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- Title
Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans.
- Authors
Doron‐LaMarca, Susan; Niles, Barbara L.; King, Daniel W.; King, Lynda A.; Pless Kaiser, Anica; Lyons, Michael J.; Doron-LaMarca, Susan; Pless Kaiser, Anica
- Abstract
The present study examined fluctuation over time in symptoms of posttraumatic stress disorder (PTSD) among 34 combat veterans (28 with diagnosed PTSD, 6 with subclinical symptoms) assessed every 2 weeks for up to 2 years (range of assessments = 13-52). Temporal relationships were examined among four PTSD symptom clusters (reexperiencing, avoidance, emotional numbing, and hyperarousal) with particular attention to the influence of hyperarousal. Multilevel cross-lagged random coefficients autoregression for intensive time series data analyses were used to model symptom fluctuation decades after combat experiences. As anticipated, hyperarousal predicted subsequent fluctuations in the 3 other PTSD symptom clusters (reexperiencing, avoidance, emotional numbing) at subsequent 2-week intervals (rs = .45, .36, and .40, respectively). Additionally, emotional numbing influenced later reexperiencing and avoidance, and reexperiencing influenced later hyperarousal (rs = .44, .40, and .34, respectively). These findings underscore the important influence of hyperarousal. Furthermore, results indicate a bidirectional relationship between hyperarousal and reexperiencing as well as a possible chaining of symptoms (hyperarousal → emotional numbing → reexperiencing → hyperarousal) and establish potential internal, intrapersonal mechanisms for the maintenance of persistent PTSD symptoms. Results suggested that clinical interventions targeting hyperarousal and emotional numbing symptoms may hold promise for PTSD of long duration.
- Subjects
MASSACHUSETTS; UNITED States; POST-traumatic stress disorder; AMERICAN veterans; SYMPTOMS; MULTILEVEL models; AUTOREGRESSION (Statistics); TIME series analysis; AROUSAL (Physiology); DIAGNOSIS of post-traumatic stress disorder; CHRONIC diseases; LONGITUDINAL method; VETERANS; RESEARCH funding; SICKNESS Impact Profile; TIME; PSYCHOLOGY of veterans; WAR; SEVERITY of illness index
- Publication
Journal of Traumatic Stress, 2015, Vol 28, Issue 5, p410
- ISSN
0894-9867
- Publication type
journal article
- DOI
10.1002/jts.22039