Article

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

ABSTRACT

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
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    • "These include intrusion symptoms (e.g., intrusive thoughts, nightmares and flashbacks), avoidance (i.e., avoiding thoughts, feelings, and people/places related to the traumatic event), negative alterations in mood (inability to remember, distorted cognitions, guilt), and arousal symptoms (e.g., irritability, trouble sleeping, hyperarousal , and startle reflex) [1]. Individuals with PTSD often experience financial, interpersonal, occupational, legal, and/or housing problems [2]. PTSD can be a severe and disabling condition. "
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    ABSTRACT: Background Posttraumatic Stress Disorder (PTSD) is a commonly occurring mental illness. There are multiple treatments for PTSD that have similar effectiveness, but these treatments differ substantially in other ways. It is desirable to have well-informed patients involved in treatment choices. A patient decision aid (PtDA) is one method to achieve this goal. This manuscript describes the rationale and development of a patient decision aid (PtDA) designed for patients with PTSD. Methods We conducted an informational needs assessment of veterans (n = 19) to obtain their baseline information needs prior to the development of the PtDA. We also conducted a literature review of effective PTSD treatments, and we calculated respective effective sizes. A PtDA prototype was developed according to the guidelines from the International Patient Decision Aid Standards. These standards guided our development of both content and format for the PtDA. In accordance with the standards, we gathered feedback from patients (n = 20) and providers (n = 7) to further refine the PtDA. The information obtained from patients and the literature review was used to develop a decision aid for patients with PTSD. Results Patients with PTSD reported a strong preference to receive information about treatment options. They expressed interest in also learning about PTSD symptoms. The patients preferred information presented in a booklet format. From our literature review several treatments emerged as effective for PTSD: Cognitive Therapy, Exposure Therapy, Eye Movement Desensitization Therapy, Selective Serotonin Reuptake Inhibitors, venlafaxine, and risperidone. Conclusion It appears that the criteria set forth to develop decision aids can effectively be applied to PTSD. The resultant PTSD patient decision aid is a booklet that describes the causes, symptoms, and treatments for PTSD. Future work will examine the effects of use of the PTSD decision aid in clinical practice. Trial registration Clinicaltrials.gov identifier NCT00908440. Registered May 20, 2009.
    Preview · Article · Dec 2016 · BMC Psychiatry
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    • "Such deficits are thought to reflect underlying neural abnormalities associated with PTSD, including dysfunction within limbic and paralimbic circuits involving the prefrontal cortex, hippocampus, and amygdala (Rauch, Shin, & Phelps, 2006). In addition to their mechanistic significance, neurocognitive deficits may contribute to the functional impairments that commonly accompany PTSD (Hoge, Terhakopian, Castro, Messer, & Engel, 2007; Rodriguez, Holowka, & Marx, 2012) and adversely affect quality of life (Schnurr, Lunney, Bovin, & Marx, 2009). Memory dysfunction holds particular significance to PTSD, as it ranks high among the cognitive domains commonly impaired in PTSD and has relevance to neuroanatomical models of PTSD implicating the hippocampus and prefrontal cortex as well as to day-to-day functioning (Geuze, Vermetten, de Kloet, Hijman, & Westenberg, 2009). "
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    ABSTRACT: Objective: Posttraumatic stress disorder (PTSD) has been linked with neuropsychological deficits in several areas, including attention, learning and memory, and cognitive inhibition. Although memory dysfunction is among the most commonly documented deficits associated with PTSD, our existing knowledge pertains only to retrospective memory. The current study investigated the relationship between PTSD symptom severity and event-based prospective memory (PM). Method: Forty veterans completed a computerized event-based PM task, a self-report measure of PTSD, and measures of retrospective memory. Results: Hierarchical regression analysis results revealed that PTSD symptom severity accounted for 16% of the variance in PM performance, F(3, 36) = 3.47, p < .05, after controlling for age and retrospective memory. Additionally, each of the three PTSD symptom clusters was related, to varying degrees, with PM performance. Conclusions: Results suggest that elevated PTSD symptoms may be associated with more difficulties completing tasks requiring PM. Further examination of PM in PTSD is warranted, especially in regard to its impact on everyday functioning.
    Full-text · Article · Dec 2015 · Journal of Clinical and Experimental Neuropsychology
    • "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: The development of PTSD after military deployment is influenced by a combination of biopsychosocial risk and resilience factors. In particular, physiological factors may mark risk for symptom progression or resiliency. Research in civilian populations suggests elevated catecholamines after trauma are associated with PTSD months following the trauma. However, less is known regarding physiological markers of PTSD resilience among post-deployment service members (SM). We therefore assessed whether catecholamines obtained shortly after deployment were associated with combat-related PTSD symptoms three months later. Eighty-seven SMs completed the Clinician-Administered PTSD Scale for DSM-IV and blood draws within two months after return from deployment to Iraq or Afghanistan (“Time 1” or “T1”) and three months later (“Time 2” or “T2”). Linear regression analyses demonstrated that lower norepinephrine at T1 was associated with lower PTSD symptoms at T2. In particular, T1 norepinephrine was positively associated with T2 symptom intensity and avoidance symptoms. The present findings represent a biologically-informed method of assessing PTSD resilience after deployment, which may aid clinicians in providing tailored treatments for those in the greatest need. Further research is needed to validate these findings and incorporate physiological measures within an assessment battery.
    No preview · Article · Jul 2015
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