{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:52:07Z","timestamp":1790301127106,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,10,12]],"date-time":"2017-10-12T00:00:00Z","timestamp":1507766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01\u2010AR\u2010057327"],"award-info":[{"award-number":["R01\u2010AR\u2010057327"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24\u2010AR\u2010066109"],"award-info":[{"award-number":["K24\u2010AR\u2010066109"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1\u2010CA\u2010176726"],"award-info":[{"award-number":["UM1\u2010CA\u2010176726"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2017,11]]},"abstract":"Objective<\/jats:title>To conduct the first longitudinal study examining whether trauma exposure and posttraumatic stress disorder (PTSD<\/jats:styled-content>) are associated with increased risk of incident systemic lupus erythematosus (SLE<\/jats:styled-content>) in a civilian cohort.<\/jats:p><\/jats:sec>Methods<\/jats:title>We examined the association of trauma exposure and PTSD<\/jats:styled-content> symptoms with SLE<\/jats:styled-content> incidence over 24 years of follow\u2010up in a US<\/jats:styled-content> longitudinal cohort of women (n = 54,763). Incident SLE<\/jats:styled-content> in women meeting \u22654 American College of Rheumatology criteria was ascertained by self\u2010report and confirmed by medical record review. PTSD<\/jats:styled-content> and trauma exposure were assessed with the Short Screening Scale for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition PTSD<\/jats:styled-content> and the Brief Trauma Questionnaire, respectively. Women were categorized as having no trauma, trauma and no PTSD<\/jats:styled-content> symptoms, subclinical PTSD<\/jats:styled-content> (1\u20133 symptoms), or probable PTSD<\/jats:styled-content> (4\u20137 symptoms). We examined whether longitudinally assessed health risk factors (e.g., smoking, body mass index [BMI<\/jats:styled-content>], oral contraceptive use) accounted for increased SLE<\/jats:styled-content> risk among women with trauma exposure and PTSD<\/jats:styled-content> versus those without.<\/jats:p><\/jats:sec>Results<\/jats:title>During follow\u2010up, 73 cases of SLE<\/jats:styled-content> occurred. Compared to women with no trauma, probable PTSD<\/jats:styled-content> was associated with increased SLE<\/jats:styled-content> risk (for 4\u20137 symptoms, hazard ratio [HR<\/jats:styled-content>] 2.94 [95% confidence interval {95% CI<\/jats:styled-content>} 1.19\u20137.26], P<\/jats:italic> < 0.05). Subclinical PTSD<\/jats:styled-content> was associated with increased SLE<\/jats:styled-content> risk, although this did not reach statistical significance (for 1\u20133 symptoms, HR<\/jats:styled-content> 1.83 [95% CI<\/jats:styled-content> 0.74\u20134.56], P<\/jats:italic> = 0.19). Smoking, BMI<\/jats:styled-content>, and oral contraceptive use slightly attenuated the associations (e.g., for 4\u20137 symptoms, adjusted HR<\/jats:styled-content> 2.62 [95% CI<\/jats:styled-content> 1.09\u20136.48], P<\/jats:italic> < 0.05). Trauma exposure, regardless of PTSD<\/jats:styled-content> symptoms, was strongly associated with incident SLE<\/jats:styled-content> (HR<\/jats:styled-content> 2.83 [95% CI<\/jats:styled-content> 1.29\u20136.21], P<\/jats:italic> < 0.01).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>This study contributes to growing evidence that psychosocial trauma and associated stress responses may lead to autoimmune disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40222","type":"journal-article","created":{"date-parts":[[2017,9,20]],"date-time":"2017-09-20T01:02:45Z","timestamp":1505869365000},"page":"2162-2169","source":"Crossref","is-referenced-by-count":110,"title":["Association of Trauma and Posttraumatic Stress Disorder With Incident Systemic Lupus Erythematosus in a Longitudinal Cohort of Women"],"prefix":"10.1002","volume":"69","author":[{"given":"Andrea L.","family":"Roberts","sequence":"first","affiliation":[{"name":"Harvard T. H. Chan School of Public Health Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Malspeis","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura D.","family":"Kubzansky","sequence":"additional","affiliation":[{"name":"Harvard T. H. Chan School of Public Health Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candace H.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun\u2010Chiao","family":"Chang","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karestan C.","family":"Koenen","sequence":"additional","affiliation":[{"name":"Harvard T. H. 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