Risk assessment for posttraumatic stress disorder in a cohort of U.S. Navy personnel

Abstract

Objective. This research examined vulnerability to PTSD during Navy service in relation to prior histories of trauma and stress. Using a prospective design this study: (1) assessed rates of PTSD symptomology among U.S. Navy recruits at the time they reported for basic training and documented the percentages of personnel whose symptoms met criteria for PTSD over their first 2 years of service; (2) evaluated whether participants with histories of premilitary trauma had significantly greater PTSD symptomology than did those without such histories; (3) assessed the relationship of PTSD symptomology with adjustment and job performance during military service; and (4) explored whether experiences of premilitary victimization moderated the relationship between postmilitary trauma and subsequent PTSD symptomology.Approach. During their first week of training, male and female U.S. Navy recruits were asked about their premilitary experiences of childhood sexual abuse, physical abuse, intimate partner violence, and life-threatening adult trauma such as car accidents and violent assault. They were also assessed for symptoms of PTSD using the Los Angeles Symptom Checklist (LASC). 15% of all participants reported symptoms that met the LASC classification for PTSD; 18% were classified with partial PTSD.In comparison with men, 6% more women were classified with partial PTSD and 5% more women were classified with full PTSD.6% to 20% of the participants had scores in the clinical range on the Trauma Symptom Inventory Subscales. The lowest percentages were for Anxious Arousal (6%), Depression (8%), and Sexual Concerns (8%). The highest percentage was for Dysfunctional Sexual Behavior.Longitudinally over the first two years of service (see page 18):There were significant gender differences in PTSD classification at each follow-up.However, at 12 and 24 months there were only significant differences in the percentages with partial, not full PTSD.PTSD symptoms increased significantly among participants who remained in the study between baseline and 6 months and between 1 year and 2 years. There were no significant differences from 6-months to 1-year. In multivariate analysis interpersonal and criminal traumas were most associated with PTSD. Specifically adult sexual assault, intimate partner violence, and parental verbal aggression in childhood were consistently predictive of PTSD.Sexual trauma has been particularly important in the development of PTSD for women in past research (Fontana & Rosenheck, 1998;Wolfe et al., 1998). However, we found no significant differences in the strength of the relationships of sexual versus other types of trauma with PTSD for men or women.In evaluating multiple trauma and PTSD, we found that (see page 24):Among participants reporting any type of interpersonal trauma, 60% reported multiple types of experiences.Only 8% to 9% of those who had not experienced any interpersonal trauma were categorized with PTSD, while 44% of men and 48% of women were identified with PTSD among those who reported 5 or more t...