Publication year
2015
Citation Title
PTSD symptom presentation across the deployment cycle.
Journal Name
Journal of Affective Disorders
Journal Volume
176
Issue Number
1
Page Numbers
87-94
DOI
10.1016/j.jad.2015.01.043
Summary
Nearly 900 Marines participated in longitudinal study to examine symptom-level variations in posttraumatic stress disorder (PTSD) across the deployment cycle (pre- and several post-deployment time points). There was considerable variation in PTSD symptoms at each time point, and symptom patterns stabilized over time.
Key Findings
There was heterogeneity in PTSD symptom presentation at each assessment point.
The “Anxious Arousal” class (characterized by elevations in hypervigiliance and exaggerated startle reactions) at one-month post deployment was similar to the presentation of PTSD, but their symptoms subsided naturally with time.
One month post-deployment, Marines in the partial symptom expression classes engaged in less avoidant coping and had fewer prior lifetime traumas than those in the full expression classes.
Prior lifetime trauma, avoidant coping, and greater combat exposure generally predicted worse outcomes at all time points.
Implications for Program Leaders
Disseminate information on effective coping strategies for returning Service members
Provide classes for recently returned Service members and their families to explain common symptom trajectories, emphasizing that symptoms decrease on their own over time for most military personnel
Host support services for families of Service members living with PTSD
Implications for Policy Makers
Recommend that Service members who are exposed to higher amounts of combat exposure be routinely assessed for mental health symptoms
Recommend education for service providers around the possible effects of deployment on Service members’ families
Encourage collaboration among DoD programs and community-based organizations to support a smooth reintegration for Service members and their families
Methods
Data were derived from a longitudinal study of four battalion cohorts of Active Duty male Marines deployed to Iraq and Afghanistan between 2008 and 2012.
Marines were assessed one-month pre-deployment, 1 week and 5 and 8 months post-deployment; 63% completed all time points.
Participants completed a measure of PTSD symptoms, coping strategies, lifetime exposure to potentially traumatic events, and war zone traumatic events exposure.
Statistical analyses was used to identify patterns of responses in PTSD symptoms.
Participants
Eight hundred ninety-two male Marines participated.
Average age of the sample was 23.16 years (SD = 3.67 years), most were White (83%), and 41% were married.
Fifty-two percent had deployed at least once before, and average years served in the military was 3.10 years (SD = 3.15 years).
Limitations
All measures were self-reported and may be subject to social desirability biased.
The sample consisted of all male Marines; these findings may not generalize to women and those in other Service branches.
There was a high degree of attrition which may have impacted the results.
Avenues for Future Research
Develop a longitudinal study to follow Service members for a longer time period to see how these patterns predict later functioning
Replicate the study and include additional predictors of these variables such as personality or childhood experiences
Gather data from Service members' families to better understand how relationships or home environments might impact patterns of PTSD and other symptoms
Focus
Marines
Target Population
Population Focus
Military Branch
Military Component
Abstract
Background: Symptom-level variation in posttraumatic stress disorder (PTSD) has not yet been examined in the early post-deployment phase, but may be meaningful etiologically, prognostically, and clinically. Using latent class analysis (LCA), we examined PTSD symptom heterogeneity in a cohort of participants from the Marine Resiliency Study (MRS), a longitudinal study of combat Marines deployed to Iraq and Afghanistan (N=892). Typologies of PTSD symptom presentation were examined at one month pre-deployment and again one, five, and eight months post-deployment. Results: Heterogeneity in PTSD symptom presentation was evident at each assessment point, and the degree of symptom heterogeneity (i.e., the number of classes identified) differed by time point. Symptom patterns stabilized over time from notable symptom fluctuations during the early post-deployment period to high, medium, and low symptom severity by eight months post-deployment. Hypervigilance and exaggerated startle were frequently endorsed by participants in the initial month post-deployment. Flashbacks, amnesia, and foreshortened future were infrequently endorsed. Greater combat exposure, lifespan trauma, and avoidant coping generally predicted worse outcomes. Limitations: Data were self-report and may have limited generalizability due to our lack of women and inclusion of only combat Marines. Attrition and re-ranging of data resulted in significant missing data and affected the representativeness of the sample. Conclusions: Symptom-level variability is highest in the month following deployment and then stabilizes over time. Should post-deployment assessments occur too soon, they may capture common and transient early post-deployment reactions, particularly anxious arousal.
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