Affiliation:
1. Women's Health Sciences Division, National Center for PTSD VA Boston Healthcare System Boston Massachusetts USA
2. Department of Psychiatry Boston University Chobanian & Avedisian School of Medicine Boston Massachusetts USA
3. Center for Care Delivery and Outcomes Research Minneapolis Veterans Affairs Health Care System Minneapolis Minnesota USA
4. Department of Medicine University of Minnesota Medical School Minneapolis Minnesota USA
Abstract
AbstractRevisions to the posttraumatic stress disorder (PTSD) criteria in the DSM‐5 included a new criterion in the alterations in arousal and reactivity cluster (i.e., engagement in reckless and self‐destructive behaviors; Criterion E2). Despite its clinical significance, little is known about how this symptom corresponds to engagement in specific direct and indirect self‐harm behaviors. We examined associations between E2 and self‐reported recent engagement in direct and indirect self‐harm behaviors, including disordered eating, which is not included in the prototypical E2 symptom scope, in a trauma‐exposed sample of 1,010 recent‐era veterans (61.5% self‐identified women, 38.5% self‐identified men). We also tested whether gender moderated these associations. We repeated analyses in a subsample of participants with clinically elevated PTSD symptoms. Participants self‐reported past‐month PTSD symptoms (PCL‐5) as well as past‐month nonsuicidal self‐injury, suicidal ideation, suicide planning, fasting, purging, binge eating, compulsive exercise, and problematic alcohol and drug use. We found no evidence for moderation by gender for any of the behaviors examined in the main sample. However, after controlling for gender and demographic covariates, weighted logistic regressions showed small, significant associations between E2 score and direct self‐harm behaviors, substance use, purging, and binge eating, aORs = 1.30–1.91. Criterion E2 was linked to behaviors included in the typical symptom scope (self‐directed violence, substance use) and those that are not (disordered eating behaviors). Comprehensive screening for self‐destructive behaviors, including disordered eating, among veteran men and women who endorse Criterion E2 is indicated.
Funder
U.S. Department of Defense
U.S. Department of Veterans Affairs
Subject
Psychiatry and Mental health,Clinical Psychology
Cited by
1 articles.
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