title: Living with PTSD Symptoms: A Comprehensive Exploration of Functioning Reports and Symptom Interpretation
Creators: name: (:Unkn) Unknown
Publisher: name: George Mason University
Year: 2020

description: PTSD has been negatively associated with numerous indices of functioning within veterans. However, most empirical evidence of this association has relied on the use of global self-report measures. In some areas, empirical study has revealed incongruencies between global reports of impairments and more time-specific reports, with greater symptoms sometimes linked to overreporting bias particularly on broader, global measures. Additionally, studies in this area typically have focused solely on individual functioning outcomes (e.g., life satisfaction), despite the possibility that interpersonal domains (e.g., marital satisfaction) might be differentially affected by the presence of PTSD symptoms. Also, different clusters of PTSD symptoms may have differing impacts on functioning, but most research findings focus on overall symptom severity. Finally, despite efforts to increase veterans’ knowledge about PTSD, no research has yet examined the role that knowledge about PTSD itself plays in functioning. This dissertation addressed these gaps in our understanding through two separate but related studies. The first study was a 7-day, daily diary study of PTSD symptom severity, individual functioning, and interpersonal functioning. A sample of 31 U.S. military veterans provided online reports of their past-week PTSD symptom severity and past-week functioning at baseline, followed by 7 days of daily reports of both PTSD symptoms and functioning. Consistent with prior research, past-week PTSD symptoms and past-week functioning were negatively correlated. In addition, hierarchical linear modeling confirmed that daily reports of PTSD symptoms and functioning were negatively associated. Furthermore, past-week functioning was positively associated with daily reports of functioning; however, this association was moderated by baseline PTSD symptoms, with the association weaker in the context of more severe PTSD symptoms. These results are consistent with the notion that respondents might demonstrate greater reporting bias on self-report measures that stretch over longer periods of time. In the second study, 96 U.S. military veterans provided online self-reports of PTSD symptoms, individual and interpersonal functional impairment, and PTSD knowledge. For individual functioning, contrary to hypotheses, no PTSD cluster exerted a significant association with functional impairment, and greater PTSD knowledge showed a significant association with more impairment. For interpersonal functioning, avoidance symptom severity was associated with less impairment, whereas severity of negative alterations in mood/cognition was associated with more impairment. Furthermore, for individual functioning, re-experiencing symptoms were nonsignificantly associated with less impairment at higher levels of PTSD knowledge but significantly more impairment at lower levels of knowledge. On the other hand, avoidance symptoms were nonsignificantly associated with more impairment at higher levels of knowledge but significantly less impairment at lower levels of knowledge. Finally, for interpersonal functioning, re-experiencing symptoms were significantly associated with less impairment at higher levels of PTSD knowledge and nonsignificantly associated with more impairment at lower levels of knowledge. Also, avoidance symptoms were nonsignificantly associated with more impairment at higher levels of knowledge but significantly associated with less impairment at lower levels. Although complicated, these results suggest differences in the associations of PTSD symptoms and PTSD knowledge with individual vs. relationship functioning. Further research is needed to improve our understanding of how PTSD knowledge impacts psychosocial functioning, and to determine whether my results related to associations among PTSD clusters and impairment replicate.