Posttraumatic stress disorder and quality of life: Extension of findings to veterans of wars in Iraq and Afghanistan

National Center for PTSD, Executive Division, United States.
Clinical psychology review (Impact Factor: 7.18). 09/2009; 29(8):727-35. DOI: 10.1016/j.cpr.2009.08.006
Source: PubMed


The wars in Iraq and Afghanistan-Operation Iraqi Freedom and Operation Enduring Freedom, or OEF/OIF-have created unique conditions for promoting the development of psychological difficulties such as posttraumatic stress disorder (PTSD). PTSD is an important outcome because it can affect quality of life, impairing psychosocial and occupational functioning and overall well-being. The literature on PTSD and quality of life in OEF/OIF Veterans is at an early stage, but the consistency of the evidence is striking. Our review indicates that the findings on PTSD and quality of life in OEF/OIF veterans are comparable to findings obtained from other war cohorts and from nonveterans as well. Even though the duration of PTSD in OEF/OIF Veterans is much shorter than in Vietnam Veterans, for example, those with PTSD in both cohorts are likely to experience poorer functioning and lower objective living conditions and satisfaction. The review ends with discussion of the implications of the evidence for research and clinical practice.

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Available from: Michelle J Bovin, Jun 18, 2015
    • "Military service members (SM) deployed to wars in Iraq and Afghanistan are more likely to experience posttraumatic stress disorder (PTSD) symptoms related to both warzone and homefront experiences (Smith et al., 2008; Vasterling et al., 2010) than those who did not deploy. Post-deployment PTSD symptoms are associated with reduced quality of life and functional status in SMs (Schnurr et al., 2009; Tsai et al., 2012), even for those whose symptoms fall short of meeting full diagnostic criteria for PTSD (Cukor et al., 2010; Grubaugh et al., 2005; Magruder et al., 2004). The current literature implies a variable risk for PTSD symptom development, attributable to a number of risk (e.g. "
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    ABSTRACT: Abstract
    07/2015; 2:62-66. DOI:10.1016/j.ynstr.2015.07.001
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    • "mptoms , hazardous drinking , and relationship stress , which persist for at least 9 months after returning home ( Cigrang et al . , 2014 ) . PTSD symptoms resulting from combat - related events can impair quality of life and functional status ( e . g . , degree of disability across domains of health and behav - ior ) among service members ( SMs ; Schnurr et al . , 2009 ) , includ - ing those who are subthreshold , or lacking a sufficient num - ber or distribution of symptoms to meet full criteria for PTSD ( Magruder et al . , 2004 ; Grubaugh et al . , 2005 ; Cukor et al . , 2010 ) . PTSD symptom clusters include re - experiencing ( e . g . , intru - sive memories and bad dreams ) , avoidance ( e . g ."
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    ABSTRACT: Posttraumatic stress disorder (PTSD) symptoms can result in functional impairment among service members (SMs), even in those without a clinical diagnosis. The variability in outcomes may be related to underlying catecholamine mechanisms. Individuals with PTSD tend to have elevated basal catecholamine levels, though less is known regarding catecholamine responses to trauma-related stimuli. We assessed whether catecholamine responses to a virtual combat environment impact the relationship between PTSD symptom clusters and elements of functioning. Eighty-seven clinically healthy SMs, within 2 months after deployment to Iraq or Afghanistan, completed self-report measures, viewed virtual-reality (VR) combat sequences, and had sequential blood draws. Norepinephrine responses to VR combat exposure moderated the relationship between avoidance symptoms and scales of functioning including physical functioning, physical-role functioning, and vitality. Among those with high levels of avoidance, norepinephrine change was inversely associated with functional status, whereas a positive correlation was observed for those with low levels of avoidance. Our findings represent a novel use of a virtual environment to display combat-related stimuli to returning SMs to elucidate mind-body connections inherent in their responses. The insight gained improves our understanding of post-deployment symptoms and quality of life in SMs and may facilitate enhancements in treatment. Further research is needed to validate these findings in other populations and to define the implications for treatment effectiveness.
    Frontiers in Psychology 04/2015; 6. DOI:10.3389/fpsyg.2015.00256 · 2.80 Impact Factor
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    • "life after military service. Disability in occupational functioning , social functioning, and quality of life has been related to psychiatric symptoms in returning veterans (Erbes, Kaler, Schult, Polusny, & Arbisi, 2011; Pietrzak, Goldstein, Malley, Johnson, & Southwick, 2009; Pittman, Goldsmith, Lemmer, Kilmer, & Baker, 2012; Schnurr, Lunney, Bovin, & Marx, 2009). This cohort of veterans could potentially have many years of productive contribution to society ahead, or in some cases, significant, costly disability. "
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    ABSTRACT: Understanding the factors that influence veterans' functional outcome after deployment is critical to provide appropriately targeted care. Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) have been related to disability, but other psychiatric and behavioral conditions are not as well examined. We investigated the impact of deployment-related psychiatric and behavioral conditions on disability among 255 OEF/OIF/OND service members and veterans. Structured clinical interviews assessed TBI and the psychiatric conditions of depression, PTSD, anxiety, and substance use. Self-report questionnaires assessed disability and the behavioral conditions of sleep disturbance and pain. Over 90% of participants had a psychiatric and/or behavioral condition, with approximately half presenting with ≥ 3 conditions. Exploratory factor analysis revealed 4 clinically relevant psychiatric and behavioral factors which accounted for 76.9% of the variance: (a) depression, PTSD, and military mTBI (deployment trauma factor); (b) pain and sleep (somatic factor); (c) anxiety disorders, other than PTSD (anxiety factor); and (d) substance abuse or dependence (substance use factor). Individuals with the conditions comprising the deployment trauma factor were more likely to be substantially disabled than individuals with depression and PTSD, but no military mTBI, OR = 3.52; 95% CI [1.09, 11.37]. Depression, PTSD, and a history of military mTBI may comprise an especially harmful combination associated with high risk for substantial disability. Published 2015. This article is a US Government work and is in the public domain in the USA.
    Journal of Traumatic Stress 02/2015; 28(1). DOI:10.1002/jts.21979 · 2.72 Impact Factor
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