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性别、权威地位与美国后备役部队人员全国样本中的抑郁症和创伤后应激障碍风险

Gender, Position of Authority, and the Risk of Depression and Posttraumatic Stress Disorder among a National Sample of U.S. Reserve Component Personnel.

作者信息

Cohen Gregory H, Sampson Laura A, Fink David S, Wang Jing, Russell Dale, Gifford Robert, Fullerton Carol, Ursano Robert, Galea Sandro

机构信息

Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts.

Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts.

出版信息

Womens Health Issues. 2016 May-Jun;26(3):268-77. doi: 10.1016/j.whi.2016.01.001. Epub 2016 Feb 18.

Abstract

BACKGROUND

Recent U.S. military operations in Iraq and Afghanistan have seen dramatic increases in the proportion of women serving and the breadth of their occupational roles. General population studies suggest that women, compared with men, and persons with lower, as compared with higher, social position may be at greater risk of posttraumatic stress disorder (PTSD) and depression. However, these relations remain unclear in military populations. Accordingly, we aimed to estimate the effects of 1) gender, 2) military authority (i.e., rank), and 3) the interaction of gender and military authority on a) risk of most recent deployment-related PTSD and b) risk of depression since most recent deployment.

METHODS

Using a nationally representative sample of 1,024 previously deployed Reserve Component personnel surveyed in 2010, we constructed multivariable logistic regression models to estimate effects of interest.

RESULTS

Weighted multivariable logistic regression models demonstrated no statistically significant associations between gender or authority, and either PTSD or depression. Interaction models demonstrated multiplicative statistical interaction between gender and authority for PTSD (beta = -2.37; p = .01), and depression (beta = -1.21; p = .057). Predicted probabilities of PTSD and depression, respectively, were lowest in male officers (0.06, 0.09), followed by male enlisted (0.07, 0.14), female enlisted (0.07, 0.15), and female officers (0.30, 0.25).

CONCLUSIONS

Female officers in the Reserve Component may be at greatest risk for PTSD and depression after deployment, relative to their male and enlisted counterparts, and this relation is not explained by deployment trauma exposure. Future studies may fruitfully examine whether social support, family responsibilities peri-deployment, or contradictory class status may explain these findings.

摘要

背景

近期美国在伊拉克和阿富汗的军事行动中,女性服役人员比例显著增加,其职业角色范围也有所拓宽。一般人群研究表明,与男性相比,女性以及与社会地位较高者相比,社会地位较低者可能患创伤后应激障碍(PTSD)和抑郁症的风险更高。然而,这些关系在军事人群中仍不明确。因此,我们旨在评估以下因素的影响:1)性别,2)军事权威(即军衔),以及3)性别与军事权威的相互作用对a)最近一次部署相关PTSD风险和b)自最近一次部署以来的抑郁症风险的影响。

方法

我们使用2010年对1024名曾部署的后备役军人进行的全国代表性样本,构建多变量逻辑回归模型来估计相关影响。

结果

加权多变量逻辑回归模型显示,性别或权威与PTSD或抑郁症之间均无统计学上的显著关联。相互作用模型显示,性别与权威在PTSD方面存在相乘性统计相互作用(β = -2.37;p = 0.01),在抑郁症方面也存在相乘性统计相互作用(β = -1.21;p = 0.057)。PTSD和抑郁症的预测概率分别在男性军官中最低(0.06,0.09),其次是男性士兵(0.07,0.14)、女性士兵(0.07,0.15)和女性军官(0.30,0.25)。

结论

相对于男性和士兵同行,后备役部队中的女性军官在部署后患PTSD和抑郁症的风险可能最高,且这种关系无法用部署创伤暴露来解释。未来的研究可以有益地探讨社会支持、部署期间的家庭责任或相互矛盾的阶级地位是否可以解释这些发现。

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