new onset, persistence, and resiliency in a large population-based military cohort
.PUBLICATION, DISTRIBUTION, ETC
Name of Publisher, Distributor, etc.
UC San Diego
Date of Publication, Distribution, etc.
2007
DISSERTATION (THESIS) NOTE
Body granting the degree
UC San Diego
Text preceding or following the note
2007
SUMMARY OR ABSTRACT
Text of Note
Background: Posttraumatic stress disorder (PTSD) results from experiencing or witnessing traumatic, life- threatening events including military combat. There is concern about the health impact of military deployment to Iraq and Afghanistan after reports of higher prevalence of PTSD in combat-exposed veterans. Further, the vulnerability or resiliency for PTSD symptoms in individuals following overwhelming stress is not well understood. Methods: Using data from a large population- based military cohort, the Millennium Cohort Study baseline (July 2001 - June 2003) and follow-up (June 2004 - February 2006), the objective of this dissertation was to 1) document the prevalence of PTSD symptoms and diagnosis, associated physical and mental health, and the association with self-reported exposure to chemical and biological warfare agents independent of other combat- related exposures, 2) prospectively investigate the effect of military deployment and self-reported combat exposures on new-onset and persistent PTSD symptoms, and 3) prospectively investigate the association of prior assault and new-onset PTSD symptoms among combat deployed. : At baseline, the combined weighted prevalence PTSD symptoms in the Millennium Cohort was 3.6%, with the majority (2.0%) being those with PTSD symptoms without a diagnosis. Nearly 25% of the Cohort deployed between baseline and follow-up. New-onset PTSD symptoms or diagnoses were identified in 7.6%-8.7% of deployers reporting combat exposures, 1.4%-2.1% of deployers not reporting combat exposures, and 2.3%-3.0% of nondeployers. Persistence of PTSD symptoms was similar in nondeployed and those deployed with combat exposures. New-onset PTSD symptoms or diagnosis among deployers reporting combat exposures was 21.7% for women reporting prior assault and 10.1% for women not reporting prior assault. Among men, the rates were 12.4% and 5.9% respectively. Conclusions: These data suggest a 2% prevalence of PTSD symptoms without diagnosis and a threefold increase in new-onset PTSD symptoms or diagnosis among deployed military personnel reporting combat exposures. Further, these prospective data indicate a two-fold increase in new-onset PTSD symptoms or diagnosis among deployed military personnel reporting combat exposures who reported a prior assault at baseline. The findings of this dissertation define the vulnerability of some individuals to new-onset PTSD symptoms and emphasize that specific combat exposures, rather than deployment itself, significantly affect the onset of PTSD symptoms postdeployment