title: Deployment-related injury and posttraumatic stress disorder in US military personnel.
abstract: BACKGROUND
  The current military conflicts in Iraq and Afghanistan have resulted in the most US casualties since the Vietnam War. Previous research on the association between deployment-related injury and posttraumatic stress disorder (PTSD) has yielded mixed results.
  
  
  OBJECTIVE
  To examine the effect of battle injury (BI) relative to non-battle injury (NBI) on the manifestation of PTSD symptoms in military personnel and to assess the demographic, injury-specific, and pre-injury factors associated with PTSD following a BI.
  
  
  METHODS
  A total of 3403 personnel with deployment-related injury (1777 BI and 1626 NBI) were identified from the Expeditionary Medical Encounter Database. Records were electronically matched to Post-Deployment Health Assessment (PDHA) data completed 1-6 months post-injury. The PTSD screening outcome was identified using a four-item screening tool on the PDHA.
  
  
  RESULTS
  Compared to those with NBI, personnel with BI had more severe injuries, reported higher levels of combat exposure, and had higher rates of positive PTSD screen. After adjusting for covariates, personnel with BI were twice as likely to screen positive for PTSD compared to those with NBI (odds ratio [OR], 2.10; 95% confidence interval [CI], 1.60-2.75). In multivariable analysis among battle-injured personnel only, moderate and serious-severe injury (OR, 1.49; 95% CI, 1.12-2.00 and OR, 1.64; 95% CI, 1.01-2.68, respectively), previous mental health diagnosis within 1 year of deployment (OR, 2.69; 95% CI, 1.50-4.81), and previous BI (OR, 1.96; 95% CI, 1.22-3.16) predicted a positive PTSD screen.
  
  
  CONCLUSIONS
  Military personnel with BI have increased odds of positive PTSD screen following combat deployment compared to those with NBI. Post-deployment health questionnaires may benefit from questions that specifically address whether service members experienced an injury during combat.
authors.affiliation: Department of Medical Modeling, Simulation and Mission Support, Naval Health Research Center, San Diego, CA, United States. Electronic address: andrew.macgregor@med.navy.mil.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Macgregor
authors.forename: Janet J
authors.initials: JJ
authors.lastname: Tang
authors.forename: Amber L
authors.initials: AL
authors.lastname: Dougherty
authors.forename: Michael R
authors.initials: MR
authors.lastname: Galarneau
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D003130:Combat Disorders / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D054542:Iraq War, 2003-2011; D008297:Male; D008403:Mass Screening; D008889:Military Personnel / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000209:etiology; D011795:Surveys and Questionnaires; D014481:United States; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology
keywords: Battle; Deployment; Injury; Mental health; Military; Non-battle; PTSD; Posttraumatic stress disorder