The role of emotional functioning in military-related PTSD and its treatment

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Abstract

This two-part study investigated the cross-sectional and across-treatment relationships among measures of emotional functioning and posttraumatic stress disorder (PTSD) symptomatology for veterans receiving specialized treatment for military-related PTSD. Cross-sectional analyses revealed overlap among emotion regulation, affective control, depressive symptoms, and PTSD symptoms at pre-treatment. In regression analyses, fear of losing affective control was most predictive of PTSD symptoms. Bivariate analyses of residualized change scores showed that changes in emotion regulation and fear of losing affective control were associated with changes in PTSD and depressive symptoms across treatment. Regression analyses revealed that changes in fear of losing affective control most strongly predicted changes in PTSD and depressive symptoms. Theoretical and clinical implications are discussed, including an understanding of the differences between emotion regulation and affective control processes. Future research directions are offered, including improved measurement of emotional functioning and longitudinal research delineating the likely bi-directional relationship between emotional functioning and PTSD.

Section snippets

Participants

A total of 81 male participants diagnosed with military-related PTSD completed the assessment materials prior and subsequent to their participation in a specialized Department of Veterans Affairs Medical Center intensive day treatment program for PTSD. Their mean age was 52.83 years (S.D. = 6.17), and they were predominantly Caucasian (89%; 9% African-American; 1% American Indian/Alaskan; 1% missing data). About equal proportions of the participants were married (35%) or divorced (31%), while the

Cross-sectional relationships

Correlational analyses revealed significant overlap between depressive symptoms and state anxiety (r = .26, P < .05) as well as depressive symptoms and total PTSD symptoms (r = .47, P < .05). Depressive symptoms were significantly correlated with all PTSD symptom clusters as well, including re-experiencing (r = .50, P < .05), avoidance/numbing (r = .25, P < .05), and hyperarousal (r = .34, P < .05). However, as shown in Table 1, emotion regulation and fear of losing affective control were not consistently

Discussion

This study investigated the relationships among PTSD, depressive symptoms, state anxiety, emotion regulation, and affective control, both cross-sectionally and across PTSD treatment. The initial step of examining the bivariate relationships among the variables revealed substantial overlap between symptoms of depression and anxiety as well as between symptoms of depression and PTSD. Overlap among these variables is not surprising given the similarity in people's reporting of their experiences of

Acknowledgments

This research was supported by a Career Development Award to the second author from the VA Cooperative Studies Program. This material is also the result of work supported with resources and the use of facilities at the National Center for PTSD and White River Junction VA Medical and Regional Office Center, White River Junction, VT.

We would like to thank the veterans willing to contribute to this research effort. We would also like to thank staff of the PTSD Day Hospital Program, and especially

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