Relationships among trauma exposure, chronic posttraumatic stress disorder symptoms, and self‐reported health in women: Replication and extension

Abstract

Fifty-two women who served during the Vietnam era were assessed for war-zone exposure, traumatic life events, post-traumatic stress disorder (PTSD), and self-reported health status. Symptoms of PTSD were examined as mediators in the relationship between traumatic exposure and subsequent reports of health problems. Results showed that PTSD symptoms accounted significantly for variance in health problems reported by women with prior traumatic stressor exposure. When the cardinal symptom domains of PTSD (re-experiencing, numbing, avoidance, hyper-arousal) were analyzed separately, the symptom cluster representing hyper-arousal accounted uniquely for the variance associated with health complaints, beyond that contributed by other symptom clusters. Discussion of the results focuses on mechanisms underlying the relationship between specific symptoms of PTSD and self-reported health. Implications for intervention within the medical system are also considered.

Childhood trauma and adulthood physical health in Mexico

“…Reviews and past research have emphasized an indirect pathway between trauma, PTSD and physical health (Friedman and Schnurr 1995;Kimerling et al 2000;Norris et al 2006;Schnurr and Green 2004;Schnurr and Jankowski 1999;Zoellner et al 2000). Others have proposed that individuals who develop depression following traumatic events may also be at increased risk of adverse health outcomes (Ford 2004).…”

The structure of post-traumatic stress disorder symptoms in three female trauma samples: A comparison of interview and self-report measures

“…In most cases authors are permitted to post their version of the article (e.g. (Foa, Zinbarg, & Rothbaum, 1992), and may bear different functional relationships with interpersonal functioning, with physical health, and with symptoms often found co-morbid with post-traumatic stress symptoms (Kimerling, Clum, & Wolfe, 2000;Ruscio, Weathers, King, & King, 2002;Stewart, Conrod, Pihl, & Dongier, 1999;Stewart, Pihl, Conrod, & Dongier, 1998). Thus, a clear understanding of the nature of PTSD symptom clusters has the potential to inform both knowledge of how various PTSD symptoms develop and how these symptoms relate to co-occurring difficulties.…”

Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey-Replication (NCS-R)

“…In fact, extant research has also demonstrated a robust relationship between trauma exposure and poor physical health (Hidalgo & Davidson, 2000;Norman, 2006;Schnurr, Spiro, Aldwin, & Stukel, 1998;Ullman & Siegel, 1996), with the development of PTSD following trauma exposure being posited as the primary mechanism through which trauma results in adverse health outcomes (for reviews see Friedman & Schnurr, 1995; Schnurr & Green, 2004). Some research has lent support to this theory in that after controlling for PTSD symptoms, the association between trauma exposure and subjective evaluation of physical health status became nonsignificant or was greatly reduced (Cloitre, Cohen, Edelman, & Han, 2001;Kimerling, Clum, & Wolfe, 2000;Lang, Laffaye, Satz, McQuaid, Malcarne, Dresselhaus et al, 2006;Norris, Slone, Baker, & Murphy, 2006;Vedantham et al, 2001;Wagner et al, 2000;Wolfe et al, 1994). For example, among female Vietnam veterans, the relationship between trauma exposure and poor subjective health status and global health perception became nonsignificant once PTSD symptoms were taken into account (Kimerling et al, 2000).…”

“…Some research has lent support to this theory in that after controlling for PTSD symptoms, the association between trauma exposure and subjective evaluation of physical health status became nonsignificant or was greatly reduced (Cloitre, Cohen, Edelman, & Han, 2001;Kimerling, Clum, & Wolfe, 2000;Lang, Laffaye, Satz, McQuaid, Malcarne, Dresselhaus et al, 2006;Norris, Slone, Baker, & Murphy, 2006;Vedantham et al, 2001;Wagner et al, 2000;Wolfe et al, 1994). For example, among female Vietnam veterans, the relationship between trauma exposure and poor subjective health status and global health perception became nonsignificant once PTSD symptoms were taken into account (Kimerling et al, 2000).Alternately, research focused on the more direct role of trauma on physical health has suggested that it may be the cumulative effect of multiple lifetime traumas that translates into chronic medical conditions via chronic over-activation of the physiological stress pathways (i.e. hypothalamic-pituitary-adrenal axis, sympathetic nervous system) resulting in wear and tear to bodily systems (e.g.…”