Risk Factors for Posttraumatic Stress Disorder Among Deployed US Male Marines

Abstract

BackgroundCombat exposure has been reported as one of the strongest risk factors for postdeployment posttraumatic stress disorder (PTSD) among military service members. Determining the impact of specific deployment-related exposures on the risk of developing PTSD has not been fully explored. Our study objective was to explore the relationship between specific combat exposures and other life experiences with postdeployment PTSD.MethodsThis study consisted of male Marines who completed a Recruit Assessment Program (RAP) survey during recruit training at the Marine Corps Recruit Depot in San Diego, California as well as a follow-up survey several years after recruit training. Study participants included those Marines who deployed to the current operations in Iraq or Afghanistan between the baseline and follow-up surveys. Multivariable logistic regression was performed to determine which significant exposures and experiences were associated with postdeployment PTSD.ResultsOf the 706 study participants, 10.8% screened positive for postdeployment PTSD. Those who reported feeling in great danger of death (odds ratio [OR] = 4.63, 95% confidence interval [CI]: 2.46-8.73), were shot or seriously injured (OR = 3.51, 95% CI: 1.58-7.77), saw someone wounded or killed (OR = 2.47, 95% CI: 1.08-5.67), and baseline (before recruit training) prior violence exposures (OR = 2.99, 95% CI: 1.46-6.10) were at increased odds for reporting PTSD symptoms. Number of deployments, number of close friends or relatives reported at follow-up, and enlisted pay grade were also significantly associated with postdeployment PTSD.ConclusionsCombat exposures, specifically the threat of death, serious injury, and witnessing injury or death are significant risk factors for screening positive for postdeployment PTSD among male Marines as well as violence exposures prior to entering the Marine Corps, which are independent of future combat exposures. A thorough history of lifetime violence exposures should be pursued when considering a clinical diagnosis of PTSD.

Prospective prediction of functional difficulties among recently separated Veterans

“…Across a number of studies, combat exposure has been linked with PTSD in a "dose response" manner, with greater severity of combat exposure associated with greater likelihood and greater severity of PTSD symptoms [34][35][36][37]. In a retrospective study, Iversen and colleagues (2008) found that combat-related experiences were the strongest predictor of PTSD in a sample of U.K. military personnel when evaluating demographic, predeployment, and deployment-related factors [34].…”

Physical comorbidities of post‐traumatic stress disorder in Australian Vietnam War veterans

“…US studies have shown that in addition to injury on deployment, combat experiences [91,188], combat exposure [27,147], killing in war [27,121], witnessing dead bodies [90,137], discharging a weapon and deployment-related stressors [27] were related to adverse health conditions such as PTSD and alcohol problems. In addition to combat exposures, the fear of injury or death while on deployment has also been identified as an important risk factor for both PTSD symptoms and alcohol misuse [95,137,188].…”

“…Exposure to chemical, biological and other environmental factors continues to be a major non-combat concern in some military members deployed to the Middle East [137,165,171], although in some studies [86] the level of concern was low. It is important to note that ADF members may have been located in different areas in the MEAO and performed different tasks from US and UK defence forces, so findings about particular health conditions may not be applicable to Australian serving personnel.…”

Pilot study of Internet-based early intervention for combat-related mental distress

“…For example, for the item "I would recommend VETS PREVAIL to a friend dealing with combat or postdeployment stress," participants reported "strong" agreement (4.54 ± 0.89). Table 5 shows that depressed mood, as measured by the CES-D 10 in the intention-to-treat analysis, significantly declined from baseline (week 0) to week 4 and from baseline to week 12, but not from baseline to week 8 Table 5 shows that symptoms of posttraumatic stress in the intention-to-treat analysis significantly declined from baseline (week 0) to weeks 4, 8, and 12. A similar significance pattern occurred in the per-protocol and completer analyses.…”

“…Conversely, several common resiliency factors have been identified for these disorders in the same domains that are expected to be protective based on prior studies of mental disorders: behavioral (engagement in meaningful activities), cognitive (self-efficacy, problem-solving skills), and interpersonal relations (enhanced social support) [6][7]. However, negative affect can exacerbate both disorders, increasing functional impairment and worsening corespecific symptoms [8][9][10][11]. Without intervention, both disorders impair the individual's performance in work, military, and personal roles [5].…”