PTSD symptom severity mediates the impact of war zone stress exposure on postdeployment physical health: The Fort Devens Gulf War veterans cohort.

OBJECTIVE: Exposure to traumatic events is associated with increased risk for negative physical health outcomes, but more work is needed to advance understanding of the mechanisms underlying this relationship. As military deployments frequently involve trauma exposure, this issue has clear implications for veteran populations. This longitudinal study examined the role of mental health symptomatology (i.e., PTSD, depression, and anxiety) in the association between war zone stress and postdeployment physical health in Gulf War veterans. METHOD: Data were collected in three waves over 7 years from a sample of 2,929 (92% male) Army personnel who were deployed to the 1990-1991 Gulf War. Structural equation modeling (SEM) was used to examine the associations linking war zone stress exposure reported at deployment return with subsequent physical health 6 to 7 years later, including the postdeployment onset of health symptoms and conditions and health functioning. The roles of PTSD, depression, and anxiety symptom severity as potential risk mechanisms linking stress exposure with later health outcomes were examined. RESULTS: Self-reported higher stress exposure was linked with greater severity of PTSD, depression, and anxiety symptoms. SEM analyses revealed that PTSD symptom severity was the only significant mediator of stress exposure on subsequent physical health. CONCLUSION: Findings support the unique and significant role of PTSD in the development of physical health problems in the wake of war zone stress for Gulf War veterans. These results suggest that targeted PTSD interventions could reduce or prevent future physical health problems that can result from trauma exposure and mental health sequelae linked to military service. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Spiritually integrated psychotherapies in real-world clinical practice: Synthesizing the literature to identify best practices and future research directions.

A comprehensive review of the practice-based evidence for spiritually integrated psychotherapy (SIP) is necessary in order to catalyze research and training in this important diversity area. In this article, we identify and synthesize key findings from 35 studies in six key areas: (a) SIPs in trauma treatment, (b) SIPs in treating eating disorders, (c) SIPs in general psychotherapy, (d) existential concerns as part of SIPs, (e) patients and therapist attitudes about SIPs, and (f) SIP supervision and training models. Building on this, we propose a culturally contextual understanding of this diversity area, drawing from the Relational Spirituality Model (RSM). Finally, we discuss best practices for spiritually responsive clinical care and offer a research prospectus to strengthen the evidence base for real-world effectiveness. (PsycInfo Database Record (c) 2022 APA, all rights reserved).