Prospective study of externalizing and internalizing subtypes of posttraumatic stress disorder and their relationship to mortality among Vietnam veterans.

Journal Article (Journal Article)

Posttraumatic stress disorder (PTSD) can be a complex disorder, and some studies have found that samples of individuals with PTSD contain subtypes that may relate to health outcomes. The goals were to replicate previously identified PTSD subtypes and examine how subtype membership relates to mortality. Data from the Vietnam Experience Study and a clinical sample of Vietnam veterans were combined (n = 5248) to address these research questions. Consistent with previous studies, 3 PTSD subtypes emerged: externalizers (n = 317), internalizers (n = 579), and low pathology (n = 280). Posttraumatic stress disorder diagnosis was associated with increased risk of all-cause and behavioral-cause (eg, homicide, suicide) mortality. Both externalizing and internalizing subtypes had higher mortality and were more likely to die from cardiovascular causes than those without PTSD. Externalizers were more likely to die from substance-related causes than those without PTSD. The value of considering possible PTSD subtypes is significant in that it may contribute to identifying more specific targets for treatment and rehabilitation in veterans with PTSD.

Full Text

Duke Authors

Cited Authors

  • Flood, AM; Boyle, SH; Calhoun, PS; Dennis, MF; Barefoot, JC; Moore, SD; Beckham, JC

Published Date

  • 2010

Published In

Volume / Issue

  • 51 / 3

Start / End Page

  • 236 - 242

PubMed ID

  • 20399332

Pubmed Central ID

  • PMC2858053

Electronic International Standard Serial Number (EISSN)

  • 1532-8384

Digital Object Identifier (DOI)

  • 10.1016/j.comppsych.2009.08.002


  • eng

Conference Location

  • United States