The impact of PTSD symptoms on physical and mental health functioning in returning veterans

This study aimed to determine the unique impact of PTSD symptoms, beyond other frequently examined factors on physical and mental health functioning in a sample of returning veterans. Assessments of 168 returning OEF/OIF veterans conducted an average of six months following return from deployment included measures of emotional disorders and the Short Form (36) Health Survey. Hierarchical multiple regressions revealed significant, unique contribution of Clinician-Administered PTSD Scale (CAPS) score above all other predictors in the model (demographics, severity of trauma exposure, physical injury, substance abuse and depressive symptoms), for both the physical (8%) and mental (6%) health aggregate scores, along with significant prediction of physical health (4–10%) and mental health (3–7%) subscale scores. The only other significant predictors were age for physical health scores, and depressive symptoms for mental health scores. PTSD criterion B (re-experiencing) symptoms uniquely predicted reduced physical health functioning and higher experience of bodily pain, while criterion D (hyperarousal) symptoms uniquely predicted lower feelings of energy/vitality and poorer perceptions of emotional health.     

Psychiatric diagnoses, comorbidity, and functioning in National Guard troops deployed to Iraq

Objective

Over 1.8 million troops have been deployed to Iraq (OIF) and Afghanistan. Estimates of mental health problems postdeployment have been based on screening instruments; no studies have examined the postdeployment mental health of troops returning from OIF using structured diagnostic interviews. The goal of the current study is to (a) report on rates of mental health diagnoses and comorbidity in soldiers after deployment to OIF using clinical interviews, and (b) examine the relationship between mental health diagnoses and overall functioning and quality of life.

Method

Participants were 348 National Guard soldiers drawn from the Readiness and Resilience in National Guard Soldiers (RINGS) study, a longitudinal study of mental health after deployment to OIF from March 2006 to July 2007. Participants completed clinical interviews, including the Clinician Administered PTSD Scale and the Structured Clinical Interview for the DSM-IV, and self-report measures of social adjustment and quality of life 6-12 months following deployment.

Results

Most participants did not meet criteria for a mental health diagnosis. Non-PTSD anxiety disorders and depressive disorders were the most common. Mental health diagnoses were associated with poorer functioning and quality of life. PTSD had the strongest relationship with social functioning and quality of life. For those with PTSD, comorbid diagnoses were not associated with an incremental decrease in functioning or quality of life.

Conclusions

The findings highlight the significant rate and burden of mental health disorders among this population and suggest that while PTSD is relatively uncommon, it is a particularly deleterious disorder.     

Psychosocial Difficulties in Adolescents nine Months after a Railway Accident

A railway accident which occurred in Lac-Megantic in Quebec, Canada, caused disruption for an entire community. This study examines the psychosocial difficulties in a group of exposed adolescents aged between 11 to 17, nine months after the tragedy. The analyses were conducted on a sample of 515 adolescents, attending high school, and living near the impact area. Post-traumatic stress disorder (PTSD), mental health problems (depression, anxiety), and problem use of alcohol or drugs prevalence were estimated. Multiple logistic regression was used to identify risk factors for PTSD clinical threshold. Almost half (43.4%) of adolescents reported being severely exposed to the railway accident and one third (31.3%) have reported a PTSD. Serious injuries, depression and anxiety (p?<?.05) were associated with greater risks for adolescents with a PTSD. However, sex, victimization, and emerging problems or problem use of alcohol or drugs are not associated with the PTSD. The results of the study highlight the relationship between a traumatic event such as the railway accident and the presence of PTSD nine months after, as well as risk factors for PTSD in adolescents. Paying close attention to mental health problems in adolescents when a traumatic event occurs and provide adequate aid is essential.     

Minor physical anomalies and neurological soft signs in patients with schizophrenia and their siblings

The aim of this study was to investigate the impact of lifetime posttraumatic stress disorder (PTSD), dissociation and a history of childhood trauma on quality of life (QoL) among men with alcohol dependency. A consecutive series of alcohol-dependent men (N = 156) admitted to an inpatient treatment unit were screened using the Michigan Alcoholism Screening Test, the Clinician Administered PTSD Scale, the Dissociative Experiences Scale, and the Childhood Trauma Questionnaire. QoL was assessed using the Medical Outcomes Study Short-Form 36-item health survey. Fifty (32.1%) patients had lifetime diagnosis of PTSD. Besides problems related to severity of alcohol use, the lifetime PTSD group was impaired on several physical and mental components of QoL. While the lifetime PTSD group and remaining patients did not differ on reports of childhood trauma and dissociation, in lifetime PTSD group, dissociative patients had higher scores of childhood emotional abuse than those of the non-dissociative patients. In multivariate covariance analysis, both dissociation and lifetime PTSD predicted impairment in physical functioning, general health, vitality, and mental health components of QoL. Among alcohol-dependent men with lifetime PTSD, a history of childhood emotional abuse contributes to impairment of QoL through its relationship with dissociation.     

A prospective study on personality and the cortisol awakening response to predict posttraumatic stress symptoms in response to military deployment

Few prospective studies on pre-trauma predictors for subsequent development of posttraumatic stress disorder (PTSD) have been conducted. In this study we prospectively investigated whether pre-deployment personality and the cortisol awakening response (CAR) predicted development of PTSD symptoms in response to military deployment. Furthermore, we hypothesized that potential effects of age, childhood trauma and previous deployment on development of PTSD symptoms were mediated via pre-deployment personality, CAR and PTSD symptoms.Path analysis was performed on data from 470 male soldiers collected before and six months after a 4-month deployment to Afghanistan. Before deployment, personality was assessed with the short-form Temperament-Character Inventory and the Cook-Medley Hostility scale. In addition, pre-deployment saliva sampling for assessment of the CAR was performed immediately after awakening and 15, 30 and 60 min thereafter.Pre-deployment high hostility and low self-directedness represented intrinsic vulnerabilities for development of PTSD symptoms after deployment. The CAR assessed before deployment did not predict PTSD symptoms after deployment. Pre-deployment low-to-moderate PTSD symptoms were associated with PTSD symptoms after deployment. As hypothesized, the effects of age and childhood trauma on PTSD symptoms after deployment were mediated via personality and pre-deployment PTSD symptoms. However, the number of previous deployments was not related to development of PTSD symptoms. The total model explained 24% of variance in PTSD symptoms after military deployment.     

The impact of the conflicts of Iraq and Afghanistan: A UK perspective

Abstract

Concerns about the mental health of military personnel deployed to Iraq and Afghanistan has led to a new generation of research. This review is an examination of the UK literature on the mental health consequences of deployment of armed forces personnel to Iraq and Afghanistan. As yet, deployment to Iraq or Afghanistan has not been associated with a general increase in mental health problems for the UK Armed Forces. However, research has highlighted certain problems that continue to need to be addressed. Whilst, the rate of post-traumatic stress disorder (PTSD) is low in the UK Armed Forces (1.6–6%), deployment to Iraq or Afghanistan is associated with an increased risk of PTSD for reserve personnel. In contrast to PTSD, the rate of alcohol misuse is high in the UK Armed Forces (between 16–20%), and has been associated with deployment to Iraq or Afghanistan for regular personnel. As the UK military engagement in Afghanistan continues and more personnel are deployed, the demand for help from military health services, the NHS and the service charities will increase.     

Trauma exposure,posttraumatic stress disorder and risk for alcohol,nicotine, and marijuana dependence in Israel

Background

Substance dependence is more common among trauma-exposed individuals; however, most studies suggest that Posttraumatic Stress Disorder (PTSD) accounts for the link between trauma exposure (TE) and substance dependence.

Objectives

This study examined associations between TE and substance dependence (alcohol, nicotine, and marijuana), and whether PTSD accounted for this association.

Method

1317 Jewish Israeli household residents completed in-person structured interviews assessing TE, PTSD, and substance (alcohol, nicotine, marijuana) dependence between 2007 and 2009. Regression analyses examined associations among TE, PTSD, and substance dependence.

Results

In the full sample, mean number of traumatic events was 2.7 (sd = 2.2), with 83.7% experiencing at least one event. In the full sample, mean number of PTSD symptoms was 2.5 (sd = 3.4), with 13.5% meeting PTSD diagnostic criteria. Prevalence of alcohol dependence was 13.4%; nicotine dependence 52.8%; and marijuana dependence 12.1%. Number of traumatic events was associated with increased odds of alcohol (OR = 1.3; 95% CI = 1.2–1.4) and nicotine (OR = 1.2; 95% CI = 1.1–1.3) dependence. Similarly, any traumatic event exposure was associated with increased odds of alcohol (OR = 3.1; 95% CI = 1.6–6.0) and nicotine (OR = 1.9; 95% CI = 1.2–2.9) dependence. PTSD symptoms were associated with increased odds of alcohol (OR = 1.2; 95% CI = 1.1–1.3), nicotine (OR = 1.1; 95% CI = 1.1–1.2), and marijuana (OR = 1.1; 95% CI = 1.04–1.2) dependence; similarly, a PTSD diagnosis was associated with increased odds of alcohol (OR = 3.4; 95% CI = 2.1–5.5), nicotine (OR = 2.2; 95% CI = 1.4–3.4), and marijuana (OR = 2.6; 95% CI = 1.2–5.9) dependence. PTSD symptoms accounted for a sizeable proportion of the TE effect on alcohol (46%) and nicotine dependence (31%).

Conclusion

Individuals with more traumatic events had heightened risk for alcohol and nicotine dependence, and PTSD symptoms partially accounted for this risk. However, marijuana dependence was only significantly related to PTSD symptoms. Clinicians and researchers should separately assess different types of dependence among trauma-exposed individuals both with and without PTSD symptoms.     

Long-term development of post-traumatic stress symptoms and associated risk factors in military service members deployed to Afghanistan: Results from the PRISMO 10-year follow-up

BackgroundSymptoms of post-traumatic stress disorder (PTSD) can manifest several years after trauma exposure, and may impact everyday life even longer. Military deployment can put soldiers at increased risk for developing PTSD symptoms. Longitudinal evaluations of PTSD symptoms in deployed military personnel are essential for mapping the long-term psychological burden of recent operations on our service members, and may improve current practice in veterans’ mental health care.MethodsThe current study examined PTSD symptoms and associated risk factors in a cohort of Dutch Afghanistan veterans 10 years after homecoming. Participants (N = 963) were assessed seven times from predeployment up to 10 years after deployment. Growth mixture modeling was used to identify distinct trajectories of PTSD symptom development.ResultsThe probable PTSD prevalence at 10 years after deployment was 8%. Previously identified risk factors like younger age, lower rank, more deployment stressors, and less social support were still relevant 10 years after deployment. Four trajectories of PTSD symptom development were identified: resilient (85%), improved (6%), severely elevated-recovering (2%), and delayed onset (7%). Only the delayed onset group reported increasing symptom levels between 5 and 10 years postdeployment, even though 77% reported seeking help.ConclusionsThis study provides insights into the long-term burden of deployment on the psychological health of military service members. It identifies a group of veterans with further increasing PTSD symptoms that does not seem to improve from currently available mental health support, and underlines the urgent need for developing and implementing alternative treatment opportunities for this group.     

An examination of the relation between combat experiences and combat-related posttraumatic stress disorder in a sample of Connecticut OEF-OIF Veterans

Background

Combat exposure is an important risk factor for posttraumatic stress disorder (PTSD). However, little research has examined specific combat experiences associated with PTSD and confirmatory factor analytically (CFA)-derived re-experiencing, avoidance, dysphoria, and hyperarousal symptom clusters.

Methods

A total of 285 predominantly older National Guard/Reservist OEF–OIF Veterans completed an anonymous mail survey that assessed demographics and deployment history, a broad range of combat experiences, PTSD, and unit and postdeployment social support.

Results

Personally witnessing someone from one’s unit or an ally unit being seriously wounded or killed (β = 0.22), and being exposed to “friendly” fire (β = 0.14) and land mines/traps (β = 0.13) were the only three combat experiences associated with severity of combat-related PTSD symptoms, after adjustment for age, relationship status, unit support, postdeployment social support, and other combat experiences. Differential patterns of associations were observed for specific combat experiences in relation to CFA-derived symptom clusters (e.g., experiencing “friendly” fire was associated with re-experiencing and dysphoria symptoms, but not avoidance and hyperarousal symptoms). Personally witnessing someone from one’s unit or an ally unit being seriously wounded or killed (odds ratio [OR] = 4.34; 95% confidence interval [CI] = 1.62–11.61) and being exposed to “friendly” fire (OR = 2.94; 95%CI = 1.16–7.47) emerged as independent predictors of a positive screen for probable PTSD.

Conclusions

Results of this study suggest that witnessing someone in one’s unit or ally unit being seriously wounded or killed while in a combat zone and being exposed to “friendly” fire are most strongly associated with combat-related PTSD in this sample of OEF/OIF Veterans. Examination of the relation between specific combat experiences and combat-related PTSD in OEF/OIF Veterans may help inform etiologic models of PTSD, and guide prevention and treatment approaches in this population.     

The impact of the conflicts of Iraq and Afghanistan: a UK perspective

Concerns about the mental health of military personnel deployed to Iraq and Afghanistan has led to a new generation of research. This review is an examination of the UK literature on the mental health consequences of deployment of armed forces personnel to Iraq and Afghanistan. As yet, deployment to Iraq or Afghanistan has not been associated with a general increase in mental health problems for the UK Armed Forces. However, research has highlighted certain problems that continue to need to be addressed. Whilst, the rate of post-traumatic stress disorder (PTSD) is low in the UK Armed Forces (1.6-6%), deployment to Iraq or Afghanistan is associated with an increased risk of PTSD for reserve personnel. In contrast to PTSD, the rate of alcohol misuse is high in the UK Armed Forces (between 16-20%), and has been associated with deployment to Iraq or Afghanistan for regular personnel. As the UK military engagement in Afghanistan continues and more personnel are deployed, the demand for help from military health services, the NHS and the service charities will increase.     

Subsyndromal posttraumatic stress disorder is associated with health and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom

Background: This study examined health and psychosocial correlates of subsyndromal/partial posttraumatic stress disorder (PTSD) and full PTSD in veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). Methods: Five hundred and fifty‐seven OEF/OIF veterans in Connecticut completed measures of PTSD and health and psychosocial functioning. Results: A total 22.3% of the sample met screening criteria for partial PTSD and 21.5% for full PTSD. Veterans with partial PTSD reported an intermediate level of impairment (e.g., health ratings, work problems, relationship problems) relative to veterans without PTSD and veterans with full PTSD. Conclusions: These results suggest that subsyndromal/partial PTSD is associated with significant health and psychosocial difficulties and underscore the importance of assessing for partial PTSD in OEF/OIF veterans. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

Use of a two‐phase process to identify possible cases of mental ill health in the UK military

Two‐phase mental health screening methods, in which an abridged mental health measure is used to establish who should receive a more comprehensive assessment, may be more efficient and acceptable to respondents than a stand‐alone complete questionnaire. Such two‐phase methods are in use in US armed forces post‐deployment mental health screening. This study assesses the sensitivity and specificity of abridged instruments (used in the first phase) compared to the full instruments (the second phase), and whether false negative cases resulting from the use of abridged tests were detected by another test, among a UK military screening sample. Data from a group of UK Armed Forces personnel (n = 1464) who had completed full questionnaires assessing symptoms of post‐traumatic stress disorder (PTSD) (PTSD Checklist – Civilian Version, PCL‐C) and alcohol misuse (Alcohol Use Disorder Identification Test, AUDIT) were used. An abridged version of the PCL‐C performed well in discriminating potential PTSD cases (as measured by the full instrument); AUDIT showed less discriminatory power, particularly due to poor specificity. Many cases missed by one abridged test would have been detected by an alternative test. Thus two‐phase screening designs reduce the resource burden of a project without substantial loss of sensitivity for PTSD, but are less effective in discriminating potential cases of alcohol misuse. Copyright © 2016 John Wiley & Sons, Ltd.     

Trauma Risk Management (TRiM): Promoting Help Seeking for Mental Health Problems Among Combat-Exposed U.K. Military Personnel

Objectives: Trauma Risk Management (TRiM) is a peer-led, occupational mental health support process that aims to identify and assist U.K. military personnel with persistent mental ill health related to potentially traumatic events (PTEs). This study compared help seeking, mental disorder symptoms, and alcohol use between TRiM recipients and personnel experiencing similar combat events who did not receive TRiM; an unexposed group provided context. Methods: Records of TRiM activity during a U.K. military deployment in Afghanistan were linked to contemporaneous survey data assessing mental health and combat experiences. The resulting deployment data set was amalgamated with mental health, alcohol use, and help-seeking data collected within 12 weeks of homecoming and again one to two years later. Mental health and help-seeking outcomes were compared between a nonexposed, non-TRiM sample (n = 161), an exposed, non-TRiM sample (n = 149), and an exposed, TRiM-recipient sample (n = 328) using logistic regression analyses. Results: At follow-up, TRiM recipients were significantly more likely to seek help from mental health services than exposed, non-TRiM personnel. At baseline, TRiM recipients had significantly greater adjusted odds of reporting possible posttraumatic stress disorder (PTSD) symptoms than exposed non-TRiM personnel; the difference was not significant at follow-up. TRiM recipients were significantly more likely to report persistent mental disorder and alcohol misuse caseness over the follow-up period. Conclusions: TRiM recipients were significantly more likely to seek help from mental health services than a similar PTE-exposed group that did not receive TRiM; however, TRiM recipients experienced more persistent mental ill-health symptoms and hazardous alcohol use over the period of follow-up despite seeking help.     

Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

The present study used data from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (n = 34,653) to examine lifetime Axis I psychiatric comorbidity of posttraumatic stress disorder (PTSD) in a nationally representative sample of U.S. adults. Lifetime prevalences ± standard errors of PTSD and partial PTSD were 6.4% ± 0.18 and 6.6% ± 0.18, respectively. Rates of PTSD and partial PTSD were higher among women (8.6% ± 0.26 and 8.6% ± 0.26) than men (4.1% ± 0.19 and 4.5% ± 0.21). Respondents with both PTSD and partial PTSD most commonly reported unexpected death of someone close, serious illness or injury to someone close, and sexual assault as their worst stressful experiences. PTSD and partial PTSD were associated with elevated lifetime rates of mood, anxiety, and substance use disorders, and suicide attempts. Respondents with partial PTSD generally had intermediate odds of comorbid Axis I disorders and psychosocial impairment relative to trauma controls and full PTSD.     

Suicide risk in Iraq and Afghanistan veterans with mental health problems in VA care

Suicide rates among U.S. military personnel and veterans are a public health concern, and those with mental health conditions are at particular risk. We examined demographic, military, temporal, and diagnostic associations with suicidality in veterans. We conducted a population-based, retrospective cohort study of all Iraq and Afghanistan war veterans who screened positive for posttraumatic stress disorder (PTSD) and/or depression, received a suicide risk assessment, and endorsed hopelessness about the present or future after their last deployment and between January 1, 2010 and June 29, 2014 (N = 45,741). We used bivariate and multivariate logistic regression analyses to examine variables associated with having endorsed suicidal thoughts and a plan. Multiple factors were associated with suicidality outcomes, including longer time from last deployment to screening (proxy for time to seeking VA care), an alcohol use disorder diagnosis, further distance from VA (rurality), and being active duty during military service. Hispanic veterans were at decreased risk of having suicidal ideation and a plan, compared to their white counterparts. In high-risk veterans, some of the strongest associations with suicidality were with modifiable risk factors, including time to VA care and alcohol use disorder diagnoses. Promising avenues for suicide prevention efforts can include early engagement/intervention strategies with a focus on amelioration of high-risk drinking.     

Course and Predictors of Posttraumatic Stress Disorder in the Canadian Armed Forces: A Nationally Representative, 16-Year Follow-up Study: Cours et prédicteurs du trouble de stress post-traumatique dans les Forces armées canadiennes: une étude de suivi de 16 ans nationalement représentative

Objective:This study examined baseline risk and protective predictors and interim correlates of the persistence/recurrence, remission, and onset of posttraumatic stress disorder (PTSD) in a 16-year prospective, nationally representative sample of Canadian Forces members and veterans.Methods:The 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey is a prospective study of 2,941 regular force service members and veterans who participated in the 2002 Canadian Community Health Survey on Mental Health and Wellbeing: Canadian Forces Supplement (n = 5,155; ages 15 to 64 years; response rate 68%). PTSD diagnoses in 2002 and 2018 were used to create 4 groups: (1) no lifetime, (2) remitted, (3) new onset, and (4) persistent/recurrent PTSD. Multinomial regressions were conducted to identify predictors of PTSD courses.Results:Female sex, being a junior noncommissioned member (vs. officer), and land (vs. air) operations in 2002 were associated with all PTSD courses relative to no lifetime PTSD (relative risk ratio [RRR] range: 1.28 to 3.65). After adjusting for sociodemographic variables, baseline predictors of all PTSD courses included lifetime mental disorder, history of mental health care utilization, all trauma type categories (deployment-associated, sexual, “other”), and the number of lifetime traumatic events (RRR range: 1.14 to 8.95). New (“since 2002”) traumas, transitioning to veteran status, and alcohol dependence were mostly associated with the new onset and persistent/recurrent PTSD courses (RRR range: 1.79 to 4.31), while mental health care utilization and greater avoidance coping were associated with all PTSD courses (RRR range: 1.10 to 17.87). Protective factors for several PTSD courses at one or both time points included social support, social network size, and problem-focused coping (RRR range: 0.71 to 0.98).Conclusions:This is the first population-based survey to examine the longitudinal course of PTSD in Canadian Forces members. Prevention and intervention programs focused on bolstering social support and active coping strategies as possible protective factors/correlates may help mitigate the development and persistence of PTSD.     

Lifetime history of traumatic events in a young adult Mexican American sample: Relation to substance dependence,affective disorder,acculturation stress,and PTSD

Mexican Americans comprise one of the most rapidly growing populations in the United States, and within this population, trauma and post-traumatic stress disorder (PTSD) are associated with physical and mental health problems. Therefore, efforts to delineate factors that may uniquely contribute to increased likelihood of trauma, PTSD, and substance use disorders over the lifetime in Mexican Americans are important to address health disparities and to develop treatment and prevention programs. Six hundred fourteen young adults (age 18–30 yrs) of Mexican American heritage, largely second generation, were recruited from the community and assessed with the Semi-Structured Assessment for the Genetics of Alcoholism and an acculturation stress scale. More males (51.2%) reported experiencing traumas than females (41.1%), however, a larger proportion of females received a PTSD diagnosis (15%) than males (8%). Alcohol dependence and affective disorders, but not anxiety disorders, antisocial disorders, nicotine, marijuana, or stimulant dependence, were significantly comorbid with PTSD. Endorsing higher levels of acculturation stress was also significantly associated with both trauma exposure and a diagnosis of PTSD. Logistic regression revealed that female gender, having an affective disorder, alcohol dependence, higher levels of acculturation stress, and lower levels of education were all predictors of PTSD status. Additionally, alcohol dependence generally occurred after the PTSD diagnosis in early adulthood in this high-risk population. These studies suggest that treatment and prevention efforts should particularly focus on young adult second generation Mexican American women with higher levels of acculturation stress, who may be at higher risk for PTSD, affective disorder, and alcohol dependence following trauma exposure.     

Association of posttraumatic stress disorder with low-grade elevation of C-reactive protein: Evidence from the general population

Background

Posttraumatic stress disorder (PTSD) has been associated with several somatic diseases, and low-grade inflammation may be one psychobiological mechanism mediating this relationship. We assessed the association between PTSD and elevated serum levels of C-reactive protein (CRP; >3 mg/L) in a large general population sample.

Methods

About 3049 adults living in the community were included in the present study. CRP, lipoproteins and triglycerides were determined. Participants were also examined with regard to blood pressure, body mass index (BMI), physical activity, comorbid somatic diseases, medication, daily alcohol intake, and depression.

Results

PTSD was diagnosed in 55 participants (1.8%), and low-grade inflammation (i.e. CRP >3 mg/L) was found in 701 subjects (23.0%). PTSD positive participants had significantly higher odds for elevated CRP values than those without PTSD (OR = 2.27; 95% CI: 1.32-3.93). Even after adjusting for sex, age, other sociodemographic factors, BMI, blood pressure, lipoproteins and triglycerides, physical activity, comorbid somatic diseases, daily alcohol intake, and trauma exposure, there were almost twofold higher odds for elevated CRP levels in participants with PTSD compared to those without PTSD (OR = 1.87; 95% CI: 1.05-3.35).

Conclusions

Our findings suggest a close relationship between PTSD and low-grade inflammation possibly representing one psychobiological pathway from PTSD to poor physical health, particularly with respect to cardiovascular and pulmonary disease as well as diabetes.     

Disgust and the development of posttraumatic stress among soldiers deployed to Afghanistan

Although the DSM-IV recognizes that events can traumatize by evoking horror, not just fear, the role of disgust in the development of posttraumatic stress disorder (PTSD) has received little research attention. In a study of soldiers deployed to Afghanistan, we examined whether reports of peritraumatic disgust and trait disgust vulnerability factors (disgust propensity and disgust sensitivity) predict PTSD-symptoms, independently of peritraumatic fear, neuroticism, and anxiety sensitivity. Participants (N = 174) enrolled in this study before deployment, and were retested around 6 months (N = 138; 79%) and, again, 15 months (N = 107; 62%) after returning home. The results showed that (1) greater peritraumatic disgust and fear independently predicted PTSD-symptom severity at 6 months, (2) greater disgust propensity predicted more peritraumatic disgust, but not PTSD-symptom severity, and (3) disgust sensitivity moderated the relationship between peritraumatic disgust and PTSD-symptom severity. Implications of these findings for broadening the affective vulnerabilities that may contribute to PTSD will be discussed.