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Risk factors for the development of posttraumatic stress disorder following combat trauma: a semiprospective study.
J Clin Psychiatry. 2009 Dec; 70(12):1629-35.JC

Abstract

OBJECTIVE

When positioned in a combat situation, soldiers may be subjected to extreme stress. However, only a few combat-exposed soldiers develop long-term disturbance, namely, posttraumatic stress disorder (PTSD). This study aimed to explore risk factors for developing PTSD in order to improve the psychiatric screening process of new recruits.

METHOD

In a semiprospective design, we compared 2,362 war veterans who developed PTSD (according to DSM-IV criteria) with an equal number of war veterans who did not develop PTSD. Controls were matched on the basis of sequential army identification numbers, that is, the soldier drafted immediately after the index PTSD veteran (usually on the same day). This method ensured similar demographic variables such as socioeconomic level and education. Data were collected from the Israeli Defense Force database and used in a comprehensive survey conducted between January 2000 and March 2001. Comparisons were made on predrafting personal factors (behavioral assessment, cognitive assessment, linguistic ability, and education) and pretrauma army characteristics (ie, rank and training).

RESULTS

Neither behavioral assessment nor training were found to predict PTSD. The predictive factors that were found were essentially nonspecific, such as cognitive functioning, education, rank, and position during the trauma, with little effect from training.

CONCLUSIONS

In an armed force that uses universal recruitment, carefully structured predrafting psychological assessment of social and individual qualifications (including motivation) failed to identify increased risk factors for PTSD. However, nonspecific factors were found to be associated with an increased risk for PTSD. This study suggests that the focus of future research on risk factors for PTSD should incorporate other domains rather than behavioral assessment alone.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: NCT00229359.

Authors+Show Affiliations

Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. Jzohar@post.tau.ac.ilNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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, Non-U.S. Gov't

Language

eng

PubMed ID

19852906

Citation

Zohar, Joseph, et al. "Risk Factors for the Development of Posttraumatic Stress Disorder Following Combat Trauma: a Semiprospective Study." The Journal of Clinical Psychiatry, vol. 70, no. 12, 2009, pp. 1629-35.
Zohar J, Fostick L, Cohen A, et al. Risk factors for the development of posttraumatic stress disorder following combat trauma: a semiprospective study. J Clin Psychiatry. 2009;70(12):1629-35.
Zohar, J., Fostick, L., Cohen, A., Bleich, A., Dolfin, D., Weissman, Z., Doron, M., Kaplan, Z., Klein, E., & Shalev, A. Y. (2009). Risk factors for the development of posttraumatic stress disorder following combat trauma: a semiprospective study. The Journal of Clinical Psychiatry, 70(12), 1629-35. https://doi.org/10.4088/JCP.08m04378blu
Zohar J, et al. Risk Factors for the Development of Posttraumatic Stress Disorder Following Combat Trauma: a Semiprospective Study. J Clin Psychiatry. 2009;70(12):1629-35. PubMed PMID: 19852906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for the development of posttraumatic stress disorder following combat trauma: a semiprospective study. AU - Zohar,Joseph, AU - Fostick,Leah, AU - Cohen,Ayala, AU - Bleich,Avi, AU - Dolfin,Dan, AU - Weissman,Zeev, AU - Doron,Miki, AU - Kaplan,Zeev, AU - Klein,Ehud, AU - Shalev,Arieh Y, AU - ,, Y1 - 2009/10/20/ PY - 2008/01/13/received PY - 2008/11/10/accepted PY - 2009/10/27/entrez PY - 2009/10/27/pubmed PY - 2010/2/24/medline SP - 1629 EP - 35 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 70 IS - 12 N2 - OBJECTIVE: When positioned in a combat situation, soldiers may be subjected to extreme stress. However, only a few combat-exposed soldiers develop long-term disturbance, namely, posttraumatic stress disorder (PTSD). This study aimed to explore risk factors for developing PTSD in order to improve the psychiatric screening process of new recruits. METHOD: In a semiprospective design, we compared 2,362 war veterans who developed PTSD (according to DSM-IV criteria) with an equal number of war veterans who did not develop PTSD. Controls were matched on the basis of sequential army identification numbers, that is, the soldier drafted immediately after the index PTSD veteran (usually on the same day). This method ensured similar demographic variables such as socioeconomic level and education. Data were collected from the Israeli Defense Force database and used in a comprehensive survey conducted between January 2000 and March 2001. Comparisons were made on predrafting personal factors (behavioral assessment, cognitive assessment, linguistic ability, and education) and pretrauma army characteristics (ie, rank and training). RESULTS: Neither behavioral assessment nor training were found to predict PTSD. The predictive factors that were found were essentially nonspecific, such as cognitive functioning, education, rank, and position during the trauma, with little effect from training. CONCLUSIONS: In an armed force that uses universal recruitment, carefully structured predrafting psychological assessment of social and individual qualifications (including motivation) failed to identify increased risk factors for PTSD. However, nonspecific factors were found to be associated with an increased risk for PTSD. This study suggests that the focus of future research on risk factors for PTSD should incorporate other domains rather than behavioral assessment alone. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00229359. SN - 1555-2101 UR - https://www.unboundmedicine.com/medline/citation/19852906/Risk_factors_for_the_development_of_posttraumatic_stress_disorder_following_combat_trauma:_a_semiprospective_study_ L2 - http://www.psychiatrist.com/jcp/article/pages/2009/v70n12/v70n1202.aspx DB - PRIME DP - Unbound Medicine ER -