Copeland Laurel A, Finley Erin P, Rubin Miriam L, Perkins Daniel F, Vogt Dawne S
VA Central Western Massachusetts Healthcare System.
Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System.
Psychol Trauma. 2023 May;15(4):697-704. doi: 10.1037/tra0001329. Epub 2022 Aug 4.
Despite theorizing that posttraumatic stress disorder (PTSD) symptomatology may be exacerbated during the military-to-civilian transition, little research has delved into the trajectory of trauma-related symptomatology or the impact of diverse factors on timing of PTSD onset. To understand risk and protective factors for PTSD during the transition into civilian life, this study examined demographic, experiential, and psychosocial characteristics that may explain variation in PTSD symptoms and timing of onset.
A nationwide sample representing 48,965 U.S. veterans separating from military service in fall 2016 responded to six Web-based surveys over 3 years. Assessments included PTSD symptoms, stress, warfare exposures, military sexual trauma, moral injury events, resilience, and social support. Multivariable models estimated covariates of positive PTSD screen or symptoms.
Trauma exposure during military service was high at 59%. Probable PTSD was detected in 26% of the sample at baseline, with additional cases in each survey wave for an overall rate of 30%. Meeting criteria for probable PTSD covaried with current stress, female gender, and minority race/ethnicity; baseline psychological resilience and concurrent social support mitigated the risk. PTSD symptoms correlated positively with stress levels at current and previous time points. Social support was protective but only when contemporaneous with the PTSD symptoms.
This study illustrates the need for ongoing social support for veterans coping with symptoms of PTSD, life stressors, and postmilitary trauma, suggesting a countervailing influence of psychological resilience and contemporaneous (but not historical) social support on symptom exacerbation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
尽管有理论认为创伤后应激障碍（PTSD）症状在从军队过渡到平民生活期间可能会加剧，但很少有研究深入探讨创伤相关症状的发展轨迹或各种因素对PTSD发病时间的影响。为了了解向平民生活过渡期间PTSD的风险和保护因素，本研究考察了可能解释PTSD症状和发病时间差异的人口统计学、经历和心理社会特征。
一个代表2016年秋季从军队退役的48965名美国退伍军人的全国性样本，在3年时间里回应了6次基于网络的调查。评估内容包括PTSD症状、压力、战争暴露、军事性创伤、道德伤害事件、复原力和社会支持。多变量模型估计了PTSD筛查呈阳性或有症状的协变量。
服役期间的创伤暴露率很高，为59%。在基线时，26%的样本被检测出可能患有PTSD，在每次调查波次中都有新增病例，总体发生率为30%。符合可能患有PTSD的标准与当前压力、女性性别和少数族裔/种族相关；基线心理复原力和同时期的社会支持降低了风险。PTSD症状与当前和以前时间点的压力水平呈正相关。社会支持具有保护作用，但仅在与PTSD症状同时存在时有效。
本研究表明，需要为应对PTSD症状、生活压力源和退役后创伤的退伍军人持续提供社会支持，这表明心理复原力和同时期（而非历史上的）社会支持对症状加剧有抵消作用。（PsycInfo数据库记录（c）2023美国心理学会，保留所有权利）
