{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T01:01:49Z","timestamp":1782954109412,"version":"3.54.5"},"reference-count":40,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T00:00:00Z","timestamp":1652227200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Rijeka","award":["uniri-pr-biomed-19-3"],"award-info":[{"award-number":["uniri-pr-biomed-19-3"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The aim of this study was to examine post-traumatic stress disorder (PTSD) symptom levels and coping strategies during the COVID-19 pandemic among treatment-seeking veterans with pre-existing PTSD. Method: A cohort of 176 male treatment-seeking veterans with pre-existing PTSD during the first COVID-19 pandemic lockdown (T1) and 132 participants from the same cohort one year after the onset of the pandemic (T2) participated in a longitudinal study. All participants responded to a COVID-19-related questionnaire and the following measures: the Life Events Checklist for DSM-5 (LEC-5), PTSD Checklist for DSM-5 (PCL-5) and the Brief COPE. Results: The intensity of overall PTSD symptoms, avoidance symptoms and negative alterations in cognitions and mood was lower at T2. PTSD symptoms were not significantly correlated with SARS-CoV-2 potentially traumatic events (PTE) at T2. Veterans scored higher on emotion-focused and problem-focused coping than on dysfunctional coping. Conclusions: Veterans with pre-existing PTSD who were receiving long-term treatment coped with COVID-19 stressors without the effects of retraumatization and a consequent worsening of PTSD symptoms.<\/jats:p>","DOI":"10.3390\/jcm11102715","type":"journal-article","created":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T10:19:46Z","timestamp":1652264386000},"page":"2715","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["PTSD Symptoms and Coping with COVID-19 Pandemic among Treatment-Seeking Veterans: Prospective Cohort Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1928-7980","authenticated-orcid":false,"given":"Marina","family":"Letica-Crepulja","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia"},{"name":"Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center of the Ministry of Health of the Republic of Croatia, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1927-500X","authenticated-orcid":false,"given":"Aleksandra","family":"Stevanovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia"},{"name":"Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center of the Ministry of Health of the Republic of Croatia, 51000 Rijeka, Croatia"},{"name":"Department of Basic Medical Sciences, Faculty of Health Studies, University of Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Palai\u0107","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center of the Ministry of Health of the Republic of Croatia, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iva","family":"Vidovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Fran\u010di\u0161kovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia"},{"name":"Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center of the Ministry of Health of the Republic of Croatia, 51000 Rijeka, Croatia"},{"name":"Department of Basic Medical Sciences, Faculty of Health Studies, University of Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Gersons, B.P.R., Smid, G.E., Smit, A.S., Kazlauskas, E., and McFarlane, A. (2020). Can a \u2018second disaster\u2019 during and after the COVID-19 pandemic be mitigated?. Eur. J. Psychotraumatol., 11.","DOI":"10.1080\/20008198.2020.1815283"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Krishnamoorthy, Y., Nagarajan, R., Saya, G.K., and Menon, V. (2020). Prevalence of psychological morbidities among general population, healthcare workers and COVID-19 patients amidst the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res., 293.","DOI":"10.1016\/j.psychres.2020.113382"},{"key":"ref_3","unstructured":"COVID-19 Mental Disorders Collaborators (2021). Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet, 398, 1700\u20131712."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Emodi-Perlman, A., Eli, I., Uziel, N., Smardz, J., Khehra, A., Gilon, E., Wieckiewicz, G., Levin, L., and Wieckiewicz, M. (2021). Public Concerns during the COVID-19 Lockdown: A Multicultural Cross-Sectional Study among Internet Survey Respondents in Three Countries. J. Clin. Med., 10.","DOI":"10.3390\/jcm10081577"},{"key":"ref_5","first-page":"657","article-title":"Addressing the public mental health challenge of COVID-19","volume":"7","author":"Campion","year":"2020","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Holman, E.A., Thompson, R.R., Garfin, D.R., and Silver, R.C. (2020). The unfolding COVID-19 pandemic: A probability-based, nationally representative study of mental health in the United States. Sci. Adv., 6.","DOI":"10.1126\/sciadv.abd5390"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.jpsychires.2020.10.035","article-title":"Psychological distress and adaptation to the COVID-19 crisis in the United States","volume":"136","author":"Daly","year":"2021","journal-title":"J. Psychiatr. Res."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Pietrzak, R.H., Tsai, J., and Southwick, S.M. (2021). Association of symptoms of posttraumatic stress disorder with posttraumatic psychological growth among US veterans during the COVID-19 pandemic. JAMA, 4.","DOI":"10.1001\/jamanetworkopen.2021.4972"},{"key":"ref_9","first-page":"1218","article-title":"Prevalence and trends in suicidal behavior among US Military veterans during the COVID-19 pandemic","volume":"78","author":"Nichter","year":"2021","journal-title":"JAMA"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Hill, M.L., Nichter, B., Na, P.J., Norman, S.B., Morland, L.A., Krystal, J.H., and Pietrzak, R.H. (2021). Mental health impact of the COVID-19 pandemic in U.S. military veterans: A population-based, prospective cohort study. Psychol. Med., 1\u201312.","DOI":"10.1017\/S0033291721002361"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1002\/jts.22742","article-title":"The impact of the COVID-19 pandemic on treatment-seeking veterans in the United Kingdom with preexisting mental health difficulties: A longitudinal study","volume":"35","author":"Hendrikx","year":"2022","journal-title":"J. Trauma. Stress"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"241","DOI":"10.3325\/cmj.2021.62.241","article-title":"Posttraumatic stress disorder symptoms and coping with the lockdown among help-seeking veterans before and during the COVID-19 pandemic","volume":"62","year":"2021","journal-title":"Croat. Med. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jpsychires.2005.07.005","article-title":"Posttraumatic stress disorder: A state-of-the-science review","volume":"40","author":"Nemeroff","year":"2006","journal-title":"J. Psychiatr. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.brat.2012.06.006","article-title":"A longitudinal test of the bi-directional relations between avoidance coping and PTSD severity during and after PTSD treatment","volume":"50","author":"Badour","year":"2012","journal-title":"Behav. Res. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1177\/1541931214581261","article-title":"How do I handle my life now? Coping and the post traumatic stress disorder checklist\u2014Military version","volume":"58","author":"Rice","year":"2014","journal-title":"Proc. Hum. Factors Ergon. Soc. Annu. Meet."},{"key":"ref_16","unstructured":"Croatian Institute of Public Health (2021, April 04). Indicators of Health Status and Use of Health Care of Croatian Veterans of the Homeland War\u2014The State of 2020 [Translated Title]. Croatian Institute of Public Health. Available online: https:\/\/www.hzjz.hr\/wp-content\/uploads\/2021\/09\/Branitelji_2020.pdf."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Letica-Crepulja, M., Stevanovi\u0107, A., Protu\u0111er, M., Grahovac Jureti\u0107, T., Rebi\u0107, J., and Fran\u010di\u0161kovi\u0107, T. (2020). Complex PTSD among treatment-seeking veterans with PTSD. Eur. J. Psychotraumatol., 11.","DOI":"10.1080\/20008198.2020.1716593"},{"key":"ref_18","unstructured":"Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., and Schnurr, P.P. (2020, March 15). The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD, Available online: www.ptsd.va.gov."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1177\/1073191104269954","article-title":"Psychometric properties of the life events checklist","volume":"11","author":"Gray","year":"2004","journal-title":"Assessment"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1002\/jts.22059","article-title":"The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation","volume":"28","author":"Blevins","year":"2015","journal-title":"J. Trauma. Stress"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1037\/pas0000254","article-title":"Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans","volume":"28","author":"Bovin","year":"2016","journal-title":"Psychol. Assess."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Sveen, J., Bondjers, K., and Willebrand, M. (2016). Psychometric properties of the PTSD checklist for DSM-5: A pilot study. Eur. J. Psychotraumatol., 7.","DOI":"10.3402\/ejpt.v7.30165"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1037\/pas0000260","article-title":"Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members","volume":"28","author":"Wortmann","year":"2016","journal-title":"Psychol. Assess."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1207\/s15327558ijbm0401_6","article-title":"You want to measure coping but your protocol\u2019s too long: Consider the brief COPE","volume":"4","author":"Carver","year":"1997","journal-title":"Int. J. Behav. Med."},{"key":"ref_25","first-page":"267","article-title":"Assessing coping strategies: A theoretically based approach","volume":"56","author":"Carver","year":"1989","journal-title":"J. Appl. Soc. Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Margeti\u0107, B., Peraica, T., Stojanovi\u0107, K., and Ivanec, D. (2021). Predictors of emotional distress during the COVID-19 pandemic; a Croatian study. Pers. Individ. Differ., 175.","DOI":"10.1016\/j.paid.2021.110691"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Schock, K., B\u00f6ttche, M., Rosner, R., Wenk-Ansohn, M., and Knaevelsrud, C. (2016). Impact of new traumatic or stressful life events on pre-existing PTSD in traumatized refugees: Results of a longitudinal study. Eur. J. Psychotraumatol., 9.","DOI":"10.3402\/ejpt.v7.32106"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1037\/a0035140","article-title":"Narrative centrality and negative affectivity: Independent and interactive contributors to stress reactions","volume":"143","author":"Rubin","year":"2014","journal-title":"J. Exp. Psychol. Gen."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1080\/10615806.2015.1080822","article-title":"Event centrality prospectively predicts PTSD symptoms","volume":"29","author":"Boals","year":"2016","journal-title":"Anxiety Stress Coping"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1002\/da.23149","article-title":"Increasing treatment-seeking intentions of US veterans in the COVID-19 era: A randomized controlled trial","volume":"38","author":"Amsalem","year":"2021","journal-title":"Depress. Anxiety"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Lotzin, A., Krause, L., Acquarini, E., Ajdukovic, D., Ardino, V., Arnberg, F., B\u00f6ttche, M., Bragesj\u00f6, M., Dragan, M., and Figueiredo-Braga, M. (2021). Risk and protective factors, stressors, and symptoms of adjustment disorder during the COVID-19 pandemic: First results of the ESTSS COVID-19 pan-European ADJUST study. Eur. J. Psychotraumatol., 12.","DOI":"10.1080\/20008198.2021.1964197"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Sharp, M.L., Serfioti, D., Jones, M., Burdett, H., Pernet, D., Hull, L., Murphy, D., Wessely, S., and Fear, N.T. (2021). UK veterans\u2019 mental health and well-being before and during the COVID-19 pandemic: A longitudinal cohort study. Brit. Med. J., 11.","DOI":"10.1136\/bmjopen-2021-049815"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1136\/bmjmilitary-2020-001622","article-title":"Exploring the impact of COVID-19 and restrictions to daily living as a result of social distancing within veterans with pre-existing mental health difficulties","volume":"168","author":"Murphy","year":"2020","journal-title":"Brit. Med. J. Mil. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1348\/014466599162836","article-title":"PTSD symptoms, response to intrusive memories and coping in ambulance service workers","volume":"8","author":"Clohessy","year":"1999","journal-title":"Br. J. Clin. Psychol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1111\/j.1939-0025.2010.01060.x","article-title":"Resilience in trauma exposed refugees: The moderating effect of coping style on resilience variables","volume":"80","author":"Hooberman","year":"2010","journal-title":"Am. J. Orthopsychiatry"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1023\/B:JOTS.0000014671.27856.7e","article-title":"Positive change following trauma and adversity: A review","volume":"17","author":"Linley","year":"2004","journal-title":"J. Trauma. Stress"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Mahar, A., Reppas-Rindlisbacher, C., Edgelow, M., Siddhpuria, S., Hallet, J., Rochon, P.A., and Cramm, H. (2021). Concerns and coping strategies of older adult veterans in Canada at the outset of the COVID-19 pandemic. J. Mil. Veteran Fam. Health, 7.","DOI":"10.3138\/jmvfh-2021-0712"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S2215-0366(20)30168-1","article-title":"Multidisciplinary research priorities for the COVID-19 pandemic: A call for action for mental health science","volume":"7","author":"Holmes","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Khubchandani, J., Wiblishauser, M.J., Price, J.H., and Webb, F.J. (2021). COVID-19 related information and psychological distress: Too much or too bad?. Brain Behav. Immun., 12.","DOI":"10.1016\/j.bbih.2021.100213"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Bridgland, V.M.E., Moeck, E.K., Green, D.M., Swain, T.L., Nayda, D.M., Matson, L.A., Hutchison, N.P., and Takarangi, M. (2021). Why the COVID-19 pandemic is a traumatic stressor. 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