Treatment-related reductions in PTSD and changes in physical health symptoms in women (original) (raw)
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Posttraumatic Stress Disorder and Health Status
The Journal of ambulatory care management, 2006
This article examines the association between self-reported prevalence of posttraumatic stress disorder (PTSD) and health status in a sample of 2425 male Department of Veterans Affairs (VA) ambulatory care patients who participated in the Veterans Health Study. Participants were recruited at 1 of 4 VA outpatient clinics in the Boston area. They completed self-report measures of PTSD (using the PTSD Checklist and measures of exposure to traumatic events), depression (using the Center for Epidemiologic Studies-Depression scale), and health status (using the Short-Form-36) and a medical history interview assessing 22 conditions and a history of psychiatric treatment. The screening prevalence of PTSD was 20.2% among all patients (24.3% among those exposed to traumatic events); another 15.5% met the criteria for depression but not PTSD. The health status of patients with either PTSD or depression was significantly worse than that of patients with neither disorder, even after controlling for age, education, and number of comorbid medical conditions. Patients with PTSD reported more medical conditions than did other patients. Patients with PTSD currently in mental health treatment had worse health status than did those who reported no treatment; the health status of patients who reported past mental health treatment was generally comparable to that of those with no treatment. The prevalence and comorbidity of PTSD among this sample of VA ambulatory care patients were higher than previously reported among samples of community-residing adults. The association of PTSD with health status was substantial, suggesting that the burden of PTSD is at least comparable to, and may be worse than, that of depression. Mental health treatment alleviated some of this burden. The potential impact of PTSD on health status should be more widely recognized.
Journal of Traumatic Stress, 2009
PTSD has been associated with poor physical health. Depression is also associated with poor health, and may be responsible for the apparent relationship between PTSD and health outcomes. The current study examined self-reported and physician diagnosed medical morbidity in women. Women with PTSD alone were compared to three other groups of women: women with PTSD and comorbid major depressive disorder (MDD), women with MDD only, or women with neither diagnosis (comparison group). Results suggest that PTSD, with or without MDD, is associated with poor health in women. PTSD severity was related to health complaints beyond the effects of both somatization and depressive symptoms among women with PTSD. Findings and implications are discussed in relation to previous research in the area.
Psychosomatics, 2015
Objective-While a large body of literature has linked posttraumatic stress disorder (PTSD) with poor physical health among older veterans, less is known regarding the association between PTSD and health among relatively younger cohorts of veterans. The current study examined the association between PTSD and self-reported health among a sample of veterans who served in the recent conflicts in Iraq and Afghanistan. Method-Veterans (N=1,030) who served in the wars in Iraq and Afghanistan completed measures of PTSD symptom severity and self-rated health between September 2009 and February 2010. Analyses examined the association between PTSD symptoms and health outcomes. Results-In analyses adjusted for age, gender, race, and combat exposure, PTSD symptom severity was positively related to the number of health conditions and health symptoms reported (ps < 0.001). Additionally, in analyses adjusted for age, gender, race, combat exposure, number of health conditions, and number of health symptoms, PTSD symptom severity was associated with increased likelihood of rating one's health as poor or fair and increased likelihood of reporting that one's physical health limits participation in activities (ps < 0.001).
Posttraumatic Growth and Perceived Health: The Role of Posttraumatic Stress Symptoms
American Journal of Orthopsychiatry, 2016
The contested discourse regarding the nature of posttraumatic growth (PTG) includes 2 main competitive claims. The first argues that PTG reflects authentic positive transformation while the second posits that PTG reflects illusory defenses that could be maladaptive in the long run. The present study assesses these competing claims by investigating secondary PTG in relation to the somatic domain. Specifically, this study investigates: (a) the association between PTG, and perceived health (PH), as measured by 3 indices of somatic complaints, self-rated health (SRH) and a number of health problems; (b) the association between PTG, posttraumatic stress symptoms (PTSS) and PH over time; and (c) the mediating role of PTSS between PTG and PH, among wives of former prisoners of war (ex-POWs) and wives of control veterans. Assessments were conducted 30 (T1) and 38 (T2) years after the Yom Kippur War. Results showed that wives of ex-POWs endorsed higher PTSS, higher PTG and poorer PH, compared to control wives. Higher PTG was associated with higher PTSS and poorer PH. PTG at T1 predicted an increase in PTSS between T1 and T2, which in turn was correlated with poorer PH. PTSS at T2 as well as changes in PTSS from T1 to T2 mediated the association between T1 PTG and T2 PH measures. The present findings imply that PTG might have negative implications on PH through the amplification of PTSS, among secondary trauma victims. It seems that although spouses of trauma victims describe benefits resulting from vicarious trauma exposures, their body indicates differently. A lthough there is an abundance of evidence for the existence of posttraumatic growth (PTG; Tedeschi & Calhoun, 2004), its nature as well as long term implications remain very partially understood. The present study works within this dearth to shed light on the nature of PTG and its long-term associations. To this end the associations between PTG, perceived health (PH) and posttraumatic stress symptoms (PTSS) are examined among wives of former prisoners of war (ex-POWs) and wives of comparable combatants who were not held captive. Moreover, the mediating role of PTSS within the PTG-PH relationship was likewise investigated. Posttraumatic Growth War captivity is among the most extreme traumatic events in existence, typically following active combat which may be devastating and traumatic in its own right. Prisoners of war are often subjected to harsh physical and psychological abuse, torture, severe deprivation of basic needs (i.e., food, water, sleep), as well as repeated humiliation and degradation at the hands of their captors (e.g., Herman, 1992). As a result, ex-POWs are at high risk for physical and psychiatric disorders, most notably posttraumatic stress disorder (PTSD; e.g., Dikel, Engdahl, & Eberly, 2005). The implications of war captivity are not limited to primary trauma survivors (i.e., ex-POWs), and may be transmitted to significant others, a phenomenon known as secondary traumatization (e.g., Figley, 1986). Moreover, it has recently been incorporated within the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V; American Psychiatric Association, 2013) that learning about a close family member's traumatic event constitutes a firsthand trauma. Wives of ex-POWs whose husbands' lives were at-risk while they were held captive, are clearly answer to this criterion and are hence at-risk themselves. Indeed, research has indicated that wives of ex-POWs endorse more PTSS and more severe psychological distress than wives of comparable combat veterans (e.g., Greene, Lahav, Bronstein, & Solomon, 2014). Having an intimate relationship with an ex-POW, however, may also lead to positive gains or transformations, characterized as PTG (e.g., Tedeschi & Calhoun, 1996). According to Tedeschi and Calhoun (2004) PTG is exhibited in three domains: elevated positive self-perception, improved interpersonal relationships, and a more optimistic world view. Research has documented PTG among survivors of various traumatic events including disasters,
Prospectively assessed posttraumatic stress disorder and associated physical activity
Public Health Reports
We examined the association of physical activity with prospectively assessed posttraumatic stress disorder (PTSD) symptoms in a military cohort. Using baseline and follow-up questionnaire data from a large prospective study of U.S. service members, we applied multivariable logistic regression to examine the adjusted odds of new-onset and persistent PTSD symptoms associated with light/moderate physical activity, vigorous physical activity, and strength training at follow-up. Of the 38,883 participants, 89.4% reported engaging in at least 30 minutes of physical activity per week. At follow-up, those who reported proportionately less physical activity were more likely to screen positive for PTSD. Vigorous physical activity had the most consistent relationship with PTSD. Those who reported at least 20 minutes of vigorous physical activity twice weekly had significantly decreased odds for new-onset (odds ratio [OR] = 0.58, 95% confidence interval [CI] 0.49, 0.70) and persistent (OR = 0.5...
PTSD symptom decrease and use of weight loss programs
Journal of Psychosomatic Research, 2019
Posttraumatic stress disorder (PTSD) is associated with poor health behaviors, including low utilization of Veteran Health Affairs (VHA) weight loss programs. It is not known if clinically meaningful PTSD improvement is associated with increased use of weight loss programs. Methods: Medical record data was obtained from VHA patients who received PTSD specialty care between Fiscal Year (FY) 2008 to FY2012. Clinically meaningful PTSD improvement was defined as ≥20 point PTSD Checklist (PCL) decrease between the first PCL ≥ 50 and a second PCL at least 8 weeks later and within 12 months of the first PCL. Eligible patients, n = 993, were followed through FY2015. Propensity scores and inverse probability of exposure weighting controlled confounding. Cox proportional hazard models estimated the association between clinically meaningful PCL decrease and weight loss clinic utilization. Supplemental analysis compared both PTSD groups vs. no PTSD. Results: Patients were 44.8 (SD ± 14) years of age, 88.9% male and 66.8% white. Patients with vs. without a clinically meaningful PCL decrease were more likely to use a weight loss clinic (HR = 1.37; 95%CI:1.02-1.85). Among those with a weight loss encounter, PCL decrease was not associated with the number of encounters (RR = 1.13; 95%CI:0.70-1.81). Compared to no PTSD, patients with PTSD improvement had more weight loss encounters. Conclusions: Large improvements in PTSD are associated with increased utilization of weight loss programs, and PTSD is not a barrier to seeking weight loss counseling. Research to understand why improvement in PTSD is not related to better weight loss outcomes is needed.
Psychosomatic medicine, 2009
Objectives: To examine the effects of combat stress reaction (CSR) and posttraumatic stress symptoms (PTS) on the level and trajectories of self-rated health (SRH) over 20 years after war exposure. Methods: A total of 675 veterans comprising two groups, a CSR group (n= 369) and a matched control group without CSR (n= 306), were assessed in a prospective longitudinal design, 1, 2, 3, and 20 years after their participation in the 1982 Lebanon War. SRH and PTS were assessed repeatedly, at each point of measurement. Results: The ...
Posttraumatic Stress Disorder, Anger and Hostility, and Physical Health Status
The Journal of Nervous and Mental Disease, 2004
Accumulating evidence suggests that posttraumatic stress disorder (PTSD) is linked to both objective and subjective indices of poorer health. Less is known about processes that may explain this association. This study examined anger/hostility as a possible mediator and moderator of PTSD and health status among a sample of 134 medical patients. Participants completed a structured interview of PTSD and questionnaires assessing health perceptions and anger and data on physician-diagnosed illnesses were gathered from computerized databases. Trait anger and anger-in partially explained the association between PTSD and poorer general health perceptions. There was a significant association between anger-in and the presence of a circulatory disorder only in patients with PTSD.
Preventive Medicine Reports, 2019
Posttraumatic stress disorder (PTSD) is a risk factor for cardiovascular disease (CVD) and diabetes. Dedert and colleagues hypothesized a model whereby PTSD leads to poor health behaviors, depression, and pre-clinical disease markers, and that these factors lead to CVD and diabetes (Ann Behav Med, 2010, 61-78). This study provides a preliminary test of that model. Using data from a mailed cross-sectional survey conducted 2012-2013, path analysis was conducted among N = 657 with complete demographic data. We first analyzed the hypothesized model, followed by four alternatives, to identify the best-fitting model. The alternate model that specified pathways from depression to health behaviors had the best fit. Contrary to hypotheses, higher PTSD symptoms were associated with better physical activity and diet quality. Of the specific indirect pathways from PTSD to Body Mass Index (BMI), only the path through depression was significant. Higher depression symptoms were significantly associated with less physical activity, poorer diet, and greater likelihood of smoking. In addition, the specific indirect effect from depression to BMI through physical activity was significant. Current smoking and higher BMI were associated with greater likelihood of diabetes, and hypertension was associated with greater likelihood of CVD. PTSD symptoms may increase risk for CVD and diabetes through the negative impact of depression on health behaviors and BMI. With or without PTSD, depression may be an important target in interventions targeting cardiovascular and metabolic diseases among veterans.