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Croatian Medical Journal, Vol. 59 No. 4, 2018.

Original scientific paper

https://doi.org/10.3325/cmj.2018.59.165

The relationship among psychopathology, religiosity, and nicotine dependence in Croatian war veterans with posttraumatic stress disorder

Marina Šagud ; University of Zagreb School of Medicine, Zagreb, Croatia
Božena Petrović ; University of Zagreb School of Medicine, Zagreb, Croatia
Maja Vilibić ; Department of Psychiatry University Hospital Center “Sisters of Mercy”, Zagreb, Croatia
Alma Mihaljević-Peleš ; University of Zagreb School of Medicine, Zagreb, Croatia
Bjanka Vuksan-Ćusa ; University of Zagreb School of Medicine, Zagreb, Croatia
Iva Radoš ; Department of PsychologicalMedicine, University HospitalCenter Zagreb, Zagreb, Croatia
Alen Greš ; Department of PsychiatryUniversity Hospital Center Zagreb,Zagreb, Croatia
Vladimir Trkulja ; Department of Pharmacology University of Zagreb School ofMedicine, Zagreb, Croatia

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Abstract

Aim To examine relationships among combat exposure,
posttraumatic stress disorder (PTSD) symptoms, depression,
suicidality, nicotine dependence, and religiosity in
Croatian veterans.
Methods This cross-sectional study used Combat Exposure
Scale (CES) to quantify the stressor severity, PTSD
Checklist 5 (PCL) to quantify PTSD severity, Duke University
Religion Index to quantify religiosity, Montgomery Asberg
(MADRS) and Hamilton Depression (HAM-D) rating scales
to measure depression/suicidality, and Fagerstrom Test for
Nicotine Dependence to assess nicotine dependence. Zero-
order correlations, cluster analysis, multivariate regression,
and mediation models were used for data analysis.
Results Of 69 patients included, 71% met “high religiosity”
criteria and 29% had moderate/high nicotine dependence.
PTSD was severe (median PCL 71), depression was
mild/moderate (median MADRS 19, HAM-D 14), while suicidality
was mild. A subset of patients was identified with
more severe PTSD/depression/suicidality and nicotine dependence
(all P < 0.001). Two “chains” of direct and indirect
independent associations were detected. Higher CES
was associated with higher level of re-experiencing and,
through re-experiencing, with higher negativity and hyperarousal.
It also showed “downstream” division into two
arms, one including a direct and indirect association with higher depression and lower probability of high religiosity,
and the other including associations with higher suicidality
and lower probability of high nicotine dependence.
Conclusions Psychopathology, religiosity, and nicotine
dependence are intertwined in a complex way not detectable
by simple direct associations. Heavy smoking might
be a marker of severe PTSD psychopathology, while spirituality
might be targeted in attempts of its alleviation.

Keywords

Hrčak ID:

237483

URI

https://hrcak.srce.hr/237483

Publication date:

15.8.2018.

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