Post-traumatic stress symptom, metacognition, emotional schema and emotion regulation: A structural equation model

BackgroundPain and post-traumatic stress disorder (PTSD) are frequently co-morbid in the aftermath of a traumatic event. Although several models attempt to explain the relationship between these two disorders, the mechanisms underlying the relationship remain unclear. The aim of this study was to investigate the relationship between each PTSD symptom cluster and pain over the course of post-traumatic adjustment.MethodIn a longitudinal study, injury patients (n=824) were assessed within 1 week post-injury, and then at 3 and 12 months. Pain was measured using a 100-mm Visual Analogue Scale (VAS). PTSD symptoms were assessed using the Clinician-Administered PTSD Scale (CAPS). Structural equation modelling (SEM) was used to identify causal relationships between pain and PTSD.ResultsIn a saturated model we found that the relationship between acute pain and 12-month pain was mediated by arousal symptoms at 3 months. We also found that the relationship between baseline arousal and re-experiencing symptoms, and later 12-month arousal and re-experiencing symptoms, was mediated by 3-month pain levels. The final model showed a good fit [χ2=16.97, df=12, p>0.05, Comparative Fit Index (CFI)=0.999, root mean square error of approximation (RMSEA)=0.022].ConclusionsThese findings provide evidence of mutual maintenance between pain and PTSD.

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High physical activity is associated with post-traumatic stress disorder among individuals aged 15 years and older in South Africa

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v25i0.1329 ◽

2019 ◽

Vol 25 ◽

Author(s):

Karl Peltzer ◽

Supa Pengpid

Keyword(s):

Physical Activity ◽

Post Traumatic Stress Disorder ◽

Indirect Effect ◽

Traumatic Stress ◽

Structural Equation ◽

Stress Disorder ◽

Post Traumatic Stress ◽

Post Traumatic ◽

Positive Direct ◽

Symptom Criteria

Background: Some research seems to suggest that physical activity (PA) was beneficial for post-traumatic stress disorder (PTSD).Aim: This study examined the association between levels of PA and PTSD among individuals 15 years and above in South Africa.Setting: Community-based survey sample representative of the national population in South Africa.Methods: In all, 15 201 individuals (mean age 36.9 years) responded to the cross-sectional South African National Health and Nutrition Examination Survey (SANHANES-1) in 2012.Results: One in five (20.1%) of participants reported exposure to at least one traumatic event in a lifetime, and 2.1% were classified as having a PTSD, 7.9% fulfilled PTSD re-experiencing criteria, 3.0% PTSD avoidance criteria and 4.3% PTSD hyperarousal criteria. Almost half (48.1%) of respondents had low PA, 17.4% moderate PA and 34.5% high PA. In logistic regression analysis, adjusted for age, sex, population group, employment status, residence status, number of trauma types, problem drinking, current tobacco use, sleep problems and depressive symptoms, high PA was associated with PTSD (odds ratio [OR] = 1.75, confidence interval [CI] = 1.11–2.75), PTSD re-experiencing symptom criteria (OR = 1.43, CI = 1.09–1.86) and PTSD avoidance symptom criteria (OR = 1.74, CI = 1.18–2.59), but high PA was not associated with PTSD hyperarousal symptom criteria. In generalised structural equation modelling, total trauma events had a positive direct and indirect effect on PTSD mediated by high PA, and high PA had a positive indirect effect on PTSD, mediated by psychological distress and problem drinking.Conclusion: After controlling for relevant covariates, high PA was associated with increased PTSD symptomatology.

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