Post-traumatic Stress Disorder by Gender and Veteran Status

Lehavot, Keren; Katon, Jodie G.; Chen, Jessica; Fortney, John C.; Simpson, Tracy L.

doi:10.1016/j.amepre.2017.09.008

Cited by 217 publications

(186 citation statements)

References 37 publications

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“…Nonetheless, two recent studies using nationally representative samples of the US population found higher prevalence of PTSD among women veterans, echoing gender differences in PTSD previously found in the general population [15, 16]. For example, a study using a nationally representative sample of the general population from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) assessed differences in PTSD prevalence by both gender and veteran status [15], using Diagnostic and Statistical Manual of Mental Disorders—Fifth Edition (DSM-5) criteria [17]. Findings indicated that women veterans reported significantly higher prevalence of age-and race-adjusted lifetime and past-year PTSD (13.4%, 11.7%, respectively) than both women civilians (8.0%, 6.0%) and men veterans (7.7%, 6.7%) [15].…”

Section: Introductionmentioning

confidence: 77%

“…Respondents further had to report symptom duration of ≥1 month and clinically significant impairment or distress. The requirement of ≥3 D and E symptoms is higher than the 2 symptoms from each cluster required for DSM-5 criteria [17], but has been used in other studies based on NESARC-III data [8, 15, 41]. Test–retest reliability of past-year PTSD was fair (0.41) and reliability of the dimensional PTSD criteria scale was good [intraclass correlation coefficient (ICC) = 0.69] [42].…”

Section: Methodsmentioning

confidence: 99%

“…In national studies of both Vietnam-era and Iraq/Afghanistan veterans, prevalence of PTSD did not differ between women and men veterans [12–14]. Nonetheless, two recent studies using nationally representative samples of the US population found higher prevalence of PTSD among women veterans, echoing gender differences in PTSD previously found in the general population [15, 16]. For example, a study using a nationally representative sample of the general population from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) assessed differences in PTSD prevalence by both gender and veteran status [15], using Diagnostic and Statistical Manual of Mental Disorders—Fifth Edition (DSM-5) criteria [17].…”

Section: Introductionmentioning

confidence: 92%

“…For example, a study using a nationally representative sample of the general population from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) assessed differences in PTSD prevalence by both gender and veteran status [15], using Diagnostic and Statistical Manual of Mental Disorders—Fifth Edition (DSM-5) criteria [17]. Findings indicated that women veterans reported significantly higher prevalence of age-and race-adjusted lifetime and past-year PTSD (13.4%, 11.7%, respectively) than both women civilians (8.0%, 6.0%) and men veterans (7.7%, 6.7%) [15]. The current study builds on these findings to examine possible factors that may explain these gender and veteran status differences in PTSD in the NESARC-III.…”

Section: Introductionmentioning

confidence: 99%

“…Researchers have noted, however that while the high rates of sexual victimization in women likely account for some of the variance in their greater prevalence of PTSD relative to men, it does not account for all of it [25–28]. Even so, a similar hypothesis might be extended to understand women veterans’ higher prevalence of PTSD compared to women civilians, as the recent NESARC-III study indicated that women veterans had greater exposure to interpersonal violence than women civilians [15]. In addition to differences in trauma type exposure, the same study indicated that women veterans experienced a significantly greater number of trauma types compared to women civilians.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Do trauma type, stressful life events, and social support explain women veterans’ high prevalence of PTSD?

Lehavot

Goldberg

Chen

et al. 2018

Soc Psychiatry Psychiatr Epidemiol

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Section: Introductionmentioning

confidence: 77%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Do trauma type, stressful life events, and social support explain women veterans’ high prevalence of PTSD?

Lehavot

Goldberg

Chen

et al. 2018

Soc Psychiatry Psychiatr Epidemiol

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Association of Posttraumatic Stress Disorder and Incident Ischemic Heart Disease in Women Veterans

et al. 2021

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IMPORTANCE Posttraumatic stress disorder (PTSD) is associated with greater risk of ischemic heart disease (IHD) in predominantly male populations or limited community samples. Women veterans represent a growing, yet understudied, population with high levels of trauma exposure and unique cardiovascular risks, but research on PTSD and IHD in this group is lacking. OBJECTIVE To determine whether PTSD is associated with incident IHD in women veterans. DESIGN, SETTING, AND PARTICIPANTSIn this retrospective, longitudinal cohort study of the national Veterans Health Administration (VHA) electronic medical records, the a priori hypothesis that PTSD would be associated with greater risk of IHD onset was tested. Women veterans 18 years or older with and without PTSD who were patients in the VHA from January 1, 2000, to December 31, 2017, were assessed for study eligibility. Exclusion criteria consisted of no VHA clinical encounters after the index visit, IHD diagnosis at or before the index visit, and IHD diagnosis within 90 days of the index visit. Propensity score matching on age at index visit, number of prior visits, and presence of traditional and female-specific cardiovascular risk factors and mental and physical health conditions was conducted to identify women veterans ever diagnosed with PTSD, who were matched in a 1:2 ratio to those never diagnosed with PTSD. Data were analyzed from October 1, 2018, to October 30, 2020. EXPOSURES PTSD, defined by International Classification of Diseases, Ninth Revision (ICD-9), or International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), diagnosis codes from inpatient or outpatient encounters. MAIN OUTCOMES AND MEASURES Incident IHD, defined as new-onset coronary artery disease, angina, or myocardial infarction, based on ICD-9 and ICD-10 diagnosis codes from inpatient or outpatient encounters, and/or coronary interventions based on Current Procedural Terminology codes.RESULTS A total of 398 769 women veterans, 132 923 with PTSD and 265 846 never diagnosed with PTSD, were included in the analysis. Baseline mean (SD) age was 40.1 (12.2) years. During median follow-up of 4.9 (interquartile range, 2.1-9.2) years, 4381 women with PTSD (3.3%) and 5559 control individuals (2.1%) developed incident IHD. In a Cox proportional hazards model, PTSD was significantly associated with greater risk of developing IHD (hazard ratio [HR], 1.44; 95% CI, 1.38-1.50). Secondary stratified analyses indicated that younger age identified women veterans with PTSD who were at greater risk of incident IHD. Effect sizes were largest for those younger than 40 years at baseline (HR, 1.72; 95% CI, 1.55-1.93) and decreased monotonically with increasing age (HR for Ն60 years, 1.24; 95% CI, 1.12-1.38).CONCLUSIONS AND RELEVANCE This cohort study found that PTSD was associated with increased risk of IHD in women veterans and may have implications for IHD risk assessment in vulnerable individuals.

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Post‐Traumatic Stress Disorder is Associated with further Increased Parkinson's Disease Risk in Veterans with Traumatic Brain Injury

White

Kunik

et al. 2020

Annals of Neurology

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Objective Determining if traumatic brain injury (TBI) and post‐traumatic stress disorder (PTSD) are risk factors for Parkinson's disease (PD). This constitutes a research priority for the Veterans Administration (VA) with implications for screening policy and prevention. Methods Population‐based, matched case‐control study among veterans using VA health care facilities from October 1, 1999, to September 30, 2013. We identified 176,871 PD cases and 707,484 randomly selected PD‐free matched controls. PD, TBI, and PTSD were ascertained by validated International Classification of Disease 9th revision (ICD)‐9 code‐based algorithms. We examined the association between both risk factors and PD using race‐adjusted conditional logistic regression. Results The overall study cohort prevalence for TBImild, TBInon‐mild, and PTSD was 0.65%, 0.69%, and 5.5%, respectively. Both TBI and PTSD were significantly associated with PD in single‐risk factor race‐adjusted analyses (conditional odds ratio [cOR] = 2.99; 95% confidence interval [CI]: 2.69–3.32), 3.82 (95% CI: 3.67–3.97), and 2.71 (95% CI: 2.66–2.77) for TBImild, TBInon‐mild, and PTSD, respectively). There was suggestive positive interaction observed with comorbid PTSD/TBI in dual‐risk factor analyses, with significant 2.69‐fold and 3.70‐fold excess relative PD risk in veterans with TBImild and TBInon‐mild versus those without TBI when PTSD was present versus 2.17‐fold and 2.80‐fold excess risk when PTSD was absent. Interpretation Our study was the first to demonstrate that both TBI and PTSD are independently associated with increased relative PD risk in a diverse nationwide cohort of military service veterans, and the first to suggest a potential modest synergistic excess risk in those with comorbid TBI/PTSD. Longitudinal research is needed to confirm these suggestive findings. ANN NEUROL 2020 ANN NEUROL 2020;88:33–41

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Post-traumatic Stress Disorder by Gender and Veteran Status

Cited by 217 publications

References 37 publications

Do trauma type, stressful life events, and social support explain women veterans’ high prevalence of PTSD?

Do trauma type, stressful life events, and social support explain women veterans’ high prevalence of PTSD?

Association of Posttraumatic Stress Disorder and Incident Ischemic Heart Disease in Women Veterans

Post‐Traumatic Stress Disorder is Associated with further Increased Parkinson's Disease Risk in Veterans with Traumatic Brain Injury

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