PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among U.S. veterans
Posttraumatic stress disorder (PTSD) is a risk factor for cardiovascular disease (CVD) and diabetes. Dedert and colleagues hypothesized a model whereby PTSD leads to poor health behaviors, depression, and pre-clinical disease markers, and that these factors lead to CVD and diabetes (Ann Behav Med, 2...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-09-01
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| Series: | Preventive Medicine Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335519301044 |
| _version_ | 1818293513897377792 |
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| author | Katherine D. Hoerster Sarah Campbell Marketa Dolan Cynthia A. Stappenbeck Samantha Yard Tracy Simpson Karin M. Nelson |
| author_facet | Katherine D. Hoerster Sarah Campbell Marketa Dolan Cynthia A. Stappenbeck Samantha Yard Tracy Simpson Karin M. Nelson |
| author_sort | Katherine D. Hoerster |
| collection | DOAJ |
| description | Posttraumatic stress disorder (PTSD) is a risk factor for cardiovascular disease (CVD) and diabetes. Dedert and colleagues hypothesized a model whereby PTSD leads to poor health behaviors, depression, and pre-clinical disease markers, and that these factors lead to CVD and diabetes (Ann Behav Med, 2010, 61–78). This study provides a preliminary test of that model. Using data from a mailed cross-sectional survey conducted 2012–2013, path analysis was conducted among N = 657 with complete demographic data. We first analyzed the hypothesized model, followed by four alternatives, to identify the best-fitting model. The alternate model that specified pathways from depression to health behaviors had the best fit. Contrary to hypotheses, higher PTSD symptoms were associated with better physical activity and diet quality. Of the specific indirect pathways from PTSD to Body Mass Index (BMI), only the path through depression was significant. Higher depression symptoms were significantly associated with less physical activity, poorer diet, and greater likelihood of smoking. In addition, the specific indirect effect from depression to BMI through physical activity was significant. Current smoking and higher BMI were associated with greater likelihood of diabetes, and hypertension was associated with greater likelihood of CVD. PTSD symptoms may increase risk for CVD and diabetes through the negative impact of depression on health behaviors and BMI. With or without PTSD, depression may be an important target in interventions targeting cardiovascular and metabolic diseases among veterans. Keywords: PTSD, Depression, Cardiovascular disease, Diabetes, Health behavior |
| first_indexed | 2024-12-13T03:17:03Z |
| format | Article |
| id | doaj.art-65d1d9f790e749a7a6ace79884baaacb |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-12-13T03:17:03Z |
| publishDate | 2019-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-65d1d9f790e749a7a6ace79884baaacb2022-12-22T00:01:27ZengElsevierPreventive Medicine Reports2211-33552019-09-0115PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among U.S. veteransKatherine D. Hoerster0Sarah Campbell1Marketa Dolan2Cynthia A. Stappenbeck3Samantha Yard4Tracy Simpson5Karin M. Nelson6VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development Service, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States; VA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 South Columbian Way (S-116), Seattle, WA 98108, United States; University of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45th Street, Suite 300, Seattle, WA 98105, United States; Corresponding author at: 1660 South Columbian Way (S-152), Seattle, WA 98108, United States.VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development Service, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States; VA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 South Columbian Way (S-116), Seattle, WA 98108, United States; University of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45th Street, Suite 300, Seattle, WA 98105, United StatesVA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 South Columbian Way (S-116), Seattle, WA 98108, United StatesUniversity of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45th Street, Suite 300, Seattle, WA 98105, United StatesVA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 South Columbian Way (S-116), Seattle, WA 98108, United StatesVA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 South Columbian Way (S-116), Seattle, WA 98108, United States; University of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45th Street, Suite 300, Seattle, WA 98105, United States; Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care, 1660 S. Columbian Way, Seattle, WA 98108, United StatesVA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development Service, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States; VA Puget Sound Healthcare System, General Internal Medicine Service, 1660 South Columbian Way, Seattle, WA 98108, United States; University of Washington Department of Medicine, 1959 NE Pacific St, Seattle, WA 98195, United StatesPosttraumatic stress disorder (PTSD) is a risk factor for cardiovascular disease (CVD) and diabetes. Dedert and colleagues hypothesized a model whereby PTSD leads to poor health behaviors, depression, and pre-clinical disease markers, and that these factors lead to CVD and diabetes (Ann Behav Med, 2010, 61–78). This study provides a preliminary test of that model. Using data from a mailed cross-sectional survey conducted 2012–2013, path analysis was conducted among N = 657 with complete demographic data. We first analyzed the hypothesized model, followed by four alternatives, to identify the best-fitting model. The alternate model that specified pathways from depression to health behaviors had the best fit. Contrary to hypotheses, higher PTSD symptoms were associated with better physical activity and diet quality. Of the specific indirect pathways from PTSD to Body Mass Index (BMI), only the path through depression was significant. Higher depression symptoms were significantly associated with less physical activity, poorer diet, and greater likelihood of smoking. In addition, the specific indirect effect from depression to BMI through physical activity was significant. Current smoking and higher BMI were associated with greater likelihood of diabetes, and hypertension was associated with greater likelihood of CVD. PTSD symptoms may increase risk for CVD and diabetes through the negative impact of depression on health behaviors and BMI. With or without PTSD, depression may be an important target in interventions targeting cardiovascular and metabolic diseases among veterans. Keywords: PTSD, Depression, Cardiovascular disease, Diabetes, Health behaviorhttp://www.sciencedirect.com/science/article/pii/S2211335519301044 |
| spellingShingle | Katherine D. Hoerster Sarah Campbell Marketa Dolan Cynthia A. Stappenbeck Samantha Yard Tracy Simpson Karin M. Nelson PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among U.S. veterans Preventive Medicine Reports |
| title | PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among U.S. veterans |
| title_full | PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among U.S. veterans |
| title_fullStr | PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among U.S. veterans |
| title_full_unstemmed | PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among U.S. veterans |
| title_short | PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among U.S. veterans |
| title_sort | ptsd is associated with poor health behavior and greater body mass index through depression increasing cardiovascular disease and diabetes risk among u s veterans |
| url | http://www.sciencedirect.com/science/article/pii/S2211335519301044 |
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