{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T20:42:31Z","timestamp":1780432951672,"version":"3.54.1"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T00:00:00Z","timestamp":1690070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["W81XWH1810697"],"award-info":[{"award-number":["W81XWH1810697"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["IK2CX002439"],"award-info":[{"award-number":["IK2CX002439"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Traumatic Stress"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Revisions to the posttraumatic stress disorder (PTSD) criteria in the <jats:italic>DSM\u20105<\/jats:italic> included a new criterion in the alterations in arousal and reactivity cluster (i.e., engagement in reckless and self\u2010destructive behaviors; Criterion E2). Despite its clinical significance, little is known about how this symptom corresponds to engagement in specific direct and indirect self\u2010harm behaviors. We examined associations between E2 and self\u2010reported recent engagement in direct and indirect self\u2010harm behaviors, including disordered eating, which is not included in the prototypical E2 symptom scope, in a trauma\u2010exposed sample of 1,010 recent\u2010era veterans (61.5% self\u2010identified women, 38.5% self\u2010identified men). We also tested whether gender moderated these associations. We repeated analyses in a subsample of participants with clinically elevated PTSD symptoms. Participants self\u2010reported past\u2010month PTSD symptoms (PCL\u20105) as well as past\u2010month nonsuicidal self\u2010injury, suicidal ideation, suicide planning, fasting, purging, binge eating, compulsive exercise, and problematic alcohol and drug use. We found no evidence for moderation by gender for any of the behaviors examined in the main sample. However, after controlling for gender and demographic covariates, weighted logistic regressions showed small, significant associations between E2 score and direct self\u2010harm behaviors, substance use, purging, and binge eating, a<jats:italic>ORs<\/jats:italic> = 1.30\u20131.91. Criterion E2 was linked to behaviors included in the typical symptom scope (self\u2010directed violence, substance use) and those that are not (disordered eating behaviors). Comprehensive screening for self\u2010destructive behaviors, including disordered eating, among veteran men and women who endorse Criterion E2 is indicated.<\/jats:p>","DOI":"10.1002\/jts.22960","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T04:29:04Z","timestamp":1690172944000},"page":"1001-1009","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Associations between <i>DSM\u20105<\/i> posttraumatic stress disorder Criterion E2 endorsement and selected self\u2010destructive behaviors in recent\u2010era veterans: A focus on disordered eating"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3083-4669","authenticated-orcid":false,"given":"Rachel L.","family":"Zelkowitz","sequence":"first","affiliation":[{"name":"Women's Health Sciences Division, National Center for PTSD VA Boston Healthcare System  Boston Massachusetts USA"},{"name":"Department of Psychiatry Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon M.","family":"Kehle\u2010Forbes","sequence":"additional","affiliation":[{"name":"Women's Health Sciences Division, National Center for PTSD VA Boston Healthcare System  Boston Massachusetts USA"},{"name":"Center for Care Delivery and Outcomes Research Minneapolis Veterans Affairs Health Care System  Minneapolis Minnesota USA"},{"name":"Department of Medicine University of Minnesota Medical School  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian N.","family":"Smith","sequence":"additional","affiliation":[{"name":"Women's Health Sciences Division, National Center for PTSD VA Boston Healthcare System  Boston Massachusetts USA"},{"name":"Department of Psychiatry Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6636-1034","authenticated-orcid":false,"given":"Dawne S.","family":"Vogt","sequence":"additional","affiliation":[{"name":"Women's Health Sciences Division, National Center for PTSD VA Boston Healthcare System  Boston Massachusetts USA"},{"name":"Department of Psychiatry Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen S.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Women's Health Sciences Division, National Center for PTSD VA Boston Healthcare System  Boston Massachusetts USA"},{"name":"Department of Psychiatry Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. 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