Combat veterans suffering from PTSD report problems with hostility and anger. Indeed, hostility in the form of irritability and anger outbursts are one of the DSM-III-R criteria for PTSD. However, although previous research has indicated that veterans with combat-related PTSD report more hostility and anger, they have not behaviorally demonstrated more hostility in laboratory settings. Behavioral demonstrations of interpersonal hostility are an important area of study because behavioral hostility is a more reliable, objective measure of hostility, and has been more strongly associated with disease outcomes than self-report measures of hostility. In addition, comprehensive empirical assessment of hostility in Vietnam combat-related PTSD veterans is lacking. Our pilot data is the first documentation that PTSD combat veterans demonstrate more hostility during a structured interpersonal interaction. The first purpose of the proposed study is to collect multiple measures of hostility (behavioral, self-report, spouse-ratings and daily activity ratings) with 4 combat veterans groups in order to describe and compare both hostility levels and modes of expression associated with combat-related PTSD. Thirty veterans with combat-related PTSD, 30 psychiatrically-healthy, help- seeking combat veterans, 30 psychiatrically-healthy community (non-help-seeking) combat veterans and 30 combat veterans with major depression will be recruited. Major depression combat veterans have been chosen because irritability is a common associated feature of the disorder, and previous research has indicated that the level and mode of hostility in major depression patients is higher than non-psychiatric groups. In non-veteran populations, hostility has been prospectively associated with poorer health and mortality outcomes. However, the possible negative physical health effects of hostility in PTSD combat veterans has only recently begun to receive investigative attention. The second purpose of this study is to collect information on a range of health parameters on two occasions one year apart (including self-report of health problems, ambulatory monitoring of blood pressure and heart rate and lipid panel profiles). These data will be used to evaluate the prospective relationship of hostility to health parameters in Vietnam veterans with combat-related PTSD.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
5R29MH051752-04
Application #
2392951
Study Section
Violence and Traumatic Stress Review Committee (VTS)
Project Start
1994-04-01
Project End
1999-03-31
Budget Start
1997-04-01
Budget End
1998-03-31
Support Year
4
Fiscal Year
1997
Total Cost
Indirect Cost
Name
Duke University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
071723621
City
Durham
State
NC
Country
United States
Zip Code
27705
Beckham, Jean C; Taft, Casey T; Vrana, Scott R et al. (2003) Ambulatory monitoring and physical health report in Vietnam veterans with and without chronic posttraumatic stress disorder. J Trauma Stress 16:329-35
Calhoun, Patrick S; Beckham, Jean C; Bosworth, Hayden B (2002) Caregiver burden and psychological distress in partners of veterans with chronic posttraumatic stress disorder. J Trauma Stress 15:205-12
Butterfield, M I; Forneris, C A; Feldman, M E et al. (2000) Hostility and functional health status in women veterans with and without posttraumatic stress disorder: a preliminary study. J Trauma Stress 13:735-41
Beckham, J C; Feldman, M E; Barefoot, J C et al. (2000) Ambulatory cardiovascular activity in Vietnam combat veterans with and without posttraumatic stress disorder. J Consult Clin Psychol 68:269-76
Hertzberg, M A; Butterfield, M I; Feldman, M E et al. (1999) A preliminary study of lamotrigine for the treatment of posttraumatic stress disorder. Biol Psychiatry 45:1226-9
Beckham, J C; Feldman, M E; Kirby, A C (1998) Atrocities exposure in Vietnam combat veterans with chronic posttraumatic stress disorder: relationship to combat exposure, symptom severity, guilt, and interpersonal violence. J Trauma Stress 11:777-85
Hertzberg, M A; Feldman, M E; Beckham, J C et al. (1998) Open trial of nefazodone for combat-related posttraumatic stress disorder. J Clin Psychiatry 59:460-4
Beckham, J C; Crawford, A L; Feldman, M E (1998) Trail making test performance in Vietnam combat veterans with and without posttraumatic stress disorder. J Trauma Stress 11:811-9
Beckham, J C; Crawford, A L; Feldman, M E et al. (1997) Chronic posttraumatic stress disorder and chronic pain in Vietnam combat veterans. J Psychosom Res 43:379-89
Beckham, J C; Feldman, M E; Kirby, A C et al. (1997) Interpersonal violence and its correlates in Vietnam veterans with chronic posttraumatic stress disorder. J Clin Psychol 53:859-69

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