Renée El-Gabalawy1, Caitlin Blaney2, Jack Tsai3, Jennifer A Sumner4, Robert H Pietrzak3. 1. Department of Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg, MB, Canada; Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada; Department of Psychology, University of Manitoba, Winnipeg, MB, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada. Electronic address: renee.el-gabalawy@umanitoba.ca. 2. Department of Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg, MB, Canada; Department of Psychology, University of Manitoba, Winnipeg, MB, Canada. 3. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; US Department of Veterans Affairs New England Mental Illness Research Education and Clinical Center, USA. 4. Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA.
Abstract
BACKGROUND: While both full and subthreshold posttraumatic stress disorder (PTSD) may be linked to physical conditions, contemporary population-based data on these associations in military veterans are scarce. Further, little is known about how component aspects of PTSD, which is a heterogeneous disorder, may relate to physical conditions in this population. METHODS: Data were analyzed from a population-based sample of 3157 U.S. military veterans who participated in the 2011 National Health and Resilience in Veterans Study. Multiple logistic regression analyses evaluated associations between full and subthreshold PTSD, and physical conditions. RESULTS: A total 6.1% of the sample met screening criteria for full PTSD and 9.0% for subthreshold PTSD. Both full and subthreshold PTSD were associated with increased odds of sleep disorder (adjusted odds ratio [AOR] = 3.52 and 2.10, respectively) and respiratory conditions (AOR = 2.60 and 1.87, respectively). Full PTSD was additionally associated with increased odds of osteoporosis or osteopenia (AOR = 2.72) and migraine (AOR = 1.91), while subthreshold PTSD only was associated with increased odds of diabetes (AOR = 1.42). Analyses of PTSD symptom clusters revealed that all of these associations were primarily driven by dysphoric arousal symptoms, which are characterized by sleep difficulties, anger/irritability, and concentration problems. LIMITATIONS: The study used self-report measures for health conditions and DSM-IV diagnostic criteria for PTSD. CONCLUSION: Results of this study provide a characterization of physical conditions associated with full and subthreshold PTSD in U.S. military veterans. They highlight the potential importance of PTSD dysphoric arousal in risk models of certain physical conditions in this population.
BACKGROUND: While both full and subthreshold posttraumatic stress disorder (PTSD) may be linked to physical conditions, contemporary population-based data on these associations in military veterans are scarce. Further, little is known about how component aspects of PTSD, which is a heterogeneous disorder, may relate to physical conditions in this population. METHODS: Data were analyzed from a population-based sample of 3157 U.S. military veterans who participated in the 2011 National Health and Resilience in Veterans Study. Multiple logistic regression analyses evaluated associations between full and subthreshold PTSD, and physical conditions. RESULTS: A total 6.1% of the sample met screening criteria for full PTSD and 9.0% for subthreshold PTSD. Both full and subthreshold PTSD were associated with increased odds of sleep disorder (adjusted odds ratio [AOR] = 3.52 and 2.10, respectively) and respiratory conditions (AOR = 2.60 and 1.87, respectively). Full PTSD was additionally associated with increased odds of osteoporosis or osteopenia (AOR = 2.72) and migraine (AOR = 1.91), while subthreshold PTSD only was associated with increased odds of diabetes (AOR = 1.42). Analyses of PTSD symptom clusters revealed that all of these associations were primarily driven by dysphoric arousal symptoms, which are characterized by sleep difficulties, anger/irritability, and concentration problems. LIMITATIONS: The study used self-report measures for health conditions and DSM-IV diagnostic criteria for PTSD. CONCLUSION: Results of this study provide a characterization of physical conditions associated with full and subthreshold PTSD in U.S. military veterans. They highlight the potential importance of PTSD dysphoric arousal in risk models of certain physical conditions in this population.
Authors: Karen S Mitchell; Suzanne E Mazzeo; Michelle R Schlesinger; Timothy D Brewerton; Brian N Smith Journal: Int J Eat Disord Date: 2011-10-19 Impact factor: 4.861
Authors: Robert H Pietrzak; Jack Tsai; Ilan Harpaz-Rotem; Julia M Whealin; Steven M Southwick Journal: J Psychiatr Res Date: 2011-12-09 Impact factor: 4.791
Authors: Jessica J Fulton; Patrick S Calhoun; H Ryan Wagner; Amie R Schry; Lauren P Hair; Nicole Feeling; Eric Elbogen; Jean C Beckham Journal: J Anxiety Disord Date: 2015-02-19
Authors: Jaimie L Gradus; Dóra Körmendiné Farkas; Elisabeth Svensson; Vera Ehrenstein; Timothy L Lash; Arnold Milstein; Nancy Adler; Henrik Toft Sørensen Journal: Eur J Epidemiol Date: 2015-05-09 Impact factor: 8.082
Authors: Yue Leng; Nick W J Wainwright; Francesco P Cappuccio; Paul G Surtees; Shabina Hayat; Robert Luben; Carol Brayne; Kay-Tee Khaw Journal: Sleep Med Date: 2016-07-12 Impact factor: 3.492
Authors: Brienna M Fogle; Jack Tsai; Natalie Mota; Ilan Harpaz-Rotem; John H Krystal; Steven M Southwick; Robert H Pietrzak Journal: Front Psychiatry Date: 2020-12-09 Impact factor: 4.157
Authors: Lindsay J Collin; Katalin Veres; Jaimie L Gradus; Thomas P Ahern; Timothy L Lash; Henrik Toft Sørensen Journal: Cancer Date: 2021-11-19 Impact factor: 6.860
Authors: Jennifer A Sumner; Laura D Kubzansky; Andrea L Roberts; Qixuan Chen; Eric B Rimm; Karestan C Koenen Journal: Psychol Med Date: 2019-01-04 Impact factor: 7.723
Authors: Jeffrey F Scherrer; Joanne Salas; Matthew J Friedman; Beth E Cohen; F David Schneider; Patrick J Lustman; Carissa van den Berk-Clark; Kathleen M Chard; Peter Tuerk; Sonya B Norman; Paula P Schnurr Journal: Health Psychol Date: 2020-03-30 Impact factor: 4.267
Authors: Meghan L Smith; Dóra Körmendiné Farkas; Jennifer A Sumner; Unnur Valdimarsdóttir; Timothy L Lash; Henrik Toft Sørensen; Jaimie L Gradus Journal: J Affect Disord Date: 2020-12-30 Impact factor: 4.839
Authors: Hongjin Li; Diane M Flynn; Krista B Highland; Patricia K Barr; Dale J Langford; Ardith Z Doorenbos Journal: Pain Med Date: 2021-12-11 Impact factor: 3.750
Authors: Jennifer A Sumner; Adam X Maihofer; Vasiliki Michopoulos; Alex O Rothbaum; Lynn M Almli; Ole A Andreassen; Allison E Ashley-Koch; Dewleen G Baker; Jean C Beckham; Bekh Bradley; Gerome Breen; Jonathan R I Coleman; Anders M Dale; Michelle F Dennis; Norah C Feeny; Carol E Franz; Melanie E Garrett; Charles F Gillespie; Guia Guffanti; Michael A Hauser; Sian M J Hemmings; Tanja Jovanovic; Nathan A Kimbrel; William S Kremen; Bruce R Lawford; Mark W Logue; Adriana Lori; Michael J Lyons; Jessica Maples-Keller; Matig R Mavissakalian; Regina E McGlinchey; Divya Mehta; Rebecca Mellor; William Milberg; Mark W Miller; Charles Phillip Morris; Matthew S Panizzon; Kerry J Ressler; Victoria B Risbrough; Barbara O Rothbaum; Peter Roy-Byrne; Soraya Seedat; Alicia K Smith; Jennifer S Stevens; Leigh Luella van den Heuvel; Joanne Voisey; Ross McD Young; Lori A Zoellner; Caroline M Nievergelt; Erika J Wolf Journal: Front Neurosci Date: 2021-06-23 Impact factor: 4.677