title: PTSD symptom presentation across the deployment cycle.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: New York University School of Medicine, United States.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Steenkamp
authors.affiliation: VA Boston Healthcare System, Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Boston University School of Medicine, United States.
authors.forename: Alyssa M
authors.initials: AM
authors.lastname: Boasso
authors.affiliation: Boston VA Research Institute (BVARI), United States.
authors.forename: William P
authors.initials: WP
authors.lastname: Nash
authors.affiliation: VA Boston Healthcare System, Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Boston University School of Medicine, United States.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Larson
authors.affiliation: VA Boston Healthcare System, Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Boston University School of Medicine, United States.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Lubin
authors.affiliation: VA Boston Healthcare System, Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Boston University School of Medicine, United States. Electronic address: Brett.Litz@va.gov.
authors.forename: Brett T
authors.initials: BT
authors.lastname: Litz
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D006801:Humans; D054542:Iraq War, 2003-2011; D008137:Longitudinal Studies; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D008960:Models, Psychological; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology*; D063189:Symptom Assessment; D013997:Time Factors; D055815:Young Adult
keywords: Afghanistan; Combat; Latent class; Military; PTSD; Symptoms