Impact of comorbid depression on quality of life in male combat Veterans with posttraumatic stress disorder.

For Veterans with posttraumatic stress disorder (PTSD), depression is a highly comorbid condition. Both conditions have been associated with decreased quality of life, and research suggests that comorbid PTSD and depression may result in worse quality of life than PTSD alone. However, research is needed to elucidate the effect of comorbidity on a broader variety of quality of life domains. In this study, we used baseline data of 158 male combat Veterans taking part in a PTSD treatment trial and examined the unique relationships between quality of life domains and PTSD symptom clusters, major depressive disorder (MDD) diagnosis, and self-reported depressive symptoms. Veterans with comorbid PTSD-MDD reported significantly worse satisfaction-related quality of life than those with PTSD alone, although this finding was largely attributable to PTSD numbing symptoms. Subsequent analyses comparing the effect of numbing symptoms to depressive symptoms revealed that depression exerted a stronger influence, although numbing symptoms were still uniquely associated with quality of life. We discuss implications for treatment and research, as well as the need to address negative affect in Veterans with PTSD.

Examination of the Content Specificity of Posttraumatic Cognitions in Combat Veterans With Posttraumatic Stress Disorder.

OBJECTIVE: Cognitive theories have proposed the idea of content specificity, which holds that emotional disorders are associated with unique sets of negative cognitions. The existent research exploring the content specificity related to posttraumatic stress disorder (PTSD) and depression is sparse, and research is especially needed in veteran samples. The purpose of this study was to examine the associations of PTSD symptom clusters and comorbid depressive symptoms with posttraumatic cognitions. METHOD: This study was cross-sectional in design, and the sample consisted of data from 150 male combat veterans with PTSD drawn from the baseline assessments of a large clinical trial. Analyses involved a series of separate and simultaneous linear regressions to examine the unique associations of comorbid depressive symptoms and PTSD symptom clusters with posttraumatic cognitions, as well as post hoc analyses to examine the mediational role of comorbid depressive symptoms. RESULTS: Findings demonstrated that posttraumatic negative cognitions about the self and self-blame were most strongly associated with comorbid depressive symptoms and the depression-related PTSD numbing cluster. Comorbid depressive symptoms also partially mediated nearly all the relationships between posttraumatic cognitions and PTSD symptom clusters. CONCLUSIONS: The findings of this study suggest that posttraumatic cognitions about the self and self-blame are not specific to PTSD but rather are more strongly related to symptoms of depression and negative affect. The results also suggest a potential pathway from posttraumatic cognitions to PTSD through the partially mediating influence of comorbid depression, and highlight the need to assess and treat comorbid depression in veterans with PTSD.

Indicators of success: academic research partnerships to implement performance indicator systems in Clubhouses.

TOPIC: This article describes a collaboration between academic researchers and Clubhouses to develop and implement a statewide Clubhouse performance indicator system. PURPOSE: Given the challenging funding climate, it is important that Clubhouses are able to gather service provision and performance data. However, establishing the necessary data structures can be a daunting task, and partnerships with academic researchers can aid in this process. We detail one such collaboration, utilizing a participatory research public-academic liaison framework, between researchers and Hawai'i's Clubhouses. SOURCES USED: Sources used include published literature, personal communication, and personal observation. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Lessons learned during the collaboration include the importance of face-to-face contact, technology training, duplicated and unduplicated variables, and tailoring data structures to the culture and work-ordered day of each Clubhouse. Experiences in this collaboration confirm that with support Clubhouse members are capable of fulfilling the rigorous responsibilities of contributing to a performance indicator system.