title: Long-Term Trajectories of PTSD in Vietnam-Era Veterans: The Course and Consequences of PTSD in Twins.
abstract: We estimated the temporal course of posttraumatic stress disorder (PTSD) in Vietnam-era veterans using a national sample of male twins with a 20-year follow-up. The complete sample included those twins with a PTSD diagnostic assessment in 1992 and who completed a DSM-IV PTSD diagnostic assessment and a self-report PTSD checklist in 2012 (n = 4,138). Using PTSD diagnostic data, we classified veterans into 5 mutually exclusive groups, including those who never had PTSD, and 4 PTSD trajectory groups: (a) early recovery, (b) late recovery, (c) late onset, and (d) chronic. The majority of veterans remained unaffected by PTSD throughout their lives (79.05% of those with theater service, 90.85% of those with nontheater service); however, an important minority (10.50% of theater veterans, 4.45% of nontheater veterans) in 2012 had current PTSD that was either late onset (6.55% theater, 3.29% nontheater) or chronic (3.95% theater, 1.16% nontheater). The distribution of trajectories was significantly different by theater service (p < .001). PTSD remains a prominent issue for many Vietnam-era veterans, especially for those who served in Vietnam.
authors.affiliation: Mental Health Service, Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA.|Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Magruder
authors.affiliation: Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington, USA.|Department of Epidemiology, University of Washington, Seattle, Washington, USA.
authors.forename: Jack
authors.initials: J
authors.lastname: Goldberg
authors.affiliation: Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington, USA.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Forsberg
authors.affiliation: National Center for Posttraumatic Stress Disorder, Department of Veterans Affairs, White River Junction, Vermont, USA.|Departments of Psychiatry and Pharmacology & Toxicology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Friedman
authors.affiliation: Massachusetts Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts, USA.|Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Brett T
authors.initials: BT
authors.lastname: Litz
authors.affiliation: Department of Epidemiology, Emory University, Atlanta, Georgia, USA.|Department of Medicine, Emory University, Atlanta, Georgia, USA.
authors.forename: Viola
authors.initials: V
authors.lastname: Vaccarino
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, Washington, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Heagerty
authors.affiliation: Cooperative Studies Program, Clinical Science Research and Development, VA Office of Research and Development, Washington, DC, USA.
authors.forename: Theresa C
authors.initials: TC
authors.lastname: Gleason
authors.affiliation: Cooperative Studies Program, Clinical Science Research and Development, VA Office of Research and Development, Washington, DC, USA.
authors.forename: Grant D
authors.initials: GD
authors.lastname: Huang
authors.affiliation: Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington, USA.|Department of Epidemiology, University of Washington, Seattle, Washington, USA.
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004200:Diseases in Twins; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D057566:Self Report; D013313:Stress Disorders, Post-Traumatic / Q000145:classification / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D014744:Vietnam; D047829:Vietnam Conflict