Posttraumatic Stress Disorder and Functioning and Quality of Life Outcomes in a Nationally Representative Sample of Male Vietnam Veterans

Zatzick, Douglas; Marmar, Charles R.; Weiss, Daniel S.; Browner, Warren S.; Metzler, Thomas J.; Golding, Jacqueline M.; Stewart, Anita L.; Schlenger, William E.; Wells, Kenneth B.

doi:10.1176/ajp.154.12.1690

Cited by 444 publications

(286 citation statements)

References 38 publications

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“…Among studies that examined PTSD symptom severity rather than presence or absence of diagnosis, greater symptom severity tended to be positively correlated with greater impairment. In the National Vietnam Veterans Readjustment Study, PTSD status was strongly associated with physical limitations, not working, compromised physical health, and diminished well-being, even when controlling for demographic factors and other comorbid conditions such as depression, alcohol use disorder, panic disorder, and other medical conditions [13].…”

Section: Studies Suggest That Iraq or Afghanistan Veterans (Operationmentioning

confidence: 97%

Prospective prediction of functional difficulties among recently separated Veterans

Larson

Norman

2014

J Rehabil Res Dev

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Abstract-Reports of functional problems are common amongVeterans who served post-9/11 (more than 25% report functional difficulties in at least one domain). However, little prospective work has examined the risk and protective factors for functional difficulties among Veterans. In a sample of recently separated Marines, we used stepwise logistic and multiple regressions to identify predictors of functional impairment, including workrelated problems, financial problems, unlawful behavior, activity limitations due to mental health symptoms, and perceived difficulty reintegrating into civilian life. Posttraumatic stress disorder symptoms assessed both before and after military separation significantly predicted functional difficulties across all domains except unlawful behavior. Certain outcomes, such as unlawful behavior and activity limitations due to mental health symptoms, were predicted by other or additional predictors. Although several forms of functioning were examined, the list was not exhaustive. The results highlight a number of areas where targeted interventions may facilitate the reintegration of military servicemembers into civilian life.

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Section: Studies Suggest That Iraq or Afghanistan Veterans (Operationmentioning

confidence: 97%

Prospective prediction of functional difficulties among recently separated Veterans

Larson

Norman

2014

J Rehabil Res Dev

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“…There are consistent findings about the lower quality of life among traumatized people (d'Ardenne et al, 2005.;Priebe et al, 2004.;Schnurr et al, 2006;Zatzick et al, 1997;Magruder et al, 2004.;Clancy et al, 2006). If we understand the concept of quality of life as a complex subjective experience of people which depends on objective circumstances of life, personality of the individual, ways of interpretation of events, value system, and expectations (Ajduković et al, 2007), then the question is what psychological variables moderate a perception of such low quality of life in traumatized people?…”

Section: Introductionmentioning

confidence: 67%

“…Priebe et al (2004) showed that people who have sought psychiatric help and had more posttraumatic, depressive, and anxiety disturbances had also a poorer quality of life. Several studies of Vietnam veterans examined the impact of PTSD on QoL using a wide range of measures and showed that PTSD negatively affected QoL in both females and males (Schnurr et al, 2006;Zatzick et al, 1997;Magruder et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

War Veterans' Quality of Life: The Impact of Lifetime Traumatic Experiences, Psychological and Physical Health-Related Characteristics

Antičević¹,

Kardum²,

Britvić³

2011

Drustvena istrazivanja

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The purpose of this study was to evaluate the cross-sectional differences in self-reported psychological symptoms, life-time exposure to traumatic events, coping styles, personality traits and overall quality of life between the PTSD and non-PTSD Croatian War veterans. A total of 113 subjects within the three groups participated in the study (veterans with PTSD, non-PTSD veterans and controls). Veterans with PTSD assessed both combat experiences and exposure to other life-time traumatic events as extremely stressful, much more so than veterans without PTSD or control subjects. Scores among the non-PTSD veterans were similar to the control subjects, except on the M-PTSD scale, scale of psychosomatic symptoms and coping by avoidance. Intensity of PTSD, extraversion and active coping were individually significant in explaining the total QoL (p<0.01). This study showed that veterans with PTSD became extremely vulnerable to lifetime stress events.

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“…The study of functional impairment may be particularly relevant among veteran samples, where individuals with PTSD experience poorer health functioning, increased disability (Goldberg et al, 2014), greater functional impairment, and reduced quality of life compared to veterans without PTSD (Shea, Vujanovic, Mansfield, Sevin, & Liu, 2010; Zatzick et al, 1997). Moreover, among trauma-exposed men, combat trauma has been related to greater incidence of PTSD, unresolved PTSD symptoms, and unemployment (Prigerson, Maciejewski, & Rosenheck, 2001).…”

Section: Introductionmentioning

confidence: 99%

Dissociative symptoms mediate the relation between PTSD symptoms and functional impairment in a sample of military members, veterans, and first responders with PTSD

Boyd

Protopopescu

O’Connor

et al. 2018

European Journal of Psychotraumatology

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Background: Posttraumatic Stress Disorder (PTSD) is associated with significant functional impairment in important areas, including interpersonal relationships and occupational or educational roles. Preliminary evidence suggests that the dissociative subtype of PTSD (PTSD+DS), characterized by marked symptoms of depersonalization and derealization, is associated with increased functional impairment and disease severity, including among military members and veterans diagnosed with PTSD. Similarly, first responders (e.g. police, fire, paramedics) have also been found to experience dissociative symptoms. Despite these findings, little work has investigated whether dissociative symptoms are related to heightened functional impairment among these populations.Objective: We examined the relation between functional impairment and symptom level variables, including dissociative symptoms of depersonalization and derealization among military members, veterans, and first responders with probable PTSD. We further investigated the hypothesis that dissociative symptoms mediate the relation between PTSD symptomatology and functional impairment.Method: Eighty-one medical charts of inpatients at a residential PTSD treatment programme were accessed via retrospective review. Sixty-two were included in the present analyses. Comparison of means on symptom measures between first responders and military members/veterans were conducted, followed by correlational and mediation analyses.Results: Compared with first responders, military members and veterans showed higher levels of derealization, functional impairment, alexithymia, anxiety, and depression. Within the total sample, dissociative symptoms emerged as the strongest correlate of functional impairment and, among the dissociative symptom clusters, derealization symptoms demonstrated the strongest relation with impairment. Mediation analyses revealed that total dissociative symptoms and derealization symptoms significantly mediated the relation between PTSD symptoms and functional impairment.Conclusions: These findings highlight the importance of assessing and treating dissociative symptoms, consistent with the dissociative subtype of PTSD, among military members, veterans, and first responders with PTSD. Successful recovery on a functional and symptomatic level may necessitate treatment of dissociative symptoms, particularly derealization.

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Posttraumatic Stress Disorder and Functioning and Quality of Life Outcomes in a Nationally Representative Sample of Male Vietnam Veterans

Cited by 444 publications

References 38 publications

Prospective prediction of functional difficulties among recently separated Veterans

Prospective prediction of functional difficulties among recently separated Veterans

War Veterans' Quality of Life: The Impact of Lifetime Traumatic Experiences, Psychological and Physical Health-Related Characteristics

Dissociative symptoms mediate the relation between PTSD symptoms and functional impairment in a sample of military members, veterans, and first responders with PTSD

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