Psychosocial Functioning and Health-Related Quality of Life Associated with Posttraumatic Stress Disorder in Male and Female Iraq and Afghanistan War Veterans: The VALOR Registry
Psychosocial Functioning and Health-Related Quality of Life Associated with Posttraumatic Stress Disorder in Male and Female Iraq and Afghanistan War Veterans: The VALOR Registry
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DOI：
10.1089/jwh.2014.5096
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发表时间：
2015-12-01
影响因子：
3.5
通讯作者：
Rosen, Raymond
中科院分区：
文献类型：
--
作者：
Fang, Shona C.;Schnurr, Paula P.;Rosen, Raymond
目的：伊拉克和阿富汗战争老兵患创伤后应激障碍（PTSD）的比例很高。鉴于军队中妇女人数不断增加，迫切需要了解持久自由行动/伊拉克自由行动退伍军人中与创伤后应激障碍相关的心理社会功能和与健康有关的生活质量（HRQOL）的潜在性别差异的性质和程度，迄今尚未对此进行研究。方法：我们使用来自战区部署的OEF/OIF退伍军人性别平衡的国家患者登记处（Project VALOR: veterans After-Discharge Longitudinal registry）的数据，以确定性别对1530名有或无PTSD的美国伊拉克和阿富汗战争退伍军人（50%为女性）PTSD相关心理社会功能和HRQOL的影响。总体心理社会功能分别用心理社会功能量表（IPF）和身心HRQOL分别用退伍军人RAND 12项健康调查（VR-12）心理和身体成分总结得分进行评估。分层线性回归模型估计了特定性别的关联，控制了人口统计学、部署和部署后因素。相互作用模型测试了显著的性别效应调节。结果：在性别分层模型中，PTSD与更高的IPF评分（更大的功能障碍）密切相关，性别之间的关联相似。在男性和女性中，创伤后应激障碍也与较低的心理成分总结得分（较低的心理HRQOL）相关，没有证据表明性别会减缓影响。在调整后的模型中，PTSD与女性较低的Physical Component Summery得分相关，而与男性无关；然而，相互作用并不显著。结论：战区部署的OEF/OIF退伍军人的创伤后应激障碍与整体社会心理功能和HRQOL的显著损害相关，且性别之间的相关性基本相似。研究结果支持在治疗PTSD期间对男性和女性OEF/OIF退伍军人进行全面和持续的功能损伤和HRQOL评估的必要性。
Objectives: Iraq and Afghanistan war veterans suffer from high rates of posttraumatic stress disorder (PTSD). Given the growing number of women in the military, there is a critical need to understand the nature and extent of potential gender differences in PTSD-associated psychosocial functioning and health-related quality of life (HRQOL) in Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans, which has not been studied to date. Methods: We used data from a gender-balanced national patient registry of warzone-deployed OEF/OIF veterans (Project VALOR: Veterans After-Discharge Longitudinal Registry) to determine the impact of gender on PTSD-related psychosocial functioning and HRQOL in 1,530 United States Iraq and Afghanistan war veterans (50% female) with and without PTSD. Overall psychosocial functioning was assessed with the Inventory of Psychosocial Functioning (IPF) and mental and physical HRQOL with the Veterans RAND 12-item Health Survey (VR-12) Mental and Physical Component Summary scores, respectively. Stratified linear regression models estimated gender-specific associations, controlling for demographic, deployment, and postdeployment factors. Interaction models tested for significant effect moderation by gender. Results: In gender-stratified models, PTSD was strongly associated with higher IPF scores (greater functional impairment), with similar associations by gender. PTSD was also associated with lower Mental Component Summary scores (lower mental HRQOL) in both men and women, with no evidence of effect moderation by gender. PTSD was associated with lower Physical Component Summery scores in women but not men in adjusted models; however, interactions were not significant. Conclusion: PTSD among warzone-deployed OEF/OIF veterans is associated with significant impairments in both overall psychosocial functioning and HRQOL, with associations that are largely similar by gender. Findings support the need for thorough and continuous assessment of functional impairment and HRQOL during treatment of PTSD for both male and female OEF/OIF veterans.