title: Dissociative subtype of DSM-5 posttraumatic stress disorder in U.S. veterans.
abstract: The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) formally introduced a dissociative subtype of posttraumatic stress disorder (PTSD). This study examined the proportion of U.S. veterans with DSM-5 PTSD that report dissociative symptoms; and compared veterans with PTSD with and without the dissociative subtype and trauma-exposed controls on sociodemographics, clinical characteristics, and quality of life. Multivariable analyses were conducted on a nationally representative sample of 1484 veterans from the National Health and Resilience in Veterans Study (second baseline survey conducted September-October, 2013). Of the 12.0% and 5.2% of veterans who screened positive for lifetime and past-month DSM-5 PTSD, 19.2% and 16.1% screened positive for the dissociative subtype, respectively. Among veterans with PTSD, those with the dissociative subtype reported more severe PTSD symptoms, comorbid depressive and anxiety symptoms, alcohol use problems, and hostility than those without the dissociative subtype. Adjusting for PTSD symptom severity, those with the dissociative subtype continued to report more depression and alcohol use problems. These results underscore the importance of assessing, monitoring, and treating the considerable proportion of veterans with PTSD and dissociative symptoms.
authors.affiliation: United States Department of Veterans Affairs, New England Mental Illness Research, Education, and Clinical Center, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States. Electronic address: Jack.Tsai@yale.edu.
authors.forename: Jack
authors.initials: J
authors.lastname: Tsai
authors.affiliation: Psychology Research Institute, University of Ulster, Coleraine, Northern Ireland, UK.
authors.forename: Cherie
authors.initials: C
authors.lastname: Armour
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, United States.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Southwick
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, United States.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pietrzak
mesh_terms: D019973:Alcohol-Related Disorders / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004213:Dissociative Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*
keywords: Dissociation; Posttraumatic stress disorder; Substance abuse; Veterans