Post-traumatic stress disorder and cardiometabolic disease: improving causal inference to inform practice
Open accessAbstract
Post-traumatic stress disorder (PTSD) has been declared ‘a life sentence’ based on evidence that the disorder leads to a host of physical health problems. Some of the strongest empirical research – in terms of methodology and findings – has shown that PTSD predicts higher risk of cardiometabolic diseases, specifically cardiovascular disease (CVD) and type 2 diabetes (T2D). Despite mounting evidence, PTSD is not currently acknowledged as a risk factor by cardiovascular or endocrinological medicine. This view is unlikely to change absent compelling evidence that PTSD causally contributes to cardiometabolic disease. This review suggests that with developments in methods for epidemiological research and the rapidly expanding knowledge of the behavioral and biological effects of PTSD the field is poised to provide more definitive answers to questions of causality. First, we discuss methods to improve causal inference using the observational data most often used in studies of PTSD and health, with particular reference to issues of temporality and confounding. Second, we consider recent work linking PTSD with specific behaviors and biological processes, and evaluate whether these may plausibly serve as mechanisms by which PTSD leads to cardiometabolic disease. Third, we evaluate how looking more comprehensively into the PTSD phenotype provides insight into whether specific aspects of PTSD phenomenology are particularly relevant to cardiometabolic disease. Finally, we discuss new areas of research that are feasible and could enhance understanding of the PTSD–cardiometabolic relationship, such as testing whether treatment of PTSD can halt or even reverse the cardiometabolic risk factors causally related to CVD and T2D.
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.
Integrity signals
Registry
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.
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?
Although some pathways are shared across negative and positive psychological factors, specific manifestations of psychological health may have distinct biobehavioral effects.
“Although some pathways are shared across negative and positive psychological factors, 11,53,77,94,95 specific manifestations of psychological health may also have distinct biobehavioral effects. 96”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [94]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(98)00017-8 · Cited by 18,943 · see citing works
Davey Smith, G., & Ebrahim, S. (2003) · International Journal of Epidemiology · doi:10.1093/ije/dyg070 · Cited by 5,882 · see citing works
Lloyd-Jones, D. M., Hong, Y., Labarthe, D., Mozaffarian, D., Appel, L. J., Van Horn, L., Greenlund, K., Daniels, S., Nichol, G., Tomaselli, G. F., et al. (2010) · Circulation · doi:10.1161/circulationaha.109.192703 · Cited by 4,750 · see citing works
Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress
Tsigos, C., & Chrousos, G. P. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00429-4 · Cited by 2,822 · cited 2× · see citing works
“…stress hormone release by the hypothalamic – pituitary – adrenal (HPA) axis and the sympathetic – adrenal – medullary system is commonly observed in PTSD (Tsigos & Chrousos, 2002; de Kloet et al. 2006; Yehuda, 2006; Blechert et al. 2007), and other work has demonstrated that these disruptions…”
A Multisite, Randomized Controlled Trial for Children With Sexual Abuse–Related PTSD Symptoms
Cohen, J. A., Deblinger, E., Mannarino, A. P., & Steer, R. A. (2004) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200404000-00005 · Cited by 1,123 · cited 2× · see citing works
“One possibility is to add assessments of cardiometabolic-related biomarkers and behaviors to new clinical trials of PTSD treatment that have not yet started (Cohen et al. 2004; Cloitre et al. 2010).”
Insights Into Causal Pathways for Ischemic Heart Disease: Adverse Childhood Experiences Study
Dong, M., Giles, W. H., Felitti, V. J., Dube, S. R., Williams, J. E., Chapman, D. P., & Anda, R. F. (2004) · Circulation · doi:10.1161/01.cir.0000143074.54995.7f · Cited by 1,027 · see citing works
Passos, I. C., Vasconcelos-Moreno, M. P., Costa, L. G., Kunz, M., Brietzke, E., Quevedo, J., Salum, G., Magalhães, P. V., Kapczinski, F., & Kauer-Sant'Anna, M. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(15)00309-0 · Cited by 743 · see citing works
Treatment for PTSD Related to Childhood Abuse: a Randomized Controlled Trial
Cloitre, M., Stovall-McClough, K. C., Nooner, K., Zorbas, P., Cherry, S., Jackson, C. L., Gan, W., & Petkova, E. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.09081247 · Cited by 642 · cited 2× · see citing works
“One possibility is to add assessments of cardiometabolic-related biomarkers and behaviors to new clinical trials of PTSD treatment that have not yet started (Cohen et al. 2004; Cloitre et al. 2010).”
Psychosomatics and psychopathology: looking up and down from the brain
Thayer, J. F., & Brosschot, J. F. (2005) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.04.014 · Cited by 616 · see citing works
Santiago, P. N., Ursano, R. J., Gray, C. L., Pynoos, R. S., Spiegel, D., Lewis-Fernandez, R., Friedman, M. J., & Fullerton, C. S. (2013) · PLoS ONE · doi:10.1371/journal.pone.0059236 · Cited by 536 · cited 2× · see citing works
“rapid remitting, slow remitting, delayed onset, chronic/non-remitting) (Galatzer-Levy et al. 2013; Santiago et al. 2013).”
Edmondson, D., Richardson, S., Falzon, L., Davidson, K. W., Mills, M. A., & Neria, Y. (2012) · PLoS ONE · doi:10.1371/journal.pone.0038915 · Cited by 400 · see citing works
Assessment of Plasma C-Reactive Protein as a Biomarker of Posttraumatic Stress Disorder Risk
Eraly, S. A., Nievergelt, C. M., Maihofer, A. X., Barkauskas, D. A., Biswas, N., Agorastos, A., O’Connor, D. T., & Baker, D. G. (2014) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2013.4374 · Cited by 386 · see citing works
Sledjeski, E. M., Speisman, B., & Dierker, L. C. (2008) · Journal of Behavioral Medicine · doi:10.1007/s10865-008-9158-3 · Cited by 300 · see citing works
Autonomic and Respiratory Characteristics of Posttraumatic Stress Disorder and Panic Disorder
Blechert, J., Michael, T., Grossman, P., Lajtman, M., & Wilhelm, F. H. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31815a8f6b · Cited by 270 · cited 2× · see citing works
“Disrupted regulation of stress hormone release by the hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic–adrenal–medullary system is commonly observed in PTSD (Tsigos & Chrousos, 2002; de Kloet et al. 2006; Yehuda, 2006; Blechert et al. 2007), and other work has demonstrated that these disruptions can lead…”
Post-Traumatic Stress Disorder and Incidence of Coronary Heart Disease
Vaccarino, V., Goldberg, J., Rooks, C., Shah, A. J., Veledar, E., Faber, T. L., Votaw, J. R., Forsberg, C. W., & Bremner, J. D. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.04.085 · Cited by 247 · see citing works
Glucocorticoids, developmental ‘programming’ and the risk of affective dysfunction
Seckl, J. R. (2007) · Progress in Brain Research · doi:10.1016/s0079-6123(07)67002-2 · Cited by 245 · see citing works
Su, S., Jimenez, M. P., Roberts, C. T. F., & Loucks, E. B. (2015) · Current Cardiology Reports · doi:10.1007/s11886-015-0645-1 · Cited by 242 · see citing works
Glucocorticoid “Programming” and PTSD Risk
SECKL, J. R., & MEANEY, M. J. (2006) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1364.027 · Cited by 234 · see citing works
Spitzer, C., Barnow, S., Völzke, H., Wallaschofski, H., John, U., Freyberger, H. J., Löwe, B., & Grabe, H. J. (2010) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2009.06.002 · Cited by 205 · see citing works
Trauma in the Lives of Older Men: Findings from the Normative Aging Study
Schnurr, P. P., Spiro, A., Vielhauer, M. J., Findler, M. N., & Hamblen, J. L. (2002) · Journal of Clinical Geropsychology · doi:10.1023/a:1015992110544 · Cited by 204 · see citing works
Prins, B. P., Abbasi, A., Wong, A., Vaez, A., Nolte, I., Franceschini, N., Stuart, P. E., Guterriez Achury, J., Mistry, V., Bradfield, J. P., et al. (2016) · PLOS Medicine · doi:10.1371/journal.pmed.1001976 · Cited by 199 · see citing works
Posttraumatic stress disorder and impaired autonomic modulation in male twins
Shah, A. J., Lampert, R., Goldberg, J., Veledar, E., Bremner, J. D., & Vaccarino, V. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.01.019 · Cited by 192 · see citing works
van Zuiden, M., Geuze, E., Willemen, H. L. D. M., Vermetten, E., Maas, M., Heijnen, C. J., & Kavelaars, A. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.10050706 · Cited by 190 · see citing works
Pace, T. W. W., Wingenfeld, K., Schmidt, I., Meinlschmidt, G., Hellhammer, D. H., & Heim, C. M. (2012) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2011.07.232 · Cited by 184 · see citing works
Pole, N., Neylan, T. C., Otte, C., Henn-Hasse, C., Metzler, T. J., & Marmar, C. R. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.07.015 · Cited by 164 · see citing works
Galatzer-Levy, I. R., Ankri, Y., Freedman, S., Israeli-Shalev, Y., Roitman, P., Gilad, M., & Shalev, A. Y. (2013) · PLoS ONE · doi:10.1371/journal.pone.0070084 · Cited by 137 · see citing works
Matthews, K. A., Schott, L. L., Bromberger, J. T., Cyranowski, J. M., Everson-Rose, S. A., & Sowers, M. (2010) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2009.08.005 · Cited by 132 · see citing works
Altered Blood Coagulation in Patients With Posttraumatic Stress Disorder
von Känel, R., Hepp, U., Buddeberg, C., Keel, M., Mica, L., Aschbacher, K., & Schnyder, U. (2006) · Psychosomatic Medicine · doi:10.1097/01.psy.0000221229.43272.9d · Cited by 86 · see citing works
Flagged first, then by citations
Research works printed but not linked: 91
- Abboud FM Harwani SC Chapleau MW Autonomic neural regulation of the immune system implications for hypertension and cardiovascular disease Hypertension 2012 59 755 762 22331383 PMC3313828
- Ahmadi N Hajsadeghi F Mirshkarlo HB Budoff M Yehuda R Ebrahimi R Post-traumatic stress disorder, coronary atherosclerosis, and mortality American Journal of Cardiology 2011 108 29 33 21530936
- Armour C Tsai J Durham TA Charak R Biehn TL Elhai JD Pietrzak RH Dimensional structure of DSM-5 posttraumatic stress symptoms: Support for a hybrid anhedonia and externalizing behaviors model Journal of Psychiatric Research 2015 61 106 113 25479765
- Baker DG Nievergelt CM O'Connor DT Biomarkers of PTSD: neuropeptides and immune signaling Neuropharmacology 2012 62 663 673 21392516
- Bedi US Arora R Cardiovascular manifestations of posttraumatic stress disorder Journal of the National Medical Association 2007 99 642 649 17595933 PMC2574374
- Beristianos MH Yaffe K Cohen B Byers AL PTSD and Risk of Incident Cardiovascular Disease in Aging Veterans American Journal of Geriatric Psychiatry 2014 25555625
- Boscarino JA Posttraumatic stress disorder and mortality among U.S. Army veterans 30 years after military service Annals of Epidemiology 2006 16 248 256 16099672
- Boscarino JA A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: implications for surveillance and prevention Psychosomatic Medicine 2008 70 668 676 18596248 PMC3552245
- Boscarino JA Chang J Electrocardiogram abnormalities among men with stress-related psychiatric disorders: implications for coronary heart disease and clinical research Annals of Behavioral Medicine 1999 21 227 234 10626030
- Boyko EJ Jacobson IG Smith B Ryan MAK Hooper TI Amoroso PJ Gackstetter GD Barrett-Connor E Smith TC Team ftMCS Risk of diabetes in U.S. military service members in relation to combat deployment and mental health Diabetes Care 2010 33 1771 1777 20484134 PMC2909060
- Brouwers CJ Wolf JM von Känel R Martin C Preedy V Patel V Inflammatory markers in PTSD Comprehensive guide to post-traumatic stress disorders (in press)
- Buckley TC Kaloupek DG A meta-analytic examination of basal cardiovascular activity in posttraumatic stress disorder Psychosomatic Medicine 2001 63 585 594 11485112
- Chapman C Mills K Slade T McFarlane AC Bryant R Creamer M Silove D Teesson M Remission from post-traumatic stress disorder in the general population Psychological Medicine 2012 42 1695 1703 22166813
- Chen M-H Pan T-L Li C-T Lin W-C Chen Y-S Lee Y-C Tsai S-J Hsu J-W Huang K-L Tsai C-F Risk of stroke among patients with post-traumatic stress disorder: nationwide longitudinal study The British Journal of Psychiatry 2015 206 302 307 25698764
- Chwastiak LA Rosenheck RA Kazis LE Association of psychiatric illness and obesity, physical inactivity, and smoking among a national sample of veterans Psychosomatics 2011 52 230 236 21565594 PMC3094543
- de Kloet CS Vermetten E Geuze E Kavelaars A Heijnen CJ Westenberg HG Assessment of HPA-axis function in posttraumatic stress disorder: pharmacological and non-pharmacological challenge tests, a review Journal of Psychiatric Research 2006 40 550 567 16214171
- Dennis PA Watkins LL Calhoun PS Oddone A Sherwood A Dennis MF Rissling MB Beckham JC Posttraumatic stress, heart rate variability, and the mediating role of behavioral health risks Psychosomatic Medicine 2014 76 629 637 25264973 PMC4197067
- Dube SR Felitti VJ Dong M Giles WH Anda RF The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900 Preventive Medicine 2003 37 268 277 12914833
- Dudley KJ Li X Kobor MS Kippin TE Bredy TW Epigenetic mechanisms mediating vulnerability and resilience to psychiatric disorders Neuroscience & Biobehavioral Reviews 2011 35 1544 1551 21251925
- Edmondson D Cohen BE Posttraumatic stress disorder and cardiovascular disease Progress in Cardiovascular Diseases 2013 55 548 556 23621964 PMC3639489
- Ehlert U Enduring psychobiological effects of childhood adversity Psychoneuroendocrinology 2013 38 1850 1857 23850228
- El-Gabalawy R Mackenzie CS Pietrzak RH Sareen J A longitudinal examination of anxiety disorders and physical health conditions in a nationally representative sample of U.S. older adults Experimental Gerontology 2014 60 46 56 25245888
- Elhai JD Biehn TL Armour C Klopper JJ Frueh BC Palmieri PA Evidence for a unique PTSD construct represented by PTSD's D1–D3 symptoms Journal of Anxiety Disorders 2011 25 340 345 21094021
- Forbes D Lockwood E Elhai JD Creamer M O'Donnell M Bryant R McFarlane A Silove D An examination of the structure of posttraumatic stress disorder in relation to the anxiety and depressive disorders Journal of Affective Disorders 2011 132 165 172 21496930
- Forbes D Parslow R Creamer M O'Donnell M Bryant R McFarlane A Silove D Shalev A A longitudinal analysis of posttraumatic stress disorder symptoms and their relationship with fear and anxious-misery disorders: implications for DSM-V Journal of Affective Disorders 2010 127 147 152 20605220
- Fu SS McFall M Saxon AJ Beckham JC Carmody TP Baker DG Joseph AM Post-traumatic stress disorder and smoking: a systematic review Nicotine & Tobacco Research 2007 9 1071 1084 17978982
- Giacco D Matanov A Priebe S Symptoms and subjective quality of life in post-traumatic stress disorder: a longitudinal study PLoS One 2013 8 e60991 23585868 PMC3621668
- Gill J Vythilingam M Page GG Low cortisol, high DHEA, and high levels of stimulated TNF-alpha, and IL-6 in women with PTSD Journal of Traumatic Stress 2008 21 530 539 19107725 PMC2829297
- Godfrey KM Lindamer LA Mostoufi S Afari N Posttraumatic stress disorder and health: a preliminary study of group differences in health and health behaviors Annals of General Psychiatry 2013 12 30 24070007 PMC3852011
- Goldstein BI Carnethon MR Matthews KA McIntyre RS Miller GE Raghuveer G Stoney CM Wasiak H McCrindle BW Major depressive disorder and bipolar disorder predispose youth to accelerated atherosclerosis and early cardiovascular disease: a scientific statement from the American Heart Association Circulation 2015 132 965 986 26260736
- Gooding HC Milliren CE Austin SB Sheridan MA McLaughlin KA Child abuse, resting blood pressure, and blood pressure reactivity to psychosocial stress Journal of Pediatric Psychology 2016 41 5 14 25979082 PMC4723669
- Gradus JL Farkas DK Svensson E Ehrenstein V Lash TL Milstein A Adler N Sørensen HT Associations between stress disorders and cardiovascular disease events in the Danish population BMJ Open 2015 5 e009334 PMC4679888 26667014
- Grant DM Beck JG Marques L Palyo SA Clapp JD The structure of distress following trauma: posttraumatic stress disorder, major depressive disorder, and generalized anxiety disorder Journal of Abnormal Psychology 2008 117 662 672 18729617
- Greenland S An introduction to instrumental variables for epidemiologists International Journal of Epidemiology 2000 29 722 729 10922351
- Hall KS Hoerster KD Yancy WS Jr Post-traumatic stress disorder, physical activity, and eating behaviors Epidemiologic Reviews 2015 37 103 115 25595169
- Harpaz-Rotem I Tsai J Pietrzak RH Hoff R The dimensional structure of posttraumatic stress symptomatology in 323,903 US veterans Journal of Psychiatric Research 2014 49 31 36 24275548
- Jordan HT Miller-Archie SA Cone JE Morabia A Stellman SD Heart disease among adults exposed to the September 11, 2001 World Trade Center disaster: Results from the World Trade Center Health Registry Preventive Medicine 2011 53 370 376 22040652
- Kagan BL Leskin G Haas B Wilkins J Foy D Elevated lipid levels in Vietnam veterans with chronic posttraumatic stress disorder Biological Psychiatry 1999 45 374 377 10023518
- Karlovic D Buljan D Martinac M Marcinko D Serum lipid concentrations in Croatian veterans with post-traumatic stress disorder, post-traumatic stress disorder comorbid with major depressive disorder, or major depressive disorder Journal of Korean Medical Science 2004 19 431 436 15201512 PMC2816847
- Kessler RC Berglund P Demler O Jin R Merikangas KR Walters EE Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication Archives of General Psychiatry 2005 62 593 602 15939837
- Kibler JL Posttraumatic stress and cardiovascular disease risk Journal of Trauma & Dissociation 2009 10 135 150 19333845
- Klungel OH Martens EP Psaty BM Grobbee DE Sullivan SD Stricker BHC Leufkens HGM de Boer A Methods to assess intended effects of drug treatment in observational studies are reviewed Journal of Clinical Epidemiology 2004 57 1223 1231 15617947
- Koenen KC Hitsman B Lyons MJ Stroud L Niaura R McCaffery J Goldberg J Eisen SA True W Tsuang M Posttraumatic stress disorder and late-onset smoking in the Vietnam era twin registry Journal of Consulting and Clinical Psychology 2006 74 186 16551156
- Koenen KC Moffitt TE Poulton R Martin J Caspi A Early childhood factors associated with the development of post-traumatic stress disorder: results from a longitudinal birth cohort Psychological Medicine 2007 37 181 192 17052377 PMC2254221
- Koenen KC Stellman SD Sommer JF Stellman JM Persisting posttraumatic stress disorder symptoms and their relationship to functioning in Vietnam veterans: A 14 - year follow - up Journal of Traumatic Stress 2008 21 49 57 18302174 PMC2654776
- Kronish IM Lin JJ Cohen BE Voils CI Edmondson D Posttraumatic stress disorder and medication nonadherence in patients with uncontrolled hypertension JAMA Internal Medicine 2014 174 468 470 24296721 PMC3999520
- Kubzansky LD Bordelois P Jun HJ Roberts AL Cerda M Bluestone N Koenen KC The weight of traumatic stress: a prospective study of posttraumatic stress disorder symptoms and weight status in women JAMA Psychiatry 2014 71 44 51 24258147 PMC4091890
- Kubzansky LD Koenen KC Jones C Eaton WW A prospective study of posttraumatic stress disorder symptoms and coronary heart disease in women Health Psychology 2009 28 125 130 19210026 PMC2757327
- Kubzansky LD Koenen KC Spiro A 3rd Vokonas PS Sparrow D Prospective study of posttraumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study Archives of General Psychiatry 2007 64 109 116 17199060
- LeardMann CA Smith TC Smith B Wells TS Ryan MA Baseline self reported functional health and vulnerability to post-traumatic stress disorder after combat deployment: prospective US military cohort study BMJ 2009 338 b1273 19372117 PMC2671472
- Lefkowitz RJ Rockman HA Koch WJ Catecholamines, cardiac β-adrenergic receptors, and heart failure Circulation 2000 101 1634 1637 10758041
- Leskin GA Woodward SH Young HE Sheikh JI Effects of comorbid diagnoses on sleep disturbance in PTSD Journal of Psychiatric Research 2002 36 449 452 12393315
- Levine AB Levine LM Levine TB Posttraumatic stress disorder and cardiometabolic disease Cardiology 2014 127 1 19 24157651
- Logue MW Amstadter AB Baker DG Duncan L Koenen KC Liberzon I Miller MW Morey RA Nievergelt CM Ressler KJ The Psychiatric Genomics Consortium Posttraumatic Stress Disorder Workgroup: posttraumatic stress disorder enters the age of large-scale genomic collaboration Neuropsychopharmacology 2015 40 2287 2297 25904361 PMC4538342
- Lohr JB Palmer BW Eidt CA Aailaboyina S Mausbach BT Wolkowitz OM Thorp SR Jeste DV Is Post-Traumatic Stress Disorder Associated with Premature Senescence? A Review of the Literature American Journal of Geriatric Psychiatry 2015 23 709 725 25959921 PMC4568841
- Lowe SR Walsh K Uddin M Galea S Koenen KC Bidirectional relationships between trauma exposure and posttraumatic stress: a longitudinal study of Detroit residents Journal of Abnormal Psychology 2014 123 533 544 24886002 PMC4122585
- Maia DB Marmar CR Mendlowicz MV Metzler T Nobrega A Peres MC Coutinho ES Volchan E Figueira I Abnormal serum lipid profile in Brazilian police officers with post-traumatic stress disorder Journal of Affective Disorders 2008 107 259 263 17888517 PMC3974924
- Morina N Wicherts JM Lobbrecht J Priebe S Remission from post-traumatic stress disorder in adults: A systematic review and meta-analysis of long term outcome studies Clinical Psychology Review 2014 34 249 255 24681171
- Mustapic M Maihofer AX Mahata M Chen Y Baker DG O'Connor DT Nievergelt CM The catecholamine biosynthetic enzyme dopamine β-hydroxylase (DBH): first genome-wide search positions trait-determining variants acting additively in the proximal promoter Human Molecular Genetics 2014 23 6375 6384 24986918 PMC4222356
- Pan A Keum N Okereke OI Sun Q Kivimaki M Rubin RR Hu FB Bidirectional Association Between Depression and Metabolic Syndrome A systematic review and meta-analysis of epidemiological studies Diabetes Care 2012 35 1171 1180 22517938 PMC3329841
- Pan A Lucas M Sun Q van Dam RM Franco OH Manson JE Willett WC Ascherio A Hu FB Bidirectional association between depression and type 2 diabetes mellitus in women Archives of Internal Medicine 2010 170 1884 1891 21098346 PMC3065781
- Parker AM Sricharoenchai T Raparla S Schneck KW Bienvenu OJ Needham DM Posttraumatic stress disorder in critical illness survivors: a metaanalysis Critical Care Medicine 2015 43 1121 1129 25654178
- Perkonigg A Owashi T Stein MB Kirschbaum C Wittchen HU Posttraumatic stress disorder and obesity: evidence for a risk association American Journal of Preventive Medicine 2009 36 1 8 18976880
- Pitman RK Rasmusson AM Koenen KC Shin LM Orr SP Gilbertson MW Milad MR Liberzon I Biological studies of post-traumatic stress disorder Nature Reviews Neuroscience 2012 13 769 787 23047775 PMC4951157
- Plantinga L Bremner JD Miller AH Jones DP Veledar E Goldberg J Vaccarino V Association between posttraumatic stress disorder and inflammation: a twin study Brain, Behavior, and Immunity 2013 30 125 132 PMC3641167 23379997
- Roberts AL Agnew-Blais JC Spiegelman D Kubzansky LD Mason SM Galea S Hu FB Rich-Edwards JW Koenen KC Posttraumatic stress disorder and incidence of type 2 diabetes mellitus in a sample of women: a 22-year longitudinal study JAMA Psychiatry 2015 72 203 210 25565410 PMC4522929
- Robins JM Hernán MA Brumback B Marginal structural models and causal inference in epidemiology Epidemiology 2000 11 550 560 10955408
- Roy SS Foraker RE Girton RA Mansfield AJ Posttraumatic Stress Disorder and Incident Heart Failure Among a Community-Based Sample of US Veterans Journal Information 2015 105 PMC4358172 25713943
- Rusiecki JA Chen L Srikantan V Zhang L Yan L Polin ML Baccarelli A DNA methylation in repetitive elements and post-traumatic stress disorder: a case-control study of US military service members Epigenomics 2012 4 29 40 22332656 PMC3809831
- Sadeh N Miller MW Wolf EJ Harkness KL Negative emotionality and disconstraint influence PTSD symptom course via exposure to new major adverse life events Journal of Anxiety Disorders 2015 31 20 27 25659969 PMC4394853
- Schaefer JD Caspi A Belsky DW Harrington H Houts R Israel S Levine ME Sugden K Williams B Poulton R Moffitt TE Early-Life Intelligence Predicts Midlife Biological Age The Journals of Gerontology Series B: Psychological Sciences & Social Sciences 2015 PMC5067943 26014827
- Scherrer JF Chrusciel T Zeringue A Garfield LD Hauptman PJ Lustman PJ Freedland KE Carney RM Bucholz KK Owen R Anxiety disorders increase risk for incident myocardial infarction in depressed and nondepressed Veterans Administration patients American Heart Journal 2010 159 772 779 20435185
- Schnurr PP Spiro AI Combat disorder, posttraumatic stress disorder symptoms, and health behaviors as predictors of self-reported physical health in older veterans Journal of Nervous and Mental Disease 1999 187 353 359 10379722
- Scott KM McGee MA Wells JE Oakley Browne MA Obesity and mental disorders in the adult general population Journal of Psychosomatic Research 2008 64 97 105 18158005
- Smith AK Conneely KN Kilaru V Mercer KB Weiss TE Bradley B Tang Y Gillespie CF Cubells JF Ressler KJ Differential immune system DNA methylation and cytokine regulation in post-traumatic stress disorder American Journal of Medical Genetics Part B: Neuropsychiatric Genetics 2011 PMC3292872 21714072
- Suglia SF Clark CJ Boynton-Jarrett R Kressin NR Koenen KC Child maltreatment and hypertension in young adulthood BMC Public Health 2014 14 1149 25374338 PMC4240900
- Sumner JA Kubzansky LD Elkind MS Roberts AL Agnew-Blais J Chen Q Cerdá M Rexrode KM Rich-Edwards JW Spiegelman D Trauma exposure and posttraumatic stress disorder symptoms predict onset of cardiovascular events in women Circulation 2015 132 251 259 26124186 PMC4519406
- Tchetgen Tchetgen EJ Identification and estimation of survivor average causal effects Statistics in Medicine 2014 33 3601 3628 24889022 PMC4131726
- Vaccarino V Goldberg J Magruder KM Forsberg CW Friedman MJ Litz BT Heagerty PJ Huang GD Gleason TC Smith NL Posttraumatic stress disorder and incidence of type-2 diabetes: a prospective twin study Journal of Psychiatric Research 2014 56 158 164 24950602 PMC4086302
- van Zuiden M Geuze E Willemen HL Vermetten E Maas M Amarouchi K Kavelaars A Heijnen CJ Glucocorticoid receptor pathway components predict posttraumatic stress disorder symptom development: a prospective study Biological Psychiatry 2012 71 309 316 22137507
- Vandenbroucke JP Broadbent A Pearce N Causality and causal inference in epidemiology: the need for a pluralistic approach International Journal of Epidemiology 2016 dyv341 PMC5841832 26800751
- Vin-Raviv N Hillyer GC Hershman DL Galea S Leoce N Bovbjerg DH Kushi LH Kroenke C Lamerato L Ambrosone CB Valdimorsdottir H Jandorf L Mandelblatt JS Tsai WY Neugut AI Racial disparities in posttraumatic stress after diagnosis of localized breast cancer: the BQUAL study Journal of the National Cancer Institute 2013 105 563 572 23434900 PMC3627645
- von Känel R Abbas CC Schmid J-P Saner H Haeberli A Stutz M Begré S Momentary stress moderates procoagulant reactivity to a trauma-specific interview in patients with posttraumatic stress disorder caused by myocardial infarction Journal of Psychiatric Research 2010 44 956 963 20381071
- von Känel R Hepp U Traber R Kraemer B Mica L Keel M Mausbach BT Schnyder U Measures of endothelial dysfunction in plasma of patients with posttraumatic stress disorder Psychiatry Research 2008 158 363 373 18252265
- Weisskopf MG Kioumourtzoglou M-A Roberts AL Air Pollution and Autism Spectrum Disorders: Causal or Confounded? Current Environmental Health Reports 2015 1 10 26399256 PMC4737505
- Wentworth BA Stein MB Redwine LS Xue Y Taub PR Clopton P Nayak KR Maisel AS Post-traumatic stress disorder: a fast track to premature cardiovascular disease? Cardiology in Review 2013 21 16 22 22717656
- Winning A Glymour MM McCormick MC Gilsanz P Kubzansky LD Psychological distress across the life course and cardiometabolic risk: findings from the 1958 british birth cohort study Journal of the American College of Cardiology 2015 66 1577 1586 26429083
- Wolf EJ Bovin MJ Green JD Mitchell KS Stoop TB Barretto KM Jackson CE Lee LO Fang SC Trachtenberg F Rosen RC Keane TM Marx BP Longitudinal associations between post-traumatic stress disorder and metabolic syndrome severity Psychological Medicine 2016 46 2215 2226 27087657 PMC4925183
- Yehuda R Advances in understanding neuroendocrine alterations in PTSD and their therapeutic implications Annals of the New York Academy of Science 2006 1071 137 166 16891568
- Yehuda R Flory J Pratchett L Buxbaum J Ising M Holsboer F Putative biological mechanisms for the association between early life adversity and the subsequent development of PTSD Psychopharmacology 2010 212 405 417 20706708
- Zoellner LA Pruitt LD Farach FJ Jun JJ Understanding heterogeneity in PTSD: fear, dysphoria, and distress Depression and Anxiety 2014 31 97 106 23761021 PMC3900595
Cited by
Sorted by citations
Levine, G. N., Cohen, B. E., Commodore-Mensah, Y., Fleury, J., Huffman, J. C., Khalid, U., Labarthe, D. R., Lavretsky, H., Michos, E. D., Spatz, E. S., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000947 · Cited by 865 · see citing works
Self-citationNievergelt, C. M., Maihofer, A. X., Klengel, T., Atkinson, E. G., Chen, C.-Y., Choi, K. W., Coleman, J. R. I., Dalvie, S., Duncan, L. E., Gelernter, J., et al. (2019) · Nature Communications · doi:10.1038/s41467-019-12576-w · Cited by 635 · see citing works
Self-citationSuglia, S. F., Koenen, K. C., Boynton-Jarrett, R., Chan, P. S., Clark, C. J., Danese, A., Faith, M. S., Goldstein, B. I., Hayman, L. L., Isasi, C. R., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000536 · Cited by 518 · see citing works
Self-citationMetabolism, Metabolomics, and Inflammation in Posttraumatic Stress Disorder
Mellon, S. H., Gautam, A., Hammamieh, R., Jett, M., & Wolkowitz, O. M. (2018) · Biological Psychiatry · doi:10.1016/j.biopsych.2018.02.007 · Cited by 184 · see citing works
Posttraumatic Stress Disorder and Inflammation: Untangling Issues of Bidirectionality
Sumner, J. A., Nishimi, K. M., Koenen, K. C., Roberts, A. L., & Kubzansky, L. D. (2020) · Biological Psychiatry · doi:10.1016/j.biopsych.2019.11.005 · Cited by 131 · see citing works
Self-citationSomvanshi, P. R., Mellon, S. H., Flory, J. D., Abu-Amara, D., PTSD Systems Biology Consortium;, Wolkowitz, O. M., Yehuda, R., Jett, M., Hood, L., Marmar, C., et al. (2019) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00065.2019 · Cited by 40 · see citing works
- Authors
- Koenen, K. C., Sumner, J. A., Gilsanz, P., Glymour, M. M., Ratanatharathorn, A., Rimm, E. B., Roberts, A. L., Winning, A., & Kubzansky, L. D.
- Affiliations
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Koenen, K. C.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2016-10-04
- Volume
- 47
- Issue
- 2
- Pages
- 209-225
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC5214599
- OpenAlex
- W2527767781
- Cited by
- 136
- References
- 28
- Citations by year
- 2026: 1 · 2025: 15 · 2024: 7 · 2023: 15 · 2022: 21 · 2021: 18 · 2020: 8 · 2019: 21 · 2018: 18 · 2017: 11 · 2013: 1
- FWCI
- 2.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- National Institutes of Health
- National Institute on Aging (T32AG049663)
- National Heart, Lung, and Blood Institute (K01HL130650)
- National Institute of Mental Health (T32MH017119, R01MH078928, R01MH101269, R01MH101227)
- National Cancer Institute (UM1CA176726)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- post-traumatic stress disorder, cardiometabolic disease, cardiovascular disease, type 2 diabetes, causal inference, temporality, confounding, biological mechanisms, behavioral risk factors, PTSD treatment, cardiovascular risk factors
- MeSH terms
- Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Stress Disorders, Post-Traumatic
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
