Foundation Centrum'45/Arq, Nienoord 5, 1112 XE, Diemen, The Netherlands,
Soc Psychiatry Psychiatr Epidemiol. 2013 Nov;48(11):1743-54. doi: 10.1007/s00127-013-0709-8. Epub 2013 May 29.
Military personnel exposed to combat are at risk for experiencing post-traumatic distress that can progress over time following deployment. We hypothesized that progression of post-traumatic distress may be related to enhanced susceptibility to post-deployment stressors. This study aimed at examining the concept of stress sensitization prospectively in a sample of Dutch military personnel deployed in support of the conflicts in Afghanistan.
In a cohort of soldiers (N = 814), symptoms of post-traumatic stress disorder (PTSD) were assessed before deployment as well as 2, 7, 14, and 26 months (N = 433; 53 %) after their return. Data were analyzed using latent growth modeling. Using multiple group analysis, we examined whether high combat stress exposure during deployment moderated the relation between post-deployment stressors and linear change in post-traumatic distress after deployment.
A higher baseline level of post-traumatic distress was associated with more early life stressors (standardized regression coefficient = 0.30, p < 0.001). In addition, a stronger increase in posttraumatic distress during deployment was associated with more deployment stressors (standardized coefficient = 0.21, p < 0.001). A steeper linear increase in posttraumatic distress post-deployment (from 2 to 26 months) was predicted by more post-deployment stressors (standardized coefficient = 0.29, p < 0.001) in high combat stress exposed soldiers, but not in a less combat stress exposed group. The group difference in the predictive effect of post-deployment stressors on progression of post-traumatic distress was significant (χ²(1) = 7.85, p = 0.005).
Progression of post-traumatic distress following combat exposure may be related to sensitization to the effects of post-deployment stressors during the first year following return from deployment.
接触战斗的军事人员面临创伤后应激障碍的风险，这种风险在部署后会随着时间的推移而逐渐加重。我们假设，创伤后应激障碍的进展可能与对部署后应激源的易感性增强有关。本研究旨在前瞻性地研究荷兰军事人员在阿富汗冲突中的支持部署样本中应激敏感化的概念。
在一组士兵（N=814）中，在部署前以及返回后 2、7、14 和 26 个月（N=433；53%）评估创伤后应激障碍（PTSD）症状。使用潜在增长建模分析数据。使用多组分析，我们检验了高战斗应激暴露是否在部署后应激源与创伤后应激障碍的线性变化之间调节关系。
较高的创伤后应激障碍基线水平与更多的早期生活应激源相关（标准化回归系数=0.30，p<0.001）。此外，在部署期间创伤后应激障碍的增加与更多的部署应激源相关（标准化系数=0.21，p<0.001）。在高战斗应激暴露的士兵中，更多的部署后应激源预测了创伤后应激障碍在部署后的线性增加（从 2 到 26 个月）（标准化系数=0.29，p<0.001），但在低战斗应激暴露组中则没有。在高战斗应激暴露组中，部署后应激源对创伤后应激障碍进展的预测作用的组间差异具有统计学意义（χ²(1)=7.85，p=0.005）。
接触战斗后创伤后应激障碍的进展可能与对部署后应激源的影响敏感化有关，这种敏感化发生在部署返回后的第一年。
