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.
"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. "
[Show abstract][Hide abstract] 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.
"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). "
[Show abstract][Hide abstract] 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.
"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. "
[Show abstract][Hide abstract] 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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