title: Psychological Impact of Deploying in Support of the U.S. Response to Ebola: A Systematic Review and Meta-Analysis of Past Outbreaks.
abstract: To examine the potential psychological impact of deploying in support of the U.S. response to Ebola in west Africa by systematic review and meta-analysis.
  
  
  
  Peer-reviewed articles published between January 2000 and December 2014 were identified using PubMed, PsycINFO, and Web of Science. Thirty-two studies involving 26,869 persons were included in the systematic review; 13 studies involving 7,785 persons were included in the meta-analysis. Pooled standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated.
  
  
  
  Reflecting the sociodemographics of the military, those who are younger, single, not living with family, have fewer years of work experience, lower education, and lower income are at increased risk for psychological distress, alcohol/drug misuse, post-traumatic stress disorder (PTSD), depression, and/or anxiety as a result of their perceived risk of infection. Effect sizes for post-traumatic stress disorder, depressive, and anxiety symptoms were considered small (SMD = 0.12, 95% CI = -0.23 to 0.47), moderate (SMD = 0.40, 95% CI = 0.24-0.51), and small (SMD = 0.08, 95% CI = -0.09 to 0.25), respectively; however, only the effect size for depressive symptoms was statistically significant.
  
  
  
  Deployed service members may return with clinically significant problems, the most notable of which is depression. Delivering resilience training and fostering altruistic acceptance may protect service members from developing mental health disorders.
authors.affiliation: Naval Center for Combat and Operational Stress Control, Bureau of Medicine and Surgery, U.S. Navy, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134-6400.
authors.forename: Kartavya J
authors.initials: KJ
authors.lastname: Vyas
authors.affiliation: Naval Center for Combat and Operational Stress Control, Bureau of Medicine and Surgery, U.S. Navy, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134-6400.
authors.forename: Eileen M
authors.initials: EM
authors.lastname: Delaney
authors.affiliation: Naval Center for Combat and Operational Stress Control, Bureau of Medicine and Surgery, U.S. Navy, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134-6400.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Webb-Murphy
authors.affiliation: Naval Center for Combat and Operational Stress Control, Bureau of Medicine and Surgery, U.S. Navy, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134-6400.
authors.forename: Scott L
authors.initials: SL
authors.lastname: Johnston
mesh_terms: D001007:Anxiety / Q000209:etiology / Q000523:psychology; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000592:standards; D003863:Depression / Q000209:etiology / Q000523:psychology; D004196:Disease Outbreaks; D019142:Hemorrhagic Fever, Ebola / Q000523:psychology*; D006801:Humans; D008889:Military Personnel / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology*