Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Cardiometabolic Morbidity (Hypertension and Obesity) in PTSD: Treatment Implications for the Predictive Validity of Two Structures of the Impact of Event Scale-Revised

Version 1 : Received: 2 December 2023 / Approved: 4 December 2023 / Online: 4 December 2023 (06:49:44 CET)

How to cite: Ali, A. M.; Al-Dossary, S. A.; Laranjeira, C.; Atout, M.; Khatatbeh, H.; Selim, A.; Alkhamees, A. A.; Aljaberi, M. A.; Pakai, A.; Al-Dwaikat, T. Cardiometabolic Morbidity (Hypertension and Obesity) in PTSD: Treatment Implications for the Predictive Validity of Two Structures of the Impact of Event Scale-Revised. Preprints 2023, 2023120147. https://doi.org/10.20944/preprints202312.0147.v1 Ali, A. M.; Al-Dossary, S. A.; Laranjeira, C.; Atout, M.; Khatatbeh, H.; Selim, A.; Alkhamees, A. A.; Aljaberi, M. A.; Pakai, A.; Al-Dwaikat, T. Cardiometabolic Morbidity (Hypertension and Obesity) in PTSD: Treatment Implications for the Predictive Validity of Two Structures of the Impact of Event Scale-Revised. Preprints 2023, 2023120147. https://doi.org/10.20944/preprints202312.0147.v1

Abstract

Posttraumatic stress disorder (PTSD) and/or specific PTSD symptoms may evoke disordered eating and unhealthy lifestyles, resulting in adverse cardiometabolic events (e.g., hypertension and obesity) in certain groups, which may implicate the treatment of this complex condition. The diagnostic criteria of PTSD have lately expanded beyond the three common symptoms (intrusion, avoidance, and hyperarousal). Simultaneously, four-, five-, and six-dimensional structures of the Impact of Event Scale-Revised (IES-R), a popular PTSD measure, seem to be more robust than the original three-dimension structure. Within the context of COVID-19, this instrumental study used a convenience sample of 58 dental healthcare workers (HCWs) from Russia (mean age = 44.1±12.2 years, 82.8% females) to examine the criterion and predictive validity of two IES-R structures: the IES-R3 and the IES-R6 (with the added symptoms of numbing, sleep disturbance, and irritability). The subscales of the two IES-R structures expressed good internal consistency, strong correlations with the PTSD Symptom Scale (PSS), hypertension diagnosis, and high body mass index (BMI). In receiver-operating characteristic (ROC) curve analysis, all IES-R models perfectly predicted the PSS (all area under the curve (AUC) >0.9, p values <0.001). The IES-R, both hyperarousal subscales, and the IES-R3 intrusion subscale significantly predicted high BMI. Both avoidance subscales and the IES-R3 intrusion subscale, not the IES-R, significantly predicted hypertension. In conclusion, both IES-R structures can reliably measure PTSD symptoms. The IES-R, hyperarousal, and intrusion may be credible criterion variables for predicting high BMI within PTSD while the intrusion and avoidance subscales may reflect the cardiovascular consequences associated with PTSD more reliably than the IES-R itself. The IES-R subscales may predict cardiometabolic adversities in PTSD, signifying a need for proper assessment of lifestyle and the application of dietary and exercise interventions in order to lower physical morbidity in PTSD. Replicating the study in larger samples, which comprise different physical and mental conditions from heterogenous cultural contexts is pivotal to validate the results (e.g., in specific groups such as those with confirmed traumatic exposure and comorbid mood dysfunction).

Keywords

Impact of Event Scale-Revised/IES-R; cutoff score/cutoff point; three factors/six factors/dimensions; receiver operator curve (ROC); cardiometabolic* /hypertension; obesity/ high body mass index; dental healthcare workers

Subject

Public Health and Healthcare, Public Health and Health Services

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