title: Research on PTSD prevalence in OEF/OIF Veterans: expanding investigation of demographic variables.
abstract: BACKGROUND
  A series of recent articles has reported on well-designed studies examining base rates of posttraumatic stress disorder (PTSD) screenings within the Operation Enduring Freedom (Afghanistan conflict)/Operation Iraqi Freedom (Iraq conflict) (OEF/OIF) military population. Although these studies have a number of strengths, this line of research points out several key areas in need of further examination.
  
  
  OBJECTIVE
  Many OEF/OIF Veterans do not use available Veterans Affairs (VA) services, especially mental health care. This highlights the need to understand the differences between those who use and do not use the VA, especially as research with pre-OEF/OIF Veterans suggests that these two groups differ in significant ways. The high rates of PTSD-related concerns in non-VA users also points to a need to understand whether-and where-Veterans are seeking care outside the VA and the accessibility of evidence-based, trauma-focused treatments in the community and private sectors. Careful examination of relationship status is also paramount as little research has examined relationship status or other relationship context issues. Social support, especially from a spouse, can buffer the development of PTSD; however, relationship discord has the potential to greatly exacerbate PTSD symptomatology. Furthermore, given the additional risk factors for sexual minority Veterans to be exposed to trauma, the 2011 repeal of the US Military "Don't Ask, Don't Tell" policy, and the emergence of the VA as likely the largest health care provider for sexual minority Veterans, it will be critically important to study the trauma and mental health experiences of this group.
  
  
  CONCLUSIONS
  Studies that examine prevalence rates of PTSD in the returning cohort contribute significantly to our understanding of the US OEF/OIF military population. Further study of PTSD in relation to demographic variables such as VA and non-VA use, relationship status, and sexual orientation will provide rich data that will enhance our ability to develop policy and practice to provide the best care to this population.
authors.affiliation: Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.|Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; lynnette.averill@yale.edu.
authors.forename: Lynnette A
authors.initials: LA
authors.lastname: Averill
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Eubanks Fleming
authors.affiliation: Department of Clinical Health Psychology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.|Operational Stress Injury Clinic, Deer Lodge Centre, Winnipeg, MB, Canada.
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Holens
authors.affiliation: Psychology Service, Clement J. Zablocki VA Medical Center, Milwaukee, WI, USA.|Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Sadie E
authors.initials: SE
authors.lastname: Larsen
keywords: Don't Ask, Don't Tell; LGBT; OEF/OIF; PTSD; VA service use; demographics; marital status; military Veteran; prevalence rates; relationships