Meredith C Erwin1, Paul A Dennis2, Lara N Coughlin3, Patrick S Calhoun4, Jean C Beckham5. 1. Durham VA Health Care System, Durham, NC, USA; University of Toledo, Department of Psychology, Toledo, OH, USA. 2. Durham VA Health Care System, Durham, NC, USA; Research and Development Service, Durham Veterans Affairs Medical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. Electronic address: paul.dennis@duke.edu. 3. Durham VA Health Care System, Durham, NC, USA; Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA, USA. 4. Durham VA Health Care System, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; VA Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Health Science Research and Development Service, Durham Veterans Affairs Medical Center, Durham, NC, USA. 5. Durham VA Health Care System, Durham, NC, USA; Research and Development Service, Durham Veterans Affairs Medical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; VA Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC, USA.
Abstract
BACKGROUND: Posttraumatic stress disorder (PTSD) and negative affect (e.g., anger, depression, anxiety), are highly co-occurring. It remains unclear whether changes in PTSD symptoms subsequently impact negative affect, or vice versa. This study assessed associations between moment-to-moment PTSD symptoms and negative affect in a sample of smokers with PTSD to determine directionality of this relationship. METHODS: Participants (N = 125) enrolled in two smoking cessation studies with co-occurring PTSD and cigarette use completed measures of PTSD and negative affect. Ecological momentary assessment (EMA) methodology was used to record symptoms during a one-week baseline period, during which participants smoked ad lib. Cross-lagged path analyses assessed PTSD symptoms and negative affect for directionality of their relationship, controlling for whether an EMA reading was smoking or non-smoking. Path analyses examined the lagged associations between PTSD symptoms and negative affect. RESULTS: Results found PTSD symptom severity at T-1 was significantly related to negative affect levels at time T, but negative affect at time T-1 was not associated with PTSD symptom severity at time T. Results indicated the model retaining the cross-lagged effect of PTSD symptom severity on negative affect provided better fit to the data than other models. LIMITATIONS: Limitations included use of self-report data, brief measures of symptoms, participants already had PTSD and/or MDD, participants were recruited from a specific clinical population, and use of DSM-IV data. CONCLUSIONS: Results suggest PTSD symptoms drive day-to-day fluctuations in negative affect, and highlight the importance of evaluating negative affect in the treatment of PTSD.
BACKGROUND:Posttraumatic stress disorder (PTSD) and negative affect (e.g., anger, depression, anxiety), are highly co-occurring. It remains unclear whether changes in PTSD symptoms subsequently impact negative affect, or vice versa. This study assessed associations between moment-to-moment PTSD symptoms and negative affect in a sample of smokers with PTSD to determine directionality of this relationship. METHODS:Participants (N = 125) enrolled in two smoking cessation studies with co-occurring PTSD and cigarette use completed measures of PTSD and negative affect. Ecological momentary assessment (EMA) methodology was used to record symptoms during a one-week baseline period, during which participants smoked ad lib. Cross-lagged path analyses assessed PTSD symptoms and negative affect for directionality of their relationship, controlling for whether an EMA reading was smoking or non-smoking. Path analyses examined the lagged associations between PTSD symptoms and negative affect. RESULTS: Results found PTSD symptom severity at T-1 was significantly related to negative affect levels at time T, but negative affect at time T-1 was not associated with PTSD symptom severity at time T. Results indicated the model retaining the cross-lagged effect of PTSD symptom severity on negative affect provided better fit to the data than other models. LIMITATIONS: Limitations included use of self-report data, brief measures of symptoms, participants already had PTSD and/or MDD, participants were recruited from a specific clinical population, and use of DSM-IV data. CONCLUSIONS: Results suggest PTSD symptoms drive day-to-day fluctuations in negative affect, and highlight the importance of evaluating negative affect in the treatment of PTSD.
Authors: Joseph C Cappelleri; Andrew G Bushmakin; Christine L Baker; Elizabeth Merikle; Abayomi O Olufade; David G Gilbert Journal: Curr Med Res Opin Date: 2005-05 Impact factor: 2.580
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