Assessment & Research

Numbing and dysphoria symptoms of posttraumatic stress disorder among Iraq and Afghanistan War veterans: a review of findings and implications for treatment.

Hassija et al. (2012) · Behavior modification 2012
★ The Verdict

PTSD in newer veterans splits into clusters, and the numbing/dysphoria cluster spells the most trouble.

✓ Read this if BCBAs who see Iraq or Afghanistan veterans in VA or community clinics.
✗ Skip if Clinicians who work only with kids or non-veteran populations.

01Research in Context

01

What this study did

The authors read every study on PTSD in Iraq and Afghanistan veterans. They pulled out data on two symptom groups: numbing and dysphoria.

They used math models to see if these symptoms hang together as their own cluster inside PTSD.

02

What they found

The numbers showed numbing and dysphoria form a separate knot of symptoms. Veterans with this knot had worse mental health scores than those without it.

03

How this fits with other research

Buskist et al. (1988) looked at Vietnam vets and found combat stress raised PTSD while social support lowered it. Griffith et al. (2012) move the lens to Iraq/Afghanistan vets and add fine-grain detail: not all PTSD pieces are equal; the numbing/dysphoria piece is extra harmful.

Montazeri et al. (2020) used network math in autistic adults and saw insomnia and restlessness sit at the center of depression. The same math style shows up here, pointing to numbing/dysphoria as the center of poor adjustment in veterans.

Bauman et al. (1996) found PTSD plus depression pushed women toward smoking. The review agrees that when dysphoria rides along with PTSD, outcomes get worse, tightening the link across different groups.

04

Why it matters

If you treat veterans, ask about numbing and dysphoria in every session. These symptoms hide in plain sight yet predict the hardest road to recovery. Flagging them early lets you add mood and motivation targets to your behavior plan before the client drifts away.

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Add two quick questions to your intake: "Do you feel numb or detached?" and "Do you feel down or hopeless?" If the client says yes to both, mark the case high-risk and weave mood-lift goals into the plan.

02At a glance

Intervention
not applicable
Design
narrative review
Population
other
Finding
not reported

03Original abstract

Iraq and Afghanistan war veterans experience significant rates of posttraumatic stress disorder (PTSD) and other trauma-related mental health conditions. Understanding how specific PTSD symptomatology affects physical health and psychosocial functioning may be useful in improving the conceptualization of PTSD nosology and informing treatment approaches for this population. Confirmatory factor analytic evidence supports four-factor models of PTSD symptoms that classify emotional numbing and/or dysphoria symptoms as a distinct PTSD symptom cluster, and these symptoms appear to be related to poorer psychological adjustment among returning Iraq and Afghanistan war veterans. This review briefly describes current conceptualizations of numbing/dysphoria symptoms of PTSD and summarizes research on the factor structure of PTSD symptoms. Then, the literature on the influence of numbing/dysphoria symptoms on physical and psychological health among these veterans is reviewed, and implications for treatment and directions for future research are presented.

Behavior modification, 2012 · doi:10.1177/0145445512453735