Latent Trajectories of Trauma Symptoms and Resilience

Andersen, Søren Bo; Karstoft, Karen-Inge; Bertelsen, Mette; Madsen, Trine

doi:10.4088/jcp.13m08914

Cited by 85 publications

(70 citation statements)

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“…A general analysis of the response rates showed no significant differences between soldiers who answered before, at homecoming and 2.5 years after homecoming (Danish Defence, 2013). Further, previous analyses have found no differences between the latent growth mixture modelling (LGMM) model established based on the 561 individuals included here and one including only those responding four or more times (Andersen et al, 2014). Further descriptive information on the measurements at pre-deployment, after homecoming and post-deployment from this study is shown in Table 1.…”

Section: Methodsmentioning

confidence: 70%

“…The PCL has been validated in this sample of Danish soldiers against the Structured Clinical Interview for Axis I disorders of the DSM-IV (SCID-I) (First, Spitzer, Gibbon, & Williams, 2002; Karstoft, Andersen, Bertelsen, & Madsen, 2014). In this sample it showed high internal consistency ( α = 0.94) (Andersen et al, 2014). The civilian version of the PCL was used to allow the respondents to report PTSD symptoms related to any traumatic events and not only symptoms caused by military experiences.…”

Section: Methodsmentioning

confidence: 84%

“…The study was approved by the Danish Data Protection Agency (Copenhagen, Denmark). Detailed data collection procedures for the PTSD trajectories are described elsewhere (Andersen et al, 2014). …”

Section: Methodsmentioning

confidence: 99%

“…In a previous study based on the same data set of Danish soldiers deployed to Afghanistan in 2009 (the USPER study; for details see Andersen, Karstoft, Bertelsen, & Madsen, 2014; Berntsen et al, 2012), six trajectories of PTSD symptoms were identified (Andersen et al, 2014). These trajectories consisted of a low–stable or resilient group with low PTSD symptom levels across all measurements (78.1% of the sample) and five other groups which had fluctuating symptom levels across the measurements.…”

Section: Introductionmentioning

confidence: 99%

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Pre-deployment dissociation and personality as risk factors for post-deployment post-traumatic stress disorder in Danish soldiers deployed to Afghanistan

León

Andersen

Karstoft

et al. 2018

European Journal of Psychotraumatology

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Objective: This study investigated whether pre-deployment dissociation was associated with previously identified post-traumatic stress disorder (PTSD) symptom trajectories from before to 2.5 years after military deployment. Furthermore, it examined whether the tendency to dissociate, pre-deployment personality factors, conceptualized by the Big Five model, and previous trauma represented independent risk factors for post-deployment PTSD symptoms.Method: This prospective study included the entire team of 743 soldiers from the Danish Contingent of the International Security Assistance Force 7 deployed to Afghanistan in 2009. Data consisted of self-report measures and were collected six times: before deployment; during deployment; and 1–3 weeks, 2 months, 7 months and 2.5 years after homecoming.Results: The findings indicate significant associations between pre-deployment dissociation and six PTSD trajectories (p < 0.001, η2 = 0.120). Based on mean differences in dissociation for the six trajectories, two main groups emerged: a group with high dissociation scores at pre-deployment, which had moderate PTSD symptom levels at pre-deployment and fluctuated over time; and a group with low dissociation scores at pre-deployment, which had low initial PTSD symptom levels and diverged over time. Our study also confirmed previous findings of a positive association between neuroticism and dissociation (r = 0.31, p < 0.001). This suggests that negative emotionality may be a vulnerability that enhances dissociative experiences, although a causal link cannot be concluded from the findings. Finally, pre-deployment dissociation, pre-deployment neuroticism and a history of traumatic events, as independent factors, were significant predictors of post-deployment PTSD (p < 0.001, R2 = 0.158).Conclusions: The study emphasizes the multiplicity of factors involved in the development of PTSD, and group differences in dissociative symptoms support the heterogeneity in PTSD. Further, this study points to specific aspects of personality that may be targeted in a clinical setting and in pre-deployment assessments in the military.

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Section: Methodsmentioning

confidence: 70%

Section: Methodsmentioning

confidence: 84%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pre-deployment dissociation and personality as risk factors for post-deployment post-traumatic stress disorder in Danish soldiers deployed to Afghanistan

León

Andersen

Karstoft

et al. 2018

European Journal of Psychotraumatology

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“…The last decades have seen a plethora of research on the toll of recent wars in Iraq and Afghanistan (Andersen, Karstoft, Bertelsen, & Madsen, 2014; Carlson et al, 2010; McDevitt-Murphy et al, 2010; Ramchand et al, 2010; Schnurr et al, 2010; Shea, Vujanovic, Mansfield, Sevin, & Liu, 2010). Many studies have aimed at estimating the prevalence of PTSD following deployment and have reported greatly varying rates.…”

Section: Introductionmentioning

confidence: 99%

Perceived danger during deployment: a Rasch validation of an instrument assessing perceived combat exposure and the witnessing of combat consequences in a war zone

Karstoft

Nielsen

2018

European Journal of Psychotraumatology

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The potential stressors associated with military deployment are related to an increased risk of adverse mental health outcomes. Perceived exposure to combat has been found to be proportional to the severity of post-deployment posttraumatic stress disorder (PTSD). However, other perceived adversities during deployment, such as witnessing danger, distress, and hardship in the war zone, have been less systematically studied, but might play an equally substantial role for post-deployment mental health. The development and validation of scales that assess these related constructs are needed to distinguish their contribution to post-deployment risk of PTSD. We evaluated the validity of 10 items measuring perceived danger distributed to all deployed personnel with the Danish Defense since 1998. We hypothesize two scales: Exposure to Danger and Combat (EDC) and Witnessing Consequences of War (WCW). Two military cohorts deployed to Afghanistan in 2009 (Cohort 1, N = 276) and 2013 (Cohort 2, N = 273) were included. Questionnaire data was collected six months after homecoming, including deployment experiences and post-deployment reactions. We tested the construct validity of the 10 items of perceived danger with Rasch models (RM), focusing specifically on presence of subscales, and differential item functioning (DIF) across cohorts. We confirmed the existence of two separate subscales, EDCS and WCWS, both with adequate reliability. None of the subscales fitted a pure RM, but adequate fit was found for graphical log-linear RMs with evidence of DIF for the ECDS. However, adjusting the score to account for DIF had practically no effect, suggesting that the total non-adjusted mean score can be used in future cohort comparisons. Perceived exposure to combat and danger and witnessing consequences of war are related, but essentially distinct, concepts, each providing unique information about deployment adversities. Future studies should evaluate their shared and unique contribution to the risk of post-deployment PTSD.

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Brain‐derived neurotropic factor polymorphisms, traumatic stress, mild traumatic brain injury, and combat exposure contribute to postdeployment traumatic stress

et al. 2015

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BackgroundIn addition to experiencing traumatic events while deployed in a combat environment, there are other factors that contribute to the development of posttraumatic stress disorder (PTSD) in military service members. This study explored the contribution of genetics, childhood environment, prior trauma, psychological, cognitive, and deployment factors to the development of traumatic stress following deployment.MethodsBoth pre‐ and postdeployment data on 231 of 458 soldiers were analyzed. Postdeployment assessments occurred within 30 days from returning stateside and included a battery of psychological health, medical history, and demographic questionnaires; neurocognitive tests; and blood serum for the D2 dopamine receptor (DRD2), apolipoprotein E (APOE), and brain‐derived neurotropic factor (BDNF) genes.ResultsSoldiers who screened positive for traumatic stress at postdeployment had significantly higher scores in depression (d = 1.91), anxiety (d = 1.61), poor sleep quality (d = 0.92), postconcussion symptoms (d = 2.21), alcohol use (d = 0.63), traumatic life events (d = 0.42), and combat exposure (d = 0.91). BDNF Val66 Met genotype was significantly associated with risk for sustaining a mild traumatic brain injury (mTBI) and screening positive for traumatic stress. Predeployment traumatic stress, greater combat exposure and sustaining an mTBI while deployed, and the BDNF Met/Met genotype accounted for 22% of the variance of postdeployment PTSD scores (R 2 = 0.22, P < 0.001). However, predeployment traumatic stress, alone, accounted for 17% of the postdeployment PTSD scores.ConclusionThese findings suggest predeployment traumatic stress, genetic, and environmental factors have unique contributions to the development of combat‐related traumatic stress in military service members.

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Latent Trajectories of Trauma Symptoms and Resilience

Abstract: The results confirm earlier findings of stress response heterogeneity following military deployment and highlight the impact of predeployment, perideployment, and postdeployment risk factors in predicting PTSD symptomatology and late-onset PTSD symptoms.

Cited by 85 publications

References 0 publications

Pre-deployment dissociation and personality as risk factors for post-deployment post-traumatic stress disorder in Danish soldiers deployed to Afghanistan

Pre-deployment dissociation and personality as risk factors for post-deployment post-traumatic stress disorder in Danish soldiers deployed to Afghanistan

Perceived danger during deployment: a Rasch validation of an instrument assessing perceived combat exposure and the witnessing of combat consequences in a war zone

Brain‐derived neurotropic factor polymorphisms, traumatic stress, mild traumatic brain injury, and combat exposure contribute to postdeployment traumatic stress

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