Gender Differences in the Effects of Deployment-Related Stressors and Pre-Deployment Risk Factors on the Development of PTSD Symptoms in National Guard Soldiers Deployed to Iraq and Afghanistan

Authors
Polusny, M. A. Kumpula, M. J. Meis, L. A. Erbes, C. R. Arbisi, P. A. Murdoch, M. Thuras, P. Kehle-Forbes, S. M. Johnson, A. K.
Publication year
2014
Citation Title
Gender differences in the effects of deployment-related stressors and pre-deployment risk factors on the development of PTSD symptoms in National Guard soldiers deployed to Iraq and Afghanistan.
Journal Name
Journal of Psychiatric Research
Journal Volume
49
Page Numbers
1-9
DOI
10.1016/j.jpsychires.2013.09.016
Summary
U.S. National Guard Soldiers deployed to Iraq and Afghanistan completed measures of potential risk/protective factors and posttraumatic stress disorder (PTSD) symptoms one month before and 2-3 months after deployment. Researchers assessed the influence of combat-related stressors and pre-deployment risk and protective factors on risk of developing PTSD symptoms following deployment by gender. Women reported more severe PTSD symptoms and higher rates of probable PTSD compared to men.
Key Findings
Women had higher post-deployment PTSD symptoms and higher rates of probable PTSD compared to men.
This gender difference remained after controlling for exposure to deployment stressors as well as other risk and protective factors (e.g., social support).
Women reported greater exposure to sexual stressors during deployment; however the interaction between sexual stressors and gender was not significant, suggesting that men and women may have similar reactions to sexual stressors.
For women, prior interpersonal victimization history was a strong risk factor that predicted greater post-deployment PTSD symptoms; however, it did not predict greater PTSD symptoms for men.
Implications for Program Leaders
Offer classes for military families with information on signs and symptoms of PTSD
Incorporate modules in their family programs specifically for female Service members, addressing the aftermath of sexual stressors during deployment
Develop support programs for women who had experienced prior interpersonal victimization
Implications for Policy Makers
Recommend screening Service members prior to deployment regarding both mental health indices and other risk and protective factors (e.g., social support)
Continue to support programs that offer services for treatment of pre-deployment mental health vulnerabilities in Service members with identified risk factors
Recommend consideration of Service members’ pre-existing risk factors when making decisions about deployments and work assignments
Methods
Data for this study were collected as part of a larger, longitudinal study of post-deployment health; recruitment procedures and rates were not specified in this paper.
One month prior to deployment to Iraq or Afghanistan, National Guard Soldiers from two Brigade Combat Teams completed questionnaires assessing PTSD symptoms, measures of risk, and resilience factors.
Two to three months following return from deployment, Soldiers were surveyed again via mail about PTSD symptoms and exposure to deployment-related stressors.
Seventy percent of those who participated in the initial survey also participated in the follow-up survey.
Participants
One thousand one hundred and forty-three National Guard Soldiers participated in the initial survey (89% male), and 801 participated in the follow-up survey (89% male).
The average age of female participants was 27.2 years (SD = 8.1), and the majority were White (94%).
Male participants had an average age of 31.0 years (SD = 9.1), and the majority were White (94%).
Limitations
The sample was largely White and male, and these findings may not apply to other groups of Soldiers.
Although the number of women was representative of gender distribution in the National Guard, the sample size was too small to conduct all the desired analyses about women.
All data were self-reported instead of using a preferred clinical interview which could influence the results.
Avenues for Future Research
Include measures of personality factors to test their associations with gender and the risk of PTSD postdeployment
Over-sample women in order to obtain a sufficient number of participants to examine three-way interactions
Explore how the military can reduce sexual stressors during deployment for female Service members
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: Although women in the military are exposed to combat and its aftermath, little is known about whether combat as well as pre-deployment risk/protective factors differentially predict post-deployment PTSD symptoms among women compared to men. The current study assesses the influence of combat-related stressors and pre-deployment risk/protective factors on women's risk of developing PTSD symptoms following deployment relative to men's risk. Method: Participants were 801 US National Guard Soldiers (712 men, 89 women) deployed to Iraq or Afghanistan who completed measures of potential risk/protective factors and PTSD symptoms one month before deployment (Time 1) and measures of deployment-related stressors and PTSD symptoms about 2–3 months after returning from deployment (Time 2). Results: Men reported greater exposure to combat situations than women, while women reported greater sexual stressors during deployment than men. Exposure to the aftermath of combat (e.g., witnessing injured/dying people) did not differ by gender. At Time 2, women reported more severe PTSD symptoms and higher rates of probable PTSD than did men. Gender remained a predictor of higher PTSD symptoms after accounting for pre-deployment symptoms, prior interpersonal victimization, and combat related stressors. Gender moderated the association between several risk factors (combat-related stressors, prior interpersonal victimization, lack of unit support and pre-deployment concerns about life/family disruptions) and post-deployment PTSD symptoms. Conclusions: Elevated PTSD symptoms among female service members were not explained simply by gender differences in pre-deployment or deployment-related risk factors. Combat related stressors, prior interpersonal victimization, and pre-deployment concerns about life and family disruptions during deployment were differentially associated with greater post-deployment PTSD symptoms for women than men.
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