Time Series Analysis of Posttraumatic Stress Disorder in Military Veterans: A Literature Review and Pilot Study

We reviewed the historical, longitudinal concept, and current cross-sectional manifestations of posttraumatic stress disorder (PTSD). Commonalities include anxiety, dysphoria, defensiveness, dissociation, dysregulation (disinhibition), sleep disturbance, and somatization. Each of these, with the exception of somatization, is represented in the Diagnostic and Statistical Manual of Mental Disorders - 5-Text Revision (DSM-5-TR).

This cross-sectional pilot study sought to develop a time sequence, including demographics, trauma type, traumatic response, posttraumatic symptoms, and subjective interference (or impairment), and sought to determine how each factor in the time series relates to all later factors in the time series. The aims included (a) the effects demographics have on trauma type, traumatic response, posttraumatic symptoms, and subjective impairment, (b) the effects trauma type have on traumatic response, posttraumatic symptoms, and subjective impairment, (c) the effects traumatic response have on posttraumatic symptoms and subjective impairment, and (d) the effects posttraumatic symptoms have on subjective impairment. This was an exploratory qualitative and quantitative inquiry using cross-sectional information from a pre-existing dataset. Variable types were defined. Then statistical tests were determined using IBM Statistical Package for the Social Sciences (SPSS) software, Version 26.

Along the time series, both qualitative and quantitative variables were assessed. Qualitatively, demographics affected seven later variables, but did not affect impairment. Trauma type affected ten later variables, but did not affect impairment. Traumatic response affected seven later variables, and did not affect impairment, except for personal physical injury predicting fun and/or leisure activity interference. Otherwise, posttraumatic symptoms were the only variables affecting later impairment and did so considerably with twenty associations. Quantitative findings were congruent with qualitative findings.

Along the time series of PTSD, there is a tendency for factors to affect those variables that are adjacent or proximal, but not to affect those variables that are more distant or further out.