Xue Chen, Ge Yang, Tang Bihan, Liu Yuan, Kang Peng, Wang Meng, Zhang Lulu
Institute of Military Health Management, Second Military Medical University, Shanghai, China.
Faculty of Health Service, Second Military Medical University, Shanghai, China.
PLoS One. 2015 Mar 20;10(3):e0120270. doi: 10.1371/journal.pone.0120270. eCollection 2015.
Post-traumatic stress disorder (PTSD), a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) were used to search for observational studies (cross-sectional, retrospective, and cohort studies) about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility to PTSD.
创伤后应激障碍（PTSD）是一种因暴露于创伤性事件而引发的复杂慢性疾病，是当前军事行动常见的心理后果。它会导致严重的痛苦，并干扰个人和社会功能。因此，识别使军事人员和退伍军人更易患创伤后应激障碍的风险因素具有学术、临床和社会意义。本研究使用了四个电子数据库（PubMed、Embase、科学网和PsycINFO）来搜索关于部署到作战地区后创伤后应激障碍的观察性研究（横断面研究、回顾性研究和队列研究）。文献检索、研究筛选和数据提取由两位作者独立进行。本研究纳入了32篇文章。使用随机效应模型获得汇总估计值。进行了亚组分析、敏感性分析和发表偏倚检验。与战斗相关的创伤后应激障碍患病率在1.09%至34.84%之间。共发现18个军事人员和退伍军人创伤后应激障碍的显著预测因素。创伤前的风险因素包括女性、少数族裔身份、低学历、非军官军衔、陆军服役、战斗专业、多次部署、累计部署时间更长、更多不良生活事件、既往创伤暴露和既往心理问题。创伤期的各个方面也构成了风险因素。这些因素包括战斗暴露增加、开枪、目睹有人受伤或死亡、严重创伤以及与部署相关的压力源。最后，创伤后时期缺乏部署后支持也增加了患创伤后应激障碍的风险。当前分析为军事人员和退伍军人与战斗相关的创伤后应激障碍的风险因素提供了证据。需要更多研究来确定这些变量如何相互作用以及如何最好地预防创伤后应激障碍易感性。
