Project VALOR: design and methods of a longitudinal registry of post‐traumatic stress disorder (PTSD) in combat‐exposed Veterans in the Afghanistan and Iraqi military theaters of operations

Rosen, Raymond C.; Marx, Brian P.; Maserejian, Nancy N.; Holowka, Darren W.; Gates, Margaret A.; Sleeper, Lynn A.; Vasterling, Jennifer J.; Kang, Han K.; Keane, Terence M.

doi:10.1002/mpr.355

Cited by 50 publications

(61 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The data from 1,649 male and female veterans who completed both questionnaires and a diagnostic interview were included in Project VALOR. Further details on study design and recruitment are available in previous publications (Rosen et al, 2012). …”

Section: Methodsmentioning

confidence: 99%

Network models of DSM–5 posttraumatic stress disorder: Implications for ICD–11.

Mitchell

Wolf

Bovin

et al. 2017

Journal of Abnormal Psychology

Self Cite

118

View full text Add to dashboard Cite

Recent proposals for revisions to the 11th edition of the International Classification of Diseases (ICD-11) posttraumatic stress disorder (PTSD) diagnostic criteria have argued that the current symptom constellation under the Diagnostic and Statistical Manual of Mental Disorders-5 is unwieldy and includes many symptoms that overlap with other disorders. The newly proposed criteria for the ICD-11 include only six symptoms. However, restricting the symptoms to those included in the ICD-11 has implications for PTSD diagnosis prevalence estimates, and it remains unclear whether these six symptoms are most strongly associated with a diagnosis of PTSD. Network analytic methods, which assume that psychiatric disorders are networks of interrelated symptoms, provide information regarding which symptoms are most central to a network. We estimated network models of PTSD in a national sample of veterans of the Iraq and Afghanistan wars. In the full sample, the most central symptoms were persistent negative emotional state, efforts to avoid external reminders, efforts to avoid thoughts or memories, inability to experience positive emotions, distressing dreams, and intrusive distressing thoughts or memories; i.e., three of the six most central items to the network would be eliminated from the diagnosis under the current proposal for ICD-11. An empirically-defined index summarizing the most central symptoms in the network performed comparably to an index reflecting the proposed ICD-11 PTSD criteria at identifying individuals with an independently-assessed DSM-5 defined PTSD diagnosis. Our results highlight the symptoms most central to PTSD in this sample, which may inform future diagnostic systems and treatment.

show abstract

Section: Methodsmentioning

confidence: 99%

Network models of DSM–5 posttraumatic stress disorder: Implications for ICD–11.

Mitchell

Wolf

Bovin

et al. 2017

Journal of Abnormal Psychology

Self Cite

118

View full text Add to dashboard Cite

show abstract

“…Of the remaining 593 potential participants, 123 (21%) completed the survey. The second recruitment source was an emailed invitation to 278 veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) who were enrolled in a PTSD registry, the Veterans' Afterdischarge Longitudinal Registry (Project VALOR; Rosen et al, 2012). Project VALOR was designed as a longitudinal patient registry of OEF/OIF veterans who have undergone a mental health evaluation in the Veterans Affairs healthcare system, with an overrepresentation of veterans with a PTSD diagnosis (75% of the final sample) and of female veterans (50% of final sample).…”

Section: Methodsmentioning

confidence: 99%

The impact of proposed changes to ICD-11 on estimates of PTSD prevalence and comorbidity

Wisco

Miller

Wolf

et al. 2016

Psychiatry Research

Self Cite

View full text Add to dashboard Cite

The World Health Organization's posttraumatic stress disorder (PTSD) work group has published a proposal for the forthcoming edition of the International Classification of Diseases (ICD-11) that would yield a very different diagnosis relative to DSM-5. This study examined the impact of the proposed ICD-11 changes on PTSD prevalence relative to the ICD-10 and DSM-5 definitions and also evaluated the extent to which these changes would accomplish the stated aim of reducing the comorbidity associated with PTSD. Diagnostic prevalence estimates were compared using a U.S. national community sample and two U.S. Department of Veterans Affairs clinical samples. The ICD-11 definition yielded prevalence estimates 10 to 30 percent lower than DSM-5 and 25 and 50 percent lower than ICD-10 with no reduction in the prevalence of common comorbidities. Findings suggest that by constraining the diagnosis to a narrower set of symptoms, the proposed ICD-11 criteria set would substantially reduce the number of individuals with the disorder. These findings raise doubt about the extent to which the ICD-11 proposal would achieve the aim of reducing comorbidity associated with PTSD and highlight the public health and policy implications of such a redefinition.

show abstract

“…Participants were U.S. Army or Marine Corps veterans enrolled between 2009 and 2012 in the baseline assessment of Project VALOR (Veterans’ After-Discharge Longitudinal Registry), a registry of VA mental health care users with and without PTSD who deployed in support of Operation Enduring Freedom or Operation Iraqi Freedom (see Supplementary Materials and Rosen et al, 2012 for details). To be included veterans must have undergone a mental health evaluation at a VA facility.…”

Section: Methodsmentioning

confidence: 99%

“…We hypothesized that PTSD would be associated with increasing MetS risk over time, and that if there was evidence for MetS influencing subsequent PTSD, that this effect would be weaker in magnitude than that for PTSD predicting MetS. This aim was evaluated in a large national cohort of US military veterans who deployed to the wars in Iraq and/or Afghanistan and who completed two waves of assessments, separated by approximately 2.5 years (see Rosen et al, 2012). As women were over-sampled and represented just over 50% of the cohort, we were also able to evaluate potential sex differences in the relationship between PTSD and MetS.…”

mentioning

confidence: 99%

Longitudinal associations between post-traumatic stress disorder and metabolic syndrome severity

et al. 2016

View full text Add to dashboard Cite

Background Posttraumatic stress disorder (PTSD) is associated with elevated risk for metabolic syndrome (MetS). However, the direction of this association is not yet established, as most prior studies employed cross-sectional designs. The primary goal of this study was to evaluate bidirectional associations between PTSD and MetS using a longitudinal design. Methods 1,355 male and female veterans of the conflicts in Iraq and Afghanistan underwent PTSD diagnostic assessments and their biometric profiles pertaining to MetS were extracted from the electronic medical record at two time points (spanning ~2.5 years, n = 971 at time 2). Results The prevalence of MetS among veterans with PTSD was just under 40% at both time points and was significantly greater than that for veterans without PTSD; the prevalence of MetS among those with PTSD was also elevated relative to age-matched population estimates. Cross-lagged panel models revealed that PTSD severity predicted subsequent increases in MetS severity (β = .08, p = .002), after controlling for initial MetS severity, but MetS did not predict later PTSD symptoms. Logistic regression results suggested that for every 10 PTSD symptoms endorsed at time 1, the odds of a subsequent MetS diagnosis increased by 56%. Conclusions Results highlight the substantial cardiometabolic concerns of young veterans with PTSD and raise the possibility that PTSD may predispose individuals to accelerated aging, in part, manifested clinically as MetS. This demonstrates the need to identify those with PTSD at greatest risk for MetS and to develop interventions that improve both conditions.

show abstract

Project VALOR: design and methods of a longitudinal registry of post‐traumatic stress disorder (PTSD) in combat‐exposed Veterans in the Afghanistan and Iraqi military theaters of operations

Cited by 50 publications

References 43 publications

Network models of DSM–5 posttraumatic stress disorder: Implications for ICD–11.

Network models of DSM–5 posttraumatic stress disorder: Implications for ICD–11.

The impact of proposed changes to ICD-11 on estimates of PTSD prevalence and comorbidity

Longitudinal associations between post-traumatic stress disorder and metabolic syndrome severity

Contact Info

Product

Resources

About