Department of Psychology, University of Maryland, College Park, Maryland.
San Francisco VA Medical Center, San Francisco, California.
Depress Anxiety. 2019 Nov;36(11):1026-1035. doi: 10.1002/da.22945. Epub 2019 Jul 29.
Those with posttraumatic stress disorder (PTSD) have lower overall functioning than healthy controls. However, this population is not homogenous, and those with PTSD have a wide range of functional outcomes. To our knowledge, only one other study has evaluated the predictors of better functioning within patients with PTSD.
We examined 254 veterans with likely PTSD, using the Clinician-Administered PTSD Scale to assess PTSD symptom severity, and the SF-36 and single-item question to assess aspects of current functioning and quality of life.
In fully adjusted models (controlling for age, gender, and PTSD score, and including all significant psychosocial predictors of the outcome of interest), greater sleep quality (p = .03), lower C-reactive protein (p < .01), and lower erythrocyte sedimentation rate (p = 0.04) were associated with greater physical functioning; lower depression (p < .01) and greater perceived social support (p = .05) were associated with greater social functioning; lower depression (p = .02) was associated with greater occupational functioning; and greater combat exposure (p = .04), greater optimism (p < .01) and greater perceived social support (p = .05) were associated with greater quality of life.
These findings highlight the differential impact of psychosocial predictors on multiple functional outcomes. As such, they provide important information for clinicians about aspects of veterans' lives that can be targeted during the treatment to improve specific types of functioning.
患有创伤后应激障碍(PTSD)的人整体功能比健康对照组差。然而,这一人群并非同质的,患有 PTSD 的人具有广泛的功能结果。据我们所知,只有另一项研究评估了 PTSD 患者功能改善的预测因素。
我们使用临床医生管理的 PTSD 量表评估 PTSD 症状严重程度,使用 SF-36 和单项问题评估当前功能和生活质量方面,对 254 名可能患有 PTSD 的退伍军人进行了检查。
在完全调整的模型中(控制年龄、性别和 PTSD 评分,并包括对感兴趣的结果有意义的所有重要心理社会预测因素),睡眠质量更好(p=0.03)、C 反应蛋白水平更低(p<0.01)和红细胞沉降率更低(p=0.04)与更好的身体功能相关;抑郁程度更低(p<0.01)和感知社会支持更高(p=0.05)与更好的社会功能相关;抑郁程度更低(p=0.02)与更好的职业功能相关;战斗暴露更多(p=0.04)、更乐观(p<0.01)和感知社会支持更高(p=0.05)与更高的生活质量相关。
这些发现强调了心理社会预测因素对多种功能结果的不同影响。因此,它们为临床医生提供了有关退伍军人生活方面的重要信息,这些信息可以在治疗过程中针对特定类型的功能进行治疗。