Posttraumatic Stress Symptoms, Functioning, and Suicidal Ideation in Older U.S. Veterans: A Network Analysis
Robert H Pietrzak1, Ian C Fischer2, Peter J Na3
1U.S. Department of Veterans Affairs National Center for PTSD (RHP, ICF), VA Connecticut Healthcare System, West Haven, CT; Department of Psychiatry (RHP, ICF, PJN, JMC, TRS), Yale School of Medicine, New Haven, CT; Department of Social and Behavioral Sciences (RHP), Yale School of Public Health, New Haven, CT.
Objectives:
To identify posttraumatic stress disorder (PTSD) symptoms most central to the disorder and examine associations with functioning and suicidal ideation (SI) among older U.S. military veterans with full or subthreshold PTSD.
Methods:
Data were analyzed from 233 veterans aged ≥60 years (mean = 70.5) with full or subthreshold PTSD who participated in the National Health and Resilience in Veterans Study. Network analyses estimated symptom centrality (i.e., symptoms most strongly connected to others) and examined associations between PTSD symptoms, functioning, and SI.
Results:
Negative beliefs about the self or world and trauma-related emotional and physiological reactivity were the most central PTSD symptoms. Difficulty concentrating and anhedonic symptoms were most consistently associated with functional difficulties and SI.
Conclusions:
A dual-focus approach that addresses PTSD symptoms highly interconnected within the disorder and those most strongly linked to functional difficulties and suicide risk may help promote recovery among older veterans with full or subthreshold PTSD.
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