Prospective post-traumatic stress disorder symptom trajectories in active duty and separated military personnel.
Post-traumatic stress disorder (PTSD) is a serious mental illness that affects current and former military service members at a disproportionately higher rate than the civilian population. Prior studies have shown that PTSD symptoms follow multiple trajectories in civilians and military personnel. The current study examines whether the trajectories of PTSD symptoms of veterans separated from the military are similar to continuously serving military personnel. The Millennium Cohort Study is a population-based study of military service members that commenced in 2001 with follow-up assessments occurring approximately every 3 years thereafter. PTSD symptoms were assessed at each time point using the PTSD Checklist. Latent growth mixture modeling was used to compare PTSD symptom trajectories between personnel who separated (veterans; n = 5292) and personnel who remained in military service (active duty; n = 16,788). Four distinct classes (resilient, delayed-onset, improving, and elevated-recovering) described PTSD symptoms trajectories in both veterans and active duty personnel. Trajectory shapes were qualitatively similar between active duty and veterans. However, within the resilient, improving, and elevated recovering classes, the shapes were statistically different. Although the low-symptom class was the most common in both groups (veterans: 82%; active duty: 87%), veterans were more likely to be classified in the other three classes (in all cases, p < 0.01). The shape of each trajectory was highly similar between the two groups despite differences in military and civilian life.
Deployment Health Research Department, Naval Health Research Center, San Diego, CA, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA. Electronic address: Bennett.W.Porter.ctr@mail.mil.
Ben
B
Porter
Teachers College, Columbia University, New York, NY, USA.
George A
GA
Bonanno
Deployment Health Research Department, Naval Health Research Center, San Diego, CA, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
Melissa A
MA
Frasco
Post-Deployment Health Epidemiology Program, Office of Patient Care Services, Department of Veterans Affairs, Washington, DC, USA.
Erin K
EK
Dursa
Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
Edward J
EJ
Boyko
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology*; D014728:Veterans / Q000523:psychology; D055815:Young Adult
Active duty; Latent growth mixture model; Military; PTSD; Trajectory; Veteran