title: A comparison of mental health outcomes in persons entering U.S. military service before and after September 11, 2001.
abstract: It has been hypothesized that those who entered military service in the pre-September 11, 2001 era might have expectations incongruent with their subsequent experiences, increasing the risk for posttraumatic stress disorder (PTSD) or other mental disorders. A subset of Millennium Cohort Study participants who joined the military during 1995-1999 was selected and compared with a subset of members who joined the military in 2002 or later. Outcomes included new-onset symptoms of PTSD, depression, panic/anxiety, and alcohol-related problems. Multivariable methods adjusted for differences in demographic and military characteristics. More than 11,000 cohort members were included in the analyses. Those who entered service in the pre-September 11 era had lower odds of new-onset PTSD symptoms (odds ratio [OR] 0.74, 95% CI [0.59, 0.93]) compared with the post-September 11 cohort. There were no statistically significant differences in rates of new-onset symptoms of depression, panic/anxiety, or alcohol-related problems between the groups. The cohort who entered military service in the pre-September 11 era did not experience higher rates of new-onset mental health challenges compared with the cohort who entered service after September 11, 2001. Findings support the concept that the experience of war, and resulting psychological morbidity, is not a function of incongruent expectations.
authors.affiliation: Department of Deployment Health Research, Naval Health Research Center, San Diego, California 92106-5122,USA. tim_wells@broadstripe.net
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Wells
authors.forename: Margaret A K
authors.initials: MA
authors.lastname: Ryan
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Jones
authors.forename: Tomoko I
authors.initials: TI
authors.lastname: Hooper
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
authors.forename: Isabel G
authors.initials: IG
authors.lastname: Jacobson
authors.forename: Tyler C
authors.initials: TC
authors.lastname: Smith
authors.forename: Gary D
authors.initials: GD
authors.lastname: Gackstetter
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D001007:Anxiety / Q000453:epidemiology; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D016017:Odds Ratio; D047851:September 11 Terrorist Attacks; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*; D055815:Young Adult