Baseline self reported functional health and vulnerability to post-traumatic stress disorder after combat deployment: prospective US military cohort study

Abstract

Objective To determine if baseline functional health status, as measured by SF-36 (veterans), predicts new onset symptoms or diagnosis of post-traumatic stress disorder among deployed US military personnel with combat exposure.Design Prospective cohort analysis.Setting Millennium Cohort.Participants Combat deployed members who completed baseline (2001-3) and follow-up (2004-6) questionnaires. Self reported and electronic data used to examine the relation between functional health and post-traumatic stress disorder.Main outcome measures New onset post-traumatic stress disorder as measured by either meeting the DSM-IV criteria with the 17 item post-traumatic stress disorder checklist-civilian version or self report of a physician diagnosis at follow-up with the absence of both at baseline.Results Of the 5410 eligible participants, 395 (7.3%) had new onset symptoms or diagnosis of post-traumatic stress disorder at the time of follow-up. Individuals whose baseline mental or physical component summary scores were below the 15th centile had two to three times the risk of symptoms or a diagnosis of post-traumatic stress disorder by follow-up compared with those in the 15th to 85th centile. Of those with new onset symptoms or diagnosis of post-traumatic stress disorder, over half (58%) of cases occurred among participants with scores below the 15th centile at baseline.Conclusions Low mental or physical health status before combat exposure significantly increases the risk of symptoms or diagnosis of post-traumatic stress disorder after deployment. More vulnerable members of a population could be identified and benefit from interventions targeted to prevent new onset post-traumatic stress disorder.

The Deployment Life Study: Longitudinal Analysis of Military Families Across the Deployment Cycle

“…Other demographic trends from the literature suggest that, consistent with civilian populations, women who have deployed are at increased risk for depression (Carter-Visscher et al, 2010;Haskell et al, 2010;Kehle et al, 2011;Luxton, Skopp, and Maguen, 2010;Maguen, Cohen, et al, 2012;Maguen, Madden, et al, 2014;Maguen, Ren, et al, 2010;Seal et al, 2009), while men are at increased risk for substance misuse Iversen et al, 2009;Maguen, Cohen, et al, 2012;Maguen, Madden, et al, 2014;Maguen, Ren, et al, 2010;Seal et al, 2009). There is conflicting evidence about whether military PTSD is more common in men (Cohen, Brown, et al, 2010;Haskell et al, 2010;Heron et al, 2013;Iversen et al, 2009;Maguen, Madden, et al, 2014;Maguen, Ren, et al, 2010) or women (Kehle et al, 2011;LeardMann et al, 2009;Luxton, Skopp, and Maguen, 2010), although studies that control for exposure to trauma generally find an elevated risk of PTSD in women (Luxton, Skopp, and Maguen, 2010;.…”

“…Thus, combat exposure may explain the Army's higher prevalence rates of PTSD (Armed Forces Health Surveillance Center, 2012; Baker et al, 2009;Cohen, Gima, et al, 2010;LeardMann et al, 2009;Maguen, Cohen, et al, 2012;Seal et al, 2009) and depression (Maguen, Cohen, et al, 2012), as well as higher rates of PTSD in the Marine Corps (Armed Forces Health Surveillance Center, 2012; Baker et al, 2009;Cohen, Gima, et al, 2010) or higher rates of PTSD and depression among enlisted personnel and those of lower rank (Cohen, Gima, et al, 2010;Goodwin et al, 2012;Hickling et al, 2011;LeardMann et al, 2009;Maguen, Ren, et al, 2010;Mayo et al, 2013;Seal et al, 2009). …”

Heterogeneity in the course of posttraumatic stress disorder: Trajectories of symptomatology

“…Using data collected as part of the Millennium Cohort Study (e.g., Ryan et al, 2007), researchers have found female gender, a history of previous assault, poor physical and mental health functioning at baseline, and exposure to combat to confer significant risk for the development of PTSD (Leardmann, Smith, Smith, Wells, & Ryan, 2009;.…”

Deployment-related trauma and post-traumatic stress disorder: does gender matter?

“…Jacobson, Donoho, Crum-Cianflone, & Maguen, 2015; Maguen, Luxton, Skopp, & Madden, 2012), others report an increased risk of PTSD among women (e.g. LeardMann, Smith, Smith, Wells, & Ryan, 2009; Luxton, Skopp, & Maguen, 2010; Mustillo & Kysar-Moon, 2016; Xue et al, 2015), and one study reported an increased risk of PTSD among men (i.e. Hourani, Willians, Bray, Wilk, & Hoge, 2016).…”