Negative emotionality and disconstraint influence PTSD symptom course via exposure to new major adverse life events

Abstract

Identifying the factors that influence stability and change in chronic posttraumatic stress disorder (PTSD) is important for improving clinical outcomes. Using a cross-lagged design, we analyzed the reciprocal effects of personality and PTSD symptoms over time and their effects on stress exposure in a sample of 222 trauma-exposed veterans (ages 23 -68; 90.5% male). Personality functioning and PTSD were measured approximately 4 years apart, and self-reported exposure to major adverse life events during the interim was also assessed. Negative emotionality positively predicted future PTSD symptoms, and this effect was partially mediated by exposure to new events. Constraint (negatively) indirectly affected PTSD via its association with exposure to new events. There were no significant effects of positive emotionality nor did PTSD symptom severity exert influences on personality over time. Results indicate that high negative affect and disconstraint influence the course of PTSD symptoms by increasing exposure to stressful life events.Keywords stress exposure; personality; posttraumatic stress; longitudinal; veterans Although most individuals who develop posttraumatic stress disorder (PTSD) after a traumatic life event recover, a substantial minority develop chronic symptoms that persist for years and fluctuate over time (Chapman et al., 2012;Perkonigg et al., 2005;Solomon & Mikulincer, 2006). Chronic PTSD is a dynamic and environmentally-sensitive condition characterized by periods of symptom exacerbation and relative remission. Identifying predictors of stability and change in PTSD is critical for understanding why symptoms persist and reemerge over time, detecting individuals at risk for chronic trajectories, and improving outcomes for intractable cases. To advance understanding of the longitudinal Correspondence to Naomi Sadeh, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130. . Naomi.SamimiSadeh@va.gov. U.S. Department of Veterans Affairs VA Author ManuscriptVA Author Manuscript VA Author Manuscript course of PTSD, this study examined the reciprocal and stress-related effects of personality traits and PTSD symptoms over time in a sample of trauma-exposed veterans. Reciprocal Influences of Personality and PTSDPsychopathology researchers have had a long-standing interest in the interplay of personality and psychopathology, including in relation to PTSD. PTSD shows large concurrent relations with neuroticism and negative emotionality (Pearson's r = 0.49; Kotov et al., 2010), which are closely related constructs that refer to the tendency to experience high levels of distress and a range of negative affect. In contrast, personality traits that measure the tendency to have a positive, outgoing disposition (e.g., extraversion/ positive emotionality) or behave in a controlled, cautious manner (e.g., conscientiousness/low disconstraint) show relatively weaker negative associations with PTSD (Pearson's rs = −0.25 and −0.27, respectively; Kotov et al., 2010). Un...

Reckless Self‐Destructive Behavior and PTSD in Veterans: The Mediating Role of New Adverse Events

“…Based on the types of stressful events endorsed during the follow‐up period, our findings may reflect the tendency for individuals who engage in RSDB to select into dangerous environments that put them at risk for physical injury (e.g., car accidents, assaultive events) and/or associate with others who place themselves at risk for premature death or life‐threatening injury (e.g., aggressive or substance‐abusing individuals). This finding converges with our previous study (Sadeh et al., ), which found that the personality traits of negative emotionality and disconstraint perpetuate PTSD symptoms over time, in part, by increasing exposure to new adverse events. However, a key difference between this study and Sadeh et al.…”

“…Between T1 and T2, 82.0% of the sample reported at least one new adverse event, and the mean number reported was 1.86 ( SD = 1.96, range = 0 to 9). The most commonly reported adverse events were sudden death of a friend or loved one (36.5%), threatened with or completed physical assault (24.3%), motor vehicle accident (22.3%), life‐threatening or disabling event to a loved one (20.3%), life‐threatening illness (19.6%), and witnessing a severe accident (8.1%; these data overlap with the results found in Sadeh et al., ).…”

“…() who found that over half of active duty personnel reported some type of risky behavior. We also examined the relationship between RSDB and PTSD symptoms over time, which was an extension of a previous study conducted in this sample that examined reciprocal relationships between PTSD and normal range personality traits (Sadeh, Miller, Wolf, & Harkness, ). In that study, we found that trait negative emotionality and disconstraint (i.e., impulsivity) indirectly influenced later PTSD symptoms by increasing exposure to new adverse events.…”

Polygenic Risk for Externalizing Psychopathology and Executive Dysfunction in Trauma-Exposed Veterans

“…A third possibility is that genetic liability for behavioral disinhibition increases the likelihood that an individual will be exposed to high-risk environments where they will be exposed to traumatic events (i.e., indicative of a gene-environment correlation), which in turn potentiates externalizing psychopathology. Such a model is consistent with research showing that impulsivity leads to greater trauma and life stress exposure prospectively (e.g., Sadeh, Miller, Wolf, & Harkness, 2015). However, a relationship between the polygenic risk score and lifetime trauma exposure was not evident in our samples, suggesting that gene-environment correlation is unlikely.…”

Personality traits and combat exposure as predictors of psychopathology over time

“…It was unclear if NEGE would also be associated with combat exposure as this prospective relation has not been extensively studied. It was also unclear if baseline internalizing and externalizing symptoms would be related to combat exposure as findings in this area have been inconsistent (Breslau et al , 1995, Sadeh et al , 2015)…”