Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
J Psychiatr Res. 2018 Aug;103:26-32. doi: 10.1016/j.jpsychires.2018.05.005. Epub 2018 May 8.
There is increasing recognition that traumatic stress encountered throughout life, including those prior to military service, can put individuals at increased risk for developing Posttraumatic Stress Disorder (PTSD). The purpose of this study was to examine the association of both traumatic stress encountered during deployment, and traumatic stress over one's lifetime on probable PTSD diagnosis. Probable PTSD diagnosis was compared between military personnel deployed in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF; N = 21,499) and those who have recently enlisted (N = 55,814), using data obtained from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Probable PTSD diagnosis was assessed using the PTSD Checklist. The effect of exposure to multiple types (i.e. diversity) of traumatic stress and the total quantity (i.e. cumulative) of traumatic stress on probable PTSD diagnosis was also compared. Military personnel who had been deployed experienced higher rates of PTSD symptoms than new soldiers. Diversity of lifetime traumatic stress predicted probable PTSD diagnosis in both groups, whereas cumulative lifetime traumatic stress only predicted probable PTSD for those who had been deployed. For deployed soldiers, having been exposed to various types of traumatic stress during deployment predicted probable PTSD diagnosis, but cumulative deployment-related traumatic stress did not. Similarly, the total quantity of traumatic stress (i.e. cumulative lifetime traumatic stress) did not predict probable PTSD diagnosis among new soldiers. Together, traumatic stress over one's lifetime is a predictor of probable PTSD for veterans, as much as traumatic stress encountered during war. Clinicians treating military personnel with PTSD should be aware of the impact of traumatic stress beyond what occurs during war.
人们越来越认识到,一生中遇到的创伤性应激,包括服役前的创伤性应激,会使个体患创伤后应激障碍(PTSD)的风险增加。本研究的目的是检验在部署期间遇到的创伤性应激,以及一生中经历的创伤性应激与可能的 PTSD 诊断之间的关系。使用从陆军士兵风险和复原力研究(Army STARRS)中获得的数据,比较了在伊拉克自由行动/持久自由行动(OIF/OEF)中部署的军事人员(n=21499)和最近入伍的人员(n=55814)之间可能的 PTSD 诊断。使用 PTSD 检查表评估可能的 PTSD 诊断。还比较了暴露于多种类型(即多样性)的创伤性应激和创伤性应激总量(即累积)对可能的 PTSD 诊断的影响。经历过部署的军事人员比新兵有更高的 PTSD 症状发生率。一生中经历的创伤性应激多样性预测了两组人群中的可能 PTSD 诊断,而累积的一生中经历的创伤性应激仅预测了曾被部署的人群中的可能 PTSD 诊断。对于部署的士兵,在部署期间暴露于各种类型的创伤性应激会预测可能的 PTSD 诊断,但与部署相关的累积创伤性应激不会。同样,新兵中,创伤性应激的总量(即累积一生的创伤性应激)也不会预测可能的 PTSD 诊断。总的来说,一生中的创伤性应激是退伍军人 PTSD 的一个预测因素,与战争期间经历的创伤性应激一样重要。治疗 PTSD 军人的临床医生应该意识到创伤性应激对战争之外的影响。