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Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans.
J Trauma Stress. 2015 Oct; 28(5):410-7.JT

Abstract

The present study examined fluctuation over time in symptoms of posttraumatic stress disorder (PTSD) among 34 combat veterans (28 with diagnosed PTSD, 6 with subclinical symptoms) assessed every 2 weeks for up to 2 years (range of assessments = 13-52). Temporal relationships were examined among four PTSD symptom clusters (reexperiencing, avoidance, emotional numbing, and hyperarousal) with particular attention to the influence of hyperarousal. Multilevel cross-lagged random coefficients autoregression for intensive time series data analyses were used to model symptom fluctuation decades after combat experiences. As anticipated, hyperarousal predicted subsequent fluctuations in the 3 other PTSD symptom clusters (reexperiencing, avoidance, emotional numbing) at subsequent 2-week intervals (rs = .45, .36, and .40, respectively). Additionally, emotional numbing influenced later reexperiencing and avoidance, and reexperiencing influenced later hyperarousal (rs = .44, .40, and .34, respectively). These findings underscore the important influence of hyperarousal. Furthermore, results indicate a bidirectional relationship between hyperarousal and reexperiencing as well as a possible chaining of symptoms (hyperarousal → emotional numbing → reexperiencing → hyperarousal) and establish potential internal, intrapersonal mechanisms for the maintenance of persistent PTSD symptoms. Results suggested that clinical interventions targeting hyperarousal and emotional numbing symptoms may hold promise for PTSD of long duration.

Authors+Show Affiliations

Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, and Boston University School of Medicine, Boston, Massachusetts, USA.Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, and Boston University School of Medicine, Boston, Massachusetts, USA.National Center for PTSD, VA Boston Healthcare System, Department of Psychology, Boston University, and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.National Center for PTSD, VA Boston Healthcare System, Department of Psychology, Boston University, and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, and Boston University School of Medicine, Boston, Massachusetts, USA.Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

26367017

Citation

Doron-LaMarca, Susan, et al. "Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans." Journal of Traumatic Stress, vol. 28, no. 5, 2015, pp. 410-7.
Doron-LaMarca S, Niles BL, King DW, et al. Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans. J Trauma Stress. 2015;28(5):410-7.
Doron-LaMarca, S., Niles, B. L., King, D. W., King, L. A., Pless Kaiser, A., & Lyons, M. J. (2015). Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans. Journal of Traumatic Stress, 28(5), 410-7. https://doi.org/10.1002/jts.22039
Doron-LaMarca S, et al. Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans. J Trauma Stress. 2015;28(5):410-7. PubMed PMID: 26367017.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans. AU - Doron-LaMarca,Susan, AU - Niles,Barbara L, AU - King,Daniel W, AU - King,Lynda A, AU - Pless Kaiser,Anica, AU - Lyons,Michael J, Y1 - 2015/09/14/ PY - 2015/9/15/entrez PY - 2015/9/15/pubmed PY - 2016/8/6/medline SP - 410 EP - 7 JF - Journal of traumatic stress JO - J Trauma Stress VL - 28 IS - 5 N2 - The present study examined fluctuation over time in symptoms of posttraumatic stress disorder (PTSD) among 34 combat veterans (28 with diagnosed PTSD, 6 with subclinical symptoms) assessed every 2 weeks for up to 2 years (range of assessments = 13-52). Temporal relationships were examined among four PTSD symptom clusters (reexperiencing, avoidance, emotional numbing, and hyperarousal) with particular attention to the influence of hyperarousal. Multilevel cross-lagged random coefficients autoregression for intensive time series data analyses were used to model symptom fluctuation decades after combat experiences. As anticipated, hyperarousal predicted subsequent fluctuations in the 3 other PTSD symptom clusters (reexperiencing, avoidance, emotional numbing) at subsequent 2-week intervals (rs = .45, .36, and .40, respectively). Additionally, emotional numbing influenced later reexperiencing and avoidance, and reexperiencing influenced later hyperarousal (rs = .44, .40, and .34, respectively). These findings underscore the important influence of hyperarousal. Furthermore, results indicate a bidirectional relationship between hyperarousal and reexperiencing as well as a possible chaining of symptoms (hyperarousal → emotional numbing → reexperiencing → hyperarousal) and establish potential internal, intrapersonal mechanisms for the maintenance of persistent PTSD symptoms. Results suggested that clinical interventions targeting hyperarousal and emotional numbing symptoms may hold promise for PTSD of long duration. SN - 1573-6598 UR - https://www.unboundmedicine.com/medline/citation/26367017/Temporal_Associations_Among_Chronic_PTSD_Symptoms_in_U_S__Combat_Veterans_ L2 - https://doi.org/10.1002/jts.22039 DB - PRIME DP - Unbound Medicine ER -