The evolution of PTSD symptoms in serving and ex-serving personnel of the UK armed forces from 2004 to 16: A longitudinal examination.

Armed forces Cohort study Latent class Longitudinal data Military Post-traumatic stress disorder Trajectories

Journal

Journal of psychiatric research
ISSN: 1879-1379
Titre abrégé: J Psychiatr Res
Pays: England
ID NLM: 0376331

Informations de publication

Date de publication:
01 2023
Historique:
received: 13 07 2022
revised: 04 11 2022
accepted: 12 11 2022
pubmed: 28 11 2022
medline: 7 2 2023
entrez: 27 11 2022
Statut: ppublish

Résumé

Whilst most military personnel do not develop Post-Traumatic Stress Disorder (PTSD), ex-serving personnel exhibit higher levels compared to those in the military. The heterogeneity of symptom development for serving and ex-serving personnel has not yet been compared in the UK Armed Forces (UK AF). Latent class growth modelling was employed to estimate the trajectories of PTSD symptoms from three waves of data from the PTSD Checklist (PCL-C) from a UK AF sample (N = 7357). Regression mixture models were conducted to investigate covariates of class membership. Five trajectory classes were identified. Most of the sample reported no-low symptoms (71.3%). Of those reporting probable PTSD during the 12 year-period, 4.6% showed improvements, 4.9% worsened, and 1.8% displayed chronic symptoms. A class with subthreshold elevated symptoms (17.3%) was also identified. Trajectories of serving and ex-serving personnel were not substantially different, but more ex-serving personnel were symptomatic and those with chronic symptoms worsened over time. Chronic disorder was associated with lower rank, experiencing violent combat, and proximity to wounding/death on deployment. Worsening symptoms were associated with childhood stress/violence, lower rank, not being in a relationship, inconsistent post-deployment social support, proximity to wounding/death, and voluntary, or medical discharge. The present study found most UKAF personnel did not report PTSD symptoms between 2004 and 16 but, among those experiencing probable PTSD, more participants reported deteriorating/persistent symptoms than who improved. PTSD-onset was related to adversities across childhood and deployment, and lack of social support. Findings underscore the importance of addressing the through-life contributors of PTSD in order to prevent ingrained disorder.

Identifiants

pubmed: 36436424
pii: S0022-3956(22)00631-8
doi: 10.1016/j.jpsychires.2022.11.007
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

18-25

Subventions

Organisme : Department of Health
ID : NIHR300592
Pays : United Kingdom

Informations de copyright

Copyright © 2022 Elsevier Ltd. All rights reserved.

Auteurs

Laura Palmer (L)

King's Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK. Electronic address: laura.m.palmer@kcl.ac.uk.

Sam Norton (S)

Academic Department of Rheumatology, King's College London, London, UK.

Roberto J Rona (RJ)

Academic Department of Military Mental Health, King's College London, London, UK.

Nicola T Fear (NT)

King's Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK; Academic Department of Military Mental Health, King's College London, London, UK.

Sharon A M Stevelink (SAM)

Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK.

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Classifications MeSH