Deployment-Related Injury and Posttraumatic Stress Disorder in US Military Personnel
NAVAL HEALTH RESEARCH CENTER SAN DIEGO CA
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The current military conflicts in Iraq and Afghanistan have resulted in the most US casualties since the Vietnam War. Previous research on the association between deployment-related injury and posttraumatic stress disorder PTSD has yielded mixed results. The objective of the present study was to examine the effect of battle injury BI relative to nonbattle injury NBI on the manifestation of PTSD symptoms in military personnel and to assess the demographic, injury-specific, and pre-injury factors associated with PTSD following a BI. A total of 3,403 people with deployment-related injury 1,777 BI and 1,626 NBI were identified from the Expeditionary Medical Encounter Database. Records were electronically matched to Post-Deployment Health Assessment PDHA data completed 1 6 months post-injury. The PTSD screening outcome was identified using a four-item screening tool on the PDHA. Compared to those with NBI, personnel with BI had more severe injuries, reported higher levels of combat exposure, and had higher rates of positive PTSD screen. After adjusting for covariates, personnel with BI were twice as likely to screen positive for PTSD compared to those with NBI odds ratio OR, 2.10 95 confidence interval CI, 1.60 2.75. In multivariate analysis among battle-injured personnel only, moderate and severe injury OR, 1.49 95 CI, 1.12 2.00 and OR, 1.64 95 CI, 1.01 2.68, respectively, previous mental health diagnosis within 1 year of deployment OR, 2.69 95 CI, 1.50 4.81, and previous BI OR, 1.96 95 CI, 1.22 3.16 predicted a positive PTSD screen. Military personnel with battle injury have increased odds of positive PTSD screen following combat deployment. Post-deployment health questionnaires may benefit from questions that specifically address whether service members experienced an injury during combat.