Dysphoria Symptoms Research Articles

Predicting young adults' risk for engaging in prescription drug misuse in daily life from individual, partner, and relationship factors

ABSTRACTBackground: Mounting evidence based on retrospective and global assessments has established associations between prescription drug misuse and illicit drug use, alcohol abuse, mental health problems, risky sexual behaviors, and overdose deaths. However, there is a notable absence of identified risk and protective factors for an individual's likelihood of engaging in misuse in real-world environments. Methods: Using an experience sampling approach, the authors collected repeated moments of young adults' (n = 95 participants drawn from 49 romantic couples) prescription drug misuse instances in daily life and tested multiple factors associated with the misuse. Results: When examined in separate multilevel models, individual and relationship factors (but not partner factors) reliably predicted the likelihood of females' and males' prescription drug misuse in daily life. Specifically, females' elevated dysphoria symptoms, alcohol problems, and relationship closeness were linked with an increased likelihood of misuse, whereas cohabiting decreased the likelihood of their misuse. Males' higher levels of illicit drug use and relationship closeness were associated with increased likelihood of misuse, whereas their dysphoria symptoms were related to a lower likelihood of misuse. When examined in models that considered the predictors simultaneously, females' misuse was associated with individual, partner, and relationship factors, whereas males' misuse was not reliably associated with any of the factors. Conclusions: An experience sampling approach was effective for the near-real-time assessment of young adults' prescription drug misuse in daily environments, and the likelihood of misuse was associated with risk and protective factors from multiple levels of influence. Education and treatment efforts designed to reduce prescription drug misuse may need to be tailored to accommodate males' and females' distinct predictors of misuse.

Helicopter Parenting, Autonomy Support, and College Students' Mental Health and Well-being: The Moderating Role of Sex and Ethnicity.

Whereas parental involvement is consistently linked with positive child outcomes throughout development, parental involvement that is not developmentally appropriate and intrusive--a style of parenting called helicopter parenting--can be problematic for their child's adjustment and well-being. Helicopter parenting can be particularly harmful during emerging adulthood when young adults are working toward developmental goals of self-reliance and autonomy. The purpose of this study was to examine sex differences in the relation between helicopter parenting and autonomy support on college students' mental health and well-being. A secondary aim was to explore the extent to which there were ethnic differences (non-Hispanic White vs. Hispanic) in associations between parenting and college students' outcomes. We examined several domains of mental health, including dysphoria symptoms, social anxiety, and general well-being. A sample of 118 undergraduate students (Mage = 19.82 years, SD = 1.38; 83.1% female; 57% European American) completed measures of parenting and mental health and well-being. The results showed that higher levels of helicopter parenting predicted lower levels of well-being for females, whereas higher levels of autonomy support predicted lower levels of dysphoria symptoms and social anxiety among males. No ethnic differences were found. The findings highlight that parents' behavior continues to predict their child's well-being even in emerging adulthood, and that parenting may differentially predict male and female college students' mental health outcomes.

Coping Strategies in War Veterans 20 Years After the Exposure to Extreme Stress

Many soldiers encounter difficulties while transitioning from military to civilian life. Such severe traumatic events may also have long-term effects. Previous studies have shown a strong relationship between coping strategies and posttraumatic stress disorder (PTSD) symptoms. The aim of this study was to investigate how veterans who were exposed to war trauma 20 years ago now deal with everyday life stressors, and how their current coping strategies relate to the four-factor model of PTSD. A total of 220 male Croatian Homeland War Veterans between the ages of 38 and 75 participated. Questionnaires included Combat Exposure Scale, Posttraumatic Stress Disorder Checklist – Military Version and Ways of Coping Questionnaire. Results showed positive association between dysphoria and escape-avoidance coping strategy and negative association between dysphoria and positive reappraisal coping strategy. Given that dysphoria symptoms are associated with the chronicity of PTSD and poorer response to PTSD therapy treatment in war veterans, our results underscore the importance of treating dysphoria symptoms and promoting engagement coping strategies for this population.

The Role of Body Vigilance in Depression Symptomatology

The aim of the present study is to examine the unique predictive ability of body vigilance in terms of both global (i.e., general depression, dysphoria) and specific (i.e., suicidality, lassitude, insomnia, appetite change, ill temper, well-being) depressive symptoms in a sample of undergraduates (n = 452; 72.3% female; Mage = 19.06, SD = 2.50). Results indicated that, after controlling for the effects of the presence of medical problems, trait anxiety, and anxiety sensitivity, body vigilance was a significant predictor of greater symptoms of general depression, dysphoria, lassitude, and appetite loss. Body vigilance was not a significant predictor of suicidality, insomnia, appetite gain, ill temper, and well-being. These results suggest that attentional focus on bodily sensations is associated with increased global symptoms of depression as well as some specific physical symptoms, and interventions targeting body vigilance may be helpful in reducing such symptoms in college students.

Depressive symptoms and all-cause mortality in people with type 2 diabetes: a focus on potential mechanisms.

Depression has been associated with increased all-cause mortality in people with type 2 diabetes. To test whether anhedonia, dysphoria and anxiety are differentially associated with all-cause mortality and examine symptom-specific behavioural or pathophysiological mechanisms. A total of 1465 people completed the Edinburgh Postnatal Depression Scale in 2005 and were followed until death or 31 December 2010. Cox regression analyses compared survival time for people with a low v. high baseline dysphoria/anhedonia/anxiety score and identified mediating mechanisms. After a mean follow-up of 1878 days (s.d. = 306), 139 participants had died. At all time points, people with anhedonia had an almost twofold increased mortality risk compared with those without anhedonia. Physical activity met criteria for mediation. Symptoms of dysphoria and anxiety were not associated with survival time. Symptoms of anhedonia predicted shorter survival time, whereas dysphoria/anxiety did not. Mechanistic pathways, in particular physical activity, should be explored further.

Suicidal tendencies as correlates of disability measures.

Disabilities and handicaps affect health-related quality-of-life (HRQOL) and dysphoria symptoms (helpless, hopeless, worthless, dissatisfied with life, depressed, suicidal). Archived 2009 Canadian Community Health Survey (CCHS) data (N=124,188) replicated 49 positive correlations (p<.001) of seven kinds of disability measured by the Health Utilities Index (HUI) with seven measures of dysphoria. Cognition and pain disabilities appeared most dysphoric. Individuals (N=724) in the 2009 CCHS data with HUI total scores less than 0.00 are defined by HUI protocols as "worse than dead." This HUI categorization has doubtful validity based on 17 measures of disability, suicidality, self-perceived health, and social engagement.

Gender dysphoria in an Omani female

A case of a girl who presented with symptoms of gender dysphoria is described here. She received cognitive behavioral therapy that helped her explore her thoughts and address any distorted cognition. She was able to live as a female and changed her mind about undergoing sex change surgery. This article explores the concept of gender dysphoria and the role of psychological interventions in its management.

The moderating role of dysphoria in the relationship between intrusions and alcohol use

Posttraumatic Stress Disorder (PTSD) is frequently comorbid with alcohol use disorders (AUD; Calabrese et al., 2011; McFall, Mackay, & Donovan, 1992). Among several explanations for this comorbidity, the most empirically supported is the self-medication theory which postulates that substances are used to medicate PTSD-related distress (Keane & Wolfe, 1990; Khantzian, 1985; Stewart, 1996). The current study examines the effects of trauma-related distress on alcohol use (total drinking days, drinks per drinking day, heavy drinking days) in a sample of 127 trauma-exposed Veterans following deployment to Iraq or Afghanistan. The dysphoria symptoms of PTSD were used as an indicator of distress, and examined as a moderator in the relationship between intrusion symptoms of PTSD and alcohol use. The proposed moderation model was tested using cross-sectional data from the first month following return from deployment, and at 6months and at 12months post-deployment. Results showed that dysphoria symptoms significantly moderated relations between intrusions and total drinking days and heavy drinking days at one month post-deployment; however, a significant pattern was not demonstrated at 6months and 12months. Further, dysphoria did not moderate the relation between intrusion symptoms and drinks per drinking day at the three time points. Theoretical and clinical implications are subsequently discussed.

The OnTrack Diabetes Web-Based Program for Type 2 Diabetes and Dysphoria Self-Management: A Randomized Controlled Trial Protocol.

BackgroundThe prevalence of type 2 diabetes is rising with the majority of patients practicing inadequate disease self-management. Depression, anxiety, and diabetes-specific distress present motivational challenges to adequate self-care. Health systems globally struggle to deliver routine services that are accessible to the entire population, in particular in rural areas. Web-based diabetes self-management interventions can provide frequent, accessible support regardless of time and locationObjectiveThis paper describes the protocol of an Australian national randomized controlled trial (RCT) of the OnTrack Diabetes program, an automated, interactive, self-guided Web program aimed to improve glycemic control, diabetes self-care, and dysphoria symptoms in type 2 diabetes patients.MethodsA small pilot trial is conducted that primarily tests program functionality, efficacy, and user acceptability and satisfaction. This is followed by the main RCT, which compares 3 treatments: (1) delayed program access: usual diabetes care for 3 months postbaseline followed by access to the full OnTrack Diabetes program; (2) immediate program: full access to the self-guided program from baseline onward; and (3) immediate program plus therapist support via Functional Imagery Training (FIT). Measures are administered at baseline and at 3, 6, and 12 months postbaseline. Primary outcomes are diabetes self-care behaviors (physical activity participation, diet, medication adherence, and blood glucose monitoring), glycated hemoglobin A1c (HbA1c) level, and diabetes-specific distress. Secondary outcomes are depression, anxiety, self-efficacy and adherence, and quality of life. Exposure data in terms of program uptake, use, time on each page, and program completion, as well as implementation feasibility will be conducted.ResultsThis trial is currently underway with funding support from the Wesley Research Institute in Brisbane, Australia.ConclusionsThis is the first known trial of an automated, self-guided, Web-based support program that uses a holistic approach in targeting both type 2 diabetes self-management and dysphoria. Findings will inform the feasibility of implementing such a program on an ongoing basis, including in rural and regional locations.Trial RegistrationAustralian and New Zealand Clinical Trials Registration number: ACTRN12612000620820; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612000620820 (Archived by WebCite at http://www.webcitation.org/6a3BeXC5m).

Hardiness, parenting stress, and PTSD symptomatology in U.S. Afghanistan/Iraq era veteran fathers.

There has been a call to identify variables that may contribute to positive outcomes in veterans of operations in Iraq and Afghanistan (e.g., Cornum, Matthews, & Seligman, 2011). Hardiness has been identified as a factor that buffers against the development of psychological symptoms in veterans, but has not been studied in relation to parenting. Previous research has demonstrated a link between PTSD symptomatology and parenting problems in male veterans, but has not investigated the role that hardiness may play in predicting parenting stress in this population. The current study assessed the relationships between PTSD symptomology and hardiness as predictors of parenting stress in a sample of 94 fathers who are U.S. Afghanistan/Iraq era veterans. Results indicated that PTSD symptoms, particularly symptoms of dysphoria, and the commitment component of hardiness were significant predictors of fathers’ parenting stress.

THE IMPACT OF MINDFULNESS ON PSYCHOSOMATIC COMPLAINTS AMONG FIREFIGHTERS: THE MEDIATOR ROLE OF VICARIOUS TRAUMATIZATION

ABSTRACT Firefighters are at risk to develop post-traumatic and psychosomatic symptoms. But in order to face negative health effects they have psychological resources at their disposal, such as mindfulness. This study aims to test the a model by which intrusion predicts general dysphoria in response to mindfulness. Self-report measures were administered to Italian firefighters. Structural equation modelling shown that mindfulness did not directly influence general dysphoria: mediation analyses revealed its meaningful indirect effect via intrusion. The results suggest that mindfulness can lead to reduced symptoms of general dysphoria through low levels of intrusive thoughts. Keywords mindfulness; vicarious traumatization; psychosomatic complaints; firefighters

Brief Report: Symptoms of PTSD, Coping Strategies, and Social Adjustment among Survivors of Early Life Interpersonal Trauma

Dysphoria symptoms of posttraumatic stress disorder (PTSD) have been associated with impairments in social functioning; however, this relationship has been unexamined among interpersonal trauma populations. A sample of 303 women with a history of early life interpersonal trauma completed measures of PTSD severity, coping, and social functioning. Results revealed that dysphoria symptoms had a strong and unique association with total social adjustment and social functioning (i.e., social activities). Active coping significantly mediated the relationship between dysphoria symptoms and total social adjustment, and active coping and seeking emotional support significantly mediated the relationship between dysphoria symptoms and social functioning. Findings elucidate variants of coping that might compound impaired social functioning and highlight the value of integrating coping skills into PTSD interventions.

Effect of extracts from Dendrobii ifficinalis flos on hyperthyroidism Yin deficiency mice

Some unhealthy life habits, such as long-term smoking, heavy drinking, sexual overstrain and frequent stay-up could induce the Yin deficiency symptoms of zygomatic red and dysphoria. Stems of Dendrobii officinalis flos (DOF) showed the efficacy of nourishing Yin. In this study, the hyperthyroidism Yin deficiency model was set up to study the yin nourishing effect and action mechanism of DOF, in order to provide the pharmacological basis for developing DOF resources and decreasing resource wastes. ICR mice were divided into five groups: the normal control group, the model control group, the positive control group and DOF extract groups (6.4 g · kg(-1)). Except for the normal group, the other groups were administrated with thyroxine for 30 d to set up the hyperthyroidism yin deficiency model. At the same time, the other groups were administrated with the corresponding drugs for 30 d. After administration for 4 weeks, the signs (facial temperature, pain domain, heart rate and autonomic activity) in mice were measured, and the facial and ear micro-circulation blood flow were detected by laser Doppler technology. After the last administration, all mice were fasted for 12 hours, blood were collected from their orbits, and serum were separated to detect AST, ALT, TG and TP by the automatic biochemistry analyzer and test T3, T4 and TSH levels by ELISA. (1) Compared with the normal control group, the model control group showed significant increases in facial and ear micro-circulation blood flow, facial temperature and heart rate (P < 0.05, P < 0.01), serum AST, ALT (P < 0.01), T3 level (P < 0.05), TSH level (P < 0.05) and notable deceases in pain domain (P < 0.01), TG level (P < 0.01). (2) Compared with the model control group, extracts from DOF (6 g · kg(-1)) could notably reduce facial and ear micro-circulation blood flow, facial temperature and heart rate (P < 0.05, P < 0.01) and AST (P < 0.05) and enhance pain domain (P < 0.01) and TG (P < 0.01). Extracts from DOF (4 g · kg(-1)) could remarkably reduce AST and ALT levels (P < 0.01, 0.05). Extracts from DOF (6 g · kg(-1) 4 g · kg(-1)) could significantly reduce T3 and increase serum TSH level (P < 0.05). DOF could improve Yin deficiency symptoms of zygomatic red and dysphoria in mice as well as liver function injury caused by overactive thyroid axis. According to its action mechanism, DOF may show yin nourishing and hepatic protective effects by impacting thyroxin substance metabolism, improving micro-circulation and reducing heart rate.

Treating patients with antipsychotics: an individualized management

Introduction: Subjective well-being, quality of life, cognition and psychosocial performance, including employment, have become endpoints of interest and goals for patients, families, clinicians and researchers. In this line, it is important to clarify the adverse effects caused by antipsychotics in order to innovate and complement treatment of patients with an individualize approach according to the patient’s needs and predispositions.Objectives: Discuss new treatment’s way for patients using antipsychotics, elucidating the pros and cons of their use.Results: Atypical antipsychotics cause weight gain and lead to a higher risk of diabetes and other metabolic sequelae than their typical counterparts. Besides, second-generation(atypical) has also shown adverse effects like: akathisia, sedation, abnormal metabolic laboratory results, and weight gain. On the other hand, talking about the fist-gentration (typical) antipsychotics, their clinical effectiveness is challenged by increased acute and chronic extrapyramidal side effects and related symptoms of dysphoria, compared to second-generation (atypical) antipsychotics. In addition, available evidence indicates that antipsychotic medications increase the risk of cerebrovascular adverse events (CVAEs) and death when used to treat elderly patients with Behavioral and Psychological Symptoms of Dementia (BPSD). Besides, some studies show that patient populations that are prescribed antipsychotic agents have a higher cardiovascular mortality rate than the general population. Considering that, we can see that each psychotic patient will need an individualized treatment according to their physical, social and psychological limitations and needs, leading us to realize the signifiance of this paper since it emphasizes the holistic management of this kind of patient.Conclusion: With the aim of known safety concerns and uncertainty over long-term risks and benefis, it is clear the need to reevaluate clinical practice standard and strengthen efforts to educate especially primary care physicians, concerning the known safety and effiacy of antipsychotic medications to give the patients a treatment that is based on their quality of life.

An evaluation of the DSM-5 factor structure for posttraumatic stress disorder in survivors of traumatic injury

Confirmatory factor analytic studies of the latent structure of DSM-5 PTSD symptoms using self-report data (Elhai et al., 2012; Miller et al., 2013) have found that the four-factor model implied by the DSM-5 diagnostic criteria provided adequate fit to their data. However, the fit of this model is yet to be assessed using data derived from gold standard structured interview measures. This study evaluated the fit of the DSM-5 four-factor model and an alternative four-factor model in 570 injury survivors six years post-injury using the Clinician Administered PTSD Scale (Blake et al., 1990), updated to include items measuring new DSM-5 symptoms. While both four-factor models fitted the data well, very high correlations between the ‘Intrusions’ and ‘Avoidance’ factors in both models and between the ‘Negative Alterations in Cognitions and Mood’ and ‘Arousal and Reactivity’ factors in the DSM-5 model and the ‘Dysphoria’ and ‘Hyperarousal’ factors in the alternative model were evident, suggesting that a more parsimonious two-factor model combining these pairs of factors may adequately represent the latent structure. Such a two-factor model fitted the data less well according to χ2 difference testing, but demonstrated broadly equivalent fit using other fit indices. Relationships between the factors of each of the four-factor models and the latent factors of Fear and Anxious-Misery/Distress underlying Internalizing disorders (Krueger, 1999) were also explored, with findings providing further support for the close relationship between the Intrusion and Avoidance factors. However, these findings also suggested that there may be some utility to distinguishing Negative Alterations in Cognition and Mood symptoms from Arousal and Reactivity symptoms, and/or Dysphoria symptoms from Hyperarousal symptoms. Further studies are required to assess the potential discriminant validity of the two four-factor models.

Association of in vivo κ-opioid receptor availability and the transdiagnostic dimensional expression of trauma-related psychopathology.

Exposure to trauma increases the risk for developing threat (ie, fear) symptoms, such as reexperiencing and hyperarousal symptoms, and loss (ie, dysphoria) symptoms, such as emotional numbing and depressive symptoms. While preclinical data have implicated the activated dynorphin/κ-opioid receptor (KOR) system in relation to these symptoms, the role of the KOR system in mediating these phenotypes in humans is unknown. Elucidation of molecular targets implicated in threat and loss symptoms is important because it can help inform the development of novel, mechanism-based treatments for trauma-related psychopathology. To use the newly developed [11C]LY2795050 radiotracer and high-resolution positron emission tomography to evaluate the relation between in vivo KOR availability in an amygdala-anterior cingulate cortex-ventral striatal neural circuit and the severity of threat and loss symptoms. We additionally evaluated the role of 24-hour urinary cortisol levels in mediating this association. This cross-sectional positron emission tomography study under resting conditions was conducted at an academic medical center. Thirty-five individuals representing a broad transdiagnostic and dimensional spectrum of trauma-related psychopathology, ranging from nontrauma-exposed psychiatrically healthy adults to trauma-exposed adults with severe trauma-related psychopathology (ie, posttraumatic stress disorder, major depressive disorder, and/or generalized anxiety disorder). [11C]LY2795050 volume of distribution values in amygdala-anterior cingulate cortex-ventral striatal neural circuit; composite measures of threat (ie, reexperiencing, avoidance, and hyperarousal symptoms) and loss (ie, emotional numbing, major depressive disorder, and generalized anxiety disorder symptoms) symptoms as assessed using the Clinician-Administered PTSD Scale, Hamilton Depression Rating Scale, and Hamilton Rating Scale for Anxiety; and 24-hour urinary cortisol levels. [11C]LY2795050 volume of distribution values in an amygdala-anterior cingulate cortex-ventral striatal neural circuit were negatively associated with severity of loss (r = -0.39; 95% CI, -0.08 to -0.66), but not threat (r = -0.03; 95% CI, -0.30 to 0.27), symptoms; this association was most pronounced for dysphoria symptoms (r = -0.45; 95% CI, -0.10 to -0.70). Path analysis revealed that lower [11C]LY2795050 volume of distribution values in this circuit was directly associated with greater severity of loss symptoms and indirectly mediated by 24-hour urinary cortisol levels. Results of this study suggest that KOR availability in an amygdala-anterior cingulate cortex-ventral striatal neural circuit mediates the phenotypic expression of trauma-related loss (ie, dysphoria) symptoms. They further suggest that an activated corticotropin-releasing factor/hypothalamic-pituitary-adrenal axis system, as assessed by 24-hour urinary cortisol levels, may indirectly mediate this association. These results may help inform the development of more targeted, mechanism-based transdiagnostic treatments for loss (ie, dysphoric) symptoms.

Relationships among Dispositional Attributional Style, Trauma-Specific Attributions, and PTSD Symptoms

The learned helplessness model and its various revisions suggest that causal attributions influence responses to events. This study examined relationships among the 3-factor symptom clusters of posttraumatic stress disorder (PTSD) represented in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV; American Psychiatric Association, 1994) and the individual dimensions of dispositional attributional style and trauma-specific attributions (i.e., internal–external, stable–unstable, global–specific). Relationships among attributions and clusters of PTSD symptoms represented by the 4-factor dysphoria model were also examined. Trauma-specific attributions were most predictive of PTSD symptoms, with higher associations for avoidance and numbing symptoms compared to arousal symptoms in the three-factor model and higher associations for dysphoria symptoms compared to arousal and avoidance symptoms in the four-factor dysphoria model. Results suggest that cognitive vulnerabilities could underlie the comorbidity between PTSD and depression and might represent a high-impact target for treatment.

Factor structure of PTSD symptoms in opioid-dependent patients rating their overall trauma history

BackgroundThe current standard for posttraumatic stress disorder (PTSD) diagnosis is a 3-factor model (re-experiencing, avoidance, and hyperarousal). Two 4-factor models of PTSD, the emotional numbing model (re-experiencing, avoidance, emotional numbing, and hyperarousal) and the dysphoria model (re-experiencing, avoidance, dysphoria, and hyperarousal), have considerable empirical support in the extant literature. However, a newer 5-factor model of PTSD has been introduced that is receiving interest. The 5-factor model differs from the four-factor models in its placement of three symptoms (irritability, sleep disturbance, and concentration difficulties) into a separate cluster termed dysphoric arousal. We empirically compared the theoretical factor structures of 3-, 4-, and 5-factor models of PTSD symptoms to find the best fitting model in a sample of opioid-dependent hospitalized patients. MethodsConfirmatory factor analyses were conducted on the 17 self-reported PTSD symptoms of the Posttraumatic Checklist – Civilian Version (PCL-C) in a sample of 151 men and women with opioid dependence. ResultsBoth four-factor models fit the observed data better than the three-factor model of PTSD; the dysphoria model was preferred to the emotional numbing model in this sample. The recently introduced five-factor model fit the observed data better than either four factor model. ConclusionsPTSD is a heterogeneous disorder comprised of symptoms of re-experiencing, avoidance, numbing, and dysphoria. Three symptoms, irritability, sleep disturbance, and concentration difficulties, may represent a unique latent construct separate from these four symptom clusters in opioid-dependent populations who have experienced traumatic events.

Erratum to: Influence of Depression on State and Trait Anger in Veterans with Posttraumatic Stress Disorder

A veteran with sub-threshold PTSD was erroneously included in our sample of veterans with a current PTSD diagnosis. Upon correcting the error and rerunning analyses, we found that while the magnitudes of relationships among most variables were not meaningfully altered, some statistical results were slightly changed (see Tables 1, 2). In the new analyses, PTSD numbing no longer partially mediates the relationships between all PTSD clusters and trait anger. Instead, numbing partially mediates the relationships between the reexperiencing cluster and trait anger, and between the avoidance cluster and trait anger. Hyperarousal now has a significant indirect effect on trait anger through numbing symptoms. Additionally, PTSD dysphoria symptoms now partially mediate the relationships between all PTSD clusters and trait anger. The corrected results continue to support the main findings of our study; however, contrary to our original discussion, we can now conclude that numbing and dysphoria have a similar impact on PTSD cluster–anger relationships.

Influence of Depression on State and Trait Anger in Veterans with Posttraumatic Stress Disorder

Anger is one of the most important symptoms of posttraumatic stress disorder (PTSD), and is associated with many of the adverse correlates of PTSD. Researchers have proposed theories to explain the relationship between anger and PTSD, but no study to date has examined the mediating role of depression. The purpose of this study was to explore the mediating effects of current major depression disorder (MDD), as well as PTSD numbing and dysphoria symptom clusters (King et al. 1998; Simms et al. 2002) on the relationship between PTSD and anger. There were 98 participants in the study, and all were male veterans with combat-related PTSD taking part in a clinical trial. Results indicated that MDD partially mediated the relationship between PTSD and state anger, while numbing and dysphoria clusters partially mediated the relationships between other PTSD symptom clusters and trait anger. Implications for the treatment of anger in veterans with PTSD are discussed.