Trajectories of self-rated health among veterans: A latent growth curve analysis of the impact of posttraumatic symptoms (original) (raw)
Related papers
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,
Anxiety, Stress & Coping, 2003
This study investigated the long-term health effects of combat stress reaction (CSR) among Israeli CSR casualties (112) and control veterans (184) of the 1973 Yom Kippur war. Posttraumatic stress disorder (PTSD), physical symptoms, and adverse health practices were examined 18 years after the war. The relationship between CSR, PTSD, physical symptoms and adverse health practices was examined via hierarchical linear regression. Findings indicate that although CSR was positively associated with more current physical symptoms and adverse health practices in univariate analyses, these associations were not significant once demographic differences between the groups were controlled. In contrast, current PTSD symptoms were positively associated with current physical symptoms (p B/0.001) and showed a trend association with adverse health practices (p 0/0.06). PTSD was the most powerful predictor of current physical symptoms and appears to mediate the association between CSR and physical symptoms almost two decades after the war. Both combat stress reaction and the results of the study were discussed in the light of the theory of Conservation of Resources (COR).
Anxiety, stress, and coping, 2016
This study tested three alternative explanations for research indicating a positive, but heterogeneous relationship between self-reported posttraumatic growth (PTG) and posttraumatic stress symptoms (PSS): (a) the third-variable hypothesis that the relationship between PTG and PSS is a spurious one driven by positive relationships with resource loss, (b) the growth over time hypothesis that the relationship between PTG and PSS is initially a positive one, but becomes negative over time, and (c) the moderator hypothesis that resource loss moderates the relationship between PTG and PSS such that PTG is associated with lower levels of PSS as loss increases. A nationally representative sample (N = 1622) of Israelis was assessed at three time points during a period of ongoing violence. PTG, resource loss, and the interaction between PTG and loss were examined as lagged predictors of PSS to test the proposed hypotheses. Results were inconsistent with all three hypotheses, showing that PTG...
Journal of Loss and Trauma, 2006
In this study, we identified deployment-related and demographic predictors of several factors of posttraumatic growth in a sample of combat-exposed Gulf War I veterans. Participants were obtained via a Veterans Administration registry of Gulf War I veterans and were mailed a survey containing a number of scales assessing predeployment, deployment, and postdeployment factors from the Deployment Risk and Resilience Inventory and the Posttraumatic Growth Inventory. Military status and perceived threat were significant predictors of appreciation of life. Relating to others, personal strength, and posttraumatic growth as a whole were best predicted by the postdeployment variable of social support. Minority status was the only significant predictor of new possibilities, with ethnic minorities reporting more new possibilities postdeployment. Limitations and suggestions for future research are discussed.
Drustvena istrazivanja, 2011
The purpose of this study was to evaluate the cross-sectional differences in self-reported psychological symptoms, lifetime exposure to traumatic events, coping styles, personality traits and overall quality of life between the PTSD and non-PTSD Croatian War veterans. A total of 113 subjects within the three groups participated in the study (veterans with PTSD, non-PTSD veterans and controls). Veterans with PTSD assessed both combat experiences and exposure to other lifetime traumatic events as extremely stressful, much more so than veterans without PTSD or control subjects. Scores among the non-PTSD veterans were similar to the control subjects, except on the M-PTSD scale, scale of psychosomatic symptoms and coping by avoidance. Intensity of PTSD, extraversion and active coping were individually significant in explaining the total QoL (p<0.01). This study showed that veterans with PTSD became extremely vulnerable to lifetime stress events.
Community Mental Health Journal, 2010
The study focuses on the long-term impact of war on adolescents (N = 821) and adults (N = 870) living in a war afflicted Israeli community a year after the war. Results indicate the following: (a) stress symptoms and posttraumatic growth (PTG) correlate negatively with each other. (b) Age was positively associated with stress symptoms and negatively with PTG. (c) Economic condition predicted stress symptoms as well as PTG of adults better than exposure to traumatic events, whereas for school students the best predictor of stress symptoms was exposure to traumatic events while the best predictor of PTG was age of participants.
BMJ, 2009
Objective To determine if baseline functional health status, as measured by SF-36 (veterans), predicts new onset symptoms or diagnosis of post-traumatic stress disorder among deployed US military personnel with combat exposure. Design Prospective cohort analysis. Setting Millennium Cohort. Participants Combat deployed members who completed baseline (2001-3) and follow-up (2004-6) questionnaires. Self reported and electronic data used to examine the relation between functional health and posttraumatic stress disorder. Main outcome measures New onset post-traumatic stress disorder as measured by either meeting the DSM-IV criteria with the 17 item post-traumatic stress disorder checklist-civilian version or self report of a physician diagnosis at follow-up with the absence of both at baseline. Results Of the 5410 eligible participants, 395 (7.3%) had new onset symptoms or diagnosis of post-traumatic stress disorder at the time of follow-up. Individuals whose baseline mental or physical component summary scores were below the 15th centile had two to three times the risk of symptoms or a diagnosis of post-traumatic stress disorder by follow-up compared with those in the 15th to 85th centile. Of those with new onset symptoms or diagnosis of post-traumatic stress disorder, over half (58%) of cases occurred among participants with scores below the 15th centile at baseline. Conclusions Low mental or physical health status before combat exposure significantly increases the risk of symptoms or diagnosis of post-traumatic stress disorder after deployment. More vulnerable members of a population could be identified and benefit from interventions targeted to prevent new onset posttraumatic stress disorder.
Post-traumatic stress impact on health outcomes in Gulf War Illness
BMC Psychology
Background Gulf War Illness (GWI) is a chronic, multi-symptomatic disorder affecting an estimated 25–32% of the returning military veterans of the 1990–1991 Persian Gulf War. GWI presents with a wide range of symptoms including fatigue, muscle pain, cognitive problems, insomnia, rashes and gastrointestinal issues and continues to be a poorly understood illness. This heterogeneity of GWI symptom presentation complicates diagnosis as well as the identification of effective treatments. Defining subgroups of the illness may help alleviate these complications. Our aim is to determine if GWI can be divided into distinct subgroups based on PTSD symptom presentation. Methods Veterans diagnosed with GWI (n = 47) and healthy sedentary veteran controls (n = 52) were recruited through the Miami Affairs (VA) Medical Health Center. Symptoms were assessed via the RAND short form health survey (36), the multidimensional fatigue inventory, and the Davidson trauma scale. Hierarchal regression modelin...
Risk factors for mental, physical, and functional health in Gulf War veterans
The Journal of Rehabilitation Research and Development, 2008
Risk factors associated with war-zone events and circumstances are implicated in the health and adjustment of military veterans. We assessed a national stratified sample of community-residing veterans of the Gulf War (N = 357) using scales from the Deployment Risk and Resilience Inventory, along with an array of mental (posttraumatic stress disorder, depression, and anxiety), physical (symptom and condition indicators especially pertinent to Gulf War illnesses), and functional (both mental and physical dimensions) health outcomes. We found that perceived threat or fear of bodily harm in the war zone and self-reported or perceived exposures to environmental hazards may play a critical role in all measured aspects of health. Moreover, a synergistic effect of these two risk factors was observed in the prediction of mental health and mental health functional status.