Cited by 305Posttraumatic Stress Disorder ResearchChild Abuse and TraumaPsychoanalysis and Psychopathology Research

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Comorbidity of PTSD in anxiety and depressive disorders: Prevalence and shared risk factors

Spinhoven, Philip, Penninx, Brenda W., van Hemert, Albert M., de Rooij, Mark, Elzinga, Bernet M.·2014·Child Abuse & Neglect

DOI 10.1016/j.chiabu.2014.01.017

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Abstract

The present study aims to assess comorbidity of posttraumatic stress disorder (PTSD) in anxiety and depressive disorders and to determine whether childhood trauma types and other putative independent risk factors for comorbid PTSD are unique to PTSD or shared with anxiety and depressive disorders. The sample of 2402 adults aged 18-65 included healthy controls, persons with a prior history of affective disorders, and persons with a current affective disorder. These individuals were assessed at baseline (T0) and 2 (T2) and 4 years (T4) later. At each wave, DSM-IV-TR based anxiety and depressive disorder, neuroticism, extraversion, and symptom severity were assessed. Childhood trauma was measured at T0 with an interview and at T4 with a questionnaire, and PTSD was measured with a standardized interview at T4. Prevalence of 5-year recency PTSD among anxiety and depressive disorders was 9.2%, and comorbidity, in particular with major depression, was high (84.4%). Comorbidity was associated with female gender, all types of childhood trauma, neuroticism, (low) extraversion, and symptom severity. Multivariable significant risk factors (i.e., female gender and child sexual and physical abuse) were shared among anxiety and depressive disorders. Our results support a shared vulnerability model for comorbidity of anxiety and depressive disorders with PTSD. Routine assessment of PTSD in patients with anxiety and depressive disorders seems warranted.

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Nöthling, J., Abrahams, N., Jewkes, R., Mhlongo, S., Lombard, C., Hemmings, S. M. J., & Seedat, S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.032 · Cited by 28
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“According to other research, childhood sexual abuse in particular was found to increase the risk for depression, which, due to a shared risk factor profile with PTSD, increases the likelihood of comorbid PTSD (Spinhoven et al., 2014).”
PTSD and Depression in Healthcare Workers in the Italian Epicenter of the COVID-19 Outbreak
Carmassi, C., Pedrinelli, V., Dell’Oste, V., Bertelloni, C. A., Grossi, C., Gesi, C., Cerveri, G., & Dell’Osso, L. (2021) · Clinical Practice and Epidemiology in Mental Health · doi:10.2174/1745017902117010242 · Cited by 25
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The latent structure of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD in a general population sample from USA: A factor mixture modelling approach
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Neurobiological Alterations in Females With PTSD: A Systematic Review
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A translational approach to the genetics of anxiety disorders
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Neuroinflammation is a susceptibility factor in developing a PTSD-like phenotype
Shanazz, K., Nalloor, R. I., Lucas, R., & Vazdarjanova, A. I. (2023) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2023.1112837 · Cited by 22
Comorbidity Patterns of Psychiatric Conditions in Canadian Armed Forces Personnel
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The network structure of posttraumatic stress disorder among Filipina migrant domestic workers: comorbidity with depression
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Epidemiology of DSM-5 PTSD and ICD-11 PTSD and complex PTSD in the Netherlands
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The shared and specific relationships between exposure to potentially traumatic events and transdiagnostic dimensions of psychopathology
Sunderland, M., Carragher, N., Chapman, C., Mills, K. L., Teesson, M., Lockwood, E., Forbes, D., & Slade, T. N. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.02.001 · Cited by 22
Trajectory of post-traumatic stress and depression among children and adolescents following single-incident trauma
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Relation between patterns of intrinsic network connectivity, cognitive functioning, and symptom presentation in trauma‐exposed patients with major depressive disorder
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PTSD and Burnout are Related to Lifetime Mood Spectrum in Emergency Healthcare Operator
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“The relationship between post-traumatic stress reactions and depression is considered complex, with overlapping symptomatology, mutual influence, and very high comorbidity rates [16, 19, 24, 52].”
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A pilot study adapting and validating the Harvard Trauma Questionnaire (HTQ) and PTSD checklist-5 (PCL-5) with Indian women from slums reporting gender-based violence
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“, idioms of distress and the embedded PCL-5 by examining their relationships with known correlates such as depression, anxiety, and somatic problems [25, 35, 59, 60].”
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Internalizing Symptoms Among Youth in Foster Care: Prevalence and Associations with Exposure to Maltreatment
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#4645Boricuas: Twitter reactions to the estimates of deaths by Hurricane María in Puerto Rico
García‐Ramírez, G., Bogen, K. W., Rodríguez‐Guzmán, V. M., Nugent, N. R., & Orchowski, L. M. (2020) · Journal of Community Psychology · doi:10.1002/jcop.22295 · Cited by 17
Vesicular monoamine transporter 2 mediates fear behavior in mice
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Long-term PTSD prevalence and associated adverse psychological, functional, and economic outcomes: a 12–15 year follow-up of adults with suspected serious injury
Karchoud, J. F., Haagsma, J. A., Karaban, I., Hoeboer, C. M., van de Schoot, R., Olff, M., & van Zuiden, M. (2024) · European Journal of Psychotraumatology · doi:10.1080/20008066.2024.2401285 · Cited by 18
“There are studies reporting gender differences in psychological comorbidity in people with PTSD (i.e. Brady et al., 2000; Kessler et al., 2013 higher in men; i.e. Spinhoven et al., 2014 higher in women), however, it remains uninvestigated whether this applies to the long-term as well.”
Background
Pass it on? The neural responses to rejection in the context of a family study on maltreatment
van den Berg, L. J. M., Tollenaar, M. S., Pittner, K., Block, L. C.-D., Buisman, R. S. M., van IJzendoorn, M. H., & Elzinga, B. M. (2018) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsy035 · Cited by 16
“Child physical and emotional abuse and neglect are associated with increased risk for long-lasting behavioral, physical and mental health problems (e.g. Heim et al., 2010; Spinhoven et al., 2010; Twardosz and Lutzker, 2010; McCrory et al., 2011a; Norman et al., 2012; Spinhoven et al., 2014).”
Background
Increased persistence of avoidance behaviour and social deficits with L.rhamnosus JB-1 or selective serotonin reuptake inhibitor treatment following social defeat
Liu, Y., Steinhausen, K., Bharwani, A., Mian, M. F., Neufeld, K. M., & Forsythe, P. (2020) · Scientific Reports · doi:10.1038/s41598-020-69968-y · Cited by 16
A framework for estimating the United States depression burden attributable to indoor fine particulate matter exposure
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“5 composition and toxicity (Stanek et al., 2011), and that magnitude of exposure is the sole predictor for health effects.”
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A randomized controlled trial of supervised remotely-delivered attention bias modification for posttraumatic stress disorder
Alon, Y., Azriel, O., Pine, D. S., & Bar-Haim, Y. (2022) · Psychological Medicine · doi:10.1017/s003329172200023x · Cited by 16
“PTSD is highly comorbid with major depression (Hankin, Spiro, Miller, & Kazis, 1999; Norris, Murphy, Baker, & Perilla, 2004; Spinhoven, Penninx, van Hemert, de Rooij, & Elzinga, 2014).”
The Impact of Psychedelic Drugs on Anxiety and Depression in Advanced Cancer or other Life-threatening Disease
Sicignano, D. J., Caroti, K. S., Hernández, A. V., & White, C. M. (2023) · American Journal of Clinical Oncology · doi:10.1097/coc.0000000000000998 · Cited by 15
Self-Disgust Is Associated With Loneliness, Mental Health Difficulties, and Eye-Gaze Avoidance in War Veterans With PTSD
Ypsilanti, A., Gettings, R., Lazuras, L., Robson, A., Powell, P. A., & Overton, P. G. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.559883 · Cited by 15
“, 1998), anxiety (Spinhoven et al., 2014), suicidality (Kramer et al.”
Psychological challenges and related factors of ordinary residents after “7.20” heavy rainstorm disaster in Zhengzhou: a cross-sectional survey and study
Wang, Z., Jiang, B., Wang, X., Wang, D., & Xue, H. (2023) · BMC Psychology · doi:10.1186/s40359-023-01038-0 · Cited by 16
“This finding was consistent with many previous studies [10, 44, 45], which found that females were more susceptible to certain psychiatric disorders after traumatic events, even during non-disastrous events, the proportion of females with various psychological problems was also larger than that of males [46].”
Result
Childhood maltreatment and internalizing/externalizing disorders in trauma-exposed adolescents: Does posttraumatic stress disorder (PTSD) severity have a mediating role?
van den Heuvel, L. L., Assim, A., Koning, M., Nöthling, J., & Seedat, S. (2023) · Development and Psychopathology · doi:10.1017/s0954579423001414 · Cited by 17
“Multiple studies have demonstrated that PTSD is often comorbid with other internalizing disorders, such as depression and anxiety disorders (Brady et al., 2000; Kilpatrick et al., 2003; Spinhoven et al., 2014).”
Is a Criterion A trauma necessary to elicit posttraumatic stress symptoms?
Howard, J., Lorenzo‐Luaces, L., Lind, C. M., Lakhan, P., & Rutter, L. A. (2023) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2023.12.008 · Cited by 14
Genetic Model to Study the Co-Morbid Phenotypes of Increased Alcohol Intake and Prior Stress-Induced Enhanced Fear Memory
Lim, P. H., Shi, G., Wang, T., Jenz, S. T., Mulligan, M. K., Redei, E. E., & Chen, H. (2018) · Frontiers in Genetics · doi:10.3389/fgene.2018.00566 · Cited by 14
Comorbid posttraumatic stress disorder and major depressive disorder are associated with asthma morbidity among World Trade Center workers
Wisnivesky, J. P., Markowitz, S. B., James, S., Stone, K., Dickens, B., Busse, P. J., Crowley, L. E., Federman, A. D., Katz, C. L., & Gonzalez, A. (2020) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2020.10.007 · Cited by 17
Depression in a youth population-based sample from Brazil: Prevalence and symptom structure
Manfro, P. H., da Silva, C. T. B., Anselmi, L., Barros, F. C., Eaton, W. W., Gonçalves, H., Murray, J., Oliveira, I. O., Tovo‐Rodrigues, L., Wehrmeister, F. C., et al. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.05.073 · Cited by 16

Authors: Spinhoven, P., Penninx, B. W., van Hemert, A. M., de Rooij, M., & Elzinga, B. M.
Affiliations: Leiden University (NL)
University Medical Center Groningen (NL)
Corresponding author: Spinhoven, Philip
ORCID: Spinhoven, Philip
Penninx, Brenda W.
Elzinga, Bernet M.
Venue: Child Abuse & Neglect
Publisher: Elsevier BV
Published: 2014-08
Volume: 38
Issue: 8
Pages: 1320-1330
ISSN: 0145-2134 (ISSN-L)
DOI: 10.1016/j.chiabu.2014.01.017
OpenAlex: W2137565796
Cited by: 305
References: 57
Citations by year: 2026: 21 · 2025: 51 · 2024: 28 · 2023: 38 · 2022: 28 · 2021: 27 · 2020: 30 · 2019: 15 · 2018: 16 · 2017: 22 · 2016: 15 · 2015: 11 · 2014: 2
FWCI: 19.67
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Child Abuse & Neglect (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Leiden Repository (Leiden University) (submittedVersion)
VU Research Portal (submittedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords: post-traumatic stress disorder, PTSD comorbidity, anxiety disorders, depressive disorders, major depressive disorder, childhood trauma, child sexual abuse, child physical abuse, shared risk factors, neuroticism, extraversion, symptom severity, gender differences, prevalence
MeSH terms: Adolescent, Adult, Aged, Child Abuse, Depressive Disorder, Female, Humans, Male, Middle Aged, Netherlands, Psychiatric Status Rating Scales, Risk Factors, Stress Disorders, Post-Traumatic, Cohort Studies, Comorbidity, Prevalence, Logistic Models, Diagnostic and Statistical Manual of Mental Disorders, Young Adult

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Comorbidity of PTSD in anxiety and depressive disorders: Prevalence and shared risk factors

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