CoChat
Sign Up
Cited by 45Physical Activity and HealthPosttraumatic Stress Disorder ResearchCancer survivorship and care

Post-traumatic Stress Disorder and 20-Year Physical Activity Trends Among Women

Open access
Winning, Ashley, Gilsanz, Paola, Koenen, Karestan C., Roberts, Andrea L., Chen, Qixuan, Sumner, Jennifer A., Rimm, Eric B., Maria Glymour, M. +1 more·2017·American Journal of Preventive Medicine
DOI 10.1016/j.amepre.2017.01.040PMC PMC5438780
Open this paper in CoChat — free account

Abstract

Introduction Post-traumatic stress disorder (PTSD) may be associated with physical inactivity, a modifiable lifestyle factor that contributes to risk of cardiovascular and other chronic diseases; however, no study has evaluated the association between PTSD onset and subsequent physical activity (PA) changes. Method Analyses were conducted between October 2014 and April 2016, using data from the ongoing Nurses' Health Study II (N=50,327). Trauma exposure and PTSD symptoms were assessed using two previously validated measures, the Brief Trauma Questionnaire and Short Screening Scale for DSM-IV PTSD. Average PA (hours/week) was assessed using self-report measures at six time points across 20 years (1989-2009). Linear mixed models with time-updated PTSD assessed differences in PA trajectories by trauma/PTSD status. Among a subsample of women whose trauma/PTSD onset during follow-up, group differences in PA patterns before and after onset were assessed using linear spline models. Results PA decreased more steeply over time among trauma-exposed women reporting four or five (β= -2.5E-3, SE=1.0E-3, p=0.007) or six or seven PTSD symptoms (β= -6.7E-3, SE=1.1E-3, p<0.001) versus women without trauma exposure, adjusting for potential confounders. Among a subsample of women whose trauma/PTSD symptoms onset during follow-up, no differences in PA were observed prior to onset; after onset, women with six or seven PTSD symptoms had a steeper decline (β= -17.1E-3, SE=4.2E-3, p<0.001) in PA over time than trauma-exposed women without PTSD. Conclusions Decreases in PA associated with PTSD symptoms may be a pathway through which PTSD influences cardiovascular and other chronic diseases.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.amepre.2017.01.040

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Longitudinal studies show that negative psychological factors precede and predict poorer health-related behaviors and faster rate of weight gain.

    “Although the question of bidirectionality exists between the presence of negative psychological states and these cardiac risk factors, longitudinal studies show that negative psychological factors precede and predict poorer health-related behaviors and faster rate of weight gain. 136-138”

    From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [138]

    The Discussion reports that, among women, physical activity declined faster after the onset of severe PTSD symptoms, supporting the claim about a psychological condition preceding a poorer health-related behavior. The paper does not report a faster rate of weight gain, and its longitudinal finding concerns PTSD symptoms and physical activity rather than negative psychological factors and health behaviors generally. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Those studies found a steeper decline in physical activity after the onset of PTSD symptoms.

    “Moreover, they found a steeper decline in physical activity after the onset of PTSD symptoms. 136-138”

    From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [138]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

The citation lists haven’t been fetched yet

References 55 · Cited by 45

Research works printed but not linked: 41

  1. [1]Sumner JA Kubzansky LD Elkind MS Trauma Exposure and Posttraumatic Stress Disorder Symptoms Predict Onset of Cardiovascular Events in Women Circulation 2015 132 4 251 259 https://doi.org/10.1161/CIRCULATIONAHA.114.014492 26124186 PMC4519406 · DOI
  2. [2]Kubzansky LD Bordelois P Jun HJ The weight of traumatic stress: a prospective study of posttraumatic stress disorder symptoms and weight status in women JAMA Psychiatry 2014 71 1 44 51 https://doi.org/10.1001/jamapsychiatry.2013.2798 24258147 PMC4091890 · DOI · Paper page
  3. [3]Roberts AL Agnew-Blais JC Spiegelman D Posttraumatic stress disorder and incidence of type 2 diabetes mellitus in a sample of women: a 22-year longitudinal study JAMA Psychiatry 2015 72 3 203 210 https://doi.org/10.1001/jamapsychiatry.2014.2632 25565410 PMC4522929 · DOI
  4. [6]Van der Kolk BA The body keeps the score: brain, mind, and body in the healing of trauma New York, NY Penguin Books 2014
  5. [9]Chomistek AK Chiuve SE Eliassen AH Mukamal KJ Willett WC Rimm EB Healthy lifestyle in the primordial prevention of cardiovascular disease among young women J Am Coll Cardiol 2015 65 1 43 51 https://doi.org/10.1016/j.jacc.2014.10.024 25572509 PMC4291551 · DOI · Paper page
  6. [10]Stewart AL Hays RD Wells KB Rogers WH Spritzer KL Greenfield S Long-term functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the Medical Outcomes Study J Clin Epidemiol 1994 47 7 719 730 https://doi.org/10.1016/0895-4356(94)90169-4 7722585 · DOI
  7. [12]Naci H Ioannidis JP Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study BMJ 2013 347 f5577 https://doi.org/10.1136/bmj.f5577 24473061 PMC3788175 · DOI · Paper page
  8. [13]Hall KS Hoerster KD Yancy WS Jr Post-traumatic stress disorder, physical activity, and eating behaviors Epidemiol Rev 2015 37 1 103 115 https://doi.org/10.1093/epirev/mxu011 25595169 · DOI
  9. [14]de Assis MA de Mello MF Scorza FA Evaluation of physical activity habits in patients with posttraumatic stress disorder Clinics (Sao Paulo) 2008 63 4 473 478 https://doi.org/10.1590/S1807-59322008000400010 18719757 PMC2664122 · DOI · Paper page
  10. [15]Vancampfort D Stubbs B Physical activity and metabolic disease among people with affective disorders: Prevention, management and implementation J Affect Disord In press. Online July 19, 2016. https://doi.org/10.1016/j.jad.2016.07.042 27519365 · DOI
  11. [16]Vancampfort D Stubbs B Richards J Physical fitness in people with posttraumatic stress disorder: a systematic review Disabil Rehabil In press. Online September 15, 2016, https://doi.org/10.1080/09638288.2016.1226412 27628485 · DOI
  12. [17]Ginzburg K Ein-Dor T Solomon Z Comorbidity of posttraumatic stress disorder, anxiety and depression: a 20-year longitudinal study of war veterans J Affect Disord 2010 123 1-3 249 257 https://doi.org/10.1016/j.jad.2009.08.006 19765828 · DOI
  13. [18]Breslau N Davis GC Peterson EL Schultz L Psychiatric sequelae of posttraumatic stress disorder in women Arch Gen Psychiatry 1997 54 1 81 87 https://doi.org/10.1001/archpsyc.1997.01830130087016 9006404 · DOI
  14. [19]Scarapicchia TM Sabiston CM O'Loughlin E Brunet J Chaiton M O'Loughlin JL Physical activity motivation mediates the association between depression symptoms and moderate-to-vigorous physical activity Prev Med 2014 66 45 48 https://doi.org/10.1016/j.ypmed.2014.05.017 24879889 · DOI
  15. [20]Azevedo Da Silva M Singh-Manoux A Brunner EJ Bidirectional association between physical activity and symptoms of anxiety and depression: the Whitehall II study Eur J Epidemiol 2012 27 7 537 546 https://doi.org/10.1007/s10654-012-9692-8 22623145 PMC4180054 · DOI · Paper page
  16. [21]Zen AL Whooley MA Zhao S Cohen BE Post-traumatic stress disorder is associated with poor health behaviors: findings from the heart and soul study Health Psychol 2012 31 2 194 201 https://doi.org/10.1037/a0025989 22023435 PMC3295904 · DOI
  17. [22]Morgan CA 3rd Hazlett G Wang S Richardson EG Jr Schnurr P Southwick SM Symptoms of dissociation in humans experiencing acute, uncontrollable stress: a prospective investigation Am J Psychiatry 2001 158 8 1239 1247 https://doi.org/10.1176/appi.ajp.158.8.1239 11481157 · DOI
  18. [23]Schnurr PP Lunney CA Sengupta A Spiro A 3rd A longitudinal study of retirement in older male veterans J Consult Clin Psychol 2005 73 3 561 566 https://doi.org/10.1037/0022-006X.73.3.561 15982154 · DOI
  19. [25]Breslau N Peterson EL Kessler RC Schultz LR Short screening scale for DSM-IV posttraumatic stress disorder Am J Psychiatry 1999 156 6 908 911 https://doi.org/10.1176/ajp.156.6.908 10360131 · DOI
  20. [26]Knauper B Cannell CF Schwarz N Bruce ML Kessler RC Improving accuracy of major depression age-of-onset reports in the U.S. National Comorbidity Survey Int J Methods Psychiatr Res 1999 8 1 39 48 https://doi.org/10.1002/mpr.55 · DOI · Paper page
  21. [27]Lee YC Agnew-Blais J Malspeis S Post-Traumatic Stress Disorder and Risk for Incident Rheumatoid Arthritis Arthritis Care Res (Hoboken) 2016 68 3 292 298 https://doi.org/10.1002/acr.22683 26239524 PMC4740283 · DOI
  22. [28]Kimerling R Ouimette P Prins A Brief report: Utility of a short screening scale for DSM-IV PTSD in primary care J Gen Intern Med 2006 21 1 65 67 https://doi.org/10.1111/j.1525-1497.2005.00292.x 16423126 PMC1484617 · DOI
  23. [31]Hu FB Sigal RJ Rich-Edwards JW Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study JAMA 1999 282 15 1433 1439 https://doi.org/10.1001/jama.282.15.1433 10535433 · DOI · Paper page
  24. [32]Magnusson C Baron J Persson I Body size in different periods of life and breast cancer risk in post-menopausal women Int J Cancer 1998 76 1 29 34 https://doi.org/10.1002/(SICI)1097-0215(19980330)76:1<29∷AID-IJC6>3.0.CO;2-# 9533758 · DOI
  25. [33]Must A Willett WC Dietz WH Remote recall of childhood height, weight, and body build by elderly subjects Am J Epidemiol 1993 138 1 56 64 8333427
  26. [34]Crown S Crisp AH A short clinical diagnostic self-rating scale for psychoneurotic patients. The Middlesex Hospital Questionnaire (M.H.Q.) Br J Psychiatry 1966 112 490 917 923 https://doi.org/10.1192/bjp.112.490.917 5970912 · DOI
  27. [35]Rutter LA Weatherill RP Krill SC Orazem R Taft CT Posttraumatic stress disorder symptoms, depressive symptoms, exercise, and health in college students Psychol Trauma 2013 5 1 56 61 https://doi.org/10.1037/a0021996 · DOI
  28. [36]Vancampfort D Richards J Stubbs B Physical Activity in People With Posttraumatic Stress Disorder: A Systematic Review of Correlates J Phys Act Health 2016 13 8 910 918 https://doi.org/10.1123/jpah.2015-0436 27144877 · DOI
  29. [37]Vujanovic AA Farris SG Harte CB Smits JA Zvolensky MJ Smoking Status and Exercise in relation to PTSD Symptoms: A Test among Trauma-Exposed Adults Ment Health Phys Act 2013 6 2 132 138 https://doi.org/10.1016/j.mhpa.2012.12.001 PMC3833670 24273598 · DOI · Paper page
  30. [38]Afari N Ahumada SM Wright LJ Psychological trauma and functional somatic syndromes: a systematic review and meta-analysis Psychosom Med 2014 76 1 2 11 https://doi.org/10.1097/PSY.0000000000000010 24336429 PMC3894419 · DOI · Paper page
  31. [39]Lasser K Boyd JW Woolhandler S Himmelstein DU McCormick D Bor DH Smoking and mental illness: A population-based prevalence study JAMA 2000 284 20 2606 2610 https://doi.org/10.1001/jama.284.20.2606 11086367 · DOI · Paper page
  32. [40]Mills KL Teesson M Ross J Peters L Trauma, PTSD, and substance use disorders: findings from the Australian National Survey of Mental Health and Well-Being Am J Psychiatry 2006 163 4 652 658 https://doi.org/10.1176/ajp.2006.163.4.652 16585440 · DOI
  33. [41]Leskin GA Woodward SH Young HE Sheikh JI Effects of comorbid diagnoses on sleep disturbance in PTSD J Psychiatr Res 2002 36 6 449 452 https://doi.org/10.1016/S0022-3956(02)00025-0 12393315 · DOI
  34. [42]Baron KG Reid KJ Zee PC Exercise to improve sleep in insomnia: exploration of the bidirectional effects J Clin Sleep Med 2013 9 8 819 824 https://doi.org/10.5664/jcsm.2930 23946713 PMC3716674 · DOI
  35. [44]Soundy A Roskell C Stubbs B Vancampfort D Selection, use and psychometric properties of physical activity measures to assess individuals with severe mental illness: a narrative synthesis Arch Psychiatr Nurs 2014 28 2 135 151 https://doi.org/10.1016/j.apnu.2013.12.002 24673789 · DOI · Paper page
  36. [45]Rosenbaum S Tiedemann A Sherrington C van der Ploeg HP Assessing physical activity in people with posttraumatic stress disorder: feasibility and concurrent validity of the International Physical Activity Questionnaire--short form and actigraph accelerometers BMC Res Notes 2014 7 576 https://doi.org/10.1186/1756-0500-7-576 25164278 PMC4167128 · DOI
  37. [46]Sattelmair J Pertman J Ding EL Kohl HW 3rd Haskell W Lee IM Dose response between physical activity and risk of coronary heart disease: a meta-analysis Circulation 2011 124 7 789 795 https://doi.org/10.1161/CIRCULATIONAHA.110.010710 21810663 PMC3158733 · DOI · Paper page
  38. [48]Oja P Dose response between total volume of physical activity and health and fitness Med Sci Sports Exerc 2001 33 6 Suppl S428 437 https://doi.org/10.1097/00005768-200106001-00011 11427767 · DOI
  39. [50]Haennel RG Lemire F Physical activity to prevent cardiovascular disease How much is enough? Can Fam Physician 2002 48 65 71 11852614 PMC2213927
  40. [51]Ross R Janssen I Physical activity, total and regional obesity: dose-response considerations Med Sci Sports Exerc 2001 33 6 Suppl S521 527 https://doi.org/10.1097/00005768-200106001-00023 11427779 · DOI
  41. [52]Levine AB Levine LM Levine TB Posttraumatic stress disorder and cardiometabolic disease Cardiology 2014 127 1 1 19 https://doi.org/10.1159/000354910 24157651 · DOI

Authors
Winning, A., Gilsanz, P., Koenen, K. C., Roberts, A. L., Chen, Q., Sumner, J. A., Rimm, E. B., Maria Glymour, M., & Kubzansky, L. D.
Affiliations
  • Harvard University (US)
  • Columbia University (US)
  • Brigham and Women's Hospital (US)
Corresponding author
Winning, Ashley
ORCID
Venue
American Journal of Preventive Medicine
Publisher
Elsevier BV
Published
2017-06
Volume
52
Issue
6
Pages
753-760
ISSN
0749-3797 (ISSN-L)
DOI
10.1016/j.amepre.2017.01.040
PMC
PMC5438780
OpenAlex
W2595652151
Cited by
45
References
55
Citations by year
2026: 1 · 2025: 3 · 2024: 6 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 7 · 2019: 4 · 2018: 4 · 2017: 2
FWCI
3.31
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Journal of Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
  • Columbia Academic Commons (Columbia University)
Funders
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute (K01HL130650)
  • National Institute of Mental Health (T32MH017119, R01MH101269)
  • National Cancer Institute (UM1CA176726)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
post-traumatic stress disorder, physical activity, physical inactivity, women, trauma exposure, physical activity decline, posttraumatic stress symptoms, cardiovascular risk, chronic disease risk, Nurses' Health Study II
MeSH terms
Adult, Female, Health Surveys, Humans, Longitudinal Studies, Surveys and Questionnaires, Risk Factors, Stress Disorders, Post-Traumatic, Time Factors, Exercise, Self Report

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review