Evidence map›Paper›PMID 40014289›Full record

ArticleJournal of behavioral medicine2025

The role of the working alliance in improving outcomes among veterans with Gulf War Illness: a longitudinal study.

Anna M Gentile, Caroline O Rogers, Laura M Lesnewich, Shou-En Lu, Wilfred R Pigeon, Drew A Helmer, Lisa M McAndrew

Abstract read
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Article in Journal of behavioral medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Anna M GentileDepartment of Educational and Counseling Psychology, University at Albany, 1400 Washington Ave, Albany, NY, 12222, USA.ORCID 0009-0003-9209-6715
Caroline O RogersDepartment of Educational and Counseling Psychology, University at Albany, 1400 Washington Ave, Albany, NY, 12222, USA.ORCID 0009-0001-5487-8850
Laura M LesnewichWar Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, 385 Tremont Ave, East Orange, NJ, 07018, USA.ORCID 0000-0001-8804-6385
Shou-En LuRutgers School of Public Health, 683 Hoes Ln W, Piscataway, NJ, 08854, USA.ORCID 0000-0002-0916-1842
Wilfred R PigeonU.S. Department of Veterans Affairs, Center of Excellence for Suicide Prevention, 400 Fort Hill Avenue, Canandaigua, NY, 14424, USA.ORCID 0000-0002-5753-7840
Drew A HelmerCenter for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center and Department of Medicine, Baylor College of Medicine, 2002 Holcombe Blvd (152), Houston, TX, 77030, USA.ORCID 0000-0003-0385-432X
Lisa M McAndrewWar Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, 385 Tremont Ave, East Orange, NJ, 07018, USA. lisa.mcandrew@va.gov.ORCID 0000-0002-1350-8773

Funding

Center for Innovations in Quality, Effectiveness and Safety IQuESt, #CIN 13-413Clinical Science Research and Development I01CX001053CSRD VA I01 CX001053Health Services Research and Development IK2HX001369
6 · The paper itself

Abstract

Military Veterans with Gulf War Illness (GWI), a "medically unexplained" persistent physical syndrome (PPS), have difficult experiences of care, in part, due to non-concordant relationships with their healthcare providers. A critical factor in improving care for this population may be the working alliance, which is the extent to which patients and providers agree on the goals and tasks of treatment and have a shared bond. The present study examined if, for Veterans with GWI, perceptions of the working alliance over time predicted better experiences of care (i.e., patient satisfaction and treatment adherence) and improved health outcomes (i.e., reduced disability, depression symptoms, and physical symptoms). Positive Veteran perceptions of the working alliance at 4 weeks were related to better patient satisfaction and treatment adherence at 12 weeks. Veteran perceptions of the working alliance were not consistently related to reductions in disability, depression symptoms, or physical symptoms. The results of this study suggest that the working alliance is important for improving patient experiences of care but may not be sufficient to consistently impact health outcomes.

Indexed as

Patient SatisfactionPersian Gulf SyndromeTherapeutic AllianceVeteransAdultDepressionFemaleHumansLongitudinal StudiesMaleMiddle AgedMedically unexplained symptomsPatient satisfactionPersistent physical symptomsProblem-solving treatmentTreatment adherence

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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.