Dissertations, Theses, and Capstone Projects

Date of Degree

9-2023

Document Type

Dissertation

Degree Name

Ph.D.

Program

Psychology

Advisor

Maureen Allwood

Committee Members

Cathy Spatz Widom

William Gottdiener

Isaac Galatzer-Levy

Wendy D'Andrea

Subject Categories

Clinical Psychology | Health Psychology | Psychology | Theory and Philosophy

Keywords

Traumatic stress; PTSD; Metabolic; Cardiovascular; Mental Health; Physical Health

Abstract

Metabolic conditions (MetC) have been associated with posttraumatic stress disorder (PTSD) symptoms and may be critical indicators of the systemic physical sequelae of traumatic stress. Parallel process latent growth modeling wasapplied to longitudinal data collected from 35,788 9/11 survivors and used to model PTSD symptoms and MetC to determine how the development and course of one affect the other. A unidirectional relationship was found in which the intercept of PTSD symptoms predicted the slope of MetC. Hyperarousal (ß=.172) and emotional numbing (ß=.171) PTSD symptoms demonstrated the strongest association with the growth of MetC over and above the effects of general psychological distress, smoking history, and alcohol use when equally considering age, sex, race/ethnicity, pre-existing potentially traumatic events and physical health problems. Females and participants of color, particularly Asian participants and participants identified as American Indian, Alaskan Native, multiracial, or “other” demonstrated the strongest association between PTSD symptoms and MetC. Post-hoc analyses indicated utilization of PTSD-related psychotherapy was associated with decreased growth of MetC, suggesting a potential mitigating effect on the development and course of MetC following psychological trauma. Findings have strong implications for the evaluation and integrated treatment of a diverse range of individuals exposed to trauma and may help improve healthcare equity.

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