Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination
Elucidating whether PTSD symptoms predict poorer social connectedness over time (i.e. social erosion) and/or that poor social connectedness contributes to maintenance of PTSD (i.e. social causation) has implications for PTSD treatment and relapse prevention. Most extant research has been cross-secti...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-12-01
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| Series: | European Journal of Psychotraumatology |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/20008198.2019.1646091 |
| _version_ | 1797954514854084608 |
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| author | Lauren M. Sippel Laura E. Watkins Robert H. Pietrzak Rani Hoff Ilan Harpaz-Rotem |
| author_facet | Lauren M. Sippel Laura E. Watkins Robert H. Pietrzak Rani Hoff Ilan Harpaz-Rotem |
| author_sort | Lauren M. Sippel |
| collection | DOAJ |
| description | Elucidating whether PTSD symptoms predict poorer social connectedness over time (i.e. social erosion) and/or that poor social connectedness contributes to maintenance of PTSD (i.e. social causation) has implications for PTSD treatment and relapse prevention. Most extant research has been cross-sectional and examined overall PTSD symptoms. Evidence of longitudinal associations among heterogeneous PTSD symptom clusters and social connectedness could provide insight into more nuanced targets for intervention. Using data from 1,491 U.S. military veterans in residential treatment for PTSD at 35 Department of Veterans Affairs facilities, we evaluated a two-wave cross-lagged panel model including a five-factor model of PTSD and two aspects of social connectedness. PTSD, quality of connectedness (i.e. degree of distress related to interpersonal conflict), and structural social support (i.e. number of days of contact with supportive loved ones) in the past 30 days were assessed at baseline and 4 months after discharge. The largest effect was greater severity of PTSD dysphoric arousal symptoms (i.e. irritability/anger, poor concentration, and sleep problems) at baseline predicting more conflict-related distress at follow-up (β = 0.43). Post-hoc symptom-level analyses indicated that irritability/anger drove this association. In addition, conflict-related distress predicted greater PTSD symptom severity across all five clusters (β’s = 0.10 to 0.14, p’s < 0.01). More days of contact predicted lower severity of avoidance and numbing symptoms (β’s = −.05 and −.07, p’s < 0.01), along with individual symptoms within these clusters, plus flashbacks. Results support both social erosion and social causation models. Engaging loved ones in veterans’ treatment and targeting dysphoric arousal symptoms, particularly anger and irritability, may improve long-term PTSD and relationship outcomes, respectively. |
| first_indexed | 2024-04-10T23:19:50Z |
| format | Article |
| id | doaj.art-6b7963fd65c84059b986956cfb7ed0de |
| institution | Directory Open Access Journal |
| issn | 2000-8066 |
| language | English |
| last_indexed | 2024-04-10T23:19:50Z |
| publishDate | 2019-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Journal of Psychotraumatology |
| spelling | doaj.art-6b7963fd65c84059b986956cfb7ed0de2023-01-12T15:31:31ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662019-12-0110110.1080/20008198.2019.16460911646091Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examinationLauren M. Sippel0Laura E. Watkins1Robert H. Pietrzak2Rani Hoff3Ilan Harpaz-Rotem4National Center for PTSD Executive DivisionEmory University School of MedicineNational Center for PTSD Clinical Neurosciences DivisionYale University School of MedicineNational Center for PTSD Clinical Neurosciences DivisionElucidating whether PTSD symptoms predict poorer social connectedness over time (i.e. social erosion) and/or that poor social connectedness contributes to maintenance of PTSD (i.e. social causation) has implications for PTSD treatment and relapse prevention. Most extant research has been cross-sectional and examined overall PTSD symptoms. Evidence of longitudinal associations among heterogeneous PTSD symptom clusters and social connectedness could provide insight into more nuanced targets for intervention. Using data from 1,491 U.S. military veterans in residential treatment for PTSD at 35 Department of Veterans Affairs facilities, we evaluated a two-wave cross-lagged panel model including a five-factor model of PTSD and two aspects of social connectedness. PTSD, quality of connectedness (i.e. degree of distress related to interpersonal conflict), and structural social support (i.e. number of days of contact with supportive loved ones) in the past 30 days were assessed at baseline and 4 months after discharge. The largest effect was greater severity of PTSD dysphoric arousal symptoms (i.e. irritability/anger, poor concentration, and sleep problems) at baseline predicting more conflict-related distress at follow-up (β = 0.43). Post-hoc symptom-level analyses indicated that irritability/anger drove this association. In addition, conflict-related distress predicted greater PTSD symptom severity across all five clusters (β’s = 0.10 to 0.14, p’s < 0.01). More days of contact predicted lower severity of avoidance and numbing symptoms (β’s = −.05 and −.07, p’s < 0.01), along with individual symptoms within these clusters, plus flashbacks. Results support both social erosion and social causation models. Engaging loved ones in veterans’ treatment and targeting dysphoric arousal symptoms, particularly anger and irritability, may improve long-term PTSD and relationship outcomes, respectively.http://dx.doi.org/10.1080/20008198.2019.1646091posttraumatic stress disordersocial connectednesssocial supportdysphoric arousalveteranscross-lagged panel analysis |
| spellingShingle | Lauren M. Sippel Laura E. Watkins Robert H. Pietrzak Rani Hoff Ilan Harpaz-Rotem Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination European Journal of Psychotraumatology posttraumatic stress disorder social connectedness social support dysphoric arousal veterans cross-lagged panel analysis |
| title | Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination |
| title_full | Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination |
| title_fullStr | Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination |
| title_full_unstemmed | Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination |
| title_short | Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination |
| title_sort | heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment seeking military veterans a longitudinal examination |
| topic | posttraumatic stress disorder social connectedness social support dysphoric arousal veterans cross-lagged panel analysis |
| url | http://dx.doi.org/10.1080/20008198.2019.1646091 |
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