Treatment and life goals among veterans with Gulf War illness.

Medically unexplained syndromes (MUS), also termed persistent physical symptoms, are both prevalent and disabling. Yet treatments for MUS are marked by high rates of patient dissatisfaction, as well as disagreement between patients and providers on the management of persistent physical symptoms. A better understanding of patient-generated goals could increase collaborative goal setting and promote person-centered care, a critical component of MUS treatment; yet research in this area is lacking. This paper aimed to develop a typology of treatment and life goals among Gulf War veterans with a medically unexplained syndrome (Gulf War Illness). We examined participants' responses to open-ended questions about treatment and life goals using Braun and Clarke's thematic analysis methodology. Results showed that treatment goals could be categorized into four overarching themes: 1) Get better/healthier, 2) Improve quality of life, 3) Improve or seek additional treatment, and 4) Don't know/Don't have any. Life goals were categorized into six overarching themes: 1) Live a fulfilling life, 2) Live a happy life, 3) Live a healthy life, 4) Be productive/financially successful, 5) Manage GWI, and 6) Don't know/Don't have any. Treatment goals were largely focused on getting better/healthier (e.g., improving symptoms), whereas life goals focused on living a fulfilling life. Implications for the treatment of Gulf War Illness and patient-provider communication are discussed. ClinicalTrials.gov Identifier: NCT02161133.

The Relationship Behavior Survey: A Comprehensive Measure of Psychological Intimate Partner Violence for Adolescents.

Commonly used scales of psychological intimate partner violence (ψIPV) for adolescents may not include sufficient items to measure adequately different forms of ψ aggressive behaviors. They may also characterize as harmful ψ aggressive behaviors occurring in non-conflictual or joking contexts. The current study examined a new scale, the Relationship Behavior Survey (RBS), which was designed to measure three different forms of ψIPV (denigrating, controlling, and intrusive behaviors) and the appraisals of the perpetrator's intent. Factor structure was examined, and incremental validity was tested by examining the relation of the RBS to general aggressive tendencies and physical IPV after accounting for the emotional abuse and threatening behavior subscales of the Conflict in Adolescent Dating Relationships Inventory (CADRI). Criterion validity and gender differences were also examined. Data were collected using an online survey from a national sample of 1,100 13 to 17-year-olds in the United States (51% identified as female, 80% as White) in a dating relationship. Confirmatory factor analysis supported one ψIPV construct for males and females. The RBS demonstrated incremental validity; criterion validity was supported for controlling intent for males and females and mistrust intent for females. Joking intent was the most reported intent for males and correlated unexpectedly with physical IPV. The RBS captures a larger range of ψIPV behaviors than the CADRI. The addition of intent appraisals provides important information to differentiate forms of ψIPV, particularly in relation to acts motivated by coercion and mistrust.