title: An Investigation of Depression, Trauma History, and Symptom Severity in Individuals Enrolled in a Treatment Trial for Chronic PTSD.
abstract: OBJECTIVE
  To explore how factors such as major depressive disorder (MDD) and trauma history, including the presence of childhood abuse, influence diverse clinical outcomes such as severity and functioning in a sample with posttraumatic stress disorder (PTSD).
  
  
  METHODS
  In this study, 200 men and women seeking treatment for chronic PTSD in a clinical trial were assessed for trauma history and MDD and compared on symptom severity, psychosocial functioning, dissociation, treatment history, and extent of diagnostic co-occurrence.
  
  
  RESULTS
  Overall, childhood abuse did not consistently predict clinical severity. However, co-occurring MDD, and to a lesser extent a high level of trauma exposure, did predict greater severity, worse functioning, greater dissociation, more extensive treatment history, and additional co-occurring disorders.
  
  
  CONCLUSIONS
  These findings suggest that presence of co-occurring depression may be a more critical marker of severity and impairment than history of childhood abuse or repeated trauma exposure. Furthermore, they emphasize the importance of assessing MDD and its effect on treatment seeking and treatment response for those with PTSD.
authors.affiliation: University of Washington.
authors.forename: Michele
authors.initials: M
authors.lastname: Bedard-Gilligan
authors.affiliation: Case Western Reserve University.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Duax Jakob
authors.affiliation: Case Western Reserve University.
authors.forename: Lisa Stines
authors.initials: LS
authors.lastname: Doane
authors.affiliation: University of Washington.
authors.forename: Jeff
authors.initials: J
authors.lastname: Jaeger
authors.affiliation: University of Washington.
authors.forename: Afsoon
authors.initials: A
authors.lastname: Eftekhari
authors.affiliation: Case Western Reserve University.
authors.forename: Norah
authors.initials: N
authors.lastname: Feeny
authors.affiliation: University of Washington.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Zoellner
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067073:Psychological Trauma / Q000453:epidemiology / Q000523:psychology*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D055815:Young Adult
keywords: MDD; PTSD; childhood abuse; diagnostic co-occurrence