OBJECTIVES Examine the association of multimorbidity and psychosocial functioning with posttraumatic stress disorder (PTSD) symptom severity reported among post-9/11 veterans. METHOD This was a secondary analysis of survey data collected from a national sample of post-9/11 veterans with at least 3 years of Department of Veterans Affairs care, stratified by comorbidity trajectory and sex (N = 1,989). Comorbidity trajectories were derived by latent class analysis to develop probabilistic combinations of physical and mental health conditions in a previous effort (Pugh et al., 2016). In this study, linear models analyzed symptom severity reported on the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition by psychosocial factors (i.e., resilience, self-efficacy, and postdeployment social support) while controlling for sociodemographic characteristics and deployment experiences. RESULTS Veterans in the mental health, pain, and polytrauma clinical triad comorbidity trajectories reported more severe PTSD symptoms than the healthy comorbidity trajectory (p < .01). All psychosocial factors were significantly associated with PTSD symptom severity, accounting for nearly 43% of variability in follow-up analyses. Confidence in self-efficacy demonstrated the strongest association among them (p < .01). CONCLUSION Veterans experiencing multimorbidity, particularly mental health distress, reported greater PTSD symptom severity after controlling for psychosocial factors, sociodemographics, and deployment experiences. The salience of psychosocial factors in reported PTSD symptom severity underscores resilience, self-efficacy and social support as potential facilitators of functional reintegration following military service. Our analyses underscore the need to address the systemic barriers in health care access and delivery for minority patient populations in future investigations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译：

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多重疾病和心理社会因素对 9/11 后退伍军人创伤后应激症状的影响。

目标 检查在 9/11 后退伍军人中报告的多种疾病和心理社会功能与创伤后应激障碍 (PTSD) 症状严重程度之间的关联。方法 这是对从 9/11 后退伍军人的全国样本中收集的调查数据的二次分析，这些样本至少有 3 年的退伍军人事务部护理，按合并症轨迹和性别分层 (N = 1,989)。合并症轨迹是通过潜在类别分析得出的，以在先前的努力中开发身体和心理健康状况的概率组合（Pugh 等人，2016 年）。在这项研究中，线性模型通过心理社会因素（即复原力、自我效能、和部署后的社会支持），同时控制社会人口特征和部署经验。结果 心理健康、疼痛和多发性创伤临床三联症共病轨迹中的退伍军人报告的 PTSD 症状比健康共病轨迹更严重 (p < .01)。所有心理社会因素都与 PTSD 症状严重程度显着相关，占后续分析变异性的近 43%。对自我效能的信心表现出其中最强的关联（p < .01）。结论 在控制社会心理因素、社会人口统计学和部署经验后，患有多种疾病，尤其是心理健康困扰的退伍军人报告了更严重的 PTSD 症状。所报告的 PTSD 症状严重程度中心理社会因素的显着性强调了复原力，自我效能感和社会支持作为服兵役后重新融入功能的潜在促进因素。我们的分析强调需要在未来的调查中解决少数族裔患者群体获得和提供医疗保健服务的系统性障碍。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）。