Associations Among PTSD, Cognitive Functioning, and Health-Promoting Behavior in Post-9/11 Veterans

Karen Lawrence, Natasha E. Garcia-Willingham, Emily Slade, Bryann DeBeer, Eric Meyer, Sandra Morissette

Research output: Contribution to journalArticlepeer-review


PTSD is associated with negative health behaviors that increase chronic disease risk, yet health behaviors and their determinants are not well investigated in this context. One understudied mechanism of health behaviors is cognitive functioning. Deficits in cognitive functioning may undermine engagement in health-promoting behavior, thereby increasing the negative impact of PTSD. We tested three hypotheses: (1) Greater PTSD symptom severity is associated with less health-promoting behavior; (2) greater PTSD symptom severity is associated with poorer cognitive functioning across verbal memory, processing speed, attention, and executive functioning domains; and (3) verbal memory and executive functioning exhibit indirect effects on the relationship between PTSD and health-promoting behavior.

Materials and Methods
We examined associations between PTSD symptom severity (Clinician-Administered PTSD Scale for DSM-IV), cognitive functioning, and health-promoting behavior (Health-Promoting Lifestyle Profile II) in 124 post-9/11 veterans (average age = 37.82; 85.5% male; 63.7% White; 18.5% Black; 26.6% Hispanic). Cognitive domains examined included verbal memory (California Verbal Learning Test), processing speed (Digit Symbol Coding), attention and working memory (Digit Span), and executive functions (Trail Making Test and Stroop Interference).

Regression analyses indicated that greater PTSD symptom severity was associated with less health-promoting behavior (B = −.0101, SE = 0.0016, P 
Therapeutic targeting of these relationships may have implications for the prevention of long-term disease impact in veterans; longitudinal research is needed to elucidate the potential impact on chronic disease.
Original languageAmerican English
Number of pages8
JournalMilitary Medicine
StatePublished - Feb 24 2023


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