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Depression and anxiety are linked to deep venous thrombosis (DVT) and posttraumatic disorder (PTSD) increases risk of venous thromboembolism in women. However, the mechanisms underlying this relationship remain unknown. We hypothesized that PTSD would associate with increased DVT risk, that neuroimmune mechanisms would mediate the PTSD-DVT link, and that these associations would be stronger in women. This cohort study included N = 106 427 participants from a large biobank. PTSD and DVT were defined using ICD-10 codes. A subset (N = 1520) underwent imaging, from which we assessed stress-associated neural activity (SNA). High-sensitivity C-reactive protein (hs-CRP) levels and heart rate variability (HRV) were used as indicators of systemic inflammation and autonomic activity, respectively. Linear, logistic, and Cox regressions and mediation analyses were used to test our hypotheses. Of 106 427 participants, 4192 (3.9%) developed DVT. PTSD associated with increased DVT risk (HR [95% CI]: 1.66 [1.34, 2.07], p < .001), and this finding remained significant after adjustment for age, sex, and traditional DVT risk factors. When analyzed separately by sex, PTSD was significantly associated with DVT risk in women but not men. Further, heightened SNA and lower HRV mediated the effect of PTSD on DVT risk. Results suggest that individuals with PTSD are at increased risk for DVT, and that risk is higher in women. This relationship was partially driven by alterations in stress-associated neural activity and autonomic function, suggesting potential targets for preventive therapies. Future studies are needed to investigate whether intervening on PTSD-DVT mechanisms has downstream beneficial effects on DVT, especially among women.
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Although trauma is closely linked with hyperarousal and cardiovascular health, little research has examined the effects of posttraumatic stress symptoms (PTSS) on cardiovascular reactivity to trauma reminders among sexual trauma survivors. One type of negative appraisal after trauma, self-blame, is common after sexual trauma, but its relation to cardiovascular reactivity is unknown. The present study aimed to examine the influence of both PTSS and self-blame on blood pressure and heart rate (HR) reactivity to a trauma reminder. Cardiovascular reactivity was measured before, during, and after a laboratory-based sexual trauma reminder among 72 young adult women who have experienced sexual trauma. Higher PTSS predicted lower diastolic blood pressure (DBP) reactivity during the trauma reminder. Higher levels of self-blame predicted higher HR and systolic blood pressure (SBP) reactivity during and after the trauma reminder. Overall, these findings suggest that survivors of sexual trauma with higher levels of PTSS experience a blunting reaction of DBP when exposed to trauma reminders, as opposed to a more typical cardiovascular stress reaction that may elevate and then extinguish to baseline levels. Meanwhile, individuals with higher levels of self-blame have heightened cardiovascular SBP and HR responses during trauma reminders that do not return to baseline levels, perhaps due to self-blame leading individuals to be more 'on guard' to prevent future threats. Longitudinal studies are needed to explore the potential long-term cardiovascular impacts of heightened self-blame and PTSS and their associated cardiovascular reactivity patterns.
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Given the importance of physical activity (PA) for both physical and mental health, the present study characterizes post-9/11 veterans' leisure-time PA engagement over time. Further, this study examines the relationship between PA and posttraumatic stress symptoms (PTSS), as well as whether this relation differs by gender and time since military discharge. This study was a secondary analysis of a 12-month longitudinal observational investigation of 410 (39.5% female) post-9/11 veterans. Participants completed self-report questionnaires at baseline and 12 months. Over a third of post-9/11 veterans were not engaging in any weekly leisure-time PA at study baseline and PA engagement significantly decreased in the subsequent year. The longitudinal relationship between PA and PTSS depended on both gender and time since military discharge. These results underscore the importance of considering both gender and time since discharge when tailoring interventions to support leisure-time PA as a key health habit in post-9/11 veterans.
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BACKGROUND: Emerging literature has demonstrated deficits in interoception (i.e., the perception of physical sensations from inside the body) in individuals with chronic pain conditions. Mind-body therapies (MBTs) are purported to improve chronic pain in part through improving or restoring interoceptive abilities. The present systematic review and meta-analysis aimed to examine changes in interoception in MBTs for chronic pain conditions. METHODS: A systematic search of PubMed, PsycINFO, Scopus, CINAHL, and ProQuest Dissertation and Theses was conducted from database inception to February 2023. English language intervention studies evaluating the effect of MBTs on interoception in adults with chronic pain conditions were examined. Changes in pain (severity and interference) following treatment were examined as secondary outcomes. RESULTS: A total of 11 studies (10 unique samples) were identified. Meta-analytic results reveal significant improvements in total interoceptive awareness (Becker's d = 1.168, p < .01) as well as improvements in seven of eight subdomains of interoceptive awareness (ds = 0.28 to 0.81). MBTs were also associated with reductions in both pain intensity (d = -1.46, p = .01) and pain interference (d = -1.07, p < .001). CONCLUSIONS: Preliminary research suggests that MBTs demonstrate improvements in interoceptive awareness and reduce pain in adults with chronic pain. Literature on changes in other domains of interoception, such as interoceptive accuracy, following MBTs is severely lacking. Although more rigorous studies are needed to corroborate results, the present findings lay an important foundation for future research to examine interoception as a possible underlying mechanism of MBTs to improve pain outcomes.
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BACKGROUND: The present study examined the relationship between religious/spiritual (R/S) responses to trauma, meaning in life, and psychopathology among US veterans (n = 729). METHODS: Participants (66.7% male and 83.2% White) completed study questionnaires assessing positive religious coping, divine spiritual struggle, meaning in life, posttraumatic stress symptoms (PTSS), and suicidality severity. Assessments were conducted via telephone interviews at baseline (T1), 3 months (T2) and 6 months (T3). RESULTS: Divine spiritual struggle was associated with lower meaning in life, higher suicidality and higher PTSS at all time points. Positive religious coping was associated with higher meaning in life at all time points and lower suicidality at T2. Meaning in life fully mediated relationships between divine spiritual struggle and both PTSS and suicidality. While higher levels of T1 positive religious coping predicted increased T3 PTSS when controlling for T1 PTSS, meaning in life partially mediated this relationship, with a negative indirect effect. Meaning in life also fully mediated the relationship between positive religious coping and later suicidality, with a negative indirect effect. DISCUSSION: These findings suggest that divine spiritual struggle consistently predicts both higher PTSS and suicidality. Further, a sense of meaning plays a large role in linking R/S responses to trauma and psychological outcomes. It holds promise as a means through which positive religious coping may exert beneficial effects. Clinicians should be particularly mindful of negative R/S responses after trauma as a risk factor for adverse psychological outcomes. Future research should examine whether meaning-based interventions are beneficial after trauma.
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Following a traumatic event, coping strategies may affect the natural course of posttraumatic stress symptoms (PTSS). In particular, cognitive coping strategies (how one thinks about stressors) may reduce PTSS by increasing individuals' perceived control over events, appraising them as less threatening, particularly for individuals who experience self-blame after trauma. Individuals who experience a traumatic event (n =344) completed assessments at baseline (T1), one month (T2), and two months (T3). We tested whether T1 cognitive coping strategies (positive reinterpretation, acceptance, religious coping) predicted reduced T3 PTSS and whether this reduction was mediated by increased perceived control at T2. We tested whether this effect was particularly strong for individuals experiencing self-blame. Positive reinterpretation predicted decreases in, religious coping predicted increases in, and acceptance had no direct effect on PTSS. Overall, acceptance showed the greatest potential for reducing PTSS through increased perceived control over one's life. In a fully moderated mediation model, positive reinterpretation significantly interacted and acceptance marginally interacted with self-blame to predict increased perceived control and, subsequently, decreased T3 PTSS. Specifically, acceptance and positive reinterpretation were most helpful for those with higher levels of self-blame. Religious coping interacted with self-blame to predict decreased perceived control and subsequent increased PTSS. For trauma survivors experiencing self-blame, cognitive coping strategies that utilize compassionate self-talk, such as positive reinterpretation and acceptance, may be particularly helpful at increasing perceived control after trauma, while religious coping may have deleterious effects.
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OBJECTIVE: Post-9/11 military deployment is commonly reported as stressful and is often followed by psychological distress after returning home. Yet veterans also frequently report experiencing meaningful military engagement (MME) that may buffer detrimental effects of military stressors. Focusing on the under-investigated topic of association of MME with post-deployment psychological adjustment, this study tests gender differences in MME and post-deployment outcomes. METHOD: This cross-sectional study examined the relationship of MME with deployment stressors, subsequent psychological distress (posttraumatic stress symptoms (PTSS) and depression), and gender among 850 recent-era U.S. veterans (41.4% female). RESULTS: On average, both male and female veterans reported high MME. Greater MME was associated with less PTSS and depression following combat and general harassment, and more depression after sexual harassment. For men only, MME associated with less PTSS after sexual harassment. CONCLUSIONS: MME is high among post-9/11 veterans, but its stress-buffering effects depend on gender and specific stressor exposure.
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Veteranos , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Resiliência Psicológica , Assédio Sexual/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Veteranos/psicologia , Veteranos/estatística & dados numéricosRESUMO
OBJECTIVES: US military veterans face many challenges in transitioning to civilian life; little information is available regarding veterans' reintegration experiences over time. The current study characterized veterans' postdeployment stressful life events and concurrent psychosocial wellbeing over one year and determined how stressors and wellbeing differ by demographic factors. METHODS: Recent Post-911 veterans (n = 402) were assessed approximately every three months for 1 year. Participants were 60% men, primarily White (78%), and 12% Latinx; the average age was 36 years. RESULTS: The frequency of stressful events decreased over time but was higher for men and minority-race veterans (independent of time since separation). Veterans reported high mean levels of posttraumatic stress disorder, anxiety, and insomnia symptoms, which improved slightly over time. Minority-race and Latinx veterans had higher symptom levels and slower rates of symptom reduction. CONCLUSION: Veterans remain distressed in their overall transition to civilian life. Interventions to promote resilience and help veterans manage readjustment to civilian life appear urgently needed.
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Militares , Distúrbios do Início e da Manutenção do Sono , Transtornos de Estresse Pós-Traumáticos , Veteranos , Adulto , Feminino , Humanos , Masculino , Transtornos de Estresse Pós-Traumáticos/epidemiologiaRESUMO
PURPOSE: Adolescents and young adults (AYAs) diagnosed with cancer between ages 15-39 years are a unique and vulnerable population, encountering many typical developmental challenges while also dealing with the demands of illness and its aftermath. Overwhelming evidence demonstrates the importance of social well-being in survivorship quality of life. For AYAs, social connections may be of heightened importance as they assert independence from their parents and create their own personal lives. Few studies have characterized AYA survivors' social well-being and its determinants over time, particularly how psychological adjustment might promote improved social well-being. METHODS: We assessed 83 AYA survivors at two time points across 1 year to characterize their social well-being, identify common social connection concerns, describe how social well-being changes over time, examine how psychological adjustment relates to social well-being at a given time point, and determine whether psychological adjustment predicts changes in social well-being over time. RESULTS: Our sample rated their quality of life as lower than population mean scores, and despite relatively high levels of social support and satisfaction, more than half of participants also reported concerns in specific social well-being domains. On average, social well-being increased across the year. Psychological adjustment was strongly positively related to various aspects of social well-being, and it predicted improved social well-being over time. CONCLUSION: These results suggest that improving psychological adjustment may be important for strengthening social support networks and improving AYAs' lives in survivorship.
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Sobreviventes de Câncer/psicologia , Qualidade de Vida/psicologia , Apoio Social , Adolescente , Adulto , Feminino , Humanos , Masculino , Sobreviventes , Adulto JovemRESUMO
Posttraumatic growth has garnered increasing interest as a potential positive consequence of traumatic events and illnesses. However, scientific investigations have yet to demonstrate the validity of self-reports of posttraumatic growth. The most common measure used to assess this construct is the Post Traumatic Growth Inventory (PTGI); however, the extent to which the PTGI (as well as other self-report measures of perceived posttraumatic growth; PPTG) assess actual positive change remains unknown. The present study aimed to examine the validity of PPTG measures. We assessed 83 adolescent and young adult (AYA) cancer survivors at two time points, one year apart. We measured the stability of PTGI from T1 to T2, correlated three measures of PPTG that used different methods (only positive, positive or negative, positive and negative change) with wellbeing measures, and compared PTGI scores with changes in psychosocial resources. PTGI scores were stable over time. More nuanced measures of PPTG appeared to capture more perceived change, although no measure of PPTG was favorably related to wellbeing. Finally, PTGI did not correlate with change in psychosocial resources, with the exception of spirituality. Overall, our results suggest that measures of PPTG do not capture actual positive changes experienced by AYA cancer survivors.