Longitudinal analysis of the relationship between symptoms and quality of life in veterans treated for posttraumatic stress disorder

The Ohio State University, Columbus, Ohio, United States
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 09/2006; 74(4):707-13. DOI: 10.1037/0022-006X.74.4.707
Source: PubMed


This study examined how change in posttraumatic stress disorder (PTSD) symptoms relates to change in quality of life. The sample consisted of 325 male Vietnam veterans with chronic PTSD who participated in a randomized trial of group psychotherapy. Latent growth modeling was used to test for synchronous effects of PTSD symptom change on psychosocial and physical health-related quality of life within the same time period and lagged effects of initial PTSD symptom change on later change in quality of life. PTSD symptoms were associated with reduced quality of life before treatment. There were synchronous effects of symptom change on change in quality of life but no significant lagged effects. Results indicate the importance of measuring quality of life in future investigations of PTSD treatment.

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Available from: Paula Schnurr
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    • "With high rates of HIV (22 %) and hepatitis C (60 %) infections among IDUs in Delhi (NACO 2007; Sharan and Johns Hopkins University 2007), abuses and acts of discrimination as mentioned above are likely to impact on quality of life, and consequently, to interfere with HIV prevention and treatment efforts. Empirical studies have found that perceived discrimination is a significant predictor of subsequent physical and psychological disorder (Kessler et al. 1999; Schnurr et al. 2006; Scogin et al. 2007). Similarly, experiencing discrimination is found to have negative effects on subjective well being. "
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    ABSTRACT: The study examines the association between quality of life (QOL) and discrimination perpetrated against a vulnerable population like injecting drug users (IDU). Given that QOL affects self efficacy which in turn affects behavior, it is relevant to examine QOL among IDUs in the context of HIV prevention, and to study whether discriminations and human rights abuses impact QOL in this population. A cross sectional study was conducted in two research sites in Delhi, India among 343 IDUs recruited through a respondent driven sampling. A Hindi version of the WHOQOL Bref survey along with a survey questionnaire of discrimination were used to interview participants. After controlling for demographic characteristics, experiencing physical and verbal abuse (OR: 0.46, CI 0.27–0.79),arrests and imprisonment for carrying needles and/or using drugs (OR: 0.53, CI 0.31–0.90) and lacking health information (OR: 0.49, CI 0.29–0.85)was associated with lower social QOL, while being denied health care services was associated with lower psychological QOL. The more discrimination experienced, the lower was the quality of life in the social and psychological domains. Participants’ perceived well being in the four domains was related to their living conditions, discriminatory acts and to perceptions of social support. Discriminatory acts and abuses appeared to have a greater toll on their psychological well being and social relationships, thus indicating the need for human rights advocacy in order to influence law enforcement practices and to reduce stigma, while expanding social support through an extended comprehensive IDU programme.
    Full-text · Article · Aug 2013 · Social Indicators Research
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    • "A limitation of these studies is that the association between PTSD symptom changes and health-related quality of life were not directly tested. In contrast, one latent growth modeling study (which directly tested these associations) showed that with change in PTSD, health-related quality of life changes also occurred over 1 year (Schnurr et al., 2006). Yet, the literature is still in the nascent stages of exploring these associations. "
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    ABSTRACT: This study examined the relationship between change in posttraumatic stress disorder (PTSD) symptoms over the course of PTSD treatment and the association with changes in general physical health symptoms. Both positive health habits (e.g., exercise) and negative (e.g., smoking), were examined to determine if they accounted for the association between changes in PTSD severity over time and changes in physical health. Participants were 150 women seeking treatment for PTSD. Latent growth curve modeling indicated a substantial relationship (R 2 = 34 %) between changes in PTSD and changes in physical health that occurred during and shortly following treatment for PTSD. However, there was no evidence to suggest that changes in health behaviors accounted for this relationship. Thus, PTSD treatment can have beneficial effects on self-reported physical health symptoms, even without direct treatment focus on health per se, and is not accounted for by shifts in health behavior.
    Full-text · Article · Mar 2013 · Journal of Behavioral Medicine
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    • "for prolonged exposure; Schnurr et al., 2007), or change in this variable was not reported (Monson et al., 2006; Resick, Nishith, Weaver, Astin, & Feuer, 2002). There is evidence that reductions in PTSD symptoms (such as emotional numbing, hyperarousal, and nightmares) are necessary for improvement in most domains of HRQOL (Lunney & Schnurr, 2007; Schnurr, Hayes, Lunney, McFall, & Uddo, 2006), although there is also some evidence in support of a reverse relationship–that improvement in HRQOL leads to improvement in PTSD symptoms (the effects of which lag in time; Schnurr et al., 2006). Measurement of HRQOL thus allows a more complete assessment of whether a treatment is successful by taking into account not only symptom improvement but also the patient's perception and the effect of the treatment on multiple domains of health (Gladis et al., 1999). "
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    ABSTRACT: Objective: To assess outcomes associated with Mindfulness-Based Stress Reduction (MBSR) for veterans with PTSD. Methods: Forty-seven veterans with posttraumatic stress disorder (PTSD; 37 male, 32 Caucasian) were randomized to treatment as usual (TAU; n = 22), or MBSR plus TAU (n = 25). PTSD, depression, and mental health-related quality of life (HRQOL) were assessed at baseline, posttreatment, and 4-month follow-up. Standardized effect sizes and the proportion with clinically meaningful changes in outcomes were calculated. Results: Intention-to-treat analyses found no reliable effects of MBSR on PTSD or depression. Mental HRQOL improved posttreatment but there was no reliable effect at 4 months. At 4-month follow-up, more veterans randomized to MBSR had clinically meaningful change in mental HRQOL, and in both mental HRQOL and PTSD symptoms. Completer analyses (≥ 4 classes attended) showed medium to large between group effect sizes for depression, mental HRQOL, and mindfulness skills. Conclusions: Additional studies are warranted to assess MBSR for veterans with PTSD.
    Full-text · Article · Jan 2013 · Journal of Clinical Psychology
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