Parallel Processes of Posttraumatic Stress and Cardiometabolic Dysfunction: A Systemic Illness of Traumatic Stress.

Objective: To determine if and how cardiometabolic conditions (MetC) may be associated with posttraumatic stress disorder (PTSD) symptoms over time when controlling for the influence of potentially confounding variables. Method: Parallel process latent growth modeling was applied to self-reported longitudinal data collected from 35,788 World Trade Center 9/11 survivors to determine how the development and course of PTSD symptoms and MetC influence each other when controlling for age, sex, race/ethnicity, preexisting traumas, physical health problems, general psychological distress, smoking, and alcohol use. Results: A unidirectional relationship was found in which the intercept of PTSD symptoms predicted the slope of MetC. Hyperarousal (β = .172) and emotional numbing (β =.171) PTSD symptoms demonstrated the strongest association with MetC changes over and above the effects of control variables and potential confounders. Post hoc analyses indicated that utilization of PTSD-related psychotherapy was associated with decreased early presentations of MetC following trauma, which may have vital implications for the integrated treatment of trauma-exposed individuals. Conclusions: Findings have strong theoretical and clinical implications for conceptualizing traumatic stress reactions as systemic processes and utilizing integrated treatment practices following psychological trauma. [ABSTRACT FROM AUTHOR]