The Influence of Posttraumatic Stress Disorder Numbing and Hyperarousal Symptom Clusters in the Prediction of Physical Health Status in Veterans With Chronic Tobacco Dependence and Posttraumatic Stress Disorder

Harder, Laura; Chen, Shuo; Baker, Dewleen G.; Chow, Bruce K.; McFall, Miles; Saxon, Andrew J.; Smith, Mark W.

doi:10.1097/nmd.0b013e3182392bfb

Cited by 25 publications

(13 citation statements)

References 35 publications

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“…Additionally, our study lends further support to previously published findings that identified depression as a factor with a large effect on physical HRQoL (Aversa et al, 2012;Harder et al, 2011). In the omnibus model with childhood maltreatment, PTSD, and depression predicting physical HRQoL, only depression explained a significant proportion of the variance in HRQoL, 10% of the unique variance.…”

Section: Discussionsupporting

confidence: 77%

Impact of childhood maltreatment on physical health-related quality of life in U.S. active duty military personnel and combat veterans

Aversa

Lemmer

Nunnink

et al. 2014

Child Abuse & Neglect

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a b s t r a c tPrevious studies have found an association between childhood maltreatment (CM) and health-related quality of life (HRQoL), and to a lesser extent have considered whether psychiatric symptoms may explain the relationship. This study aimed to further our understanding of the link between CM and HRQoL by testing whether posttraumatic stress disorder (PTSD) or depressive symptoms mediate the relationship between childhood maltreatment and physical HRQoL. Mediation models were examined in a sample of male Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) active duty and combat veterans (n = 249). PTSD and depressive symptoms mediated the relationship between CM and overall physical HRQoL, as well as participation in daily activities due to physical health, bodily pain, and social functioning. Mediation of the relationship between childhood maltreatment and physical and social functioning by depression and PTSD symptoms may lend support to neurobiological hypotheses that childhood maltreatment sensitizes the nervous system and after repeated trauma may lead to the development of psychiatric symptoms, which have a major impact on morbidity and mortality.Published by Elsevier Ltd.

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Section: Discussionsupporting

confidence: 77%

Impact of childhood maltreatment on physical health-related quality of life in U.S. active duty military personnel and combat veterans

Aversa

Lemmer

Nunnink

et al. 2014

Child Abuse & Neglect

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“…PTSR have consistently been associated with a broad spectrum of physical health problems in adult trauma survivors, such as musculoskeletal bodily pain, gastroenterological and cardiovascular symptoms (Asnaani, Reddy, & Shea, 2014;Bugge et al, 2017;Gupta, 2013;Harder et al, 2011). In the context of trauma exposure, researchers have suggested a neurobiological pathway linking PTSR to physical health problems, suggesting that PTSR activate the body's stress regulation system, leading to both overand underactivation of systems controlling immune and inflammation responses (Kearney et al, 2010).…”

Section: Ptsr and Physical Healthmentioning

confidence: 99%

The mediating role of posttraumatic stress reactions in the relationship between child abuse and physical health complaints in adolescence and young adulthood

Rueness

Myhre

Strøm

et al. 2019

European Journal of Psychotraumatology

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Background: Child abuse is associated with physical health problems in adolescence and adulthood, but the mechanisms involved are unclear. A possible mediating effect of posttraumatic stress reactions (PTSR) linking child abuse with later physical health complaints has not been fully investigated. Objective: The current study investigated whether PTSR could be a potential mediator in the relationship between child abuse and physical health complaints in adolescents and young adults. If so, we also investigated whether this was the case for different child abuse types alone or in combination. Method: The study sample comprised 506 adolescents and young adult victims of child abuse and 504 unexposed matched controls aged 16-33 from a community sample. We measured child abuse retrospectively and current PTSR at wave 1 (2013), and current physical health complaints at wave 2 (2014/15). We tested a model of PTSR as a possible mediator between child abuse and physical health complaints and conducted causal mediation analysis to estimate direct and indirect pathways. Each child abuse type was studied in isolation and in combination with other abuse types. Results: PTSR had a notable, significant mediating effect on the relationship between child abuse and physical health complaints in our overall model (average causal mediation effect; ACME = 0.14, p < 0.001), accounting for 85% of the total effect. The mediated pathway was also significant in analyses of the different child abuse types. The mediating effect of PTSR was most prominent in individuals reporting exposure to more than one child abuse type. Conclusions: The current study indicates that PTSR may be an important mediator in the relationship between child abuse and physical health complaints. Health professionals should be aware of the important role that PTSR may have in maintaining or exacerbating physical health problems in child abuse victims. However, a reverse model could not be tested in this study and the results need confirmation in future prospective studies.

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“…For instance, Harder et al. () found that hyperarousal was significantly associated with most physical health domains in a sample of tobacco‐dependent veterans with chronic PTSD. However, this study was based on a relatively older population and was limited to participants with PTSD and nicotine dependence.…”

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confidence: 99%

“…Hyperarousal symptoms, such as poor sleep and persistent hypervigilance, are thought to negatively impact physical health given the way this particular cluster of symptoms interferes with body functioning. For instance, Harder et al (2011) found that hyperarousal was significantly associated with most physical health domains in a sample of tobacco-dependent veterans with chronic PTSD. However, this study was based on a relatively older population and was limited to participants with PTSD and nicotine dependence.…”

mentioning

confidence: 99%

“…In terms of general functioning, authors of a number of studies have found that emotional numbing symptoms are associated with poorer functioning beyond the effects of reexperiencing and hyperarousal symptoms (e.g., Harder et al, 2011;Miller, Wolf, Martin, Kaloupek, & Keane, 2008;Ruscio, Weathers, King, & King, 2002;Schnurr & Lunney, 2008). Additionally, Shea, Vujanovic, Mansfield, Sevin, and Liu (2010) found that the numbing/avoidance symptom cluster was associated with poor interpersonal and social functioning, while hyperarousal was associated with overall PTSD severity and distress in service members returning from recent military conflicts in Iraq and Afghanistan.…”

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confidence: 99%

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The Influence of Posttraumatic Stress Disorder on Health Functioning in Active‐Duty Military Service Members

Asnaani

Kaczkurkin

Benhamou

et al. 2018

Journal of Traumatic Stress

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Researchers have suggested that posttraumatic stress disorder (PTSD) is associated with significant healthcare burden and utilization of medical services. The purpose of this study was to examine the impact of PTSD symptoms on health functioning among active-duty military personnel. Participants in the study were 366 treatment-seeking service members who had returned from deployment and were participating in a larger PTSD treatment study. Assessments included measures of PTSD symptom severity, combat experiences, life stress, health functioning, alcohol use, and depression. We hypothesized that at baseline, PTSD severity and its symptom clusters would be significantly associated with poorer physical and mental health functioning. We conducted separate hierarchical multiple regressions to examine the predictive contribution the hypothesized factors would have on the variance in physical and mental health scores. Consistent with previous literature, we found that PTSD severity was significantly associated with poorer mental health functioning, B = -0.25, SE = 0.08, β = -0.15, t(342) = -3.07, R = .37, p = .002; however, contrary to our hypotheses, PTSD severity was not associated with poorer physical health functioning. Further, the hyperarousal symptom cluster was significantly associated with poorer physical health functioning, B = -0.83, SE = 0.26, β = -0.18, t(340) = -3.16, R = .11, p = .002, but not mental health functioning. Limitations of our study included the use of self-report measures only and lack of objective measures. Future directions for study include examination of how health functioning perceptions change over a longer duration of PTSD symptoms and after treatment.

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The Influence of Posttraumatic Stress Disorder Numbing and Hyperarousal Symptom Clusters in the Prediction of Physical Health Status in Veterans With Chronic Tobacco Dependence and Posttraumatic Stress Disorder

Cited by 25 publications

References 35 publications

Impact of childhood maltreatment on physical health-related quality of life in U.S. active duty military personnel and combat veterans

Impact of childhood maltreatment on physical health-related quality of life in U.S. active duty military personnel and combat veterans

The mediating role of posttraumatic stress reactions in the relationship between child abuse and physical health complaints in adolescence and young adulthood

The Influence of Posttraumatic Stress Disorder on Health Functioning in Active‐Duty Military Service Members

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