title: Posttraumatic stress disorder and accelerated aging: PTSD and leukocyte telomere length in a sample of civilian women.
abstract: Studies in male combat veterans have suggested posttraumatic stress disorder (PTSD) is associated with shorter telomere length (TL). We examined the cross-sectional association of PTSD with TL in women exposed to traumas common in civilian life.
  
  
  
  Data are from a substudy of the Nurses' Health Study II (N = 116). PTSD and subclinical PTSD were assessed in trauma-exposed women using diagnostic interviews. An array of health behaviors and conditions were assessed. DNA was extracted from peripheral blood leukocytes (collected 1996-1999). Telomere repeat copy number to single gene copy number (T/S) was determined by quantitative real-time PCR telomere assay. We used linear regression models to assess associations and examine whether a range of important health behaviors (e.g., cigarette smoking) and medical conditions (e.g., hypertension) previously associated with TL might explain a PTSD-TL association. We further examined whether type of trauma exposure (e.g., interpersonal violence) was associated with TL and whether trauma type might explain a PTSD-TL association.
  
  
  
  Relative to not having PTSD, women with a PTSD diagnosis had shorter log-transformed TL (β = -.112, 95% confidence interval (CI) = -0.196, -0.028). Adjustment for health behaviors and medical conditions did not attenuate this association. Trauma type was not associated with TL and did not account for the association of PTSD with TL.
  
  
  
  Our results add to growing evidence that PTSD may be associated with more rapid cellular aging as measured by telomere erosion. Moreover, the association could not be explained by health behaviors and medical conditions assessed in this study, nor by type of trauma exposure.
authors.affiliation: Department of Social and Behavioral Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Roberts
authors.affiliation: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.|Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Karestan C
authors.initials: KC
authors.lastname: Koenen
authors.affiliation: Department of Biostatistics, Columbia Mailman School of Public Health, New York, NY, USA.
authors.forename: Qixuan
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Social and Behavioral Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Paola
authors.initials: P
authors.lastname: Gilsanz
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Mason
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Prescott
authors.affiliation: Department of Biostatistics, Columbia Mailman School of Public Health, New York, NY, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Ratanatharathorn
authors.affiliation: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.|Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
authors.affiliation: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.|Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Sumner
authors.affiliation: Department of Social and Behavioral Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Winning
authors.affiliation: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.|Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Immaculata
authors.initials: I
authors.lastname: De Vivo
authors.affiliation: Department of Social and Behavioral Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Kubzansky
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000378:metabolism; D008137:Longitudinal Studies; D008875:Middle Aged; D009726:Nurses; D013313:Stress Disorders, Post-Traumatic / Q000235:genetics*; D059506:Telomere Shortening / Q000235:genetics*
keywords: biological markers; posttraumatic stress disorders; telomere; trauma