Posttraumatic stress disorder and physical health symptoms among women seeking help for relationship aggression.

This study examined associations between intimate partner aggression and physical health symptoms among a sample of help-seeking women experiencing relationship aggression (N = 388). Using a structural equation modeling framework, the authors found posttraumatic stress disorder (PTSD) symptoms to fully mediate the associations of both physical and psychological aggression with physical health symptoms. The influence of PTSD symptoms on physical health symptoms was partially mediated by anger/irritability. Results were consistent with studies from other trauma groups suggesting that PTSD is pivotal with respect to explaining the effects of trauma on health.     

Psychopathology Following Interpersonal Violence: A Comparison of Risk Factors in Older and Younger Adults

A randomly selected sample of 549 women age 55 years and older and 2,669 women age 18–34 years was interviewed via telephone to determine prevalences of physical and sexual assault, posttraumatic stress disorder (PTSD) symptomatology, and depression. Prevalences of sexual and physical assaults were lower in older compared to younger women. In addition, given a trauma, prevalences and proportionate risk of posttraumatic psychopathology and depression were also lower for older, relative to younger women. Specifically, multivariate analyses revealed that sexual assault predicted only PTSD avoidance in older adults, but all forms of PTSD symptomatology and depression in younger adult women. Similarly, physical assault predicted only PTSD re-experiencing symptoms in older women, but all forms of PTSD symptoms and depression in younger women. Self-reported health status was not associated with any increased risk of psychopathology, and low income predicted increased avoidance and depression only in younger women.     

War exposure and post-traumatic stress as predictors of Portuguese colonial war veterans' physical health

The relationship between war exposure and post-traumatic stress disorder (PTSD) has been largely investigated but the impact of the combat experience on physical health has only recently merited attention. The authors investigated the relationship between war exposure and psychological and physical health among 350 Portuguese colonial war veterans. The role of current PTSD symptoms as a mediator of these relationships was also investigated. The results showed that 39% of the veterans met criteria for current PTSD diagnosis and psychological distress was present in half of the sample. Pain, fatigue, and sleep problems were the most reported physical symptoms and mental health and gastro-intestinal problems, the most reported illnesses. Combat exposure variables were significant predictors of current health. The results indicated that veterans with higher exposure to war trauma maintained higher current levels of psychological distress and presented more physical health problems and physical symptoms than those less exposed. Mediation analyses showed that current PTSD was a full mediator of the relationship between war exposure and physical health outcomes.     

Betrayal Trauma,Health Care Relationships,and Health in Patients with a Chronic Neurovascular Condition

Individuals who have been exposed to trauma are at a greater risk of developing a chronic physical health condition and use health services more frequently than individuals who have not experienced trauma. The mechanism by which trauma affects health is not fully understood, but relationships with health care providers could be important in understanding this association. The purpose of this study was to explore the relationships among betrayal trauma, health care relationships, and physical and mental health in a chronic medical population. Participants (N = 272) diagnosed with a chronic neurovascular condition (cavernous malformation) completed an online survey. Questionnaires assessed self-rated health, instances of betrayal trauma, posttraumatic stress disorder (PTSD) and depression symptoms, income, and other demographic factors, and health care relationships. Level of income and the experience of betrayal trauma predicted mental health symptoms (depression, PTSD, or both) and also predicted health care relationships. After controlling for income and previous trauma, mental health symptoms significantly predicted health care relationships. Finally, mental health symptoms, health care relationships, and income predicted self-rated health, although the associations were not straightforward. These results suggest complex interrelations among trauma, mental health, income, health care relationships, and physical health, and a model is proposed for explaining these associations.     

Gender Disparities in the Mental Health of Urban Survivors of Trauma

Women who experience traumatic events are at higher risk for mental health problems compared to men; however, gaps remain in our understanding of this disparity. A sample of 170 urban adults completed self-report measures. Women were significantly more likely to experience sexual assault and domestic violence compared to men, and they were significantly less likely to experience a robbery or mugging, being threatened with a weapon, or witnessing a death or assault compared to men. Also, women were more likely than men to meet criteria for probable post-traumatic stress disorder (PTSD) and depression after controlling for covariates and trauma level. Our findings suggest a possible differential vulnerability to the development of PTSD and depressive symptoms in women.     

The direct and indirect benefits of dispositional mindfulness on self-esteem and social anxiety

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 < 0.001) and showed a trend association with adverse health practices (p = 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).     

Relationships between health behaviors,posttraumatic stress disorder,and comorbid general anxiety and depression

Poor health outcomes associated with posttraumatic stress disorder (PTSD) may reflect engagement in unhealthy behaviors that increase morbidity risk and disengagement in healthy behaviors that decrease morbidity risk. Although research supports this pattern, findings are not definitive, particularly for healthy behaviors. Many studies have not controlled for effects of concurrent generalized anxiety and depression, which might explain conflicting findings. To address this limitation, we used an online cross-sectional research design and multivariate multilevel modelling to evaluate associations between a multitude of health behaviors (i.e. sedentary behavior, sleep quality, physical activity, eating habits, alcohol use and substance use) and PTSD, while adjusting for comorbid generalized anxiety and depression, in a sample of trauma-exposed individuals (N = 246). Our results indicate that PTSD and comorbid generalized anxiety and depression symptoms were differentially associated with specific health constructs. Specifically, sedentary behavior and poor sleep quality were associated with PTSD, whereas low physical activity, poor sleep quality, and unhealthy eating habits were associated with depression. Both increased alcohol and substance use were associated with generalized anxiety. Results from our study highlight the need to conceptualize associations between health behaviors and specific psychological symptoms in a comprehensive manner as part of clinical presentations of PTSD.     

Co-Occurring Traumatic Brain Injury,PTSD Symptoms,and Alcohol Use in Veterans

Traumatic brain injury (TBI) has been identified as a significant health problem among veterans. Recent research demonstrates the potential interaction and magnification of symptoms of posttraumatic stress disorder (PTSD) and substance use disorders (SUD) in veterans with a history of TBI; however, there is very limited research on the co-occurrence of the three conditions. Veterans (N = 115) with comorbid PTSD and SUD completed a baseline assessment for enrollment into a larger treatment study. As part of that assessment, participants completed a TBI screener as well as self-report measures for pain and physical health, affective symptoms, and substance use. Almost half of the sample (48 %) endorsed a history of a previous head trauma with loss of consciousness (LOC). Participants with and without head trauma with LOC were compared across various measures of functioning. Increased severity of physical health complaints and affective symptoms were reported by the TBI group compared to controls. However, the increases in affective symptoms were relatively small. No group differences were observed for alcohol use. Together, the findings suggest that treatment-seeking veterans with a history of head trauma with LOC may present with roughly equivalent symptoms of PTSD and SUD to those without said history.     

Prospective associations between changes in mental health symptoms and health-related quality of life in veterans seeking posttraumatic stress disorder residential treatment

Background and Objectives: This study examined prospective associations between changes in mental health symptoms (posttraumatic stress disorder [PTSD], depression) and health-related quality of life (physical health, psychological well-being) for veterans with PTSD. Design: This study focused on 139 patients who completed a residential treatment program for PTSD in the Veterans Health Administration. Methods: Patients completed the veteran-specific, 12-item Medical Outcomes Study Short Form, PTSD Checklist – Military version, and Beck Depression Inventory at pre-treatment, discharge, and a four-month follow-up. When accounting for demographic factors, combat exposure, and baseline scores on the respective outcome variables (e.g. mental health, physical health, PTSD, and depressive symptoms), a series of multivariate analyses were conducted for treatment-related changes in mental and physical health on the outcome measures. Results: Reductions in PTSD symptomatology during the treatment period were prospectively linked with better health-related outcomes at the four-month follow-up. In addition, improved physical health and psychological well-being during treatment were each similarly associated with better PTSD and depression outcomes in the months following treatment. Conclusions: Addressing concerns in mental and physical health might have synergistic effects across both domains, supporting the need for holistic models and integrated health care strategies for treating veterans with PTSD.     

Prior interpersonal trauma: the contribution to current PTSD symptoms in female rape victims

The purpose of the current study was to disentangle the relationship of childhood sexual abuse and childhood physical abuse from prior adult sexual and physical victimization in predicting current posttraumatic stress disorder (PTSD) symptoms in recent rape victims. The participants were a community sample of 117 adult rape victims assessed within 1 month of a recent index rape for a history of child sexual abuse, child physical abuse, other adult sexual and physical victimization, and current PTSD symptoms. Results from path analyses showed that a history of child sexual abuse seems to increase vulnerability for adult sexual and physical victimization and appears to contribute to current PTSD symptoms within the cumulative context of other adult trauma.     

Symptoms of PTSD Among Adolescents and Young Adult Survivors Six Years after the 2010 Haiti Earthquake

This study investigates the long-term consequences for adolescents and young adults who experienced the January 12, 2010, earthquake that struck Haiti. It aims to evaluate the consequences of the earthquake in adolescents and young adults six years after the disaster. During May and June 2016, in Port-au-Prince, 723 adolescents and young adults (364 girls and young women) aged 14 to 24 were assessed by means the Impact of Event Scale–Revised (IES-R) in addition to social demographic characteristics. In our sample, 35.82% reported clinically significant symptoms of PTSD, with a higher prevalence for girls and young women. They also had consistently higher scores than boys and young men on every subscale. Participants with working parents had consistently higher scores across all the subscales than participants whose parents did not work. This study showed that, more than six years after the earthquake, more than one third of the participants assessed had severe PTSD symptoms. Our results may prove useful for setting up mental health programs and devising tools appropriate for the youth population in Haiti.     

Protective role of coping flexibility in PTSD and depressive symptoms following trauma

The aim of the study was to examine whether coping flexibility would function as a protective factor for PTSD and depressive symptoms in trauma-exposed adults in Korea. A total of 510 adults with a lifetime history of traumatic events completed the Perceived Ability to Cope with Trauma (PACT), the Korea version of the Posttraumatic Stress Diagnostic Scale (PDS-K), and the Patient Health Questionnaire (PHQ-9). Hierarchical regression indicated that coping flexibility was associated with a reduced level of PTSD or depressive symptoms after controlling for comorbid symptoms, age, and elapsed time since the most distressing traumatic event. The interaction of traumatic events and coping flexibility was significant only on PTSD symptom severity but not on depressive symptom severity. Specifically, individuals with low coping flexibility reported higher levels of PTSD symptoms as the number of traumatic events increased. These findings supported the hypothesis that coping flexibility is a protective factor for PTSD and depression following trauma, and lack of coping flexibility may aggravate the risk for PTSD among people with multiple trauma.     

Physician-diagnosed medical disorders in relation to PTSD symptoms in older male military veterans.

The association between physician-diagnosed medical disorders and combat-related posttraumatic stress disorder (PTSD) symptoms was examined in 605 male combat veterans of World War II and the Korean conflict. Physician exams were performed at periodic intervals beginning in the 1960s. PTSD symptoms were assessed in 1990. Cox regression was used to examine the onset of each of 12 disorder categories as a function of PTSD symptoms, controlling for age, smoking, alcohol use, and body weight at study entry. Even with control for these factors, PTSD symptoms were associated with increased onset of arterial, lower gastrointestinal, dermatologic, and musculoskeletal disorders. There was only weak evidence that PTSD mediated the effects of combat exposure on morbidity. Possible mediators of the relationship between combat exposure, PTSD, and physical morbidity are discussed.     

Multiple health risk behaviours and posttraumatic stress disorder symptoms among university students from 22 countries

The goal of the study was to investigate multiple health risk behaviours in relation to PTSD symptoms in a sample of university students from 22 countries. Using anonymous questionnaires, data were collected from 16804 undergraduate university students (mean age 20.8, SD?=?2.8) from 23 universities in 22 countries in Africa, Asia, Caribbean and South America. Results indicate that overall, 20.9% of the university students screened positive for PTSD, and the overall mean of health risk behaviours (range from 1–10) was 2.7 for university students from all countries. Logistic regression adjusted for sociodemographic characteristics and social support found that each of the ten individual health risk behaviours was significantly associated with PTSD symptoms. In addition, logistic regression with multiple health risk behaviours found a steady increase from 1 (Odds Ratio (OR): 1.37, CI 1.05–1.77) to 5 or more (OR: 3.57, CI 2.75–4.64) health risk behaviours in association with PTSD symptoms, adjusted for age, gender, economic family background and social support.     

The Relationship of Adverse Childhood Experiences to PTSD,Depression, Poly-Drug Use and Suicide Attempt in Reservation-Based Native American Adolescents and Young Adults

Adverse childhood experiences (ACEs) are associated with numerous risk behaviors and mental health outcomes among youth. This study examines the relationship between the number of types of exposures to ACEs and risk behaviors and mental health outcomes among reservation‐based Native Americans. In 2011, data were collected from Native American (N = 288; 15–24 years of age) tribal members from a remote plains reservation using an anonymous web‐based questionnaire. We analyzed the relationship between six ACEs, emotional, physical, and sexual abuse, physical and emotional neglect, witness to intimate partner violence, for those <18 years, and included historical loss associated symptoms, and perceived discrimination for those <19 years; and four risk behavior/mental health outcomes: post‐traumatic stress disorder (PTSD) symptoms, depression symptoms, poly‐drug use, and suicide attempt. Seventy‐eight percent of the sample reported at least one ACE and 40 % reported at least two. The cumulative impact of the ACEs were significant (p < .001) for the four outcomes with each additional ACE increasing the odds of suicide attempt (37 %), poly‐drug use (51 %), PTSD symptoms (55 %), and depression symptoms (57 %). To address these findings culturally appropriate childhood and adolescent interventions for reservation‐based populations must be developed, tested and evaluated longitudinally.     

Childhood psychological maltreatment,sense of self,and PTSD symptoms in emerging adulthood

This study outlines the relationships among childhood psychological maltreatment (CPM), an understudied form of maltreatment, sense of self (SOS), a developmental construct negatively impacted by trauma, and post-traumatic stress disorder (PTSD) symptoms in emerging adults. Results from regression analysis on a sample of emerging adults (N = 358) indicated CPM to be the greatest predictor of a weaker SOS, even when considered alongside other types of child maltreatment. Among those exposed to CPM, SOS was a significant predictor of PTSD symptoms, explaining 34.1% of the variance in the outcome. Counseling interventions that focus on SOS during emerging adulthood are recommended as one important consideration for survivors of CPM who experience PTSD symptoms. Specific counseling practice and research implications are included.     

A Preliminary Investigation of the Relationship Between Emotion Dysregulation and Partner Violence Perpetration Among Individuals with PTSD and Alcohol Dependence

This study examines the link between emotion dysregulation and intimate partner violence (IPV) among 77 individuals with posttraumatic stress disorder (PTSD) and alcohol dependence. Participants were recruited from a residential substance abuse treatment program as part of the eligibility screening for an institutional review board approved clinical trial examining the efficacy of an exposure-based intervention in individuals dually diagnosed with alcohol dependence and PTSD. Participants reported on PTSD symptoms, alcohol use disorder symptoms, emotion dysregulation, and physical and verbal aggression in their intimate relationships during the past year. Findings demonstrated that difficulties with emotion regulation are associated with physical and verbal IPV perpetration in a clinical sample. Although facets of emotion regulation emerged as significant predictors of IPV in the models, alcohol and PTSD symptom severity did not emerge as predictors of IPV. These findings suggest targeted emotion regulation skills training could benefit substance abusers who engage in IPV and that emotion dysregulation might be an important target for future research aimed at understanding elevated rates of IPV perpetration in mental health samples.     

Consequences of Child and Adult Sexual and Physical Trauma among Deaf Adults

The purpose of this study was to evaluate the consequences of sexual and physical trauma among a sample of deaf adults. Thirty-two men and 45 women completed the Life Event Checklist (LEC), the Clinician Administered PTSD Scale (CAPS), the Trauma Symptom Inventory (TSI), the Somatoform Dissociation Questionnaire–20 (SDQ–20) and a sociodemographic questionnaire. In this sample, 40.6% of the male participants and 53.3% of the female participants had experienced some type of sexual trauma during their lifetimes. Physical trauma was reported by 75% of males and 71.1% of female participants. For those who had experienced childhood sexual trauma, the odds ratio of revictimization in adulthood was 6.69. Sexual trauma also rarely occurred by itself. Two thirds of all participants with sexual trauma histories also reported some type of physical abuse. Participants with sexual trauma histories displayed significantly more symptoms of PTSD and depression than people without such trauma history. Physical and sexual abuse represent significant problems in the deaf community. The authors include a call for the development of targeted intervention attempts to prevent further victimization in deaf child and adolescent populations.     

Posttraumatic Stress Disorder and its relationship with negative cognitive schemas in battered women

This study assessed the association between Posttraumatic Stress Disorder symptoms (PTSD) and maladaptive cognitive schemas among intimate partner violence victims. The sample comprised 114 women from specialized services for victims, who completed measures of physical aggression, sexual abuse, psychological abuse, PTSD, and cognitive schemas. Results showed that 67.54% of women met the diagnostic criteria of PTSD. These women endorsed higher levels of schemas related to mistrust/abuse, vulnerability to harm, defectiveness, shame, enmeshment, abandonment and dependence. A structural equation model showed that the relationship between violence and cognitive schemas was fully mediated by the PTSD symptoms. Finally, the clinical implications of the results are discussed.