New Onset and Persistent Symptoms of Post-Traumatic Stress Disorder Self-Reported after Deployment and Combat Exposures: Prospective Population Based US Military Cohort Study

Department of Defense Center for Deployment Health Research at the Naval Health Research Center, San Diego, CA 92106, USA.
BMJ (online) (Impact Factor: 17.45). 03/2008; 336(7640):366-71. DOI: 10.1136/bmj.39430.638241.AE
Source: PubMed

ABSTRACT To describe new onset and persistence of self reported post-traumatic stress disorder symptoms in a large population based military cohort, many of whom were deployed in support of the wars in Iraq and Afghanistan.
Prospective cohort analysis.
Survey enrolment data from the millennium cohort (July 2001 to June 2003) obtained before the wars in Iraq and Afghanistan. Follow-up (June 2004 to February 2006) data on health outcomes collected from 50 184 participants.
Self reported post-traumatic stress disorder as measured by the posttraumatic stress disorder checklist-civilian version using Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria.
More than 40% of the cohort were deployed between 2001 and 2006; between baseline and follow-up, 24% deployed for the first time in support of the wars in Iraq and Afghanistan. New incidence rates of 10-13 cases of post-traumatic stress disorder per 1000 person years occurred in the millennium cohort. New onset self reported post-traumatic stress disorder symptoms or diagnosis were identified in 7.6-8.7% of deployers who reported combat exposures, 1.4-2.1% of deployers who did not report combat exposures, and 2.3-3.0% of non-deployers. Among those with self reported symptoms of post-traumatic stress disorder at baseline, deployment did not affect persistence of symptoms.
After adjustment for baseline characteristics, these prospective data indicate a threefold increase in new onset self reported post-traumatic stress disorder symptoms or diagnosis among deployed military personnel who reported combat exposures. The findings define the importance of post-traumatic stress disorder in this population and emphasise that specific combat exposures, rather than deployment itself, significantly affect the onset of symptoms of post-traumatic stress disorder after deployment.

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    • "Relatively, few prevalence studies of PTSD in the OEF/ OIF populations have examined the association between relationship status and mental health, and those that have have found mixed results. For example, some studies have found no relationship between marital status and PTSD (Riddle et al., 2007; Schell & Marshall, 2008), one suggested that marital status increases risk for development of PTSD (Grieger et al., 2006) and another found higher odds of new-onset PTSD (but not persistent PTSD) among never married or divorced personnel (Smith et al., 2008). It would be useful to go beyond the categorical marital status to investigate the potentially critical moderating role of marital/committed relationship quality. "
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    European Journal of Psychotraumatology 05/2015; 6:27322. DOI:10.3402/ejpt.v6.27322 · 2.40 Impact Factor
    • "Military service members (SM) deployed to wars in Iraq and Afghanistan are more likely to experience posttraumatic stress disorder (PTSD) symptoms related to both warzone and homefront experiences (Smith et al., 2008; Vasterling et al., 2010) than those who did not deploy. Post-deployment PTSD symptoms are associated with reduced quality of life and functional status in SMs (Schnurr et al., 2009; Tsai et al., 2012), even for those whose symptoms fall short of meeting full diagnostic criteria for PTSD (Cukor et al., 2010; Grubaugh et al., 2005; Magruder et al., 2004). "
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    • "The very description of symptoms of PTSD -feeling distant from others and one's prior interests, social phobia, reduced involvement with the external world, guilt (APA, 2000; Institute of Medicine, 2012) and persistent reexperiencing of the stressors or events that preceded the development of PTSD (Smith et al, 2008) appear to support a person's adoption of these three dysfunctional coping methods -behavioral disengagement, self-blame, and venting (See Table 3 for descriptions). Most importantly, others have shown that avoidance coping strategies, such as those found in this research increased stress responses (Nuttman-Shwartz and Dekel, 2009) and are the most reliable indication that an individual may meet the criteria for PTSD (Nemeroff et al., 2006; Thompson and Waltz, 2010). "
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    ABSTRACT: Approximately 13 to 30% of service members returning from Operation Enduring Freedom and Operation Iraqi Freedom have Post-Traumatic Stress Disorder (PTSD) (Institute of Medicine, 2012). The purpose of this research is to examine the relationship between self-identified PTSD and self-reported coping abilities. Active duty and veteran volunteers (n=77) took the PTSD Checklist – Military Version (PCL-M), 26 were identified as having high PTSD scores (+PTSD) and 51 were identified as having low scores, such that they would not be suspected of having PTSD (-PTSD). Volunteers took the self-reported Brief COPE Inventory. Using independent samples T tests, those with +PTSD used dysfunctional coping strategies of Behavioral Disengagement (giving up, helplessness) t(32.735)=2.898,p=0.007; Venting (focusing on distress and venting emotions) t(36.537)=2.264, p=0.030; and Self Blame (self- criticizing and self-fault) t(38.147)=4.161, p<0.001 more often than those with -PTSD. These results provide information on the coping skills of those with self-identified +PTSD, according to the PCL-M. Further research and engaging new recruits and those with PTSD in learning positive coping skills are recommended.
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