Behavioral Science and Epidemiology Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106-3521, USA.
BMC Psychiatry. 2013 May 7;13:130. doi: 10.1186/1471-244X-13-130.
Most previous research that has examined mental health among Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) combatants has relied on self-report measures to assess mental health outcomes; few studies have examined predictors of actual mental health diagnoses. The objective of this longitudinal investigation was to identify predictors of psychiatric disorders among Marines who deployed to combat in Iraq and Afghanistan.
The study sample consisted of 1113 Marines who had deployed to Iraq or Afghanistan. Demographic and psychosocial predictor variables from a survey that all Marines in the sample had completed were studied in relation to subsequent psychiatric diagnoses. Univariate and multivariate logistic regression were used to determine the influence of the predictors on the occurrence of psychiatric disorders.
In a sample of Marines with no previous psychiatric disorder diagnoses, 18% were diagnosed with a new-onset psychiatric disorder. Adjusting for other variables, the strongest predictors of overall psychiatric disorders were female gender, mild traumatic brain injury symptoms, and satisfaction with leadership. Service members who expressed greater satisfaction with leadership were about half as likely to develop a mental disorder as those who were not satisfied. Unique predictors of specific types of mental disorders were also identified.
Overall, the study's most relevant result was that two potentially modifiable factors, low satisfaction with leadership and low organizational commitment, predicted mental disorder diagnoses in a military sample. Additional research should aim to clarify the nature and impact of these factors on combatant mental health.
大多数先前研究在审查持久自由行动和伊拉克自由行动（OEF/OIF）参战人员的心理健康时，都依赖于自我报告措施来评估心理健康结果；很少有研究检查实际心理健康诊断的预测因素。本纵向研究的目的是确定部署到伊拉克和阿富汗作战的海军陆战队员中精神障碍的预测因素。
研究样本由 1113 名部署到伊拉克或阿富汗的海军陆战队员组成。对所有样本中的海军陆战队员完成的调查中的人口统计学和心理社会预测变量进行了研究，以了解随后的精神科诊断情况。使用单变量和多变量逻辑回归来确定预测因素对精神障碍发生的影响。
在没有先前精神障碍诊断的海军陆战队员样本中，有 18%被诊断出患有新发性精神障碍。在调整其他变量后，总体精神障碍的最强预测因素是女性性别、轻度创伤性脑损伤症状和对领导的满意度。对领导表示更满意的服务成员患精神障碍的可能性比不满意的服务成员低一半。还确定了特定类型精神障碍的独特预测因素。
总体而言，该研究最相关的结果是两个潜在可改变的因素，即对领导的低满意度和低组织承诺，预测了军事样本中的精神障碍诊断。应开展进一步的研究，以澄清这些因素对战斗人员心理健康的性质和影响。
