Emotion regulation and combat severity differentiates PTSD diagnostic status among veterans. 2023

Amanda J Khan, and Annie L Ryder, and Shira Maguen, and Beth E Cohen
San Francisco VA Health Care System.

OBJECTIVE This study examined whether posttraumatic stress disorder (PTSD) diagnostic groups in veterans were differentiated by combat severity and specific avoidance and approach-related emotion regulation (ER) strategies. METHODS In a cohort study, 725 participants (Mage = 58.39, SD = 11.27, 94.5% male, 58.2% White) recruited from VHA facilities completed the Clinician Administered PTSD Scale (CAPS), Combat Exposure Scale (CES), and Emotion Regulation Questionnaire (ERQ). Participants were categorized into three PTSD groups: Current, Remitted, and Never. RESULTS Multinomial logistic regressions adjusting for age, sex, and race, showed combat severity significantly differentiated all groups from each other (ps < .001). Specifically, combat severity was significantly associated with increased odds of Current PTSD versus Remitted (OR: 1.02, 95% CI [1.01, 1.05]) and Never PTSD (OR: 1.14, [1.12, 1.17]) and odds of Remitted compared with Never PTSD (OR: 1.11, [1.09, 1.14]). Suppression, but not reappraisal, was significantly associated with increased odds of Current PTSD compared with Remitted (OR: 1.15, [1.06, 1.24]) and Never PTSD (OR: 1.14, [1.06, 1.22]; ps < .001). Lower reappraisal was only significantly associated with the likelihood of Remitted PTSD compared with Never PTSD (OR: 0.93, [0.88, 0.99], p = .03). CONCLUSIONS Increasing levels of combat severity differentiated veterans with current, remitted, and no history of PTSD, suggesting screening for severity of combat may be helpful. Greater habitual suppression distinguished current versus non-current PTSD status, whereas only less reappraisal distinguished non-current groups from each other. Lower suppression may be an important treatment target for veterans with moderate and high combat severity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

UI MeSH Term Description Entries
D008297 Male Males
D003130 Combat Disorders Neurotic reactions to unusual, severe, or overwhelming military stress. Neuroses, War,War Neuroses,Combat Neuroses,Combat Neurosis,Combat Stress Disorders,Shell Shock,War Neurosis,Combat Disorder,Combat Stress Disorder,Disorder, Combat,Disorder, Combat Stress,Disorders, Combat,Disorders, Combat Stress,Neuroses, Combat,Neurosis, Combat,Neurosis, War,Shell Shocks,Shock, Shell,Shocks, Shell,Stress Disorder, Combat,Stress Disorders, Combat
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000080103 Emotional Regulation The manifestation of an emotional response by which individuals influence the intensity, duration, valence, or manifestation of their response. Emotion regulation either precedes (avoidance, interpretation) or follows an emotion (suppression, reappraisal). Emotion regulation is distinct from coping (focuses primarily on decreasing a negative emotional experience), and can include increasing or decreasing both positive and negative emotions consciously or unconsciously. Emotion Regulation,Emotion Self-Regulation,Emotional Self-Regulation,Emotion Self Regulation,Emotion Self-Regulations,Emotional Regulations,Emotional Self Regulation,Emotional Self-Regulations,Regulation, Emotion,Regulation, Emotional,Regulations, Emotional,Self-Regulation, Emotion,Self-Regulation, Emotional,Self-Regulations, Emotion,Self-Regulations, Emotional
D013313 Stress Disorders, Post-Traumatic A class of traumatic stress disorders with symptoms that last more than one month. Moral Injury,Neuroses, Post-Traumatic,PTSD,Post Traumatic Stress Disorder,Post-Traumatic Stress Disorders,Acute Post-Traumatic Stress Disorder,Chronic Post-Traumatic Stress Disorder,Delayed Onset Post-Traumatic Stress Disorder,Neuroses, Posttraumatic,Posttraumatic Stress Disorders,Stress Disorder, Post Traumatic,Stress Disorders, Posttraumatic,Acute Post Traumatic Stress Disorder,Chronic Post Traumatic Stress Disorder,Delayed Onset Post Traumatic Stress Disorder,Injury, Moral,Moral Injuries,Neuroses, Post Traumatic,Post Traumatic Stress Disorders,Post-Traumatic Neuroses,Post-Traumatic Stress Disorder,Posttraumatic Neuroses,Posttraumatic Stress Disorder,Stress Disorder, Post-Traumatic,Stress Disorder, Posttraumatic
D014728 Veterans Former members of the armed services. Veteran
D015331 Cohort Studies Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. Birth Cohort Studies,Birth Cohort Study,Closed Cohort Studies,Cohort Analysis,Concurrent Studies,Historical Cohort Studies,Incidence Studies,Analysis, Cohort,Cohort Studies, Closed,Cohort Studies, Historical,Studies, Closed Cohort,Studies, Concurrent,Studies, Historical Cohort,Analyses, Cohort,Closed Cohort Study,Cohort Analyses,Cohort Studies, Birth,Cohort Study,Cohort Study, Birth,Cohort Study, Closed,Cohort Study, Historical,Concurrent Study,Historical Cohort Study,Incidence Study,Studies, Birth Cohort,Studies, Cohort,Studies, Incidence,Study, Birth Cohort,Study, Closed Cohort,Study, Cohort,Study, Concurrent,Study, Historical Cohort,Study, Incidence

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