Insomnia as predictor versus outcome of PTSD and depression among Iraq combat veterans

Wright, Kathleen M.; Britt, Thomas W.; Bliese, Paul D.; Adler, Amy B.; Picchioni, Dante; Moore, DeWayne

doi:10.1002/jclp.20845

Cited by 233 publications

(171 citation statements)

References 85 publications

(56 reference statements)

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“…The demoralization model suggests that PTSD symptoms are the causes of depressive symptoms (Mangelli et al, 2005). The synchronous change model suggests that PTSD and depression may be influenced by a third variable and show no real association with each other (Breslau & Schultz, 2013; Vinck, Pham, Stover, & Weinstein, 2007; Wright et al, 2011). In a twin study of 6609 members of the Vietnam Era Twin Registry (male–male twins), no residual genetic and environmental variance overlapped between combat exposure and major depression after controlling for variance common to PTSD (Scherrer et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

Cheng

Liang

et al. 2018

European Journal of Psychotraumatology

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Background: Many studies have reported the comorbidity of posttraumatic stress disorder (PTSD) and depression in children. However, the underlying relationship between PTSD and depression remains unclear.Objective: This study examines the relationship between PTSD and depressive symptoms in children who survived the Wenchuan earthquake in China.Methods: In total, 301 children were assessed at four months and then followed up at 29, 40 and 52 months after the disaster. The ages of the children ranged from 9.6–14.6 years old, and the sample included 157 males and 144 females. The children were assessed by using the University of California at Los Angeles PTSD reaction index for DSM-IV for PTSD symptoms and the Children’s Depression Inventory for depressive symptoms.Results: Comorbid PTSD and depressive symptoms were prevalent in 4.0, 3.3, 3.7 and 5.1% of the participants at times 1, 2, 3 and 4, respectively. The cross-lagged analysis indicated that PTSD symptoms at time 1 predicted depressive symptoms at time 2; depressive symptoms at time 1 predicted PTSD symptoms at time 2; depressive symptoms at time 2 predicted PTSD symptoms at time 3; and depressive symptoms at time 3 predicted PTSD symptoms at time 4. The findings also showed that being female, poor parental relationships and trauma exposure were risk factors for PTSD or depressive symptoms.Conclusions: The results suggest that the causal relationship between PTSD and depressive symptoms changes over time; the effects of PTSD symptoms tend to decrease, while those of depressive symptoms tend to increase. Two stages of the relationship between PTSD and depressive symptoms were observed, namely, that PTSD and depressive symptoms first influenced each other and then that depressive symptoms predicted PTSD. The results of our study also suggest that females with poor parental relationships and a high degree of trauma exposure are more likely to require intervention.

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Section: Introductionmentioning

confidence: 99%

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

Cheng

Liang

et al. 2018

European Journal of Psychotraumatology

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“…It is important to identify and address risk factors for worse sleep in veterans, given evidence that in addition to being a commonly reported symptom, 8 sleep has been shown to predict future psychopathology. 14,15 Thus, targeting sleep in veterans can improve current symptomatology (for those who have it), in addition to helping prevent the development of future psychiatric disorders. Additional research into risk and protective factors for sleep in OEF/OIF/OND veterans is warranted to better treat this population.…”

Section: Discussionmentioning

confidence: 99%

“…13 Further, recent evidence suggests that sleep disturbances may influence the development and course of subsequent psychopathology (e.g., depression, PTSD). 14,15 Fragmentation in rapid eye movement sleep specifically is predictive of PTSD. [16][17][18] Numerous studies have been conducted to identify correlates of sleep disturbance in veteran samples, 5,7 yet few have incorporated a three-group design that separates "true" controls from trauma-exposed controls and individuals with PTSD.…”

Section: Introductionmentioning

confidence: 99%

Sleep Disturbances in OEF/OIF/OND Veterans: Associations with PTSD, Personality, and Coping

Lind

Brown

Farrell-Carnahan

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: Sleep disturbances are well documented in relation to trauma exposure and posttraumatic stress disorder (PTSD), but correlates of such disturbances remain understudied in veteran populations. We conducted a preliminary study of sleep disturbances in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (n = 133; mean [standard deviation] age = 29.8 [4.7] y). Methods: Veterans were assigned to one of three groups based on responses to the Clinician Administered PTSD Scale: control (no trauma-exposure [TE] or PTSD), TE, and PTSD. Sleep disturbance was assessed using the Pittsburgh Sleep Quality Index (PSQI). Measures of resilience, trauma load, personality, coping, alcohol use, and mild traumatic brain injury were also assessed via self-report. Results: The PTSD group had significantly more disturbed sleep (PSQI global score mean = 8.94, standard deviation = 3.12) than control (mean = 5.27, standard deviation = 3.23) and TE (mean = 5.34, standard deviation = 3.17) groups, but there were no differences between TE and control. The same pattern emerged across most PSQI subscales. Results of linear regression analyses indicated that current smoking, Army (versus other military branches), neuroticism, and using substances to cope were all significant correlates of higher sleep disturbance, whereas post-deployment social support was associated with less sleep disturbance. However, when combined together into a model with PTSD status, only neuroticism and substance use coping remained significant as predictors of more disturbed sleep. Conclusions: These initial findings suggest that TE itself may not be an independent risk factor for disturbed sleep in veterans, and that neurotic personality and a tendency to cope by using substances may partially explain sleep disturbance, above and beyond a diagnosis of PTSD.

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“…The relationship between sleep disturbance and PTSSs may be bi-directional. It was shown that exposure to trauma may cause sleep disturbance (Babson & Feldner, 2010), but insomnia and nightmares are also associated with an increased risk for onset and continuance of PTSD (Wright, Britt, Bliese, Adler, Picchioni, & Moore, 2011), so they may serve as risk factors for PTSSs. In general, the high positive correlations between GHQ-28 dimensions and PTSSs confirmed in our study among patients with gynaecological pathology are in line with the results of previous studies (Chung et al, 2002;Taubman-Ben-Ari et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

Posttraumatic stress symptoms in women with gynaecologic pathology: the role of temperament, self-esteem and mental health

Oniszczenko¹,

Szulc²,

Bulsa³

et al. 2016

Current Issues in Personality Psychology

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Background Women with gynaecological pathology are affected by diseases associated with their femininity, attractiveness and fertility. Diseases like these can potentially be sources of trauma for women. The aim of this cross-sectional study was to investigate temperament traits, self-esteem and mental health dimensions that may contribute to the intensity of trauma in hospitalized women. Participants and procedure The study was conducted on 136 women aged from 18 to 60, hospitalized for a variety of gynaecological diseases. The level of trauma symptoms was assessed with the PTSD-Factorial Version inventory. Temperament traits were assessed with the Formal Characteristics of Behaviour – Temperament Inventory (FCB-TI), self-esteem was measured using the Multidimensional Self-Esteem Inventory, and mental health was diagnosed with the General Health Questionnaire – 28 items. Results Emotional reactivity and anxiety symptoms increase trauma symptom intensity in gynaecological patients, whereas briskness, endurance and lovability as a dimension of self-esteem may serve as protective buffers against intensification of trauma symptoms. Together, emotional reactivity, anxiety symptoms and lovability account for 48% of the variance of trauma intensity symptoms. Conclusions Emotional reactivity and anxiety symptoms increase trauma symptom intensity in gynaecological patients, whereas lovability as a dimension of self-esteem (and to a lesser extent briskness and endurance as temperament traits) may serve as protective buffers against intensification of trauma symptoms. The findings may have implications for the social support programmes that may be arranged for gynaecological patients.

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Insomnia as predictor versus outcome of PTSD and depression among Iraq combat veterans

Abstract: Results support the role of insomnia in the development of additional psychological problems and highlight the clinical implications for combat veterans, to include the importance of longitudinal assessment and monitoring of sleep disturbances, and the need for early intervention.

Cited by 233 publications

References 85 publications

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

Sleep Disturbances in OEF/OIF/OND Veterans: Associations with PTSD, Personality, and Coping

Posttraumatic stress symptoms in women with gynaecologic pathology: the role of temperament, self-esteem and mental health

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