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Association of time since deployment, combat intensity, and posttraumatic stress symptoms with neuropsychological outcomes following Iraq war deployment.
Arch Gen Psychiatry. 2009 Sep; 66(9):996-1004.AG

Abstract

CONTEXT

Previous research has demonstrated neuropsychological changes following Iraq deployment. It is unknown whether these changes endure without subsequent war-zone exposure or chronic stress symptoms.

OBJECTIVE

To determine the associations of time since deployment, combat intensity, and posttraumatic stress disorder (PTSD) and depression symptoms with longer-term neuropsychological outcomes in war-deployed soldiers.

DESIGN

Prospective cohort study involving (1) soldiers assessed at baseline (median, 42 days prior to deployment) and following return from Iraq (median, 404 days after return and 885 days since baseline), and (2) soldiers more recently returned from deployment assessed at baseline (median, 378 days prior to deployment) and following return from Iraq (median, 122 days after return and 854 days since baseline assessment).

SETTING

Active-duty military installations.

PARTICIPANTS

Two hundred sixty-eight male and female regular active-duty soldiers (164 with 1-year follow-up; 104 recently returned).

MAIN OUTCOME MEASURES

Neuropsychological performances (verbal learning, visual memory, attention, and reaction time).

RESULTS

There was a significant interaction between time and PTSD symptom severity (B= -0.01 [unstandardized], P = .04). Greater PTSD symptoms were associated with poorer attention in soldiers tested at 1-year follow-up (B = 0.01, P = .03) but not in recently returned soldiers. At 1-year follow-up, mean adjusted attention error scores increased by 0.10 points for every 10 points on the PTSD scale. Greater combat intensity was associated with more efficient postdeployment reaction-time performances, regardless of time since deployment (B = 0.48, P = .004), with mean adjusted reaction efficiency scores increasing by 4.8 points for every 10 points on the combat experiences scale. Neither depression nor contextual variables (alcohol use and deployment head injury) were significantly related to neuropsychological outcomes.

CONCLUSIONS

In this study of army soldiers deployed to the Iraq war, only PTSD symptoms (among soldiers back from deployment for 1 year) were associated with a neuropsychological deficit (reduced attention). Greater combat intensity was associated with enhanced reaction time, irrespective of time since return.

Authors+Show Affiliations

Behavioral Sciences Division, Veterans Affairs National Center for PTSD, Psychology Service, Veterans Affairs Boston Healthcare System, Boston, MA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

19736356

Citation

Marx, Brian P., et al. "Association of Time Since Deployment, Combat Intensity, and Posttraumatic Stress Symptoms With Neuropsychological Outcomes Following Iraq War Deployment." Archives of General Psychiatry, vol. 66, no. 9, 2009, pp. 996-1004.
Marx BP, Brailey K, Proctor SP, et al. Association of time since deployment, combat intensity, and posttraumatic stress symptoms with neuropsychological outcomes following Iraq war deployment. Arch Gen Psychiatry. 2009;66(9):996-1004.
Marx, B. P., Brailey, K., Proctor, S. P., Macdonald, H. Z., Graefe, A. C., Amoroso, P., Heeren, T., & Vasterling, J. J. (2009). Association of time since deployment, combat intensity, and posttraumatic stress symptoms with neuropsychological outcomes following Iraq war deployment. Archives of General Psychiatry, 66(9), 996-1004. https://doi.org/10.1001/archgenpsychiatry.2009.109
Marx BP, et al. Association of Time Since Deployment, Combat Intensity, and Posttraumatic Stress Symptoms With Neuropsychological Outcomes Following Iraq War Deployment. Arch Gen Psychiatry. 2009;66(9):996-1004. PubMed PMID: 19736356.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of time since deployment, combat intensity, and posttraumatic stress symptoms with neuropsychological outcomes following Iraq war deployment. AU - Marx,Brian P, AU - Brailey,Kevin, AU - Proctor,Susan P, AU - Macdonald,Helen Z, AU - Graefe,Anna C, AU - Amoroso,Paul, AU - Heeren,Timothy, AU - Vasterling,Jennifer J, PY - 2009/9/9/entrez PY - 2009/9/9/pubmed PY - 2009/9/11/medline SP - 996 EP - 1004 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 66 IS - 9 N2 - CONTEXT: Previous research has demonstrated neuropsychological changes following Iraq deployment. It is unknown whether these changes endure without subsequent war-zone exposure or chronic stress symptoms. OBJECTIVE: To determine the associations of time since deployment, combat intensity, and posttraumatic stress disorder (PTSD) and depression symptoms with longer-term neuropsychological outcomes in war-deployed soldiers. DESIGN: Prospective cohort study involving (1) soldiers assessed at baseline (median, 42 days prior to deployment) and following return from Iraq (median, 404 days after return and 885 days since baseline), and (2) soldiers more recently returned from deployment assessed at baseline (median, 378 days prior to deployment) and following return from Iraq (median, 122 days after return and 854 days since baseline assessment). SETTING: Active-duty military installations. PARTICIPANTS: Two hundred sixty-eight male and female regular active-duty soldiers (164 with 1-year follow-up; 104 recently returned). MAIN OUTCOME MEASURES: Neuropsychological performances (verbal learning, visual memory, attention, and reaction time). RESULTS: There was a significant interaction between time and PTSD symptom severity (B= -0.01 [unstandardized], P = .04). Greater PTSD symptoms were associated with poorer attention in soldiers tested at 1-year follow-up (B = 0.01, P = .03) but not in recently returned soldiers. At 1-year follow-up, mean adjusted attention error scores increased by 0.10 points for every 10 points on the PTSD scale. Greater combat intensity was associated with more efficient postdeployment reaction-time performances, regardless of time since deployment (B = 0.48, P = .004), with mean adjusted reaction efficiency scores increasing by 4.8 points for every 10 points on the combat experiences scale. Neither depression nor contextual variables (alcohol use and deployment head injury) were significantly related to neuropsychological outcomes. CONCLUSIONS: In this study of army soldiers deployed to the Iraq war, only PTSD symptoms (among soldiers back from deployment for 1 year) were associated with a neuropsychological deficit (reduced attention). Greater combat intensity was associated with enhanced reaction time, irrespective of time since return. SN - 1538-3636 UR - https://www.unboundmedicine.com/medline/citation/19736356/Association_of_time_since_deployment_combat_intensity_and_posttraumatic_stress_symptoms_with_neuropsychological_outcomes_following_Iraq_war_deployment_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archgenpsychiatry.2009.109 DB - PRIME DP - Unbound Medicine ER -