Evidence map›Paper›PMID 34314990›Full record

ArticleJournal of psychiatric research2021

Experiential avoidance is associated with medical and mental health diagnoses in a national sample of deployed Gulf War veterans.

Shannon M Blakey, Tate F Halverson, Mariah K Evans, Tapan A Patel, Lauren P Hair, Eric C Meyer, Bryann B DeBeer, Jean C Beckham, Mary J Pugh, Patrick S Calhoun and 1 more

Open access · greenAbstract read
In one paragraph

Article in Journal of psychiatric research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
3.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 30 citations in OpenAlex.

  1. Article
  2. Article
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  4. Evaluation of the critical warzone experiences scale among Gulf War I-era veterans: Associations with PTSD symptoms, depressive symptoms, and suicidal thoughts and behaviors.Military psychology : the official journal of the Division of Military Psychology, American Psychological Association · 2025
    Article
  5. The association of military sexual assault and nonsuicidal self-injury in U.S. Gulf War-I era veterans.Military psychology : the official journal of the Division of Military Psychology, American Psychological Association · 2024
    Article
  6. Article
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  10. The Prevalence, Humanistic Burden, and Health Care Impact of Irritable Bowel Syndrome Among United States Veterans.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023
    Article
  11. Article
  12. Article
  13. Article
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  16. Article
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  18. Experiential Avoidance, Pain, and Suicide Risk in a National Sample of Gulf War Veterans.Archives of suicide research : official journal of the International Academy for Suicide Research
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Shannon M BlakeyDurham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA. Electronic address: Shannon.Blakey@va.gov.
Tate F HalversonDurham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA. Electronic address: Tate.Halverson@va.gov.
Mariah K EvansDuke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA. Electronic address: Mariah.Evans@duke.edu.
Tapan A PatelDurham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA. Electronic address: Tapan.Patel3@va.gov.
Lauren P HairDurham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA. Electronic address: Lauren.Hair@duke.edu.
Eric C MeyerUniversity of Pittsburgh Department of Rehabilitation Science and Technology, 4028 Forbes Tower, Pittsburgh, PA, 15260, USA. Electronic address: ecm77@pitt.edu.
Bryann B DeBeerVA Rocky Mountain Mental Illness Research, Education and Clinical Center, 1700 N Wheeling St, G-3-116M, Aurora, CO, 80045, USA; Department of Physical Medicine and Rehabilitation, Anschutz Medical Campus, University of Colorado, 12631 E 17th Ave, Aurora, CO, 80045, USA. Electronic address: Bryann.Debeer@va.gov.
Jean C BeckhamDurham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA. Electronic address: Beckham@duke.edu.
Mary J PughVA Salt Lake City Healthcare System, 500 Foothill Dr, Salt Lake City, UT, 84148, USA; University of Utah School of Medicine Department of Medicine, 30 N. 1900 E, Salt Lake City, UT, 84132, USA. Electronic address: maryjo.pugh@hsc.utah.edu.
Patrick S CalhounDurham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA. Electronic address: Patrick.Calhoun@duke.edu.
Nathan A KimbrelDurham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA. Electronic address: Nathan.Kimbrel@duke.edu.
Duke University · USDurham VA Health Care System · USMental Illness Research, Education and Clinical Centers · USUniversity of Pittsburgh · USUniversity of Utah · US

Funding

Regeneration and reinnervation of mechanosensory hair cellsI01BX000377 · VA · CHARLIE NORWOOD VA MEDICAL CENTER · PI KOZLOWSKI, DAVID J · 2011 to 2014
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Healthcare utilization patterns and associated costs for Gulf War I Era VeteransI01HX001682 · VA · DURHAM VA MEDICAL CENTER · PI KIMBREL, NATHAN A. · 2019 to 2020
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CSR&D Research Career Scientist AwardIK6BX003777 · VA · DURHAM VA MEDICAL CENTER · PI BECKHAM, JEAN C. · 2017 to 2023
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BLRD VA I01 BX000377BLRD VA IK6 BX003777HSRD VA I01 HX001682
6 · The paper itself

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.

Indexed as

Persian Gulf SyndromeStress Disorders, Post-TraumaticVeteransGulf WarHumansMental HealthChronic illnessDepressionExperiential avoidanceGulf WarPTSDVeterans

Identifiers

PMID34314990
PMCPMC8429252
OpenAlexW3184755055

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.