Parallel processes of posttraumatic stress and cardiometabolic dysfunction: A systemic illness of traumatic stress.

Abstract

Objective: To determine if and how cardiometabolic conditions (MetC) may be associated with posttraumatic stress disorder (PTSD) symptoms over time when controlling for the influence of potentially confounding variables. Method: Parallel process latent growth modeling was applied to self-reported longitudinal data collected from 35,788 World Trade Center 9/11 survivors to determine how the development and course of PTSD symptoms and MetC influence each other when controlling for age, sex, race/ethnicity, preexisting traumas, physical health problems, general psychological distress, smoking, and alcohol use. Results: A unidirectional relationship was found in which the intercept of PTSD symptoms predicted the slope of MetC. Hyperarousal (β = .172) and emotional numbing (β = .171) PTSD symptoms demonstrated the strongest association with MetC changes over and above the effects of control variables and potential confounders. Post hoc analyses indicated that utilization of PTSD-related psychotherapy was associated with decreased early presentations of MetC following trauma, which may have vital implications for the integrated treatment of trauma-exposed individuals. Conclusions: Findings have strong theoretical and clinical implications for conceptualizing traumatic stress reactions as systemic processes and utilizing integrated treatment practices following psychological trauma. Public Significance StatementResults from the current study suggest that even when accounting for alternative influences, early posttraumatic stress disorder (PTSD) symptoms, and perhaps particularly hyperarousal and emotional numbing, partially predicted early presentations of and changes in cardiometabolic conditions following trauma. Findings support theories conceptualizing PTSD symptoms as part of a broader systemic illness of traumatic stress reactions that include mental and physical health components. Findings also have strong clinical implications for utilizing integrated treatment practices following psychological trauma, which may help mitigate both PTSD symptoms and cardiometabolic dysfunction.