The Weight of Traumatic Stress

Kubzansky, Laura D.; Bordelois, Paula; Jun, Hee Jin; Roberts, Andrea L.; Cerdá, Magdalena; Bluestone, Noah; Koenen, Karestan C.

doi:10.1001/jamapsychiatry.2013.2798

Cited by 146 publications

(85 citation statements)

References 46 publications

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“…Higher BMI levels have been shown to have deleterious effects on the physical health and well-being of older adults (Patterson et al, 2004; Yan et al, 2004; Villareal et al, 2005). Combined with the present findings and other studies documenting associations between PTSD and obesity (Simon et al, 2006; Scott et al, 2008; Perkonigg et al, 2009; Maguen et al, 2013; Mitchell et al, 2013; Kubzansky et al, 2014), this suggests that obesity may represent an important mechanism by which PTSD undermines physical health. With older adults facing a myriad of stress-inducing experiences, it is crucial to not only treat the mental health symptoms themselves, but to also be cognizant of physical health complications of stress and stress reactions.…”

Section: Discussionsupporting

confidence: 86%

“…In conjunction with evaluating age as a risk factor for stress-related physical health ailments, the role of gender in the association between obesity risk and PTSD is crucial to examine. While there is growing evidence that PTSD is associated with heightened risk for obesity in women (e.g., Perkonigg et al, 2009; Mitchell et al, 2013; Kubzansky et al, 2014), this association has been more elusive in male samples. For example, in Pagoto and colleagues’ (2012) study, PTSD was found to be significantly associated with overweight in men, but not obesity.…”

Section: Discussionmentioning

confidence: 99%

“…As such, the identification of potentially modifiable mechanisms linking PTSD and these and other chronic conditions is needed. Obesity represents a significant public health problem that is strongly associated with increased disease burden and mortality (Malnick and Knobler, 2006), and early studies in the area have found evidence that PTSD confers heightened risk for obesity for some groups (Scott et al, 2008; Perkonigg et al, 2009; Pagoto et al, 2012; Maguen et al, 2013; Mitchell et al, 2013; Kubzansky et al, 2014). Examining PTSD–obesity risk associations in groups at increased risk for PTSD could advance understanding of the potential mechanisms by which PTSD undermines health over the long term.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

PTSD and obesity in younger and older veterans: Results from the mind your heart study

Smith

Tyzik

Neylan

et al. 2015

Psychiatry Research

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Posttraumatic stress disorder (PTSD) is increasingly recognized as a relatively common condition that is associated with poor health, including obesity. With a sizable proportion of the population approaching older adulthood, it is important to understand PTSD health associations in the context of age. Participants were recruited from two Veterans Administration medical centers and included 380 patients age 60 and over and 365 under age 60. PTSD diagnosis was determined by the Clinician Administered PTSD Scale. BMI was trichotomized into normal/under (≤.24.9), overweight (25.0–29.9), and obese (≥30.0). Models were run in the total sample, as well as stratified by age group, and adjusted for demographics, depression, antipsychotic medication use, and physical activity. Current PTSD was associated with greater likelihood of overweight and obesity in the total sample, and lifetime PTSD was associated with significantly increased odds of obesity. In the stratified models, current and lifetime PTSD were associated with increased likelihood of overweight and obesity in the older group only. Results suggest that PTSD is associated with risk for overweight and obesity, an effect that may be particularly strong in older adults. These findings support the importance of examining PTSD and potential health correlates across the life course.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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PTSD and obesity in younger and older veterans: Results from the mind your heart study

Smith

Tyzik

Neylan

et al. 2015

Psychiatry Research

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“…For example, women with elevated PTSD symptoms in the NHS II have been found to be at increased risk of becoming overweight or obese over time,41 and body mass index has been identified as a major risk factor for PE in NHS participants 19. Furthermore, compared to women with no history of trauma, women with elevated PTSD symptoms in our sample were more likely to smoke cigarettes and use antidepressants—2 behavioral factors that have also been linked to vulnerability to developing VTE 7, 35.…”

Section: Discussionmentioning

confidence: 99%

Associations of Trauma Exposure and Posttraumatic Stress Symptoms With Venous Thromboembolism Over 22 Years in Women

Sumner

Kubzansky

Kabrhel

et al. 2016

JAHA

Self Cite

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BackgroundTrauma exposure and posttraumatic stress disorder (PTSD) have been linked to myocardial infarction and stroke in women, with biological and behavioral mechanisms implicated in underlying risk. The third most common cardiovascular illness, venous thromboembolism (VTE), is a specific health risk for women. Given previous associations with other cardiovascular diseases, we hypothesized that high levels of trauma and PTSD symptoms would be associated with higher risk of incident VTE in younger and middle‐aged women.Methods and ResultsWe used proportional hazards models to estimate hazard ratios (HRs) and 95% CIs for new‐onset VTE (960 events) over 22 years in 49 296 women in the Nurses’ Health Study II. Compared to no trauma exposure, both trauma exposure and PTSD symptoms were significantly associated with increased risk of developing VTE, adjusting for demographics, family history, and childhood adiposity. Women with the most PTSD symptoms exhibited the greatest risk elevation: trauma/6 to 7 symptoms: HR=2.42 (95% CI, 1.83–3.20); trauma/4 to 5 symptoms: HR=2.00 (95% CI, 1.55–2.59); trauma/1 to 3 symptoms: HR=1.44 (95% CI, 1.12–1.84); trauma/no symptoms: HR=1.72 (95% CI, 1.43–2.08). Results were similar, although attenuated, when adjusting for VTE‐relevant medications, medical conditions, and health behaviors.ConclusionsWomen with the highest PTSD symptom levels had nearly a 2‐fold increased risk of VTE compared to women without trauma exposure in fully adjusted models. Trauma exposure alone was also associated with elevated VTE risk. Trauma and PTSD symptoms may be associated with a hypercoagulable state. Treatment providers should be aware that women with trauma exposure and PTSD symptoms may be vulnerable to VTE.

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“…In addition, individuals who endure highly stressful life events often alter their lifestyle choices in a way that would affect cardiovascular health 30. Traumatic life events have been associated with higher chances of smoking, gaining weight, physical inactivity, and elevated CVD risk 10, 11, 31, 32. Pregnancy loss and CVD could also be potentially linked by shared risk factors.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Loss and Carotid Intima–Media Thickness in Mexican Women

Hartasanchez

Flores-Torres²,

Monge³

et al. 2018

JAHA

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BackgroundCardiovascular disease in women often develops without conventional risk factors. Prenatal loss is a common pregnancy outcome that may result in physiological changes can increase the potential future risk of cardiovascular disease. Insufficient information exists regarding the impact of pregnancy loss on early markers of cardiovascular disease risk.Methods and ResultsCross‐sectional analysis of 1767 disease‐free women from the MTC (Mexican Teachers' Cohort) who had been pregnant was used to evaluate the relationship between pregnancy loss and carotid intima–media thickness (IMT). Participants responded to a questionnaire regarding their reproductive history, risk factors, and medical conditions. We defined pregnancy loss as history of miscarriage and/or stillbirth. Trained neurologists measured IMT using ultrasound. We log‐transformed IMT and defined subclinical carotid atherosclerosis (SCA) as IMT ≥0.8 mm and/or plaque. We used multivariable linear and logistic regression models to assess the relation of pregnancy loss, IMT, and SCA. The mean age of participants was 49.8±5.1 years. The prevalence of pregnancy loss was 22%, and we observed SCA in 23% of participants. Comparing participants who reported a pregnancy loss and those who did not, the multivariable‐adjusted odds ratio for SCA was 1.52 (95% confidence interval, 1.12–2.06). Women who experienced a stillbirth had 2.32 higher odds (95% confidence interval, 1.03–5.21) of SCA than those who did not. Mean IMT appeared to be higher in women who reported a pregnancy loss relative to those who did not; nevertheless, this was not statistically significant.ConclusionsPregnancy loss could be linked to cardiovascular disease later in life. The key findings of our study await confirmation and further investigation of the potential underlying mechanisms for this association is required.

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The Weight of Traumatic Stress

Cited by 146 publications

References 46 publications

PTSD and obesity in younger and older veterans: Results from the mind your heart study

PTSD and obesity in younger and older veterans: Results from the mind your heart study

Associations of Trauma Exposure and Posttraumatic Stress Symptoms With Venous Thromboembolism Over 22 Years in Women

Pregnancy Loss and Carotid Intima–Media Thickness in Mexican Women

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