Research and Knowledge Centre, the Danish Veteran Centre, Ringsted, Denmark; Department of Psychology, University of Copenhagen, Denmark.
Research and Knowledge Centre, the Danish Veteran Centre, Ringsted, Denmark; The Research Unit and Section of General Practice, Institute of Public Health, University of Copenhagen, Denmark.
J Affect Disord. 2020 Apr 1;266:120-127. doi: 10.1016/j.jad.2020.01.112. Epub 2020 Jan 22.
A significant minority of individuals experience depression following military deployment. The course of depression symptoms varies over time and across individuals; several factors including combat exposure influence depressions incidence and course. Importantly, previous trauma, especially in childhood, have been found increase the risk of post-deployment depression.
In a prospective sample of 530 soldiers deployed to Afghanistan in 2009, we used latent growth mixture modeling (LGMM) to estimate trajectories of depression symptoms from before through 6.5 years after deployment. In a multinomial logistic regression model, we tested if childhood and adult life trauma predicted trajectory membership in combination with combat exposure and neuroticism.
We identified a large trajectory of few depression symptoms from before through 6.5 years after deployment (Low-stable, 86.5%), a trajectory with somewhat elevated symptoms (Medium-fluctuating, 4.0%), and a trajectory with few symptoms before deployment and a steep increase to a severe symptom level 6.5 years after deployment (Low-increasing, 9.4%). The Low-increasing trajectory was predicted by lower rank and childhood trauma, while the Medium-fluctuating trajectory was predicted by neuroticism, adult life trauma, and post-deployment PTSD symptoms.
Attrition and use of self-report measures for depression and trauma.
Depression symptoms follow a heterogeneous course from before through 6.5 years after deployment with 9.4% experiencing symptom increase, resulting in severe symptoms 6.5 years after deployment. Trajectories are differentially predicted by rank, childhood and adult life trauma as well as neuroticism and PTSD symptoms, illustrating the clinical importance of taking individual differences of symptom course into account.
有相当一部分人在军事部署后会出现抑郁症状。抑郁症状的发展过程在不同个体之间存在差异；一些因素，包括战斗暴露，会影响抑郁的发生和进程。重要的是，以前的创伤，尤其是童年时期的创伤，已被发现会增加部署后抑郁的风险。
在一个前瞻性的样本中，我们对 2009 年部署到阿富汗的 530 名士兵进行了研究，使用潜在增长混合模型（LGMM）来估计从部署前到 6.5 年后的抑郁症状轨迹。在一个多项逻辑回归模型中，我们测试了童年和成年生活创伤是否与战斗暴露和神经质一起预测轨迹成员身份。
我们确定了从部署前到 6.5 年后的抑郁症状的大轨迹，即少数症状的低稳定轨迹（86.5%），症状略有升高的中波动轨迹（4.0%），以及部署前症状较少，6.5 年后症状急剧上升至严重水平的低增加轨迹（9.4%）。低增加轨迹与较低的军衔和童年创伤有关，而中波动轨迹与神经质、成年生活创伤和部署后 PTSD 症状有关。
研究存在人员流失和使用自我报告的抑郁和创伤措施的局限性。
从部署前到 6.5 年后，抑郁症状呈现出一种异质的发展过程，有 9.4%的人出现症状增加，导致 6.5 年后出现严重症状。轨迹由军衔、童年和成年生活创伤以及神经质和 PTSD 症状差异预测，这说明了考虑症状发展过程中个体差异的临床重要性。
