Cardiometabolic Morbidity (Obesity and Hypertension) in PTSD: A Preliminary Investigation of the Validity of Two Structures of the Impact of Event Scale-Revised

• Published in: Journal of clinical medicine 2024-10, Vol.13 (20), p.6045
• Main Authors: Ali, Amira Mohammed, Al-Dossary, Saeed A., Laranjeira, Carlos, Atout, Maha, Khatatbeh, Haitham, Selim, Abeer, Alkhamees, Abdulmajeed A., Aljaberi, Musheer A., Pakai, Annamária, Al-Dwaikat, Tariq
• Format: Article
• Language: English
• Subjects: Body mass index; Cardiovascular disorders/CVDs/cardiometabolic/hypertension; Comorbidity; Complications and side effects; COVID-19; Cutoff score/cutoff point; Dental healthcare workers; Diabetes; Diagnosis; Hypertension; Infections; Longitudinal studies; Mental disorders; Metabolic syndrome; Obesity; Obesity/high body mass index/metabolic dysfunction; Post traumatic stress disorder; Receiver operator curve (ROC); Risk factors; Sleep disturbance/irritability/emotional numbing; Smoking; Smoking/behavioral risk factors; Three factors/six factors/dimensions; Validity
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13206045

This article belongs to the Special Issue Review Special Issue Series: Recent Advances in Epidemiology & Public Health). Acknowledgments: The researchers would like to thank the Deanship of Graduate Studies and Scientific Research at Qassim University for the financial support (QU-APC-2024-9/1). Background: Posttraumatic stress disorder (PTSD) and/or specific PTSD symptoms may evoke maladaptive behaviors (e.g., compulsive buying, disordered eating, and an unhealthy lifestyle), resulting in adverse cardiometabolic events (e.g., hypertension and obesity), which may implicate the treatment of this complex condition. The diagnostic criteria for PTSD have lately expanded beyond the three common symptoms (intrusion, avoidance, and hyperarousal). Including additional symptoms such as emotional numbing, sleep disturbance, and irritability strengthens the representation of the Impact of Event Scale-Revised (IES-R), suggesting that models with four, five, or six dimensions better capture its structure compared to the original three-dimensional model. Methods: Using a convenience sample of 58 Russian dental healthcare workers (HCWs: mean age = 44.1 ± 12.2 years, 82.8% females), this instrumental study examined the convergent, concurrent, and criterion validity of two IES-R structures: IES-R3 and IES-R6. Results: Exploratory factor analysis uncovered five factors, which explained 76.0% of the variance in the IES-R. Subscales of the IES-R3 and the IES-R6 expressed good internal consistency (coefficient alpha range = 0.69–0.88), high convergent validity (item total correlations r range = 0.39–0.81, and correlations with the IES-R’s total score r range = 0.62–0.92), excellent concurrent validity through strong correlations with the PTSD Symptom Scale-Self Report (PSS-SR: r range = 0.42–0.69), while their criterion validity was indicated by moderate-to-low correlations with high body mass index (BMI: r range = 0.12–0.39) and the diagnosis of hypertension (r range = 0.12–0.30). In the receiver-operating characteristic (ROC) curve analysis, all IES-R models were perfectly associated with the PSS-SR (all areas under the curve (AUCs) > 0.9, p values < 0.001). The IES-R, both hyperarousal subscales, and the IES-R3 intrusion subscale were significantly associated with high BMI. Both avoidance subscales and the IES-R3 intrusion subscale, not the IES-R, were significantly associated with hypertension. In the two-step cluster analysis, five sets of all trauma variables (IES-R3/IES