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Compensation & Treatment: Disability Benefits & Outcomes of US Veterans Receiving PTSD Treatment

Dolphin

Senior Member
Messages
17,567
(Unlikely to be important)

I happened to come across this as CFS is mentioned somewhere in it.

However, I'm posting it just because I thought it was interesting that receiving compentsation didn't lead to poorer outcomes: it is sometimes thrown at people with ME/CFS, or indeed people with lots of other conditions, that giving them money promotes secondary gain and leads to worse outcomes but this study didn't find that anyway (I don't know if this issue is looked at that much - perhaps it is).

It might also be useful for Gulf war veterans (I'm not sure, but perhaps they and those who served in Afghanistan are move likely to get compensation than veterans from other eras?).

Compensation and Treatment: Disability Benefits and Outcomes of U.S. Veterans Receiving Residential PTSD Treatment

Bradley E. Belsher1,2,*, Quyen Q. Tiet2,3,4, Donn W. Garvert2, Craig S. Rosen2,3

Article first published online: 9 OCT 2012
DOI: 10.1002/jts.21747

Journal of Traumatic Stress

The U.S. Department of Veterans Affairs (VA) provides specialized intensive posttraumatic stress disorder (PTSD) programs to treat trauma-related symptoms in addition to providing service-connected disability to compensate veterans for injury sustained while serving in the military. Given the percentage of veterans who are receiving treatment for PTSD, in addition to seeking compensation for PTSD, a debate has emerged about the impact of compensation on symptom recovery. This study examined the associations among status of compensation, treatment expectations, military cohort, length of stay, and outcomes for 776 veterans who were enrolled in 5 VA residential PTSD programs between the years of 2005 and 2010. Mixed model longitudinal analyses, with age, gender, and baseline symptoms nested within treatment site in the model, found that treatment expectations were modestly predictive of treatment outcomes. Veterans seeking increased compensation reported marginally lower treatment expectations (d = .008), and did not experience poorer outcomes compared to veterans not seeking increased compensation with the effect of baseline symptoms partialled out. Veterans from the era of the Iraq and Afghanistan conflicts reported lower treatment expectations (d = .020) and slightly higher symptoms at intake (d = .021), but had outcomes at discharge equivalent to veterans from other eras with baseline symptoms partialled out. These findings help further inform the debate concerning disability benefits and symptom changes across time.
 
Messages
13,774
Thanks Dolphin.

I don't know if this issue is looked at that much - perhaps it is

I get the impression that it's not looked at much, but still widely assumed!

I think that there was one study which found an association with worse outcomes, and that has been used to excuse this claim from then on.

I seem to remember that there was a recent CFS study that found being on benefits had no impact... was it even PACE? Was it a PACE abstract that we've not had the full paper released yet? Maybe it was another group... darn, my memory sucks! I think that there was also another, older study which found no association, but just got ignored.

I need a better way of filing away/storing these things. I guess I don't need it as a reference right now.

Personally, I think that this would be a difficult area to study. eg: If those applying for benefits/compensation tended to be poorer, then this could leave them with less control over their lives, and lead to worse outcomes. The stress and work of applying for benefits/compensation could cause problems. Some people might just be keener to present themselves as iller as part of the process - when the benefits system has quite arbitrary cut-offs, it can be strange when one knows one is on the edge of a boundary, and that walking an average of 201 meters a day will lead to poverty, while 199 is fine. These sorts of situations are likely to have some corrupting impact upon the way in which people describe their limitations imo, but that doesn't tell us anything about the nature of one's condition, or the impact of psychosocial factors upon it's perpetuation.

Having said all that, I know that this is a controversial area, and that there is some evidence that these sorts of issues don't have any impact on people's rehabilitation from injuries and disability. Maybe I'm too influenced by undergraduate views of homo economicus.
 

Dolphin

Senior Member
Messages
17,567
Thanks for your thoughts, E12.

I seem to remember that there was a recent CFS study that found being on benefits had no impact... was it even PACE? Was it a PACE abstract that we've not had the full paper released yet? Maybe it was another group... darn, my memory sucks! I think that there was also another, older study which found no association, but just got ignored.
There was a PACE mediators poster abstract http://www.trialsjournal.com/content/12/S1/A144 which was hard to read and understand but it is expected there will be a proper paper eventually.

I think you are thinking of the FINE Trial - see this post from Simon : http://forums.phoenixrising.me/inde...-syndrome-fine-trial-paper.18641/#post-288072

(I haven't read that paper but hope to soon now as I'm starting to finally get a bit more on top of some work).
 
Messages
13,774
(I haven't read that paper but hope to soon now as I'm starting to finally get a bit more on top of some work).

You already have a better knowledge of my own memories than I do. It will be a bit intimidating when you're more on top of things!
 

jimells

Senior Member
Messages
2,009
Location
northern Maine
I don't need a study to know that continued extreme poverty contributes to making my illness worse.

For example, there was a bad windstorm a few days ago, and a piece of roll roofing on my shed started peeling back. Repairing it took maybe 1/2 hour and two trips up the ladder. I knew full well that the repair, while requiring only a minor effort from a 'normal' person, would trigger PEM, a migraine and another day of barely out of bed. I also knew that not repairing the damage immediately would soon lead to a shed with no roofing.

If I could've hired out the repair, today would've been a much better day...
 

Dolphin

Senior Member
Messages
17,567
I don't need a study to know that continued extreme poverty contributes to making my illness worse.

For example, there was a bad windstorm a few days ago, and a piece of roll roofing on my shed started peeling back. Repairing it took maybe 1/2 hour and two trips up the ladder. I knew full well that the repair, while requiring only a minor effort from a 'normal' person, would trigger PEM, a migraine and another day of barely out of bed. I also knew that not repairing the damage immediately would soon lead to a shed with no roofing.

If I could've hired out the repair, today would've been a much better day...
Very sorry to hear the situation you find yourself in. However, not sure the study relates to what you are referring to.
 

jimells

Senior Member
Messages
2,009
Location
northern Maine
not sure the study relates to what you are referring to.

If my disability claim is ever accepted, I can hire out repairs instead of making myself sicker by doing them myself. I can't say that disability payments would improve the illness, but it could very likely slow down the deterioration.

It's hard to take serious any research that suggests Disability payments would make the illness worse.
 

Dolphin

Senior Member
Messages
17,567
If my disability claim is ever accepted, I can hire out repairs instead of making myself sicker by doing them myself. I can't say that disability payments would improve the illness, but it could very likely slow down the deterioration.

It's hard to take serious any research that suggests Disability payments would make the illness worse.
Yes, I accept that. It's just ideally to look at that effect one would look at income level rather than receipt/non-receipt of disability payments. But again, I'm sorry for the situation you find yourself in; it also makes me appreciate the situation I find myself in (living with my parents where I don't have to worry about some things).