Association of trauma exposure with psychiatric morbidity in military veterans who have served since September 11, 2001

Abstract

Objective-This study examined the association of lifetime traumatic stress with psychiatric diagnostic status and symptom severity in veterans serving in the US military after 9/11/01. Method-Data from 356 US military veterans were analyzed. Measures included a standardized clinical interview measure of psychiatric disorders, and paper-and-pencil assessments of trauma history, demo-graphic variables, intellectual functioning, posttraumatic stress disorder (PTSD) symptoms, depression, alcohol misuse, and global distress.Results-Ninety-four percent of respondents reported at least one traumatic stressor meeting DSM-IV criterion A for PTSD (i.e., life threatening event to which the person responded with fear, helplessness or horror), with a mean of four criterion A traumas. Seventy-one percent reported serving in a war-zone, with 50% reporting occurrence of an event meeting criterion A. The rate of current psychiatric disorder in this sample was: 30% PTSD, 20% major depressive disorder, 6% substance abuse or dependence and 10% for the presence of other Axis I psychiatric disorders. After accounting for demographic covariates and combat exposure, childhood physical assault and accident/disasters *Corresponding author. Tel.: +1 919 286 0411x7973. E-mail address: beckham@duke.edu (J.C. Beckham). Conflict of interestMy coauthors, Drs. Calhoun, Yoash-Gantz, Taber, Miller, Tupler, Morey, Marx, Weiner and Beckham, as well as Ms. Kimberly Green and I do not have any interests that might be interpreted as influencing the research. APA ethical standards were followed in the conduct of this research. ContributorsDr. Dedert wrote the first version of the manuscript and conducted many of the data analyses. Ms. Green conceptualized and created the poster on which this manuscript was based and participated in data management and writing of the manuscript. Dr. Calhoun participated in the study design, conceptualization and writing of the manuscript as well as assisting in data analyses. He also participated in the study design and data collection. Dr. Yoash-Gantz participated in data collection and edits of the manuscript. Dr. Taber participated in data collection and edits of the manuscript. Dr. Miller participated in data collection and edits of the manuscript. Dr.Tupler participated in the study design, data collection, and edits of the manuscript. Dr. Morey participated in the study design and data collection. Dr. Marx participated in the study design and data collection. Dr. Weiner participated in study design and data collection. Dr. Beckham contributed to each aspect of this project from study design to writing of the manuscript. were most consistently associated with increased likelihood of PTSD. However, PTSD with no comorbid major depressive disorder or substance use disorder was predicted only by combat exposure and adult physical assault. Medical/unexpected-death trauma and adult physical assault were most consistently associated with more severe symptomatology. NIH Public AccessConclusions-Particular categorie...

Altered Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes in Posttraumatic Stress Disorder

“…Participants were recruited between December 2010 and December 2011 from a large registry of US military veterans who served after September 11, 2001 (Dedert et al, 2009). Important exclusion criteria included major neurological disorders, history of brain injury, Axis I psychiatric disorders other than major depression (9 PTSD participants had comorbid MDD), current substance abuse or a history of substance dependence, and contraindications to MRI scanning.…”

Postdeployment Resilience as a Predictor of Mental Health in Operation Enduring Freedom/Operation Iraqi Freedom Returnees

“…Traumatic exposure is even greater for military veterans; as many as 94% in samples of those who served since 2001. 2,3 Combat exposure and other traumatic experiences are risk factors for posttraumatic stress disorder (PTSD) and other psychiatric and substance use conditions. [3][4][5] Recent research on military personnel returning from deployments in Afghanistan and Iraq (Operations Enduring Freedom [OEF] and Iraqi Freedom [OIF]) confirms increased risk for PTSD, alcohol and drug abuse, and other psychiatric disorders.…”

“…[6][7][8] Although the great majority of veterans exposed to PTEs do not develop PTSD, 9 much research has focused on factors that increase rather than decrease the risk for PTSD. 2,4,10 Fewer research efforts have examined resilience factors that protect trauma-exposed individuals from developing PTSD or other psychiatric conditions. Resilience is the ability of adults who are exposed to highly stressful events, such as the violent, lifethreatening situations encountered in combat, to maintain healthy psychological and physical functioning.…”

Drug use and childhood-, military- and post-military trauma exposure among women and men veterans

“…Events are scored on a sevenpoint scale with responses ranging from never, once, twice, 3 times, 4 times, 5 times, more than 5 times to indicate frequency of event exposure. We adapted the TLEQ to indicate whether each trauma was experienced (a) before the military, (b) during the military, and/or (c) after the military (Clancy et al, 2006;Dedert et al, 2009); thus, three scores were derived reflecting the mean number of trauma experiences that occurred for each time-period (pre-military, during the military, and post-military). Consistent with previous work (Kelley et al, 2013) and with DSM-IV diagnostic Note: OEF, Operation Enduring Freedom; OIF, Operation Iraqi Freedom.…”