Intimate Partner Violence and the Risk of Developing Fibromyalgia and Chronic Fatigue Syndrome, 2019, Chandan et al.

Trish

Trish

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Intimate Partner Violence and the Risk of Developing Fibromyalgia and Chronic Fatigue Syndrome

Abstract

Intimate partner violence (IPV) is a global public health issue with a variety of ill health consequences associated with exposure. Due to the stimulation of chronic stress and inflammatory pathways, childhood abuse has been associated with the subsequent development of functional syndromes such as fibromyalgia and chronic fatigue syndrome (CFS). Although IPV in women appears to elicit similar biochemical responses, this association has not been tested thoroughly in IPV survivors. These functional syndromes are complex in etiology and any indication of their risk factors would benefit health care professionals managing this population. Therefore, we aimed to investigate the association between exposure to IPV with functional syndromes: fibromyalgia and CFS.

We conducted a retrospective open cohort study using “The Heath Improvement Network” database between January 1, 1995 and December 1, 2017. A total of 18,547 women who were exposed to IPV were each matched by age to four controls who were not exposed (n = 74,188). The main outcome measures were the risk of developing fibromyalgia and CFS. These were presented as adjusted incidence rate ratios (aIRR) with 95% confidence intervals (CIs).

We found that 97 women in the exposed group developed fibromyalgia (incidence rate [IR] = 1.63 per 1,000 person-years) compared to 239 women in the unexposed group (IR = 0.83 per 1,000 person-years). Following adjustment, this translated to an IRR of 1.73 (95% CI = [1.36, 2.22]). Similarly, 19 women developed CFS in the exposed group (IR = 0.32 per 1,000 person-years), compared to 53 in the unexposed group (0.18 per 1,000 person-years), which translates to an aIRR of 1.92 (95% CI = [1.11, 3.33]).

Therefore, we have identified an association between a history of IPV in women and the development of these functional syndromes, which may provide more information to inform the biopsychosocial pathway precipitating the development of fibromyalgia and CFS.
 
I feel nauseous.

There are no depths to which they will not sink.

Imagine if they didn’t explicitly use the term “Function Syndromes”. The door might of been left a jar. For those who would presuppose good faith and supportive intent.

So I guess it is merciful that they wear their cruelty on their sleeve instead.


I see no evidence of a single heart beat between them. You’d have to be dead inside to build your career on the back of the physical brutality of another.

You can be sensitive to and up to date with your terminology IPV the convention of late. A phrase with accuracy and seriousness, if only in comparison to it’s predecessors.

Yet you accuse any female victim and survivor may suffer sickness of Functional lack, of hysteria-conversion disorder- Functional Syndrome/Condition you are not a person who should be allowed near any fellow human of all genders.

No person dealing with trauma needs a medical sadist to re-open their wounds to observe suffering and judge this pathology.


While nerve damage exists while brain injury exists while bones break and scar tissue forms while your own people suggest autoimmunities may be triggered through prolonged stress one might suggest you could in the realm of the real the known the cause and effect of a body facing impact and without recourse to a ‘complex’ magical plane where ‘aetiology’ is independent and freed from physics and biology. Where aetiology can skip freely from your mind into your body without changing a cell it floats and flows through the ethereal light then bam!! Your Function is finished.


I didn’t see mention the disparity of domestic violence rates against disabled people in comparison to non-disabled.

This is the context that makes this paper particularly sickening to me.
 
Ash said:
No person dealing with trauma needs a medical sadist to re-open their wounds to observe suffering and judge this pathology.
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This! 100%

Ash said:
I didn’t see mention the disparity of domestic violence rates against disabled people in comparison to non-disabled.

This is the context that makes this paper particularly sickening to me.
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Having worked nights in a women’s refuge in East Belfast (pre ME), I have met some amazingly resilient women. I shudder to think of any of them being exposed to another whole layer of trauma through this nonsense.
 
Illness doesn't begin with the diagnosis and the chronically ill are more often the target of various kinds of abuse. So it's not particularly surprising if some correlation is found. Sadly this is then used against patients to treat them poorly in the healthcare setting (denying them appropriate care because the problem is seen as somatization).

Also it's problematic to suggest to the chronically ill that their illness is the result of previous traumatic experiences when such a thing hasn't been proven.
 
https://www.the-health-improvement-network.com/

Maybe patients with symptoms of fibromyalgia and CFS are more likely to have had intrusive questions asked by medical professionals about 'trauma history' than those presenting with other conditions, so more likely to have any incidence of domestic violence added to their medical records? Many people suffer violence that does not get added to their medical records, especially non-physical abuse. So a complete reversal of the suggested cause and effect.

This shows how using these patient data trawls has a lot of potential to harm patients and future patient-clinician relationships, and now even create a self-perpetuating cycle of 'medical abuse'.
 
chrisb said:
they are obviously on a roll https://doi.org/10.1186/s12916-021-02119-w
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This is classic evidence of data-fishing. If they are writing multiple papers with multiple comparisons they have to statistically correct for the fact that they are testing many hypotheses and only publishing the ones where they find results.

Given the similar odds ration, there may be a reporting bias rather than an actual cause-effect relationship.
 
chrisb said:
they are obviously on a roll https://doi.org/10.1186/s12916-021-02119-w
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I wonder if the more 'brain fogged' and severely exhausted a patient is when attending a medical consultation, the more they are likely to allow themselves to be drawn into a BPS oriented clinician's intrusive questioning of their trauma history?

I must have been fortunate with my GPs as they've never asked probing questions about either childhood or adult trauma despite there being documented history of physical abuse consequences on my medical records from the 90s and 2000s. I was shocked when I attended A&E about a year ago, to have the nurse start asking so many 'BPS' questions when I was visiting due to loss of vision in an eye. My daughter was with me and we both kept stating I didn't want a 'holistic assessment' of my health, just the presenting problem investigated (I'm naturally good with personal boundaries). Despite this, he still wrote to my GP that I should have one. Fortunately she listened to my daughter explaining my view during the subsequent telephone appointment and gave reassurance she understood I only wanted my physical medical problems investigated. It was the misuse of the BPS approach in the medical encounter that was actually traumatising for me!
 
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Yes @Simbindi.

I have experienced trauma. Generally it was because I could not do the mental work to negotiate my way out of a situation with sufficient efficiency due to extreme exhaustion or pain.

Unfortunately the greatest effects of trauma that effect me almost daily is the accumulation of abusive medical encounters. This is because I have to deal with Drs I can’t dispose of them all as I might wish. Moving on is not an option when each one is as awful as the last. When their ideology is something I meet every time someone finds out I am disabled and offers me their unsolicited opinion on the matter.

Most of us are pretty experienced in radiating utter contempt in return.

In repeating our request calmly and relentlessly until some minor and minimum requirement is met.

Yet we while remain human and sick we will never have enough life to give to this project that we could avoid all the abuse that they with boundless energy for cruelty can throw our way.

It is the most traumatic experience to seek relief from pain or injury and receive more.
 
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Words cannot convey my disgust.

Simbindi said:
Maybe patients with symptoms of fibromyalgia and CFS are more likely to have had intrusive questions asked by medical professionals about 'trauma history' than those presenting with other conditions
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Case closed IMO.

I just found this in the text of the authors' other paper (linked by chrisb above):

the prevalence of DVA [domestic violence and abuse] in THIN (<0.4%) is substantially lower than the self-reported rates in the UK
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Anyone familiar with the subject matter will know that 0.4% is a complete joke -- the actual rates are at least 10x higher, or probably more. So it makes complete and total sense that any pre-existing bias by medical providers would then be reflected in their examinations, and as a consequence, the patient's chart.

The worst part is that this group of authors obviously thinks that by publishing this dreck, they are doing good and advocating for a disadvantaged group.
 
Trish said:
Therefore, we have identified an association between a history of IPV in women and the development of these functional syndromes, which may provide more information to inform the biopsychosocial pathway precipitating the development of fibromyalgia and CFS.
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So, in the abstract at least, they jump from stating they have simply found an association, straight to suggestions of causation.
 
Those differences are trivial and statistically insignificant, there is far too much unreliability and most of that unreliability is in this exact kind of poor judgment where things like domestic violence will make it more likely to prefer one label over another.

They still argue it, showing people pushing this nonsense don't care about evidence, they'll argue it anyway because it's the conclusions they are seeking.
 
I find this deeply disturbing. In NZ, within the health system, not just psych, it is a strongly encouraged to ask about domestic violence because of our very high rates. It is govt health target. This is usually to help people access support services.

There are so many confounding factors to domestic violence, many are socioeconomic and due to financial and housing issues but I can’t read the whole article. The IR is not compelling in either group to consider this as an association. Functional:mad:….the study appears abusive to me.
 
5vforest said:
The worst part is that this group of authors obviously thinks that by publishing this dreck, they are doing good and advocating for a disadvantaged group.
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have been contemplating this.

The main driving force behind this assault on all goodness, the embrace of a particular economic ideology built to assist the avoidance of responsibility to share medical care or breathable air, shelter, warmth, water, food, education with the people by those ruling capitalists and allied corporations who can profit from such denial.

In UK the idea of an NHS is allowed to flourish while the public assets behind it are stolen and sold off. The whole body is defunded.

Older traditions of victim blame, ableism, racism, homophobia, transphobia, sexism and disdain for poor people, are all woven together with this economy.

These are necessary hooks to recruit the better off into the project, grand theft of public rights and resources.

So first dog whistle. From all directions academics sympathetic to the cause are recruited to sprinkle doubt. With papers lots of papers.

Here a question is asked; whether people need healthcare or ….merely think they do?

Whistles concentrated on Drs and scientists. They listen. They begin to feel more and more comfortable with this question.

Is there any point in treating these people who may only believe themselves to be suffering?

The party who would have to pay for this treatment is paying people to tell us that no one needs any treatment. Such a dilemma who to believe…Surely not the under privileged patient?

Have you ever seen what they eat? I too would be ill after eating ‘Value Chrisps’ for dinner haha!

No we should instead believe those who will make millions billions trillions from convincing us not to treat.

If this means we will never fulfil our brains natural capacity for curiosity compassion and taking any level of adult responsibility, nor our single professional purpose, so be it!

All the scepticism for the patient. None to spare elsewhere.

Rewards reinforce this common understanding. Punishments discourage deviation.

I guess quite often they like to think of themselves as rather more sophisticated in method and agile of thought than they actually are.

They don’t feel flattered by conscious acceptance of the fact that they are simply the maintenance workers on behalf of an evil empire.

Not keen to acknowledge the fact that they have only been recruitable due to their willingness to be misdirected and distracted by their own deep seated un-examined prejudice, bias and superstition.

Perhaps this comes along with a rather poor grasp of the scientific method and or workings of the human body. Quite normal, these take some learning. But maybe here the short cut is chosen, to avoid awkwardness. Pretending that they have already arrived so that no one may observe their ignorance.

Or else an overriding cowardice that leaves them rather too eager to throw others into the fire and spare themselves.

Or they are those who just get off on hurting people. Those who crave access to people who are made vulnerable by society or sickness.

Which ever of these patterns may fit them best-perhaps they are ‘complex’ personally and it’s all of the above- they have in any case committed to harm.

They benefit materially from hurting the subjects of their studies and the patients in their consulting rooms.

Even the most harmful people have a tendency think that they are right to act as they do.

They value themselves. The work they choose is something related to themselves. It must carry value, for it is theirs.

They have been told that none of this is right. That they are actually, horrifyingly wrong. Logically wrong. Morally indefensible in their position.

Mostly it’s their patients and subjects, their victims who tell them this.

So we circle back to the beginning. They do not consider sick people as worthy of consideration. Certainly not fit to criticise them.

So they will continue to do as they feel their unique brains have directed them. This with astonishing good fortune for them, just happens to be right on over to a position of relative personal comfort and prosperity.

If after all this their subjects and patients don’t fare so well?

Well they were not functional’ were they? Check mate.


So I agree.

They will believe they are helping but I can only guess that that is mostly because they think we patients will be morally (if not physically) improved by being told how much better they understand our bodies than we do.

We can only watch them wait for us to be improved. For us to finally agree and submit to their domination. To allow ourselves to be guided by their expertise into our total submission.

Oppression isn’t enough for them. The pursuit of large nicely furnished homes and prestigious posts are not enough. They really genuinely desire us to say thank you for all they have done.


I think its possible they who make a make a career out of manipulation, bullying and poisonous ideology may be at higher than average risk for loosing perspective on their own helpfulness or otherwise?
 
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If I could I would make the following suggestion to the authors for a follow-up paper: You folks really want to be useful to society and especially to sick people? Then leave CFS and Fibro sufferers who happen to be with violent partners alone, and instead offer their partners treatment for their violence.
 
"Or else an overriding cowardice that leaves them rather too eager to throw others into the fire and spare themselves." this posted by Ash is why i think the medical industry fails so massively when it comes to dealing with political pressures to reduce costs and so called research papers that should never see the light of day .
 
Ha, we were just talking on another thread about how easy it is to find these sorts of retrospective associations, by capitalising on retrospective reporting biases, third variable effects or through just plain overfishing.

@hibiscuswahine is going for third variable effects. Could be. I'm inclined to go with @Snow Leopard and opt for overfishing - who knows what else they fished for in that huge database and didn't find?

Astonishing when you think what these figures actually show - that less than 2 in a thousand CFS/fibro cases has ever been reported by their GP as having been the victim of IPV. Wonder what's up with the other 998 then?
 
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