Jennifer Moye1, Anica Pless Kaiser2, Joan Cook3, Robert H Pietrzak4. 1. VA New England Geriatric Research Education and Clinical Center (GRECC) (JM), Boston, MA; VA Boston Healthcare System (JM, APK), Boston, MA; Department of Psychiatry, Harvard Medical School (JM), Boston, MA. Electronic address: Jennifer.moye@va.gov. 2. VA Boston Healthcare System (JM, APK), Boston, MA; National Center for PTSD (APK), Boston MA; Boston University School of Medicine (APK), Boston, MA. 3. U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System (JC, RHP), West Haven, CT; Department of Psychiatry, Yale School of Medicine (JC, RHP), New Haven, CT. 4. U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System (JC, RHP), West Haven, CT; Department of Psychiatry, Yale School of Medicine (JC, RHP), New Haven, CT; Department of Social and Behavioral Sciences, Yale School of Public Health (RHP), New Haven, CT.
Abstract
OBJECTIVE: To characterize the prevalence, characteristics, and comorbidities of subthreshold and full post-traumatic stress disorder (PTSD) in older U.S. military veterans. DESIGN AND SETTING: A nationally representative web-based survey of older U.S. military veterans who participated in the National Health and Resilience in Veterans Study (NHRVS) between November 18, 2019 and March 8, 2020. PARTICIPANTS: U.S. veterans aged 60 and older (n = 3,001; mean age = 73.2, SD: 7.9, range: 60-99). MEASUREMENTS: PTSD was assessed using the PTSD Checklist for DSM-5. Self-report measures assessed sociodemographic characteristics, trauma exposures, suicidal behaviors, psychiatric and substance use disorders, as well as mental, cognitive, and physical functioning. Multivariable analyses examined correlates of subthreshold and full PTSD. RESULTS: The vast majority of the sample (n = 2,821; 92.7%) reported exposure to one or more potentially traumatic events. Of those exposed to such events, 262 (9.6%, 95% confidence interval [CI]: 8.4%-10.9%) and 68 (1.9%, 95% CI: 1.3%-2.6%) screened positive for subthreshold and full PTSD, respectively. The prevalence of subthreshold and full PTSD was significantly higher in female veterans and veterans who use VA as their primary healthcare. Subthreshold and full PTSD groups endorsed more adverse childhood experiences and total traumas than the no/minimal PTSD symptom group, the most common traumatic experiences endorsed were combat exposure, physical or sexual assault, and life-threatening illness or injury. Veterans with subthreshold and full PTSD were also more likely to screen positive for depression, substance use disorders, suicide attempts, nonsuicidal self-injury, and suicidal ideation, and reported lower mental, cognitive, and physical functioning. CONCLUSION: Subthreshold PTSD and full PTSD are prevalent and associated with substantial clinical burden in older U.S. veterans. Results underscore the importance of assessing both subthreshold and full PTSD in this population. Published by Elsevier Inc.
OBJECTIVE: To characterize the prevalence, characteristics, and comorbidities of subthreshold and full post-traumatic stress disorder (PTSD) in older U.S. military veterans. DESIGN AND SETTING: A nationally representative web-based survey of older U.S. military veterans who participated in the National Health and Resilience in Veterans Study (NHRVS) between November 18, 2019 and March 8, 2020. PARTICIPANTS: U.S. veterans aged 60 and older (n = 3,001; mean age = 73.2, SD: 7.9, range: 60-99). MEASUREMENTS: PTSD was assessed using the PTSD Checklist for DSM-5. Self-report measures assessed sociodemographic characteristics, trauma exposures, suicidal behaviors, psychiatric and substance use disorders, as well as mental, cognitive, and physical functioning. Multivariable analyses examined correlates of subthreshold and full PTSD. RESULTS: The vast majority of the sample (n = 2,821; 92.7%) reported exposure to one or more potentially traumatic events. Of those exposed to such events, 262 (9.6%, 95% confidence interval [CI]: 8.4%-10.9%) and 68 (1.9%, 95% CI: 1.3%-2.6%) screened positive for subthreshold and full PTSD, respectively. The prevalence of subthreshold and full PTSD was significantly higher in female veterans and veterans who use VA as their primary healthcare. Subthreshold and full PTSD groups endorsed more adverse childhood experiences and total traumas than the no/minimal PTSD symptom group, the most common traumatic experiences endorsed were combat exposure, physical or sexual assault, and life-threatening illness or injury. Veterans with subthreshold and full PTSD were also more likely to screen positive for depression, substance use disorders, suicide attempts, nonsuicidal self-injury, and suicidal ideation, and reported lower mental, cognitive, and physical functioning. CONCLUSION: Subthreshold PTSD and full PTSD are prevalent and associated with substantial clinical burden in older U.S. veterans. Results underscore the importance of assessing both subthreshold and full PTSD in this population. Published by Elsevier Inc.
Authors: Heide Glaesmer; Thomas Gunzelmann; Elmar Braehler; Simon Forstmeier; Andreas Maercker Journal: Int Psychogeriatr Date: 2010-03-31 Impact factor: 3.878
Authors: Brandon Nichter; Shira Maguen; Lindsey L Monteith; Lorig Kachadourian; Sonya B Norman; Melanie L Hill; Sarah Herzog; Robert H Pietrzak Journal: J Psychiatr Res Date: 2021-06-07 Impact factor: 4.791
Authors: U Nalla B Durai; Mohit P Chopra; Eugenie Coakley; Maria D Llorente; JoAnn E Kirchner; Joan M Cook; Sue E Levkoff Journal: J Am Geriatr Soc Date: 2011-06-07 Impact factor: 5.562
Authors: Jack Goldberg; Kathryn M Magruder; Christopher W Forsberg; Matthew J Friedman; Brett T Litz; Viola Vaccarino; Patrick J Heagerty; Theresa C Gleason; Grant D Huang; Nicholas L Smith Journal: Am J Geriatr Psychiatry Date: 2015-05-16 Impact factor: 4.105
Authors: Joan M Cook; Corey Pilver; Stephanie Dinnen; Paula P Schnurr; Rani Hoff Journal: Am J Geriatr Psychiatry Date: 2013-02-06 Impact factor: 4.105
Authors: Karen Hughes; Mark A Bellis; Katherine A Hardcastle; Dinesh Sethi; Alexander Butchart; Christopher Mikton; Lisa Jones; Michael P Dunne Journal: Lancet Public Health Date: 2017-07-31