Experiential avoidance is associated with medical and mental health diagnoses in a national sample of deployed Gulf War veterans, 2021, Blakey et al

Andy

Andy

Retired committee member
Highlights

• Many Gulf War veterans have developed chronic, difficult-to-treat illnesses.
• Biopsychosocial models can improve chronic illness diagnosis and treatment.
• Experiential avoidance (EA) is a psychosocial mental/medical illness risk factor.
• EA was associated with PTSD, depression, and several chronic medical illnesses.
• EA-focused assessment and intervention might improve Gulf War veterans' health.

Abstract

A substantial minority of deployed Gulf War veterans developed posttraumatic stress disorder (PTSD), depression, and several chronic illnesses. Although military combat and exposure to certain nuclear, biological, and chemical agents (NBCs) increase risk for post-deployment health problems, they do not fully explain many Gulf War veteran health diagnoses and are not viable treatment targets. Experiential avoidance (EA; one's unwillingness to remain in contact with unpleasant internal experiences) is a modifiable psychosocial risk factor associated with PTSD and depression in veterans as well as pain and gastrointestinal diseases in the general population.

In this study, we recruited a national sample of deployed Gulf War veterans (N = 454) to test the hypothesis that greater EA would be significantly associated with higher lifetime odds of PTSD, depression, “Gulf War Illness” (GWI/CMI), and other chronic illnesses common in this veteran cohort. Participants completed a self-report battery assessing demographic, military-related, and health-related information. Multivariate analyses showed that after adjusting for age, sex, race, combat exposure, and NBC exposure, worse EA was associated with higher lifetime odds of PTSD, depression GWI/CMI, gastrointestinal problems, irritable bowel syndrome, arthritis, fibromyalgia, and chronic fatigue syndrome (ORs ranged 1.25 to 2.89; effect sizes ranged small to large), but not asthma or chronic obstructive pulmonary disease. Our findings suggest medical and mental health providers alike should assess for EA and potentially target EA as part of a comprehensive, biopsychosocial approach to improving Gulf War veterans' health and wellbeing. Study limitations and future research directions are also discussed.

Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0022395621004660
 
Feels like explaining illness to these people is like trying to explain color to a species that has no vision. All meaning gets lost, they simply cannot process the concept and its implications. Which in the context of health care is especially inept.

Let's give those people super emetics then scold them for avoiding riding on roller coasters all day. That's about how ridiculous they are behaving here. All awareness of reality ends at the limits of their nose.
 
People who have a disease will avoid the things that make their symptoms worse. That happens in everyone. Just think how the benefits system would deal with you if you said you can't work because you spend all weekend making your arthritis worse by gardening just because you do not want to avoid doing it!

Maybe looking at PTSD or depression where withdrawal from the world could be a risk factor but once you bring in avoidance of physical problems it makes no sense.
 
Andy said:
Although military combat and exposure to certain nuclear, biological, and chemical agents (NBCs) increase risk for post-deployment health problems, they do not fully explain many Gulf War veteran health diagnoses and are not viable treatment targets.
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i.e. we don't know how to fix whatever problems resulted from exposure to the 'certain nuclear, biological and chemical agents', so we'll label these people with a made-up patient-blaming problem and treat them for that instead.
 
alktipping said:
if it was me i would refuse in strong terms .
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And therein lies one major bias in this sort of research. Any veteran with a chronic illness and a firm belief that their illness is not psychogenic is likely to not be keen on participating in a study where the lead author comes from a 'Mental-illness Research, Education and Clinical Centre', especially if the veteran has participated in similar sorts of research before.
 
alktipping said:
are gulf war veterans somehow forced into these ridiculous experiments if it was me i would refuse in strong terms .
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I initially misread this study as relating to ‘experimental avoidance’ rather than ‘experiential avoidance’, and thought perhaps it was specifically addressing differences between Gulf War Veterans who did and who did not want to participate in research.

Certainly with ME I would expect a relationship between people’s understanding of their condition and what research they would be willing to participate in, and also a relationship between how long post onset someone was and their willingness to participate in psychologically focused research.
 
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