For the person who has been told that their current ill-health probably is a result of past trauma, events of all sorts will be given much more weight.
     
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  12. Sean

    Sean Moderator Staff Member

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    Could also be a stable sub-clinical state, which then gets flipped more or less overnight into a much more serious state by a short term infection, for example.

    ––––––––––

    "An increasing number of sexual assaults (SAs) are being reported."

    Which is a different metric from an increase in sexual assaults, reported or not.
     
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  13. Arvo

    Arvo Senior Member (Voting Rights)

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    This bps movement is constantly looking for ways to justify and promote their ideology and the presence of it in health care.


    Like others mentioned here, being a victim of sexual assault is -unfortunately- super common for women. (And is also common among children.)

    Being groped happened all the time, and until recently it was expected you did not make a big deal out of it. This "just happened" when you were female. I use the pas tense, because although I expect it's still happening a lot, due to the recent developments where women started to discuss this en masse and be vocal how this is not ok, I suspect it's less regular than before. There's a young generation of women in their 20s who will defenitely not put up with that shit, and they can because their surroundings are more aware of this not being acceptable.

    Rape is also incredibly common. A large chunk of women experiences it in her life. And again, the way it is talked about and accepted is undergoing social change. (In fact, Denmark changed its rape laws per 1 January 2021: if both parties do not consent to sex then it's rape. This indicates that this change in consideration has been happening in Denmark for a while now.)

    So yes, "an increasing number of sexual assaults is being reported", but that's happening in a context where women recognize it better and feel more secure and justified in reporting it. Like Sean mentions above, this says nothing about the increase of sexual assaults in itself.

    Of course the next stage of this awfullness is "asking the question" why these sexual assault survivors "developed" symptoms, or more symptoms, as a "consequence" of their sexual assault, in comparison with those sexual assault survivors.

    I don't think anyone will want to place a bet with me that the answer of course will lie in the person themselves, following bps beliefs. Like the paper says:

    Quelle surprise.
     
    Last edited: Oct 28, 2023
  14. Arvo

    Arvo Senior Member (Voting Rights)

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    By the way, there's a special place in hell for those using the term "sensitization" with regard to rape victims.
     
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  15. Arvo

    Arvo Senior Member (Voting Rights)

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    Also, the effects of rape are intense and life-altering, particularly in the period just after. (It calms down after that, although triggers can conjure it up again.) Your whole being is shattered to pieces the size of a grain of sand, and you have to carefully tweezer them back into place, building yourself up again.

    There are nightmares, flashbacks, reliving were you hardly notice where you are, retching, uncharacteristic aggression when it flares up, horrible murder fantasies which horrify you as you'd never want to hurt people but in this case you very much desire it, clothes you can't wear, clothes you can't wear in a certain way, physical appearances of people that are like those of your perp which set off an attack, weird shit you do to keep yourself safe, etc, etc.

    What I mean is that, in a society where the disablist belief is widespread that people who are chronically ill or disabled are secretly different than people who are not (weaker personality), and in which stuff like "the secret" can be all the rage as it is a common human trait to believe we have control over things we do not with our thoughts and attitude, it is to be expected that some people buy into the FD setup because it totally makes "sense" to them that something so incredibly intense and overwhelming is related to the physical illness occuring some time after it.

    This does not make the sexual assault victims who believe it gullible btw. The whole setup of the bps movement is to use "inoffensive" terminology,: they substitute "functional disorder" for psychiatric disorder or hysteria so the patients won't get mad at them and to make it sound like they are taking the patients seriously. If you have patients coming in from the other end in the way I just described, it is a recipe for e.g. a situation where some sexual assault survivors accept the belief that they have mysterious inorganic physical symptoms related to their sexual assault and that these "experts" take them seriously.
     
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  16. Ash

    Ash Senior Member (Voting Rights)

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    Also it’s often a condition of receiving support, demonstrate buy in to our framework or be considered “not yet ready for healing”.


    It can be very difficult for people to get decent support.

    BPS ideology is a slight tweak on victim blaming going back centuries, so your community will also be expecting to some extent or other, that you work hard and “take responsibility for your own healing”.

    It’s not a framework you can opt out of without consequences.
     
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  17. Solstice

    Solstice Senior Member (Voting Rights)

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    Gotta admit that as a man it's a very difficult issue for me to grasp. There was a Dutch comedian(Peter Pannekoek) that made a prison-analogy in one of his stand-ups, where in prison you constantly feel vulnerable because something might happen to you that you don't agree with whether it be sexual or else. The inference then was that that's everyday life for women.
     
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  18. Ash

    Ash Senior Member (Voting Rights)

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    When you sit to wait for someone or some bus and spend a bit of time watching people go about on the streets, and then you tune into watching the way some men watch women usually younger than them, it becomes clear that the looks aren’t always friendly or benign. That doesn’t tell you about the stuff that can go wrong for women after this but it does show you something about gender based power relations.


    Women can be predatory towards younger people too but that isn’t on the same scale that you can be sure to witness it any day on any street. You will also likely see certain men looking at adolescent girls in an unsettling manner on most cities streets parks beaches….
    Sometimes some men will be seen looking at adolescent boys but this is not usually so blatant or commonplace.

    Thankfully this isn’t most men. It is a reliable minority. Once you’ve seen it you can’t unsee it.
     
    Last edited: Oct 28, 2023
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  19. Midnattsol

    Midnattsol Moderator Staff Member

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    One article I read from ECTRIMS (behind paywall) was that one group of researchers presented findings that people who go on to have an MS diagnosis have increased sick leave starting ~ten years before diagnosis. Indicating a long prodromal phase.

    Found a non-paywalled article that also include a link to a pdf of the study presentation: ECTRIMS 2023: Sick days in years before diagnosis suggest MS prodrome This was based on data from Sweden. In Norway we recently got data that showed people who go on to get an ME diagnosis lose income starting ~three years pre diagnosis.
     
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  20. Sean

    Sean Moderator Staff Member

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    For some patients, at least. Not suggesting it happens to all patients.
     
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