Cardiovascular Disease Risk Factors in Patients with Posttraumatic Stress Disorder (PTSD): A Narrative Review.

Posttraumatic stress disorder (PTSD) is a chronic condition related to severe stress and trauma. There is a mounting evidence about increased prevalence and mortality from cardiovascular diseases (CVD) in patients with PTSD. This review summarizes the current data on possible relations between PTSD and increased risks of CVD, including biological, psychological and behavioral factors. Biological factors refer to increased prevalence of metabolic syndrome (MetS), hypertension, elevation of pro-inflammatory cytokines and homocysteine levels. Peripheral Brain-derived neurotropic factor (BDNF), serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and quantitative electroencephalogram (qEEG) are promising surrogate markers of increased cardiovascular risk. Among psychological factors, some personality traits, such as neuroticism and trait impulsivity/hostility, contribute to the development of PTSD, and are associated with general cardiovascular distress. Recently, type-D (distressed) personality is usually investigated in relation to cardiovascular morbidity, but in populations other than PTSD patients. Behavioral factors refer to unhealthy life-styles, encompassing high smoking rate, drug substances abuse and addiction, physical inactivity and unhealthy diet. The relationships among all these factors are complex and yet incompletely taken into consideration. Because of a high prevalence of CVD in patients with PTSD, there is a strong need for a more intensive focus on this vulnerable population in both primary and secondary cardiovascular prevention as well as in effective treatment possibilities.

Anger in Adulthood in Participants Who Lost Their Father During the War in Croatia When They Were in Their Formative Age.

BACKGROUND: Loss of parents in early childhood can have serious long-term psychological consequences. Abandoned by a close figure of attachment, many persons have developed the emotion of anger, even though the separation was caused by death. The traumatic experience of the loss of a parent is particularly hard in war, because most often it does not occur as an individual trauma. Our aim is to research anger as a personality trait in persons whose father had died in war at a time when they were children, and to compare it with an appropriate civilian control group of subjects. SUBJECTS AND METHODS: The study comprised 155 persons of both sexes. The target group consisted of persons (N=98) whose father had died in the Homeland War and who had just been born at the time of their father's death, or were children or adolescents, and had since their father's death grown up in a single-parent family with their mother, while the control group of subjects (N=57) had not suffered any war losses in the family in the war time from 1991 to 1995. The examined variables were: sex, age, loss of father due to civilian or war causes, marital status, age when the subject lost their father, anger as a state and as a personality trait. STAXI is used in this study; it is frequently used in studies of experiencing, expressing and controlling anger in persons suffering from PTSD. RESULTS: Statistically significant differences were demonstrated in some of the scales and subscales of anger as a state and anger as a personality trait between the abovementioned subject groups, with higher scores in persons who had suffered a civilian loss of father. CONCLUSIONS: The study supports the opinion that the social context in which the grieving person is before, during and after the loss of a close person has an important role in the process of grieving, and eventually defines the social and personal meaning of death.