title: Posttraumatic stress symptomatology as a mediator of the relationship between warzone exposure and physical health symptoms in men and women.
abstract: The mediating role of posttraumatic stress symptomatology (PSS) on the association between warzone exposure and physical health symptoms in 7 bodily systems (cardiovascular, dermatological, gastrointestinal, genitourinary, musculoskeletal, neurological, and pulmonary) was examined. We also examined if mediation effects varied as a function of sex. A sample of 317 U.S. Gulf war veterans was assessed for warzone exposure, PSS, and physical health symptoms 10 years after deployment. PSS was significantly associated with postdeployment physical health in all symptom categories when accounting for predeployment health (with effect sizes ranging from a 1.27-1.64 increase in the likelihood of postdeployment physical health symptoms with a 1 standard deviation increase in the PSS symptoms). PSS severity mediated the relationship between warzone exposure and postdeployment symptoms in all physical health domains (with percent mediation ranging 44%-75%). A significant Warzone Exposure × PSS interaction emerged for 5 outcomes such that the effect of PSS on physical health was stronger for veterans reporting lower warzone exposure. No significant interactions with sex emerged. These findings suggest the important influence of PSS on physical health symptoms for both men and women.
authors.affiliation: VA Boston Healthcare System, National Center for PTSD, Women's Health Sciences Division, Boston, MA 02130, USA. Jennifer.Wachen@va.gov
authors.forename: Jennifer Schuster
authors.initials: JS
authors.lastname: Wachen
authors.forename: Jillian C
authors.initials: JC
authors.lastname: Shipherd
authors.forename: Michael
authors.initials: M
authors.lastname: Suvak
authors.forename: Dawne
authors.initials: D
authors.lastname: Vogt
authors.forename: Lynda A
authors.initials: LA
authors.lastname: King
authors.forename: Daniel W
authors.initials: DW
authors.lastname: King
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology; D005260:Female; D052776:Female Urogenital Diseases / Q000453:epidemiology; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D047830:Gulf War; D006304:Health Status; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology; D008297:Male; D052801:Male Urogenital Diseases / Q000453:epidemiology; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D009422:Nervous System Diseases / Q000453:epidemiology; D057566:Self Report; D012720:Severity of Illness Index; D012737:Sex Factors; D012871:Skin Diseases / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D013997:Time Factors; D014728:Veterans / Q000523:psychology*