Longitudinal Study Research Articles

Association between sagittal abdominal diameter-to-height ratio and all-cause mortality among adults in the United States: a longitudinal study.

The global health crisis of obesity has prompted a need for better indicators of abdominal obesity than body mass index, with sagittal abdominal diameter emerging as a potential candidate. Nonetheless, the association between sagittal abdominal diameter-to-height ratio (SADHtR) and mortality remains inadequately established. Our objective was to contribute novel evidence to this association. This study encompassed 12,572 participants aged 18-80 years from the National Health and Nutrition Examination Survey 2011-2016. Mortality data were tracked until December 31, 2019. Weighted multivariable Cox proportional hazard models were employed to evaluate the association between SADHtR and all-cause mortality, with subgroup analyses conducted for result robustness. Following a median follow-up period of 69 months, each standard deviation (SD) increase in SADHtR was consistently associated with a higher risk of all-cause mortality across three models, yielding a hazard ratio (HR) and 95% confidence interval (CI) of 1.51(1.29,1.76) in model 3. Additionally, compared to the first tertile of SADHtR, the third tertile exhibited a higher risk for all-cause mortality, with HRs(95%CIs) of 1.58(1.25,2.01) in model 1, 2.01(1.33,3.02) in model 2, and 1.74(1.19,2.57) in model 3. Notably, subgroup analysis revealed persistent positive associations between SADHtR and all-cause mortality among subgroups based on age-at-risk (< 65, ≥ 65 years), sex, diabetes, hypertension, and hyperlipidemia. Elevated SADHtR was consistently associated with a higher risk of all-cause mortality in American adults. Regular SADHtR measurement should be considered to be integrated into clinical practice and healthcare examinations.

Seroconversion of SARS-CoV-2 Antibodies in Pregnant Women During the Second Wave of the COVID-19 Pandemic in India: A Longitudinal Study

Seroconversion of SARS-CoV-2 Antibodies in Pregnant Women During the Second Wave of the COVID-19 Pandemic in India: A Longitudinal Study

Chest pain and coronary artery disease in cardiac amyloidosis: Prevalence, mechanisms, and clinical implications.

Amyloidosis is a systemic disease affecting multiple organs, and often presents with cardiac involvement, with two primary underlying pathologies: amyloid light chain- and transthyretin cardiac amyloidosis. Chest pain can occur in both types with variable clinical presentations. This narrative review describes the relationship between CA and chest pain. A PubMed search (June 03. 2024) identified 393 articles related to chest pain in CA. Twenty-eight studies, in English and with full text, were selected. Articles included were case reports, reviews, perfusion- and autopsy studies. In CA patients 10-20% report chest pain as the initial symptom preceding the diagnosis, and the overall prevalence of chest pain is 38% of patients with CA and it is related to an increased risk of heart failure hospitalization. The mechanisms leading to chest pain in CA patients include increased left ventricular diastolic pressure, infiltration of amyloid fibrils inside and around coronary arteries, and amyloid compression of the microvasculature. The mechanisms commonly lead to elevations of plasma troponin levels, which are higher in amyloid patients with chest pain compared to amyloid patients without chest pain. Symptomatic treatment of chest pain can be challenging due to the low tolerability of medical therapy and poor outcomes of coronary interventions in alleviating the pain and with a higher rate of complications. Our review underscores the importance of recognizing chest pain as a CA symptom, particularly in the elderly. Persistent troponin elevation without coronary artery disease could indicate CA. Screening-based and longitudinal studies are crucial for understanding the relationship between chest pain and CA. Acknowledging the significance of chest pain in CA may facilitate early intervention and improve patient outcomes.

Air Pollution and Interstitial Lung Disease.

This review article explores the multifaceted relationship between air pollution and interstitial lung diseases (ILDs), particularly focusing on idiopathic pulmonary fibrosis (IPF), the most severe form of fibrotic ILD. Air pollutants are mainly composed of particulate matter (PM), ozone (O3), nitrogen dioxide (NO2), carbon monoxide (CO), and sulfur dioxide (SO2). They are recognized as risk factors for several respiratory diseases. However, their specific effects on ILDs and related mechanisms have not been thoroughly studied yet. Emerging evidence suggests that air pollutants may contribute to the development and acute exacerbation of ILDs. Longitudinal studies have indicated that air pollution can adversely affect the prognosis of disease by decreasing lung function and increasing mortality. Lots of in vitro, in vivo, and epidemiologic studies have proposed possible mechanisms linking ILDs to air pollution, including inflammation and oxidative stress induced by exposure to air pollutants, which may induce mitochondrial dysfunction, promote cellular senescence, and disrupt normal epithelial repair processes. Despite these findings, effective interventions to mitigate effects of air pollution on ILD are not well established yet. This review emphasizes the urgent need to address air pollution as a key environmental risk factor for ILDs and calls for further studies to clarify its effects and develop preventive and therapeutic strategies.

Risk assessment of uranium in water sources near coal mines and in human organs of Shahdol District, Madhya Pradesh, using biokinetic modelling.

This study concentrated on determining the levels of uranium present in drinking water samples obtained from various locations throughout the Shahdol district in Madhya Pradesh, India. In this assessment a LED fluorimeter Quantalase (LF-2a) was utilized. Uranium, being a radioactive substance, can be hazardous to health when consumed in significant quantities over extended durations. The study found that the average uranium concentration was 167.91µg/L. 82% of samples exceeded recommended limits, emphasizing the essential aspect of this study. The study utilizes the age-specific biokinetic model developed by the International Commission on Radiological Protection to examine uranium distribution across various organs. Using dosimetric model, the study provides a comprehensive health risk analysis by assessing the chemical toxicity and the radiation dosages received by particular organs. Longitudinal studies on uranium distribution across different organs and tissues showed that the kidneys, liver, non-exchangeable bone volume, and soft tissues are the primary locations where uranium accumulates.

Impact of New York City's 4-year multi-component natural experiment to improve elementary school physical education on student cardiorespiratory fitness.

School physical education is an important population-level health intervention for improving youth fitness. This study estimated the impact of New York City's PE Works program - which included providing PE teachers, training for classroom teachers, and administrative/ teacher support for PE - on student cardiorespiratory fitness as measured by the FitnessGram's 15-meter PACER test for aerobic capacity. This longitudinal study (2014/15-2018/19) includes 581 elementary schools (n = 315,999 4th /5th -grade students; 84% non-white; 74% who qualify for free or reduced-price meals, a proxy for socioeconomic status). We apply the parametric g-formula to address schools' time-varying exposure to intervention components and time-varying confounding. After four years of staggered PE Works implementation, 49.7% of students/school (95% CI: 42.6%, 54.2%) met age/sex-specific Healthy Fitness Zone (HFZ) aerobic capacity standards set by the FitnessGram. Had PE Works not been implemented, we estimate 45.7% (95% CI: 36.9%, 52.1%) would have met aerobic capacity HFZ standards. Had PE Works been fully implemented in all schools from the program's inception, we estimate 57.4% (95% CI: 49.1%, 63.3%) would have met aerobic capacity HFZ standards. Adding a PE teacher, alone, had the largest impact (6.4% (95% CI: 1.0, 12.0) increase). PE Works positively impacted student cardiorespiratory fitness. Mandating and funding multicomponent PE programs is an important public health intervention to increase children's cardiorespiratory fitness.

A Bayesian Approach to Modeling Variance of Intensive Longitudinal Biomarker Data as a Predictor of Health Outcomes.

Intensive longitudinal biomarker data are increasingly common in scientific studies that seek temporally granular understanding of the role of behavioral and physiological factors in relation to outcomes of interest. Intensive longitudinal biomarker data, such as those obtained from wearable devices, are often obtained at a high frequency typically resulting in several hundred to thousand observations per individual measured over minutes, hours, or days. Often in longitudinal studies, the primary focus is on relating the means of biomarker trajectories to an outcome, and the variances are treated as nuisance parameters, although they may also be informative for the outcomes. In this paper, we propose a Bayesian hierarchical model to jointly model a cross-sectional outcome and the intensive longitudinal biomarkers. To model the variability of biomarkers and deal with the high intensity of data, we develop subject-level cubic B-splines and allow the sharing of information across individuals for both the residual variability and the random effects variability. Then different levels of variability are extracted and incorporated into an outcome submodel for inferential and predictive purposes. We demonstrate the utility of the proposed model via an application involving bio-monitoring of hertz-level heart rate information from a study on social stress.

Does dietary intake of vitamin A and beta-carotene increase the risk of hypertension?

Background Hypertension (HTN) is a major global public health issue influenced by genetics and lifestyle factors such as diet and psychological stress. Previous research suggests a potential link between HTN and dietary vitamin A intake. This study aims to explore the association between HTN and the intake of various forms of vitamin A. Methods This cross-sectional study was conducted on 1239 patients with HTN and 2945 normotensive individuals aged 35–70 years in Sabzevar, Iran. Dietary vitamin A intake was assessed using the Nutritionist IV software and a food frequency questionnaire. Result A positive association was found between HTN with total vitamin A intake [odds ratio (OR): 1.03, 95% confidence interval (CI): 1.01–1.05, P = 0.04] and β-carotene intake (OR: 1.03, 95% CI: 1.02–1.05, P = 0.03) after adjusting for age and sex. These associations remained statistically significant after adjusting for physical activity and BMI. The association between HTN and β-carotene intake remained significant after additional adjustment for calorie intake. No significant association was observed between dietary retinol intake and HTN. Conclusion Increased dietary intake of vitamin A and β-carotene may be associated with a higher risk of HTN. Further longitudinal studies are needed to confirm these findings and elucidate the underlying mechanisms.

How does emotional insecurity affect non-suicidal self-injury among Chinese early adolescents: a longitudinal study.

Non-suicidal self-injury (NSSI) is a serious public health concern. Emotional insecurity is a crucial predictor of NSSI among adolescents. However, few studies have elucidated the specific mechanisms between emotional insecurity and NSSI. This study employed a longitudinal research design, using a sample of 886 Chinese early adolescents (Mage at T1 = 10.62 years, SD = 0.77 years; 47.40% females), and conducted two surveys six months apart to examine the mediating role of peer exclusion between emotional insecurity and NSSI, as well as the moderating effect of school climate. The results indicated that peer exclusion significantly mediated the connection between emotional insecurity and adolescent NSSI. Moreover, school climate significantly moderated the connection between emotional insecurity and peer exclusion. Specifically, the impact of emotional insecurity on peer exclusion was significant only in adolescents who reported a negative school climate, but non-significant in those who reported a positive school climate. These findings provide a robust theoretical foundation and practical insights to help inform the prevention of and interventions for NSSI in adolescents.

Long-term outcome of transanal irrigation for individuals with spina bifida: a 12-year experience study.

Transanal irrigation (TAI) effectively addresses fecal incontinence and improves quality of life in individuals with spina bifida. Given the scarcity of follow-up studies lasting > 5years and reports of numerous TAI discontinuations, we assessed the enduring effectiveness and impact of TAI > 10years after its initiation on the quality of life in individuals with spina bifida. We recruited individuals with spina bifida enrolled in a bowel management program who initiated TAI in 2010 and participated in 4-month and 3-year follow-up studies at a spina bifida clinic. Raw data on bowel-related characteristics at baseline and after 4months and 3years of TAI were collected, and new survey-based demographic information, bowel-related characteristics, and the Fecal Incontinence Quality of Life scale scores were analyzed alongside extant datasets. Among 34 participants (age, mean [standard deviation] 17.7 [3.2] years), the mean follow-up was 11.8 (0.3) years; 21 participants persistently used TAI (persistent users), 12 discontinued TAI (discontinued users), and 1 used TAI and antegrade continence enema at the time of analysis. The fecal incontinence rate among persistent users decreased from 76.2% at baseline to 14.3% at the time of analysis; 11 (91.7%) discontinued users had fecal incontinence before TAI initiation, and the majority of discontinued users (66.7%) discontinued TAI because of improved bowel function. The fecal incontinence rate and quality of life did not differ significantly between discontinued users and persistent users. TAI effectively alleviated fecal incontinence among persistent users. One-third of users discontinued TAI but had improved fecal continence. We recommend periodic bowel function evaluation in TAI users and to reevaluate the necessity for TAI maintenance.

An analysis of active consumer behavior in a fitness boutique: satisfaction levels, perceived quality dimensions, and dropout reasons

The European fitness market is experiencing continuous growth, prompting enhancements in service quality at boutique gyms. These establishments are recognized for their personalized attention, professional staff, and innovative technology use. The perceived quality in these gyms significantly influences client satisfaction and loyalty, which are critical for retention. The aim of the contribution is to understand satisfaction levels, perceived quality dimensions, and dropout reasons inside this business model. The study sample comprises 67 adults, aged 18 to 70 years, predominantly aged 41-50. The EPOD2 Questionnaire and Dropout Reasons Scale were utilized for data collection. An analysis of a boutique fitness center in Zaragoza (Spain), indicates high demand, particularly among women. Most users positively rate the service, especially commending the staff, though communication is rated lower. Higher satisfaction is associated with increased loyalty, and reasons for dropout include distance and congestion, consistent with previous studies. The study has some limitations, including: sample size, gender imbalance, and a lack of longitudinal data. Further approaches should encompass larger samples, longitudinal designs, and broader comparisons to enhance the understanding of satisfaction and loyalty in boutique fitness centers.

Epigenetics Embedding of Oral Feeding Skill Development in Preterm Infants

Background: Preterm infants face challenges to feed orally, which may lead to failure to thrive. Oral feeding skill development requires intact neurobehaviors. Early life stress results in DNA methylation of NR3C1 and HSD11B2, which may disrupt neurobehaviors. Yet, the extent to which early life stress impairs oral feeding skill development and the biomechanism whereby this occurs remains unknown. Our team is conducting an NIH funded study (K23NR019847, 2022-2024) to address this knowledge gap. Purpose: To describe an ongoing study protocol to determine the extent to which early life stress, reflected by DNA methylation of NR3C1 and HSD11B2 promoter regions, compromises oral feeding skill development. Methods: This protocol employs a longitudinal prospective cohort study. Preterm infants born between 26 and 34 weeks gestational age have been enrolled. We evaluate early life stress, DNA methylation, cortisol reactivity, neurobehaviors, and oral feeding skill development during neonatal intensive care unit hospitalization and at 2-week post-discharge. Results: To date, we have enrolled 70 infants. We have completed the data collection. Currently, we are in the data analysis phase of the study, and expect to disseminate the findings in 2025. Implications for Practice and Research: The findings from this study will serve as a foundation for future clinical and scientific inquiries that support oral feeding and nutrition, reduce post-discharge feeding difficulties and lifelong risk of maladaptive feeding behaviors and poor health outcomes. Findings from this study will also provide further support for the implementation of interventions to minimize stress in the vulnerable preterm infant population.

Epicardial Lead Performance Trends in Pediatric and Congenital Heart Disease.

Background: Epicardial pacing systems, rather than transvenous systems, are utilized in pediatric patients who are too small to undergo transvenous access and/or have complex congenital heart disease (CHD) anatomically precluding a transvenous system. Longitudinal performance studies indicate that epicardial leads have higher failure rates when compared with transvenous leads but there are limited data on lead measurement changes in the acute phase after implantation. The objective of this study was to assess epicardial lead performance in the acute postimplant period and at one-year follow-up. Methods: This is a retrospective single center study of children and adult patients with CHD undergoing epicardial bipolar pacing lead and generator implantation between January 2012 and June 2022. We empirically selected 2 V as a critical lead threshold. Results: There were 256 leads implanted in 127 patients (mean age 6.1 ± 9.8 years), including 201/256 (79%) leads in patients with CHD. At the time of implant, 47/256 leads (18%) had a lead threshold of ≥2 V. Of those, 42 of 47 (89%) had recorded threshold values on postoperative day 1 (POD1) and 37 of 42 (88%) had decreased to a more acceptable threshold that was <2 V. For patients with an implant threshold of ≥2 V; impedance >1000 ohms, presence of CHD, perioperative or acute postop status, and location of the lead (atrial vs ventricular) did not significantly impact the odds of having a persistently high threshold (≥2 V) on POD1. Conclusion: Epicardial pacing lead thresholds generally improve in the immediate postop period and in our experience most leads with a high implant threshold improved to <2 V by POD1.

Local food procurement behavior and overall diet quality among adults in Québec: results from the NutriQuébec project.

Consumption of locally produced foods is generally perceived as being part of a healthy dietary pattern. Accordingly, in 2020, the provincial government of Québec (Canada) promoted the purchase of local foods for economic and health benefits. The present cross-sectional study aimed to document the association between the behavior of local food procurement and overall diet quality in a sample of adults from the province of Québec. Data were collected in a sample of 834 adults (86.6% females) from the NutriQuébec project, a web-based longitudinal population study that aims to document the lifestyle and eating habits of adults in Québec, Canada. Dietary intakes were measured using a validated web-based 24-h recall tool and diet quality was assessed using the Healthy Eating Food Index (HEFI-2019), which measures adherence to the 2019-Canada's Food Guide recommendations on healthy food choices. Local food procurement behavior was measured using the Locavore-I-SF score, which assesses the frequency of short food supply chain use as well as the geographical origin of three locally produced foods. The Locavore-I-SF score was weakly correlated with the HEFI-2019 score (r = 0.08, p < 0.02). Positive correlations were observed for the Vegetables and fruits (r = 0.09, p = 0.005), Beverages (r = 0.08, p = 0.04) and Free sugars (r = 0.14, p < 0.001) components of the HEFI-2019. Associations between the Locavore-I-SF and the HEFI-2019 scores were found in specific subgroups of participants: males (r = 0.33, p < 0.001), participants aged between 50 and 70 years (r = 0.16, p = 0.003), participants with a greater education level (r = 0.13, p = 0.003) and higher income (r = 0.12, p = 0.02), non-vegetarian participants (r = 0.10, p = 0.008) and participants living in Census Metropolitan Areas (r = 0.11, p = 0.004). These results suggest that the behavior of local food procurement is only weakly associated with better overall diet quality among a sample of adults from Québec, raising doubts on the relevance of promoting local food procurement as an effective public health measure for improving diet quality in Québec. NCT04140071.

Impact of hospital readmissions following hospitalisation with delirium on 12-month mortality: a quaternary Australian hospital experience.

Inpatient delirium and unplanned hospital readmissions are associated with increased mortality. This study aimed to determine the effect of 28-day unplanned hospital readmissions on 12-month mortality post-discharge in patients with delirium during index hospitalisation. Retrospective longitudinal cohort study of adults aged 65 or above with delirium during hospitalisation at a Victorian quaternary hospital was performed. Delirium was identified by the inclusion of ICD-10 (International Classification of Diseases, 10th revision) codes in the hospital medical discharge summary. Descriptive statistics was obtained for baseline characteristics. Cox proportional hazards model was developed to identify independent predictors of 12-month post-discharge mortality. One thousand six hundred thirty-four patients with delirium during in-patient admission were included. The overall 12-month mortality rate was 35% (572 patients). Of the 1,425 patients who survived their index admission, 11.2% had an unplanned 28-day readmission. In Cox regression analysis, unplanned readmission (hazard ratio (HR) 2.3, 95% confidence internal (CI) 1.7-2.9), older age (HR 1.38, CI 1.11-1.72), Charlson Comorbidity Index (HR 1.21, CI 1.17-1.27), and discharge to nursing home (HR 1.58, CI 1.23-2.02) were independent predictors of 12-month mortality. Readmitted patients with 12-month mortality were older, with higher rates of dementia, polypharmacy, and nursing home residence compared to readmitted patients who did not reach this endpoint. Unplanned hospital readmission within 28days of discharge is an independent predictor of 12-month mortality post in-hospital delirium admission. Admissions complicated by delirium and readmission episodes should instigate discussions regarding prognostication and goals of care. Greater research is required to minimise hospital readmission rates following discharge in this cohort.

Understanding Parenting Stress in Adoptive Parents: A Longitudinal Multilevel Study of Parents' Self-Criticism, Child Negative Emotionality, and Child Age at Placement.

Research on parenting stress in adoptive parents during the early years post-placement reveals significant variability, yet few studies examine both parent- and child-related factors. This study investigates the role of the personality dimension of self-criticism and perceived negative child emotionality in relation to parenting stress during the first four years after transnational adoption. Additionally, it explores the moderating effect of child age at placement, a key factor associated with early adversity. Drawing upon a longitudinal five-wave dataset in the first 4 years after the child arrived in the adoptive family, this study used multi-informant data of 96 adoptive mothers and fathers of transnationally adopted children (mean child age at placement = 13.48 months). Data were analyzed using a multilevel structural equation modeling approach. Parents' self-criticism was positively associated with parenting stress at the between-parent level. At the within-parent level, year-to-year fluctuations in both parents' self-criticism and perceived child's negative emotionality were positively associated with corresponding fluctuations in parenting stress. Child age at placement did not moderate any of these associations. Overall, this study yielded convincing evidence for the dynamic nature of parenting stress in the first years after child placement, the role of parental self-criticism, and the child's perceived negative emotionality herein.

Psoriatic arthritis phenotype clusters and their association with treatment response: a real-world longitudinal cohort study from the psoriatic arthritis research consortium

ObjectivesTo identify phenotype clusters and their trajectories in psoriatic arthritis (PsA) and examine the association of the clusters with treatment response in a real-world setting.MethodsIn the multicentre PsA Research Consortium...

Earliest location of glaucomatous retinal nerve fibre layer damage is determined by intact baseline RNFL thickness profile

Background/aimsTo identify whether an intact retinal nerve fibre layer (RNFL) thickness profile could determine the location of the earliest RNFL defect in glaucoma.MethodsRetrospective longitudinal cohort study of patients with initial...

Association Between Fatty Liver Index and Incidence of Cataract Surgery in Individuals Aged 50 Years and Older Based on the Korean National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) Data: Longitudinal Retrospective Cohort Study.

Cataract is a leading cause of vision impairment. Obesity-related risk factors, including insulin resistance, increase the risk of cataract. The fatty liver index (FLI) is a biomarker for noninvasive fat layer prediction of nonalcoholic fatty liver disease. The FLI has been used to evaluate the metabolic contribution in other organs besides the eye. However, no study exists on the FLI and eye disease. This retrospective cohort study for the association between the FLI and incidence of cataract surgery in individuals older than 50 years was designed to show that a higher FLI is associated with an increased incidence of cataract surgery in individuals aged 50 years and older. This study was retrospectively designed based on the Korean National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) cohort (median follow-up of 9.8 years). Participants were assigned to 1 of 3 groups based on the FLI: low (FLI<30), intermediate (FLI 30-59), or high (FLI≥60). Kaplan-Meier survival analysis was performed on the cumulative incidence of all-cataract and senile-cataract surgery. Multivariable Cox proportional hazards regression models were used to study the association between the FLI group and cataract surgery after adjusting for potential confounders. Of the 138,347 included participants, the incidence of cataract surgery was 12.49% (4779/38,274), 13.95% (6680/47,875), and 14.16% (7496/52,930) in the low, intermediate, and high FLI groups, respectively. After adjusting for all confounding factors, hazard ratios (HRs; 95% CIs) in the high FLI group for all-cataract surgery were 1.111 (1.028-1.199) and 1.184 (1.101-1.274) in men and women, respectively, when compared with the low FLI group. HRs (95% CIs) in the high FLI group for senile-cataract surgery were 1.106 (1.022-1.197) and 1.147 (1.065-1.237) in men and women, respectively, when compared with the low FLI group. The project was conducted between August 2023 and February 2024 without donations from external bodies. Individuals with a higher FLI had a higher risk of all-cataract surgery. This association was maintained even after limiting the analyses to senile-cataract surgery.

Longitudinal associations among resilience, social isolation, and gender in U.S. Iraq and Afghanistan-era veterans.

Negative mental health outcomes are prevalent among veterans exposed to military-related stressors and are associated with social isolation. Limited research exists on resilience following military separation and its impact on social isolation in veterans. We examined resilience against military-related stressors and 2-year longitudinal associations with social isolation indicators; gender differences were also explored. U.S. military veterans (N = 351, 70.4% men) who deployed to the wars in and around Iraq and Afghanistan following the September 11, 2001, terrorist attacks (9/11) were recruited as part of a longitudinal assessment study examining predictors of postdeployment adjustment. Using a residualization approach, resilience was approximated as low stressor reactivity (SR), calculated by regressing mental health onto military-related stressor exposure. Military-related stressors were significantly associated with posttraumatic stress disorder (PTSD) related to both events during post-9/11 deployment (deployment event) and outside of post-9/11 deployment (other event), functional disability, and depression. After correcting for multiple comparisons, only SR derived from depressive symptoms predicted more closeness difficulties in social relationships longitudinally, B = 0.50, q =.023. Women also demonstrated higher SR than men regarding other event-related PTSD symptoms, B = -0.52, q <.001; functional disability, B = -0.28, q =.028; and depression, B = -0.34, q =.012. Results suggest that veterans with higher depressogenic reactivity to military-related stressors were more likely to endorse discomfort with closeness than those with lower depressogenic reactivity. Women veterans may also be more impacted by nondeployment traumatic distress, psychosocial dysfunction, and depression in response to military-related stressors.