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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Rootes-Murdy, K., Panta, S. R., Kelly, R., Romero, J., Quidé, Y., Cairns, M. J., Loughland, C. M., Carr, V. J., Catts, S. V., Jablensky, A. V., et al. (2023) · medRxiv · doi:10.1101/2023.09.28.23296219
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“Indeed, both individuals who smoke and those who do not smoke had elevated anxiety scores, which is not uncommon among individuals with probable PTSD (Spinhoven et al., 2014).”
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“Those with psychiatric disorders were also excluded with the exception of depressive, anxiety, or trauma-related disorders (including PTSD and other trauma-and stressor-related disorders), given their high rate of comorbidity with early trauma (Spinhoven et al. 2014).”
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“Given the specific sample enrichment for PTSD and high collinearity between PTSD symptoms and anxiety [ r (76)=0.59, p 0.0001] and depression [ r (77)=0.49, p 0.0001] symptoms[30], sensitivity analyses specifically controlling for these alternate symptom domains were not assessed.”
Influential
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“Given the specific sample enrichment for PTSD and high collinearity between PTSD symptoms and anxiety [ r (76) = 0.59, p 0.0001] and depression [ r (77) = 0.49, p 0.0001] symptoms 42 , sensitivity analyses specifically controlling for these alternate symptom domains were not assessed.”
Influential
Additional file 1 of Design and rationale of the REStoring mood after early life trauma with psychotherapy (RESET-psychotherapy) study: a multicenter randomized controlled trial on the efficacy of adjunctive trauma-focused therapy (TFT) versus treatment as usual (TAU) for adult patients with major depressive disorder (MDD) and childhood trauma
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“…ranging from 3.4% to 26.9% (Schein et al., 2021) and sequelae that include mental and physical health comorbidities (e.g., Pacella et al., 2013; Spinhoven et al., 2014; Tripp et al., 2019), psychosocial impairments (e.g., Creech et al., 2014; Maslow et al., 2015) and increased risk of suicide…”
Influential
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Durand, F. (2023) · theses.fr (ABES) · doi:10.70675/9de4ddcdzc32bz44bezbe3ez91904f8c6479
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Exploring anxiety as a potential mediator of the association between home destruction and PTSD symptoms among hemodialysis patients in Gaza after 7th Oct 2023
AbuZarifa, M., Hamam, M., Hamam, M., Alaloul, S. W., Alinaby, K., Alaloul, M. W., Hijazi, Y. M., AbuZarifa, M. B., AbuZarifa, R., & Veronese, G. (2026) · PLOS mental health. · doi:10.1371/journal.pmen.0000682
Clinical Boundaries of Trauma
Abargil, M., Rubinstein, D., Lerner, A., Basol, E. Z., Maynard, J., Davydovska, T., & Harpaz‐Rotem, I. (2026) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001885

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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