Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Phillip J. Brantley


Research suggests that individuals with Posttraumatic Stress Disorder (PTSD) have significant dysregulation in a number of physiological indices, especially the sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal (HPA) axis. Biological theories of PTSD propose that prolonged SNS and HPA axis dysregulation places individuals with PTSD at risk for development of medical morbidity and impairments in health status. The present study examined the following research questions: (a) what is the prevalence of traumatic life events and PTSD in a low-income primary care population? (b) does PTSD predict impairments in self-reported health status after controlling for age, alcohol abuse, tobacco use, and obesity? and (c) does PTSD predict the presence of physician diagnosed medical disease? The sample included 431 randomly selected adult patients recruited from primary care clinics at a public teaching hospital in the state of Louisiana. The sample consisted predominately of uninsured, African-American, low-income females. The results indicated that prevalence of at least one traumatic life event (88%) was similar to that of community surveys. For females, the lifetime prevalence of PTSD was significantly higher than in community samples. The same was not true for males, however. Individuals with PTSD were likely to have at least one other comorbid mental disorder. The median duration of symptoms for those with a PTSD diagnosis was 12 months, but considerable variability in remission rates was found as a function of traumatic event type. Individuals who developed PTSD from some type of interpersonal violence had a median symptom duration of 48 months, compared to 12 months for either other events directly experienced, or events experienced by a close friend or loved one. Logistic regression analyses revealed that PTSD was predictive of impairments in self-reported health status, but only when compared to control subjects with no history of mental disorder. Logistic regression analyses also revealed that PTSD was predictive of presence of circulatory system disease, but only when compared to control subjects with no history of mental disorder. Results provided tentative support for the notion that PTSD, like other psychiatric conditions, is associated with increased risk of impaired health status and medical disease.