Posttraumatic stress disorder–related anhedonia as a predictor of psychosocial functional impairment among United States veterans

Abstract

Prior research suggests that anhedonia symptoms related to posttraumatic stress disorder (PTSD; i.e., diminished interest, detachment from others, and difficulty experiencing positive emotions) are consistently associated with a higher degree of impairment in psychosocial functioning beyond that associated with other PTSD symptoms. Unfortunately, much of this research has used cross‐sectional study designs; relied upon outdated DSM diagnostic criteria; and failed to control for potentially confounding variables, such as the presence of co‐occurring depression. This study used data from Waves 2 and 4 (n = 1,649) of the Veterans’ After‐Discharge Longitudinal Registry (Project VALOR), a longitudinal dataset of U.S. Army and Marine veterans. As measured using the Inventory of Psychosocial Functioning, Wave 4 psychosocial functioning was regressed on seven PTSD symptom factors at Wave 2 (i.e., intrusions, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal) and potential Wave 2 confounds. The Anhedonia factor, β = .123, most strongly predicted later psychosocial functional impairment beyond the impact of other PTSD symptom factors, βs = −.076–.046. Clinical implications of these findings are also discussed.

Brief family involvement enhances veteran homework quality during trauma-focused psychotherapy.

“…Posttraumatic stress disorder (PTSD) is a highly prevalent diagnosis among veterans (Seal, 2007;Wisco et al, 2014), and epidemiological data suggests that rates of the diagnosis are rising at faster rates than other disorders in this population (Hunt et al, 2019). PTSD is linked with heightened functional impairment (May et al, 2022), substance abuse (Livingston et al, 2022), and rates of suicide (Akbar et al, 2023). Given the deleterious effects that PTSD can have on individuals, much focus has been devoted to developing trauma-focused treatments to help alleviate symptoms.…”

Positive emotion in posttraumatic stress disorder: A global or context‐specific problem?

“…Despite the importance of positive psychological processes in PTSD, most research has focused on negative emotions (e.g., fear and anxiety; Foa et al, 1986), memories (e.g., disturbances in autobiographical trauma memory; Brewin, 2011), and cognitions (e.g., negative appraisals; Ehlers & Clark, 2000). This is problematic because positive emotions (e.g., happiness), cognitions (e.g., positive self-statements and self-talk), and memories (e.g., positive autobiographical memories) are often neglected relative to negative processes in empirically validated PTSD treatments (Contractor et al, 2022) and because anhedonia symptoms are associated with more functional impairment than other PTSD symptom factors (May et al, 2022). In this study, we sought to reduce this research gap by examining positive emotion in the daily lives of trauma-exposed community members with and without PTSD.…”