title: Risk factors for posttraumatic stress disorder among deployed US male marines.
abstract: BACKGROUND
  Combat exposure has been reported as one of the strongest risk factors for postdeployment posttraumatic stress disorder (PTSD) among military service members. Determining the impact of specific deployment-related exposures on the risk of developing PTSD has not been fully explored. Our study objective was to explore the relationship between specific combat exposures and other life experiences with postdeployment PTSD.
  
  
  METHODS
  This study consisted of male Marines who completed a Recruit Assessment Program (RAP) survey during recruit training at the Marine Corps Recruit Depot in San Diego, California as well as a follow-up survey several years after recruit training. Study participants included those Marines who deployed to the current operations in Iraq or Afghanistan between the baseline and follow-up surveys. Multivariable logistic regression was performed to determine which significant exposures and experiences were associated with postdeployment PTSD.
  
  
  RESULTS
  Of the 706 study participants, 10.8% screened positive for postdeployment PTSD. Those who reported feeling in great danger of death (odds ratio [OR] = 4.63, 95% confidence interval [CI]: 2.46-8.73), were shot or seriously injured (OR = 3.51, 95% CI: 1.58-7.77), saw someone wounded or killed (OR = 2.47, 95% CI: 1.08-5.67), and baseline (before recruit training) prior violence exposures (OR = 2.99, 95% CI: 1.46-6.10) were at increased odds for reporting PTSD symptoms. Number of deployments, number of close friends or relatives reported at follow-up, and enlisted pay grade were also significantly associated with postdeployment PTSD.
  
  
  CONCLUSIONS
  Combat exposures, specifically the threat of death, serious injury, and witnessing injury or death are significant risk factors for screening positive for postdeployment PTSD among male Marines as well as violence exposures prior to entering the Marine Corps, which are independent of future combat exposures. A thorough history of lifetime violence exposures should be pursued when considering a clinical diagnosis of PTSD.
authors.affiliation: Department of Defense Center for Deployment Health Research, Naval Health Research Center, Department 164, 140 Sylvester Road, San Diego, CA 92106, USA. chris.phillips@med.navy.mil
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Phillips
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Leardmann
authors.forename: Gia R
authors.initials: GR
authors.lastname: Gumbs
authors.forename: Besa
authors.initials: B
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D000346:Afghanistan; D002140:California / Q000453:epidemiology; D003130:Combat Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D054542:Iraq War, 2003-2011; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D011336:Probability; D011446:Prospective Studies; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014754:Violence / Q000523:psychology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology