title: Current posttraumatic stress disorder and exaggerated threat sensitivity associated with elevated inflammation in the Mind Your Heart Study.
abstract: OBJECTIVE
  Elevated inflammation has been repeatedly observed in posttraumatic stress disorder (PTSD), and it may drive the development of both psychiatric symptoms and physical comorbidities. However, it is not clear if elevated inflammation is a feature of both remitted and current PTSD, and little is known about relationships between specific clusters of PTSD symptoms and inflammation. Exaggerated threat sensitivity, as indexed by threat reactivity and avoidance of perceived threats, may be particularly closely associated with inflammation.
  
  
  METHODS
  We assessed PTSD symptoms and threat sensitivity using the Clinician Administered PTSD Scale in 735 Veterans Affairs patients (35% current PTSD; 16% remitted PTSD) who participated in the Mind Your Heart Study (mean age=59±11; 94% male). High sensitivity C-reactive protein (hsCRP), white blood cell count (WBC), and fibrinogen were used as indices of inflammation. Analysis of covariance models with planned contrasts were used to examine differences in inflammation by PTSD status, adjusting for age, sex, race, kidney function and socioeconomic status.
  
  
  RESULTS
  Individuals with current PTSD had significantly higher hsCRP and WBC than patients with no history of PTSD, but there were no significant differences in inflammatory markers between those with remitted versus no history of PTSD. Within patients with current PTSD, higher threat reactivity was independently associated with higher hsCRP (β=0.16, p=0.01) and WBC count (β=0.24, <0.001), and higher effortful avoidance was associated with higher fibrinogen (β=0.13, p=0.04).
  
  
  CONCLUSIONS
  Our data indicate that elevated inflammation may be a feature of current, but not remitted, PTSD. Within patients with PTSD, higher threat reactivity was also associated with elevated inflammation. A better understanding of the relationship between threat sensitivity and inflammation may inform interventions for patients with PTSD.
authors.affiliation: University of California, San Francisco, CA, USA; San Francisco Veteran's Affairs Medical Center and Northern California Institute for Research and Education, San Francisco, CA, USA. Electronic address: Aoife.ODonovan@ucsf.edu.
authors.forename: Aoife
authors.initials: A
authors.lastname: O'Donovan
authors.affiliation: University of California, San Francisco, CA, USA; San Francisco Veteran's Affairs Medical Center and Northern California Institute for Research and Education, San Francisco, CA, USA.
authors.forename: Ashkan J
authors.initials: AJ
authors.lastname: Ahmadian
authors.affiliation: University of California, San Francisco, CA, USA; San Francisco Veteran's Affairs Medical Center and Northern California Institute for Research and Education, San Francisco, CA, USA.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Neylan
authors.affiliation: University of California, San Francisco, CA, USA; San Francisco Veteran's Affairs Medical Center and Northern California Institute for Research and Education, San Francisco, CA, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Pacult
authors.affiliation: Columbia University Medical Center, NY, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Edmondson
authors.affiliation: University of California, San Francisco, CA, USA; San Francisco Veteran's Affairs Medical Center and Northern California Institute for Research and Education, San Francisco, CA, USA.
authors.forename: Beth E
authors.initials: BE
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D015897:Comorbidity; D005260:Female; D005340:Fibrinogen / Q000096:biosynthesis; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000097:blood* / Q000175:diagnosis / Q000523:psychology*; D014728:Veterans / Q000523:psychology
chemical_list: D015415:Biomarkers; D005340:Fibrinogen; D002097:C-Reactive Protein
keywords: Avoidance; C-reactive protein; Fibrinogen; Inflammation; Posttraumatic stress disorder; Threat reactivity; Threat sensitivity; Trauma; Veterans; White blood cell count