PTSD

Citation:

King, Matthew W., Amy E. Street, Jaimie L. Gradus, Dawne S. Vogt, and Patricia A. Resick. 2013. “Gender Differences in Posttraumatic Stress Symptoms Among OEF/OIF Veterans: An Item Response Theory Analysis.” Journal of Traumatic Stress 26 (2): 175–83. doi:10.1002/jts.21802.

Authors: Jaimie L. Gradus, Matthew W. King, Patricia A. Resick, Amy E. Street, Dawne S. Vogt

Abstract:

Establishing whether men and women tend to express different symptoms of posttraumatic stress in reaction to trauma is important for both etiological research and the design of assessment instruments. Use of item response theory (IRT) can reveal how symptom reporting varies by gender and help determine if estimates of symptom severity for men and women are equally reliable. We analyzed responses to the PTSD Checklist (PCL) from 2,341 U.S. military veterans (51% female) who completed deployments in support of operations in Afghanistan and Iraq (Operation Enduring Freedom/Operation Iraqi Freedom [OEF/OIF]), and tested for differential item functioning by gender with an IRT-based approach. Among men and women with the same overall posttraumatic stress severity, women tended to report more frequent concentration difficulties and distress from reminders whereas men tended to report more frequent nightmares, emotional numbing, and hypervigilance. These item-level gender differences were small (on average d = 0.05), however, and had little impact on PCL measurement precision or expected total scores. For practical purposes, men's and women's severity estimates had similar reliability. This provides evidence that men and women veterans demonstrate largely similar profiles of posttraumatic stress symptoms following exposure to military-related stressors, and some theoretical perspectives suggest this may hold in other traumatized populations.

Topics: Combatants, Female Combatants, Male Combatants, Women, Men, Gender Analysis, Mental Health, PTSD, Military Forces & Armed Groups Regions: Africa, MENA, Americas, North America, Asia, Middle East, South Asia Countries: Afghanistan, Iraq, United States of America

Year: 2013

Citation:

Renshaw, Keith D., Sarah B. Campbell, Laura Meis, and Christopher Erbes. 2014. “Gender Differences in the Associations of PTSD Symptom Clusters With Relationship Distress in U.S. Vietnam Veterans and Their Partners.” Journal of Traumatic Stress 27 (3): 283–90. doi:10.1002/jts.21916.

Authors: Sarah B. Campbell, Christopher Erbes, Laura Meis, Keith D. Renshaw

Abstract:

Research has consistently linked symptoms of posttraumatic stress disorder (PTSD) with relationship distress in combat veterans and their partners. Studies of specific clusters of PTSD symptoms indicate that symptoms of emotional numbing/withdrawal (now referred to as negative alterations in cognition and mood) are more strongly linked with relationship distress than other symptom clusters. These findings, however, are based predominantly on samples of male veterans. Given the increasing numbers of female veterans, research on potential gender differences in these associations is needed. The present study examined gender differences in the multivariate associations of PTSD symptom clusters with relationship distress in 465 opposite-sex couples (375 with male veterans and 90 with female veterans) from the National Vietnam Veterans Readjustment Study. Comparisons of nested path models revealed that emotional numbing/withdrawal symptoms were associated with relationship distress in both types of couples. The strength of this association, however, was stronger for female veterans (b = .46) and female partners (b = .28), compared to male veterans (b = .38) and male partners (b = .26). Results suggest that couples-based interventions (e.g., psychoeducation regarding emotional numbing symptoms as part of PTSD) are particularly important for both female partners of male veterans and female veterans themselves.

Topics: Female Combatants, Male Combatants, Women, Men, Gender Analysis, Mental Health, PTSD, Military Forces & Armed Groups Regions: Americas, North America Countries: United States of America

Year: 2014

Citation:

Kimerling, Rachel, Tracey Serpi, Frank Weathers, Amy M. Kilbourne, Han Kang, Joseph F. Collins, Yasmin Cypel, et al. 2014. “Diagnostic Accuracy of the Composite International Diagnostic Interview (CIDI 3.0) PTSD Module Among Female Vietnam-Era Veterans.” Journal of Traumatic Stress 27 (2): 160–67. doi:10.1002/jts.21905.

Authors: Joseph F. Collins, Yasmin Cypel, Susan M. Frayne, Joan Furey, Grant D. Huang, Han Kang, Amy M. Kilbourne, Rachel Kimerling, Kathryn Magruder, Matthew J. Reinhard, Tracey Serpi, Avron Spiro, Frank Weathers

Abstract:

The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) posttraumatic stress disorder (PTSD) module is widely used in epidemiological studies of PTSD, yet relatively few data attest to the instrument's diagnostic utility. The current study evaluated the diagnostic utility of the CIDI 3.0 PTSD module with U. S. women Vietnam-era veterans. The CIDI and the Clinician-Administered PTSD Scale (CAPS) were independently administered to a stratified sample of 160 women, oversampled for current PTSD. Both lifetime PTSD and recent (past year) PTSD were assessed within a 3-week interval. Forty-five percent of the sample met criteria for a CAPS diagnosis of lifetime PTSD, and 21.9% of the sample met criteria for a CAPS diagnosis of past-year PTSD. Using CAPS as the diagnostic criterion, the CIDI correctly classified 78.8% of cases for lifetime PTSD (κ = .56) and 82.0% of past year PTSD cases (κ = .51). Estimates of diagnostic performance for the CIDI were sensitivity of .61 and specificity of .91 for lifetime PTSD and sensitivity of .71 and specificity of .85 for past-year PTSD. Results suggest that the CIDI has good utility for identifying PTSD, though it is a somewhat conservative indicator of lifetime PTSD as compared to the CAPS.

Topics: Female Combatants, Gender, Women, Health, PTSD, Military Forces & Armed Groups Regions: Americas, North America Countries: United States of America

Year: 2014

Citation:

Lunney, Carole A., Paula P. Schnurr, and Joan M. Cook. 2014. “Comparison of Clinician- and Self-Assessments of Posttraumatic Stress Symptoms in Older Versus Younger Veterans.” Journal of Traumatic Stress 27 (2): 144–51. doi:10.1002/jts.21908.

Authors: Joan M. Cook, Carole A. Lunney, Paula P. Schnurr

Abstract:

Assessment of posttraumatic stress disorder (PTSD) in older adults has received limited investigation. The purpose of this study was to compare the severity of PTSD symptoms in treatment-seeking older and younger U.S. veterans with PTSD. Participants were 360 male and 284 female veterans enrolled in 2 separate clinical trials of psychotherapy for PTSD. About 4% of the participants were age 60 years or older. Symptoms were assessed before treatment using clinician-rated and self-report measures. For men, only numbing symptoms were lower in older veterans; this was so in clinician ratings, d = 0.76, and self-reports, d = 0.65. For women, clinician-rated hyperarousal symptoms were lower in older veterans, d = 0.57. Clinician-rated and self-reported symptoms were strongly related, Bs = 0.95 and 0.80 in the male and female samples, respectively. Among men, clinician-rated and self-reported reexperiencing and hyperarousal symptoms were associated only in younger veterans. Accurate assessment of PTSD symptoms in older adults is essential to identifying and implementing effective treatment. Our findings suggest that some symptoms may be lower in older men, and that some symptoms of PTSD may be underdetected in older women. Future research should assess the combined effect of gender and age on PTSD symptom presentation.

Topics: Age, Female Combatants, Male Combatants, Women, Men, Health, PTSD, Military Forces & Armed Groups Regions: Americas, North America Countries: United States of America

Year: 2014

Citation:

Stricker, Nikki H., Jenna E. Keller, Diane T. Castillo, and Kathleen Y. Haaland. 2015. “The Neurocognitive Performance of Female Veterans With Posttraumatic Stress Disorder.” Journal of Traumatic Stress 28 (2): 102–9. doi:10.1002/jts.22000.

Authors: Diane T. Castillo, Kathleen Y. Haaland, Jenna E. Keller, Nikki H. Stricker

Abstract:

Neurocognitive problems are common with posttraumatic stress disorder (PTSD) and are important to understand because of their association with the success of PTSD treatment and its potential neural correlates. To our knowledge, this is the first neurocognitive study in an all-female U.S. veteran sample, some of whom had PTSD. We examined neurocognitive performance and assessed whether learning deficits, common in PTSD, were associated with executive functioning. Veterans with PTSD (n = 56) and without (n = 53) were evaluated for psychiatric and neurocognitive status. The PTSD group had a lower estimated IQ (d = 0.53) and performed more poorly on all neurocognitive domains (d range = 0.57–0.88), except verbal retention (d = 0.04). A subset of the 2 groups that were matched on IQ and demographics similarly demonstrated poorer performance for the PTSD group on all neurocognitive domains (d range = 0.52–0.79), except verbal retention (d = 0.15). Within the PTSD group, executive functioning accounted for significant variance in verbal learning over and above IQ and processing speed (ΔR2 = .06), as well as depression (ΔR2 = .07) and PTSD severity (ΔR2 = .06). This study demonstrated that female veterans with PTSD performed more poorly than females without PTSD on several neurocognitive domains, including verbal learning, processing speed, and executive functioning. Replication of these results using a control group of veterans with more similar trauma exposure, history of mild traumatic brain injury, and psychiatric comorbidities would solidify these findings.

Topics: Combatants, Female Combatants, Health, Mental Health, PTSD, Military Forces & Armed Groups Regions: Americas, North America Countries: United States of America

Year: 2015

Citation:

Banford, Alyssa, David C. Ivey, Thulitha Wickrama, Judith Fischer, Anne Prouty, and Douglas Smith. 2016. “The Role of Natural Disaster in Individual and Relational Adjustment in Sri Lankan Mothers Following the 2004 Tsunami.” Disasters 40 (1): 134–57. doi:10.1111/disa.12137.

Authors: Alyssa Banford, David C. Ivey, Thulitha Wickrama, Judith Fischer, Anne Prouty, Douglas Smith

Abstract:

The purpose of this study is to examine the associations between maternal mental health distress symptoms, including depression and post-traumatic stress disorder, the extent to which the presence of a child's disaster-related physical health problem(s) have interfered with daily functioning, and family cohesion over time among Sri Lankan mothers who survived the tsunami on 26 December 2004. Study variables were measured using a self-report questionnaire administered approximately four months after the event and three years later in summer 2008. Univariate, bivariate, and multivariate analyses were conducted. Path analysis was employed to assess the relationships between the key variables over time and the correlations in the study variables at each time point. Among other findings, the results of the path analysis indicated that post-traumatic stress symptom distress four months after the disaster significantly predicted variance in family cohesion three years later. Clinical and empirical research implications are presented and discussed.

Keywords: mental health, mothers, Sri Lanka, tsunami

Topics: Environment, Environmental Disasters, Gender, Women, Health, Mental Health, PTSD Regions: Asia, South Asia Countries: Sri Lanka

Year: 2016

Citation:

Muralidharan, Anjana, David Austern, Samantha Hack, and Dawne Vogt. 2016. “Deployment Experiences, Social Support, and Mental Health: Comparison of Black, White, and Hispanic U.S. Veterans Deployed to Afghanistan and Iraq.” Journal of Traumatic Stress 29 (3): 273–78. doi:10.1002/jts.22104.

Authors: David Austern, Samantha Hack, Anjana Muralidharan, Dawne Vogt

Abstract:

Compared to their White counterparts, Black and Hispanic Vietnam-era, male, combat veterans in the United States have experienced discrimination and increased trauma exposure during deployment and exhibited higher rates of postdeployment mental health disorders. The present study examined differences in deployment experiences and postdeployment mental health among male and female Black, Hispanic, and White veterans deployed in support of Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom in Iraq. Data were drawn from a national survey of veterans (N = 924) who had returned from deployment within the last 2 years. Ethnoracial minority veterans were compared to White veterans of the same gender on deployment experiences and postdeployment mental health. The majority of comparisons did not show significant differences; however, several small group differences did emerge (.02 < η2 < .04). Ethnoracial minority veterans reported greater perceived threat in the warzone and more family-related concerns and stressors during deployment than White veterans of the same gender. Minority female veterans reported higher levels of postdeployment symptoms of anxiety than their White counterparts, which were accounted for by differences in deployment experience. These differences call for ongoing monitoring.

Topics: Armed Conflict, Female Combatants, Male Combatants, Gender, Gender Analysis, Mental Health, PTSD, Trauma, Race Regions: Africa, MENA, Americas, North America, Asia, Middle East, South Asia Countries: Afghanistan, Iraq, United States of America

Year: 2016

Citation:

Breyer, Benjamin N., Shona C. Fang, Karen H. Seal, Gayatri Ranganathan, Brian P. Marx, Terence M. Keane, and Raymond C. Rosen. 2016. “Sexual Health in Male and Female Iraq and Afghanistan U. S. War Veterans With and Without PTSD: Findings From the VALOR Cohort.” Journal of Traumatic Stress 29 (3): 229–36. doi:10.1002/jts.22097.

Authors: Benjamin N. Breyer, Shona C. Fang, Terence M. Keane, Brian P. Marx, Gayatri Ranganathan, Raymond C. Rosen, Karen H. Seal

Abstract:

We sought to determine whether posttraumatic stress disorder (PTSD) was associated with sexual health in returned warzone-deployed veterans from the recent Iraq and Afghanistan conflicts. We studied 1,581 males and females from the Veterans After-Discharge Longitudinal Registry, a gender-balanced U.S. Department of Veterans Affairs registry of health care-seeking veterans with and without PTSD. Approximately one quarter (25.1%) of males (n = 198) and 12.7% of females (n = 101) had a sexual dysfunction diagnosis and/or prescription treatment for sexual dysfunction. Both genders were more likely to have a sexual dysfunction diagnosis and/or prescription treatment if they had PTSD compared with those without PTSD (male: 27.3% vs. 21.1%, p = .054; female: 14.9% vs. 9.4%, p = .022). Among the 1,557 subjects analyzed here, males with PTSD had similar levels of sexual activity compared to those without PTSD (71.2% vs. 75.4%, p = .22), whereas females with PTSD were less likely to be sexually active compared to females without PTSD (58.7% vs. 72.1%, p < .001). Participants with PTSD were also less likely to report sex-life satisfaction (male: 27.6% vs. 46.0%, p < .001; female: 23.0% vs. 45.7%, p < .001) compared with those without PTSD. Although PTSD was not associated with sexual dysfunction after adjusting for confounding factors, it was significantly negatively associated with sex-life satisfaction in female veterans with a prevalence ratio of .71, 95% confidence interval [.57, .90].

Topics: Armed Conflict, Female Combatants, Male Combatants, Gender Analysis, Mental Health, PTSD, Trauma, Military Forces & Armed Groups Regions: Africa, MENA, Americas, North America, Asia, Middle East, South Asia Countries: Afghanistan, Iraq, United States of America

Year: 2016

Citation:

Millegan, Jeffrey, Lawrence Wang, Cynthia A. LeardMann, Derek Miletich, and Amy E. Street. 2016. “Sexual Trauma and Adverse Health and Occupational Outcomes Among Men Serving in the U.S. Military.” Journal of Traumatic Stress 29 (2): 132–40. doi:10.1002/jts.22081.

Authors: Cynthia A. LeardMann, Derek Miletich, Jeffrey Millegan, Amy E. Street, Lawrence Wang

Annotation:

Although absolute counts of U.S. service men who experience sexual trauma are comparable to service women, little is known about the impact of sexual trauma on men. The association of recent sexual trauma (last 3 years) with health and occupational outcomes was investigated using longitudinal data (2004–2013) from the Millennium Cohort Study. Of 37,711 service men, 391 (1.0%) reported recent sexual harassment and 76 (0.2%) sexual assault. In multivariable models, sexual harassment or assault, respectively, was associated with poorer mental health: AOR = 1.60, 95% CI [1.22, 2.12], AOR = 4.39, 95% CI [2.40, 8.05]; posttraumatic stress disorder: AOR = 2.50, 95% CI [1.87, 3.33], AOR = 6.63, 95% CI [3.65, 12.06]; depression: AOR = 2.37, 95% CI [1.69, 3.33], AOR = 5.60, 95% CI [2.83, 11.09]; and multiple physical symptoms: AOR = 2.22, 95% CI [1.69, 2.92]; AOR = 3.57, 95% CI [1.98, 6.42], after adjustment for relevant covariates. Sexual harassment was also associated with poorer physical health: AOR = 1.68, 95% CI [1.27, 2.22]. Men who reported sexual trauma were more likely to have left military service: AOR = 1.60, 95% CI [1.14, 2.24], and be disabled/unemployed postservice: AOR = 1.76, 95% CI [1.02, 3.02]. Results suggest that sexual trauma was significantly associated with adverse health and functionality extending to postmilitary life. Findings support the need for developing better prevention strategies and services to reduce the burden of sexual trauma on service men.

Topics: Armed Conflict, Male Combatants, Men, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, SV against Men Regions: Americas, North America Countries: United States of America

Year: 2016

Citation:

Qin, Yanyun, Ya Zhou, Fang Fan, Shijian Chen, Rong Huang, Rouna Cai, and Ting Peng. 2016. “Developmental Trajectories and Predictors of Prosocial Behavior Among Adolescents Exposed to the 2008 Wenchuan Earthquake.” Journal of Traumatic Stress 29 (1): 80–87. doi:10.1002/jts.22064.

Authors: Rouna Cai, Shijian Chen, Fang Fan, Rong Huang, Ting Peng, Yanyun Qin, Ya Zhou

Abstract:

This longitudinal study examined the developmental trajectories of prosocial behavior and related predictors among adolescents exposed to the 2008 Wenchuan earthquake. At 6-, 18-, and 30-months postearthquake, we followed a sample of 1,573 adolescents. Self-report measures were used to assess earthquake exposure, postearthquake negative life events, prosocial behavior, symptoms of posttraumatic stress disorder, depression, anxiety, social support, and coping style. Data were analyzed using growth mixture modeling and multinomial logistic regressions. Four trajectories of postearthquake prosocial behavior were identified in the sample: (a) high/enhancing (35.0%), (b) high/stable (29.4%), (c) low/declining (33.6%), and (d) low/steeply declining (2.0%). Female gender, more social support, and greater positive coping were significant factors related to a higher probability of developing the high/enhancing trajectory. These findings may be helpful for us to identify adolescents with poor prosocial behavior after exposure to earthquakes so as to provide them with appropriate intervention.

Topics: Environment, Environmental Disasters, Gender, Gender Analysis, Health, Mental Health, PTSD, Trauma Regions: Asia, East Asia Countries: China

Year: 2016