The Impact of Common Psychiatric and Behavioral Comorbidities on Functional Disability Across Time and Individuals in Post‐9/11 Veterans

Autor:	Regina E. McGlinchey, Francesca C. Fortenbaugh, Catherine Fortier, William P. Milberg, Jennifer R. Fonda, Melissa M. Amick
Rok vydání:	2020
Předmět:	Adult Male 050103 clinical psychology medicine.medical_specialty Population Poison control Comorbidity Suicide prevention Article Occupational safety and health Stress Disorders Post-Traumatic 03 medical and health sciences 0302 clinical medicine Brain Injuries Traumatic Injury prevention medicine Humans Disabled Persons 0501 psychology and cognitive sciences Longitudinal Studies Prospective Studies Psychiatry education Iraq War 2003-2011 Veterans Affairs Veterans Depressive Disorder education.field_of_study Sleep disorder Afghan Campaign 2001 business.industry Mental Disorders 05 social sciences Human factors and ergonomics medicine.disease 030227 psychiatry Psychiatry and Mental health Clinical Psychology Cross-Sectional Studies Case-Control Studies Female Chronic Pain business
Zdroj:	J Trauma Stress
ISSN:	1573-6598 0894-9867
DOI:	10.1002/jts.22501
Popis:	Returning veterans often face multiple concurrent psychiatric and behavioral conditions that negatively impact reintegration into civilian life and are associated with functional disability. Understanding how conditions interact to negatively impact functioning is an important step toward developing holistic treatment approaches that are optimized for this population. This study utilized a cross-sectional and prospective longitudinal cohort design applying regression algorithms to understand the relative contribution of common clinical issues to functional disability in U.S. veterans who served after the September 11, 2001 (9/11) terror attacks. Community-dwelling post-9/11 veterans (N = 397) completed detailed assessments, including common clinical condition diagnoses, combat experience, and demographics, which were used to predict functional disability (World Health Organization Disability Assessment Schedule); 205 participants were reassessed approximately 1–2 years after enrollment. Regression analyses showed a strong association between the predictor variables and functional disability, f (2) = 1.488. Validation analyses showed high prediction ability of functional disability both to independent samples, r = .719, and across time in the same individuals, r = .780. The strongest predictors included current posttraumatic stress disorder, depressive disorder, sleep disturbance, and pain diagnoses. These results demonstrate the importance of considering multiple common co-occurring conditions when assessing functional disability in post-9/11 veterans, and suggest that certain syndromes contribute the most unique information for predicting functional disability with high confidence. As most U.S. veterans utilize private healthcare systems, these results have clinical utility for both Veterans Affairs and civilian healthcare practitioners in assessing and monitoring functional disability in post-9/11 veterans over time.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::25ab9a49d7c3e2f5f1a2af565d2dca05 https://doi.org/10.1002/jts.22501 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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