Rates of Subthreshold PTSD Among U.S. Military Veterans and Service Members: A Literature Review

Bergman, Hannah E.; Przeworski, Amy; Feeny, Norah C.

doi:10.1037/mil0000154

Cited by 69 publications

(41 citation statements)

References 53 publications

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“…In both samples, the proportion screening positive for subthreshold PTSD or PTSD is generally consistent with the range of 6.9 to 22.3% obtained from a range of self-report criteria across 16 studies 26 and 13.5% reporting past-month prevalence in a national sample of veterans with and without combat deployment experience. 27 Subthreshold PTSD symptoms have also been identified as associated with comorbidity and decrements in functioning.…”

Section: Discussionsupporting

confidence: 74%

Post-traumatic stress disorder risk and witnessing team members in acute psychological stress during combat

2020

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Background Occupational groups operating in dangerous environments may witness the development of acute stress reaction (ASR) in team members. Witnessing ASR in team members may increase the risk of developing subsequent post-traumatic stress disorder (PTSD) symptoms. Aims To describe ASR symptoms that individuals witness, assess the relationship between witnessing a team member exhibiting ASR symptoms and an individual's own PTSD symptoms, and describe common intervention responses by peers. Method Cross-sectional, anonymous surveys were conducted with US soldiers who were previously deployed (sample 1; n = 176) and currently deployed sample 2; n = 497). Surveys assessed combat experiences, PTSD (PTSD Checklist-5), ASR exposure and intervention responses. Analyses included frequencies and binary logistic regression. Results Witnessing at least one ASR symptom during a combat-related event was reported by 51.7% in sample 1 and 42.4% in sample 2; the most commonly observed symptoms were being unable to function or being detached. Controlling for combat experiences, high levels of witnessing a team member exhibit ASR symptoms was associated with increased risk of subthreshold PTSD or PTSD in sample 1 (odds ratio (OR) = 8.69, 95% CI 2.29–42.60) and approached significance in sample 2 (OR = 1.67, 95% CI 0.98–2.81). Common intervention responses included providing a directive or yelling; many also reported being unsure how to respond. Conclusions Witnessing team members who exhibit ASR symptoms appears to be associated with screening positive for subthreshold PTSD or PTSD. Results suggest the need for further research into how to prepare individuals to manage ASR in team members and to examine ASR in other high-risk occupations.

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Section: Discussionsupporting

confidence: 74%

Post-traumatic stress disorder risk and witnessing team members in acute psychological stress during combat

2020

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“…Exploratory Analyses. Beck Scale for Suicide Ideation (BSS; Beck & Steer, 1991). The BSS is a brief scale used to quickly distinguish individuals at risk for suicide.…”

Section: Methodsmentioning

confidence: 99%

“…Prior longitudinal research has indicated that a mental health diagnosis (or combination of diagnoses) does not predict suicide attempts, but does predict suicide ideation (Borges et al, 2006). Despite this, PTSD has been found to be associated with lifetime suicide attempts (Nepon, Belik, Bolton, & Sareen, 2010), suicidal behavior (Sareen et al, 2007), and suicide ideation (Sareen, Houlahan, Cox, & Asmundson, 2005).…”

Section: Post-traumatic Stress Disordermentioning

confidence: 99%

“…PTSD prevalence is a significant concern within military populations, who have higher rates of exposure to traumatic situations (e.g., combat experience, military sexual trauma). It is important to note that PTSD symptoms can vary in severity with subthreshold PTSD rates among U.S. military veterans ranging from 2.3% to 22.3% (Bergman, Przeworski, & Feeny, ) and estimates ranging from 10% to 18% of military personnel who have combat experiences exhibiting probable PTSD symptoms (Litz & Schlenger, ). Substantial research examines the relationship between PTSD and the military, including statistics dating back to 1998 showing that 30.9% of veterans had developed PTSD at some point throughout their lifetimes (King, King, Fairbank, Keane, & Adams, ).…”

Section: Post‐traumatic Stress Disordermentioning

confidence: 99%

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How Distress Tolerance Mediates the Relationship Between Posttraumatic Stress Disorder and the Interpersonal Theory of Suicide Constructs in a U.S. Military Sample

Martin

Bauer

Ramsey

et al. 2018

Suicide & Life Threat Behav

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Objectives Despite the general suicide rate within the military being comparable to the general population when comparing peers, there are certain branches of the military that have elevated risk. Specifically, the U.S. National Guard has suicide rates that are constantly higher than other military branches and civilian peers. The National Guard are a unique military population in which they frequently transition between military and civilian life. With these unique experiences and heightened risk, military suicide prevention efforts may benefit from further research within this population. Posttraumatic stress disorder (PTSD) is another concern amongst military personnel and has been linked to suicidal behavior. Methods The current study examined the indirect effects that distress tolerance, a protective factor against suicide, has on the relationship between PTSD and constructs within a well‐validated theory for suicide (the Interpersonal‐Psychological Theory for suicidal behaviors) in a sample of U.S. Army National Guard personnel. Results Results indicated that distress tolerance had a significant indirect effect on the relationship between PTSD and thwarted belongingness, perceived burdensomeness, and capability for suicide. Conclusions These findings are consistent with previous literature examining the relationship between distress tolerance and our outcome variables. These results could have important clinical implications, mainly that intervention strategies targeting distress tolerance could have significant impacts on suicide‐relate thoughts.

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“…Maximum likelihood estimation was used to account for missing values on mental health, health behavior, and outcome (endogenous) variables (Kline, 2010). To maximize power (Altman and Royston, 2006), and consistent with research demonstrating that subclinical symptoms of PTSD are associated with significant impairment (Bergman et al, 2017), we used continuous measures of PTSD and depressive symptom constructs.…”

Section: Methodsmentioning

confidence: 99%

PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among U.S. veterans

Hoerster

Campbell

Dolan

et al. 2019

Preventive Medicine Reports

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Posttraumatic stress disorder (PTSD) is a risk factor for cardiovascular disease (CVD) and diabetes. Dedert and colleagues hypothesized a model whereby PTSD leads to poor health behaviors, depression, and pre-clinical disease markers, and that these factors lead to CVD and diabetes ( Ann Behav Med , 2010, 61–78). This study provides a preliminary test of that model. Using data from a mailed cross-sectional survey conducted 2012–2013, path analysis was conducted among N = 657 with complete demographic data. We first analyzed the hypothesized model, followed by four alternatives, to identify the best-fitting model. The alternate model that specified pathways from depression to health behaviors had the best fit. Contrary to hypotheses, higher PTSD symptoms were associated with better physical activity and diet quality. Of the specific indirect pathways from PTSD to Body Mass Index (BMI), only the path through depression was significant. Higher depression symptoms were significantly associated with less physical activity, poorer diet, and greater likelihood of smoking. In addition, the specific indirect effect from depression to BMI through physical activity was significant. Current smoking and higher BMI were associated with greater likelihood of diabetes, and hypertension was associated with greater likelihood of CVD. PTSD symptoms may increase risk for CVD and diabetes through the negative impact of depression on health behaviors and BMI. With or without PTSD, depression may be an important target in interventions targeting cardiovascular and metabolic diseases among veterans.

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Rates of Subthreshold PTSD Among U.S. Military Veterans and Service Members: A Literature Review

Cited by 69 publications

References 53 publications

Post-traumatic stress disorder risk and witnessing team members in acute psychological stress during combat

Post-traumatic stress disorder risk and witnessing team members in acute psychological stress during combat

How Distress Tolerance Mediates the Relationship Between Posttraumatic Stress Disorder and the Interpersonal Theory of Suicide Constructs in a U.S. Military Sample

PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among U.S. veterans

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