title: Longitudinal Examination of Posttraumatic Stress Disorder as a Long-Term Outcome of Iraq War Deployment.
abstract: The mental health toll of the Iraq and Afghanistan Wars on military veterans has been considerable, yet little is known about the persistence of these adverse outcomes, especially relative to predeployment status. We prospectively examined posttraumatic stress disorder (PTSD) as a long-term consequence of warzone deployment, integrating data collected from 2003-2014. In the Neurocognition Deployment Health Study, we measured PTSD symptoms in US Army soldiers before and shortly after Iraq War deployment. We used the PTSD Checklist-Civilian Version and a structured clinical interview (i.e., Clinician-Administered PTSD Scale) to reassess PTSD in 598 service members and military veterans a median of 7.9 years (interquartile range, 7.2-8.5 years) after an index Iraq deployment. At long-term follow-up, 24.7% (95% confidence interval (CI): 21.5, 28.4) of participants met the case definition for PTSD, which was an absolute increase of 14.2% from the percentage assessed postdeployment (10.5%; 95% CI: 7.8, 13.7) and of 17.3% from the percentage assessed predeployment (7.4%; 95% CI: 5.5, 9.8). These findings highlight that PTSD is an enduring consequence of warzone participation among contemporary military personnel and veterans. The largest increase in PTSD cases occurred between the postdeployment and long-term follow-up assessments, which suggests that adverse stress reactions cannot necessarily be expected to dissipate over time and actually may increase.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Vasterling
authors.forename: Mihaela
authors.initials: M
authors.lastname: Aslan
authors.forename: Susan P
authors.initials: SP
authors.lastname: Proctor
authors.forename: John
authors.initials: J
authors.lastname: Ko
authors.forename: Brian P
authors.initials: BP
authors.lastname: Marx
authors.forename: Matthew
authors.initials: M
authors.lastname: Jakupcak
authors.forename: Paula P
authors.initials: PP
authors.lastname: Schnurr
authors.forename: Theresa
authors.initials: T
authors.lastname: Gleason
authors.forename: Grant D
authors.initials: GD
authors.lastname: Huang
authors.forename: John
authors.initials: J
authors.lastname: Concato
mesh_terms: D000328:Adult; D000367:Age Factors; D003130:Combat Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008137:Longitudinal Studies; D008297:Male; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*
keywords: Iraq War; PTSD prevalence; longitudinal study; military deployment; prospective study