title: PTSD symptom severity and sensitivity to blood, injury, and mutilation in U.S. army special operations soldiers.
abstract: Sensitivity to blood, injury, and mutilation (SBIM) may increase risk for posttraumatic stress disorder (PTSD), given that traumatic events often involve actual or perceived threat of bodily harm to oneself and/or others, including exposure to blood and other mutilation-related stimuli. A self-report questionnaire was administered to male, active duty, U.S. Army Special Operations Command soldiers who had deployed to Iraq and Afghanistan (n =694 males). We first used exploratory factor analysis to examine whether the 30-item Mutilation Questionnaire (Klorman et al., 1974) comprised a unitary measure of SBIM, finding that 10 of the items form a cohesive SBIM factor. Summed, those 10 SBIM items had a significant bivariate correlation with PTSD symptom severity. In a multiple regression analysis that included demographic characteristics and lifetime trauma exposure, SBIM was positively associated with PTSD symptom severity. Other significant multivariate predictors were high lifetime trauma exposure and junior enlisted rank. When trait neuroticism was added to the model to test the robustness of these findings, the association of SBIM with PTSD symptom severity remained significant. The results suggest that SBIM may be a risk factor for PTSD in male soldiers. Further research is warranted to improve measurement and understanding of SBIM.
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Naifeh
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA. Electronic address: robert.ursano@usuhs.edu.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ursano
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Natasha
authors.initials: N
authors.lastname: Benfer
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Wu
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Herman
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Benedek
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Dale W
authors.initials: DW
authors.lastname: Russell
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: K Nikki
authors.initials: KN
authors.lastname: Benevides
authors.affiliation: Division of Epidemiology and Biostatistics, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Tzu-Cheg
authors.initials: TC
authors.lastname: Kao
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Tsz Hin H
authors.initials: THH
authors.lastname: Ng
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Aliaga
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Gary H
authors.initials: GH
authors.lastname: Wynn
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: United States Army War College, Carlisle, PA, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Forsten
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Carol S
authors.initials: CS
authors.lastname: Fullerton
mesh_terms: D000328:Adult; D000346:Afghanistan; D006801:Humans; D007493:Iraq; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D000075384:Neuroticism; D012307:Risk Factors; D057566:Self Report; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D055815:Young Adult