title: Structure of posttraumatic stress disorder symptoms and psychosocial functioning in Veterans of Operations Enduring Freedom and Iraqi Freedom.
abstract: Posttraumatic stress disorder (PTSD) is one of the most prevalent psychiatric conditions in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF), but little is known about the structure of PTSD symptoms, and associations between PTSD symptom clusters and psychosocial functioning in this population. A total of 272 OEF-OIF Veterans in Connecticut completed a mail survey containing measures of psychopathology, resilience, and psychosocial functioning. Confirmatory factor analyses revealed that the 4-factor dysphoria model, which is comprised of separate re-experiencing, avoidance, dysphoria, and hyperarousal symptom clusters, provided the best representation of PTSD symptom structure in this sample. Dysphoria symptoms were independently associated with a broad range of psychosocial measures, even after controlling for age, combat exposure, and other PTSD symptom clusters. Re-experiencing symptoms were associated with alcohol use problems, and avoidance symptoms were associated with increased psychosocial difficulties and decreased perceptions of postdeployment social support. These results suggest that dysphoria symptoms were strongly related to a broad range of psychosocial measures in this sample of OEF-OIF Veterans. Dysphoria symptoms may deserve special attention in the assessment and treatment of symptomatic OEF-OIF Veterans.
authors.affiliation: National Center for Posttraumatic Stress Disorder, Resilience Laboratory, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT 06516, USA. robert.pietrzak@yale.edu
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pietrzak
authors.forename: Marc B
authors.initials: MB
authors.lastname: Goldstein
authors.forename: James C
authors.initials: JC
authors.lastname: Malley
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Rivers
authors.forename: Steven M
authors.initials: SM
authors.lastname: Southwick
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D055826:Afghan Campaign 2001-; D003130:Combat Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006306:Health Surveys; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D011569:Psychiatric Status Rating Scales; D011584:Psychology; D012044:Regression Analysis; D012938:Social Perception; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States; D014728:Veterans / Q000523:psychology*