Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey-Replication (NCS-R)

Abstract

The present study sought to extend prior research by using data from the National Comorbidity Survey-Replication (NCS-R) to examine the relationship between number of lifetime traumas, posttraumatic stress disorder (PTSD) and 15 self-reported chronic medical conditions. The goal was to determine whether the commonly found relationship between PTSD symptomatology and physical health were better explained by the number of lifetime traumas experienced. The NCS-R is a representative US household survey that assessed lifetime experience of a variety of traumas, lifetime diagnosis of PTSD and 15 chronic medical conditions (e.g. pain conditions, cardiovascular disorders, etc.). Two major findings emerged: (1) there was a graded relationship between trauma exposure, PTSD, and the majority of chronic medical conditions where individuals with PTSD had the highest likelihood of chronic medical condition and non-traumatized individuals had the lowest risk and; (2) with the exception of headaches, the relationship between PTSD and chronic medical conditions was explained by the number of lifetime traumas experienced when analyses were subset to traumatized individuals. The present study supports prior research suggesting that multiple traumas have a cumulative effect on physical health. The impact of trauma on health may be independent of PTSD symptomatology.