Coppola Elizabeth C, Wadsworth Shelley MacDermid, Taylor Zoe E, Schwab-Reese Laura, Christ Sharon L
VA Connecticut Healthcare System, West Haven, CT, USA.
Department of Human Development and Family Studies, Purdue University, USA.
SSM Popul Health. 2024 Nov 29;29:101733. doi: 10.1016/j.ssmph.2024.101733. eCollection 2025 Mar.
Using a national sample of Americans, this study estimated and compared patterns of depressive symptom trajectories stratified by military service. This study then examined associations between sociodemographic factors theorized to shape entry into military service and trajectory patterns.
Data came from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative study that followed participants from adolescence (1994-1995) through midlife (2016-2018). Latent growth mixture modeling was used to estimate depressive symptom trajectories among civilians ( = 17,644) and participants who served in the military ( = 1266). Associations between trajectory membership and sociodemographic factors were tested with multinomial regression.
Trajectories were best represented by 4-class linear models. "Low" was the largest class, representing 74.4% of civilians and 70.4% of those who served. The second largest class, "low then increasing," was comprised of 13.6% of civilians and 19.6% of service members. The third smallest class, "high then decreasing" class, included 8.8% of civilians and 4.5% of service members. An "increasing" class emerged with high depressive symptoms by midlife, comprised of 3.2% of civilians and 5.5% of those who served. Gender and family structure had robust associations with trajectory membership.
A larger percentage of those who served were in the "increasing" trajectory characterized by concerningly high depressive symptoms by midlife, underscoring the need for continued screening in depressive symptoms throughout the life course. Associations between family structure and gender on depressive symptoms support calls for conceptualizing family structure as a social determinant of health and continued investment in women's health.
本研究以美国全国样本为基础，估计并比较了按兵役状况分层的抑郁症状轨迹模式。然后，本研究考察了理论上影响服兵役的社会人口学因素与轨迹模式之间的关联。
数据来自全国青少年至成人健康纵向研究，这是一项具有全国代表性的研究，跟踪参与者从青春期（1994 - 1995年）到中年（2016 - 2018年）的情况。使用潜在增长混合模型来估计平民（n = 17,644）和曾服兵役的参与者（n = 1266）的抑郁症状轨迹。用多项回归检验轨迹类别与社会人口学因素之间的关联。
轨迹最好用四类线性模型来表示。“低”是最大的类别，占平民的74.4%和服役人员的70.4%。第二大类别“先低后升”，占平民的13.6%和服役人员的19.6%。第三小的类别“先高后降”，包括8.8%的平民和4.5%的服役人员。出现了一个“上升”类别，到中年时抑郁症状严重，占平民的3.2%和服役人员的5.5%。性别和家庭结构与轨迹类别有密切关联。
更大比例的服役人员处于“上升”轨迹，其特征是到中年时抑郁症状高得令人担忧，这凸显了在整个生命过程中持续筛查抑郁症状的必要性。家庭结构和性别与抑郁症状之间的关联支持了将家庭结构概念化为健康的社会决定因素以及持续投资于妇女健康的呼吁。
