Dell Lisa, Madden Kelsey, Baur Jenelle, Sbisa Alyssa, McFarlane Alexander, VanHooff Miranda, Bryant Richard, Lawrence-Wood Ellie
Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia.
Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.
Aust N Z J Psychiatry. 2025 Jan;59(1):48-59. doi: 10.1177/00048674241286818. Epub 2024 Oct 11.
Military service is historically a male-dominated occupation, as such, the majority of research examining the development of mental disorder in Australian Defence Force members has had primarily male samples. While there have been mixed findings internationally regarding sex differences in rates of mental disorder and subthreshold symptoms among military personnel, across studies, the evidence tends to suggest that female military members are at least as likely as males to experience subthreshold mental health symptoms and have similar or higher rates of posttraumatic stress disorder despite the differences in roles during service. What is less understood is the impact of sex differences in symptom emergence over time and in predictors of clinical disorder.
The sample included a longitudinal cohort of Australian Defence Force members ( = 8497) surveyed at Time 1 (2010) and followed up at Time 2 (2015) on measures of anger, self-perceived resilience, trauma exposure, deployment exposure, suicidality, help-seeking, relationship satisfaction and mental health disorder symptoms. Outcomes included Subthreshold Disorder (above the optimal screening cut-off on the 10-item Kessler distress scale or posttraumatic stress disorder checklist) and Probable Disorder (above the epidemiological cut-off on the 10-item Kessler distress scale or posttraumatic stress disorder checklist).
Results found that while lifetime trauma exposure remained the strongest predictor of later probable disorder emergence among both males and females, for females specifically, self-reported resilience was also a significant protective factor. In contrast, being in a significant relationship at Time 1 was a protective factor against the development of subthreshold disorder in males.
For the first time, sex differences in mental health symptom emergence over time have been explored in a large Australian cohort of military members. The capacity to adapt and bounce back after adversity emerged as a proactive factor against poor mental health for females in the military and could be addressed as part of routine skills training. Social support from significant relationship was particularly important for males' mental health, suggesting that maintaining positive relationships and supporting military spouses and partners are critical for males' mental health.
从历史上看，军事服务是男性主导的职业，因此，大多数研究澳大利亚国防军成员精神障碍发展情况的研究主要以男性为样本。虽然国际上关于军事人员精神障碍发生率和阈下症状的性别差异存在不同的研究结果，但综合各项研究来看，有证据表明，尽管女性军人在服役期间的角色有所不同，但她们至少与男性一样容易出现阈下心理健康症状，且创伤后应激障碍的发生率相似或更高。然而，对于症状随时间出现的性别差异以及临床障碍预测因素的影响，人们了解得较少。
样本包括一组澳大利亚国防军成员的纵向队列（n = 8497），在时间1（2010年）进行调查，并在时间2（2015年）对愤怒、自我感知的复原力、创伤暴露、部署暴露、自杀倾向、寻求帮助、关系满意度和精神障碍症状等指标进行随访。结果包括阈下障碍（高于10项凯斯勒痛苦量表或创伤后应激障碍清单的最佳筛查临界值）和可能障碍（高于10项凯斯勒痛苦量表或创伤后应激障碍清单的流行病学临界值）。
研究发现，虽然终生创伤暴露仍然是男性和女性后期可能出现障碍的最强预测因素，但具体对于女性而言，自我报告的复原力也是一个重要的保护因素。相比之下，在时间1处于重要关系中是男性预防阈下障碍发展的保护因素。
首次在一大群澳大利亚军人队列中探讨了心理健康症状随时间出现的性别差异。在逆境中适应和恢复的能力成为军队中女性心理健康不佳的一个积极预防因素，可作为常规技能培训的一部分加以解决。来自重要关系的社会支持对男性心理健康尤为重要，这表明维持积极关系以及支持军人配偶和伴侣对男性心理健康至关重要。
