Severity of Combat-Related Posttraumatic Stress Disorder Versus Noncombat-Related Posttraumatic Stress Disorder

Abstract

The goal of the study was to compare severity of combat-related posttraumatic stress disorder (PTSD) versus noncombat-related PTSD in a group known to have high rates of combat-related PTSD. Sample consisted of 255 male American Indian and Hispanic veterans with lifetime PTSD who were contacted in communities in 2 regions of the country. Measures of PTSD severity included current posttraumatic symptoms, remission from lifetime PTSD, lifetime severity of alcohol-drug related problems, and mental health treatment history. Our findings revealed that veterans with combat-related PTSD had more severe posttraumatic symptoms, were less apt to have remitted from PTSD during the last year, and-contrary to expectation-were less apt to have sought mental health treatment since military duty. In conclusion, combat-related PTSD was more severe, as compared with noncombat-related PTSD, in this group, on 2 out of 5 measures. A low rate of mental health treatment since military duty may have contributed to increased symptoms and a lower remission rate.

PTSD and Combat-Related Injuries: Functional Neuroanatomy

“…24 There is also evidence that veterans with combat-related PTSD have more severe symptoms than veterans with PTSD due to noncombat-related events. 25 Increased incidence of PTSD in military personnel experiencing TBI is consistent with research studies in other populations. These have concluded that development of psychiatric symptoms following TBI is relatively common, with 13%-27% exhibiting PTSD.…”

Deep brain stimulation of the basolateral amygdala for treatment-refractory combat post-traumatic stress disorder (PTSD): study protocol for a pilot randomized controlled trial with blinded, staggered onset of stimulation

“…Combat PTSD is generally more severe and has a lower rate of remission than noncombat PTSD[51, 52]. A meta-analysis of controlled psychotherapy and psychopharmacology trials found that overall, nearly 2/3 of patients treated with exposure therapy who completed treatment no longer met criteria for PTSD, but treatment response was significantly poorer in combat compared to noncombat PTSD[53].…”

“…A meta-analysis of controlled psychotherapy and psychopharmacology trials found that overall, nearly 2/3 of patients treated with exposure therapy who completed treatment no longer met criteria for PTSD, but treatment response was significantly poorer in combat compared to noncombat PTSD[53]. In a study of Hispanic and American Indian veterans, only 20% of 106 with combat PTSD had experienced a year or longer without symptoms since onset, in contrast to 40% of veterans with PTSD from noncombat trauma[51]. In a long-term follow-up study of over 200 Israeli combat veterans, 26 to 50% were still diagnosed with PTSD 20 years later[54].…”

Substance use, post-traumatic stress disorder and violence

“…The impact of combat-related PTSD was found to be more severe and less likely to be in remission than noncombatrelated PTSD [28]. The comorbidity of SUD and PTSD among women is much higher and has more clinical severity than in men, and this could potentially be a result of the higher rates of violence and assault experienced by women [56][57][58].…”

“…Structured measures utilized among comorbid samples include the Structured Clinical Interview for DSM-IV (SCID) [24 ,26 ], the Composite International Diagnostic Interview (CIDI) [18 ,27 ], the Computerized Diagnostic Interview Schedule (C-DIS) [21,28] and the Clinician-Administered Posttraumatic Stress Disorder Scale [29,30]. Each of these measures assesses the criteria denoted within the DSM-IV for PTSD-related symptoms that correspond to a DSM-IV qualifying traumatic event.…”