Publication year
2012
Citation Title
Effect of dwell time on the mental health of US Military personnel with multiple combat tours.
Journal Name
American Journal of Public Health
Journal Volume
102
Issue Number
S1
Page Numbers
S55-S59
DOI
10.2105/AJPH.2011.300341
Summary
The health care records of 65,704 Active Duty Marines who deployed to Operation Iraqi Freedom (OIF) once or twice were used to investigate the association between the length of time spent at home between deployments (dwell time) with posttraumatic stress disorder (PTSD) and other mental health disorders. The study revealed significant differences in mental health disorders between Marines with one versus two deployments during OIF. Increased time spent at home between deployments was associated with reduced risk of PTSD and other mental health concerns.
Key Findings
Marines who were at home for longer intervals between deployments had lower odds of PTSD and other mental health disorders.
Marines with two deployments had significantly higher rates of PTSD than did those with one deployment (2.1% versus 1.2%).
Substance abuse was the most common subcategory of mental health disorders, with higher rates among those with one deployment than among those with two deployments (2.4% versus 1.7%). Similarly, mood disorders were slightly higher among those with one deployment.
Implications for Program Leaders
Develop educational opportunities for military families to learn about symptoms Service members may experience after deployments, particularly the symptoms of PTSD
Host support groups to help military spouses better cope with issues related to Service members' mental health symptoms
Provide outreach services to Service members with repeated deployments and short dwell times (length of time between deployments)
Implications for Policy Makers
Encourage programs to provide more resources and support for Service members in between deployments
Recommend periodic screening for PTSD and other mental health concerns among Service members that incorporate assessment of alcohol and illicit drug abuse
Promote reintegration programs that include attention to assisting Service members’ family in adjusting to the Service member’s return
Methods
U.S. Marine Corps personnel were identified from military deployment records; new-onset mental health diagnoses from military medical databases were included in the analysis.
The ratio of time spent at home between deployments to length of deployment was calculated as the length of time between deployments divided by the length of the first deployment.
To be included in the study, Service members had to have one or two deployments which lasted between four and eight months.
Participants
The records of 65,704 Active Duty Marines deployed to OIF were reviewed for this study; 49,328 had been deployed once and 16,376 had been deployed twice.
The sample was 100% male, the median age was 22 years (range: 17–57 years), and 83% were E1–E5, 10% were E6–E9, and 7% were officers.
The racial composition of the sample was not specified.
Limitations
Due to the use of electronic medical databases, mild or subclinical level cases of mental health disorders may be underrepresented.
Unmeasured deployment-related variables may have impacted the results of the study. For instance, combat exposure, which could impact the relationship between deployment and mental health, was not measured.
No data were gathered about how Service members occupied their time in-between deployments, which limits the ability to understand if factors related to dwell time impacted outcomes.
Avenues for Future Research
Incorporate self-report measures of mental health status into the assessment of well-being
Explore the effects of specific experiences on well-being while at home between deployments
Include Service Members with three or more deployments as to compare their functioning to those with one or two deployments
Focus
Marines
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: We investigated the association of the length of time spent at home between deployments, or dwell time, with posttraumatic stress disorder (PTSD) and other mental health disorders. Methods: We included US Marine Corps personnel identified from military deployment records who deployed to Operation Iraqi Freedom once (n = 49 328) or twice (n = 16 376). New-onset mental health diagnoses from military medical databases were included. We calculated the ratio of dwell-to-deployment time (DDR) as the length of time between deployments divided by the length of the first deployment. Results: Marines with 2 deployments had higher rates of PTSD than did those with 1 deployment (2.1% versus 1.2%; P < .001). A DDR representing longer dwell times at home relative to first deployment length was associated with reduced odds of PTSD (odds ratio [OR] = 0.47; 95% confidence interval [CI] = 0.32, 0.70), PTSD with other mental health disorder (OR = 0.56; 95% CI = 0.33, 0.94), and other mental health disorders (OR = 0.62; 95% CI = 0.51, 0.75). Conclusions: Longer dwell times may reduce postdeployment risk of PTSD and other mental health disorders. Future research should focus on the role of dwell time in adverse health outcomes.
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