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Long-Term Trajectories of Posttraumatic Stress Disorder in Veterans: The Role of Social Resources

Karstoft, Karen-Inge, Armour, Cherie, Elklit, Ask and Solomon, Zahava (2013) Long-Term Trajectories of Posttraumatic Stress Disorder in Veterans: The Role of Social Resources. The Journal of Clinical Psychiatry, 74 (12). e1163-e1168. [Journal article]

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URL: http://dx.doi.org/10.4088/JCP.13.m08482

DOI: doi:10.4088/JCP.13.m08482

Abstract

OBJECTIVE:To (1) identify long-term trajectories of combat-induced posttraumatic stress disorder (PTSD) symptoms over a 20-year period from 1983 to 2002 in veterans with and without combat stress reaction (CSR) and (2) identify social predictors of these trajectories.METHOD:A latent growth mixture modeling analysis on PTSD symptoms was conducted to identify PTSD trajectories and predictors. PTSD was defined according to DSM-III and assessed through the PTSD Inventory. Israeli male veterans with (n = 369) and without (n = 306) CSR were queried at 1, 2, and 20 years after war about combat exposure, military unit support, family environment, and social reintegration.RESULTS:For both study groups, we identified 4 distinct trajectories with varying prevalence across groups: resilience (CSR = 34.4%, non-CSR = 76.5%), recovery (CSR = 36.3%, non-CSR = 10.5%), delayed onset (CSR = 8.4%, non-CSR = 6.9%), and chronicity (CSR = 20.9%, non-CSR = 6.2%). Predictors of trajectories in both groups included perception of war threat (ORs = 1.59-2.47, P values ≤ .30), and negative social reintegration (ORs = 0.24-0.51, P values ≤ .047). Social support was associated with symptomatology only in the CSR group (ORs = 0.40-0.61, P values ≤ .045), while family coherence was predictive of symptomatology in the non-CSR group (OR = 0.76, P = .015) but not in the CSR group.CONCLUSIONS:Findings confirmed heterogeneity of long-term sequelae of combat, revealing 4 trajectories of resilience, recovery, delay, and chronicity in veterans with and without CSR. Symptomatic trajectories were more prevalent for the CSR group, suggesting that acute functional impairment predicts pathological outcomes. Predictors of symptomatic trajectories included perceived threat and social resources at the family, network, and societal levels.

Item Type:Journal article
Keywords:PTSD, Veterans, LGMM, Social Support
Faculties and Schools:Faculty of Life and Health Sciences
Faculty of Life and Health Sciences > School of Psychology
Research Institutes and Groups:Psychology Research Institute > Population Health Sciences and Mental Health Services
Psychology Research Institute
ID Code:33105
Deposited By: Prof Cherie Armour
Deposited On:08 Mar 2016 16:29
Last Modified:08 Mar 2016 16:29

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