The Neurocognition Deployment Health Study: A Prospective Cohort Study of Army Soldiers

Veterans Affairs Medical Center, New Orleans, LA 70112, USA.
Military medicine (Impact Factor: 0.77). 04/2006; 171(3):253-60. DOI: 10.7205/MILMED.171.3.253
Source: PubMed


Questions remain regarding the effects of military operational deployment on health. The Neurocognition Deployment Health Study addresses several gaps in the deployment health literature, including lack of baseline health data, reliance on subjective measures of exposure and health variables, prolonged intervals between redeployment and health assessments, and lack of a uniform case definition. The Neurocognition Deployment Health Study uses a prospective cohort design to assess neuropsychological outcomes associated with Iraq deployment. Methods incorporate administration of performance-based neuropsychological measures to Army soldiers before and after Iraq deployment and to nondeployed Army Soldiers assessed during comparable periods of garrison duty. Findings should have the potential to delineate neuropsychological outcomes related to combat theater deployment and to identify potential risk and protective factors related to health outcomes.

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Available from: Jennifer Vasterling, Nov 24, 2015
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    • "National Guard units included combat arms/combat support functions. Further sampling, recruitment, and consent procedures are described elsewhere (Vasterling, Proctor, Amoroso, Kane, Heeren, et al., 2006). A total of 1595 participants enrolled in the NDHS, representing a response rate of almost 94% at baseline enrollment. "
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    ABSTRACT: Research suggests that military unit support and community postdeployment social support are associated with fewer PTSD symptoms following military deployment. This study extended prior research by examining the associations among predeployment unit support and PTSD symptoms before Iraq deployment as well as unit support, PTSD symptoms, and postdeployment social support after deployment among 835 U.S. Army and 173 National Guard soldiers. Multiple regression analyses indicated that predeployment unit support was not significantly associated with postdeployment PTSD severity in either group of soldiers, whereas higher unit support during deployment was significantly associated with lower postdeployment PTSD severity among active duty soldiers only. Among both groups, higher levels of postdeployment social support were associated with lower levels of postdeployment PTSD symptom severity. These findings suggest that postdeployment social support is a particularly strong buffer against postdeployment PTSD symptoms among both groups of soldiers whereas the effects of unit support may be limited.
    Journal of anxiety disorders 04/2014; 28(5):446-453. DOI:10.1016/j.janxdis.2014.04.004 · 2.68 Impact Factor
    • "Participants were 774 male and female regular active duty and activated National Guard U.S. Army soldiers who deployed to Iraq as part of OIF between April 2003 and June 2005. Participants were selected from a larger pool of soldiers enrolled in the Neurocognition Deployment Health Study (NDHS), a study designed to examine neuropsychological outcomes of Iraq deployment (Vasterling et al., 2006). As part of the NDHS, military units were assessed before deploying to Iraq (predeployment) and again following return from deployment (postdeployment). "
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    ABSTRACT: Previous research indicates a relationship between perceived fear for one's safety (i.e., threat appraisal) and posttraumatic stress disorder (PTSD). This prospective study examined relationships among deployment- and predeployment-related variables, threat appraisal, and postdeployment PTSD symptom severity. Prior to Iraq deployment, 774 U.S. Army soldiers completed self-report measures assessing previous life stressors, deployment history, current (predeployment) PTSD symptoms, deployment preparedness, and unit cohesion. Following deployment, participants completed self-report measures assessing combat intensity, deployment threat appraisal, and current (postdeployment) PTSD symptoms. Structural equation modeling revealed that predeployment PTSD symptom severity, prior warzone deployment, unit cohesion, and preparedness were each independently associated with deployment threat appraisal, even after taking into account combat intensity. Deployment threat appraisal was associated with postdeployment PTSD severity. Results indicated that predeployment PTSD symptom severity, history of warzone deployment, and preparedness—risk factors previously thought to influence PTSD outcomes directly—were either partially or fully mediated by threat appraisal. The model explained 15% of the variance in deployment threat appraisal and 50% of the variance in postdeployment PTSD severity. Helping service members cope with exposure to extreme stress during deployment by modifying certain prewar risk factors may facilitate reduction of PTSD symptoms following deployment. 標題:服役前風險因素、戰區危險度評價和退役後PTSD症狀的關係 撮要:有研究指出自身安全的覺察恐懼(即危險度評價)和創傷後壓力症(PTSD)互相關連。本前瞻性研究檢視服役中和服役前的相關變量、危險度評價、和退役後PTSD症狀幅度。774名美國人到伊拉克服役前完成自我報告測試,評核:昔日生活壓力、服役史、現行(服役前)PTSD症狀、服役準備、和單位凝聚力。而退役後,軍人亦會填寫自我報告測試,評估:戰鬥劇烈程度、服役危險度評價和現行(退役後)PTSD症狀。結構方程式模型顯示:在撇除戰鬥劇烈程度後,服役前PTSD症狀幅度,以往戰區服役情況,單位凝聚力和服役準備都各自獨立地與服役危險度評價有關連。服役危險度評價亦與退役後PTSD幅度相關。結果指出服役前PTSD症狀幅度、戰區服役史和服役準備此等風險因素,曾被認為直接影響PTSD後果,都是局部或全部經由危險評價作中介。此模型能有效解釋服役危險度評價的15%方差,和服役後PTSD幅度的50%方差。透過調整某些戰前風險因素,以協助軍人面對極端服役壓力,可能服役後有效減少PTSD症狀。 标题:服役前风险因素、战区危险度评价和退役后PTSD症状的关系 撮要:有研究指出自身安全的觉察恐惧(即危险度评价)和创伤后压力症(PTSD)互相关连。本前瞻性研究检视服役中和服役前的相关变量、危险度评价、和退役后PTSD症状幅度。774名美国人到伊拉克服役前完成自我报告测试,评核:昔日生活压力、服役史、现行(服役前)PTSD症状、服役准备、和单位凝聚力。而退役后,军人亦会填写自我报告测试,评估:战斗剧烈程度、服役危险度评价和现行(退役后)PTSD症状。结构方程式模型显示:在撇除战斗剧烈程度后,服役前PTSD症状幅度,以往战区服役情况,单位凝聚力和服役准备都各自独立地与服役危险度评价有关连。服役危险度评价亦与退役后PTSD幅度相关。结果指出服役前PTSD症状幅度、战区服役史和服役准备此等风险因素,曾被认为直接影响PTSD后果,都是局部或全部经由危险评价作中介。此模型能有效解释服役危险度评价的15%方差,和服役后PTSD幅度的50%方差。透过调整某些战前风险因素,以协助军人面对极端服役压力,可能服役后有效减少PTSD症状。
    Journal of Traumatic Stress 08/2013; 26(4). DOI:10.1002/jts.21827 · 2.72 Impact Factor
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    • "Soldiers that were initially seen as control subjects but later deployed were also tested postdeployment ; these soldiers were also included in the analyses. See Vasterling et al. (2006a, 2006b) for details regarding sampling rationale and characteristics. Subjects were 780 active duty soldiers who deployed to Iraq, with pre (Time 1) and post (Time 2) deployment data on relevant neurocognitive measures. "
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    ABSTRACT: This prospective/longitudinal study examined the effects of Operation Iraqi Freedom-related emotional symptoms and mTBI exposure on post-deployment function. Both performance-based and self-report outcome measures were collected. Regression analytic strategies examined post-OIF function on objective neurocognitive measures and self-reported cognitive and physical problems, measuring the predictive contribution of self-report of mild TBI; self-report regarding emotional function immediately post-deployment (e.g., symptoms of PTSD and depression); and self-report of combat exposure. A survey of predeployment factors failed to uncover any reliable predictors of deployment-related mild TBI beyond previous occurrence of related TBI. Regression analyses utilizing self-report of PTSD indicate that symptoms of deployment-related emotional distress are significantly related to postdeployment cognitive outcomes. The existence of an analogous depression-cognitive outcome suggests that the impact of deployment is not related strictly to PTSD and instead reflects more global levels of emotional distress. Mild traumatic brain injury (mTBI) was not a significant predictor of cognitive outcome in this sample, despite use of liberal exploratory techniques designed to maximize the likelihood of uncovering meaningful mTBI-cognition effects. However, a significant mTBI/physical complaints relationship suggests that mTBI may be exerting a deleterious effect on the readjustment of deployed troops. This relationship is unlikely to be due solely to demand characteristics, since no relationship was found between mTBI and self-report of cognitive complaints. The congruence between cognitive objective performance and cognitive self-report data in this sample instead is consistent with the possibility that simple self-report of mTBI is tapping a distress factor with unclear consequences. Improved reliability of mTBI measures would assist in further delineating this potential relationship.
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