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Etiology of depression comorbidity in combat-related PTSD: A review of the literature
Abstract
Posttraumatic stress disorder is often diagnosed with other mental health problems, particularly depression. Although PTSD comorbidity has been associated with more severe and chronic symptomology, relationships among commonly co-occurring disorders are not well understood. The purpose of this study was to review the literature regarding the development of depression comorbid with combat-related PTSD among military personnel. We summarize results of commonly tested hypotheses about the etiology of PTSD and depression comorbidity, including (1) causal hypotheses, (2) common factor hypotheses, and (3) potential confounds. Evidence suggests that PTSD may be a causal risk factor for subsequent depression; however, associations are likely complex, involving bidirectional causality, common risk factors, and common vulnerabilities. The unique nature of PTSD-depression comorbidity in the context of military deployment and combat exposure is emphasized. Implications of our results for clinical practice and future research are discussed.
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“Because depression commonly co-occurs with PTSD, and is typically identified as an important outcome in clinical trials treating these disorders (see Stander et al., 2014, for review)”
From Augmenting Prolonged Exposure therapy for PTSD with intranasal oxytocin: a randomized, placebo-controlled pilot trial (2018) · cites this paper as Stander et al., 2014
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Metadata
- Authors
- Stander, V. A., Thomsen, C. J., & Highfill-McRoy, R. M.
- Affiliations
- Naval Health Research Center (US)
- Corresponding author
- Stander, Valerie A.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 34
- Issue
- 2
- Pages
- 87-98
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2015000636
- Cited by
- 271
- References
- 135
- Citations by year
- 2026: 10 · 2025: 21 · 2024: 29 · 2023: 23 · 2022: 27 · 2021: 23 · 2020: 34 · 2019: 25 · 2018: 21 · 2017: 18 · 2016: 15 · 2015: 21 · 2014: 4
- FWCI
- 1.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Keywords
- post-traumatic stress disorder, depression, comorbidities, combat exposure, military personnel, etiology, bidirectional causality, shared risk factors, military deployment
- MeSH terms
- Combat Disorders, Depressive Disorder, Humans, Military Personnel, Stress Disorders, Post-Traumatic, Veterans
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