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Latent trajectories of trauma symptoms and resilience: the 3-year longitudinal prospective USPER study of Danish veterans deployed in Afghanistan.
J Clin Psychiatry. 2014 Sep; 75(9):1001-8.JC

Abstract

OBJECTIVE

To identify trajectories of posttraumatic stress disorder (PTSD) symptoms from before to 2.5 years after deployment and to assess risk factors for symptom fluctuations and late-onset PTSD.

METHOD

743 soldiers deployed to Afghanistan in 2009 were assessed for PTSD symptoms using the PTSD Checklist (PCL) at 6 occasions from predeployment to 2.5 years postdeployment (study sample = 561). Predeployment vulnerabilities and deployment and postdeployment stressors were also assessed.

RESULTS

Six trajectories were identified: a resilient trajectory with low symptom levels across all assessments (78.1%) and 5 trajectories showing symptom fluctuations. These included a trajectory of late onset (5.7%), independently predicted by earlier emotional problems (OR = 5.59; 95% CI, 1.57-19.89) and predeployment and postdeployment traumas (OR = 1.10; 95% CI, 1.04-1.17 and OR = 1.13; 95% CI, 1.00-1.26). Two trajectories of symptom fluctuations in the low-to-moderate range (7.5% and 4.1%); a trajectory of symptom relief during deployment, but with a drastic increase at the final assessments (2.0%); and a trajectory with mild symptom increase during deployment followed by relief at return (2.7%) were also found. Symptom fluctuation was predicted independently by predeployment risk factors (depression [OR = 1.27; 95% CI, 1.16-1.39], neuroticism [OR = 1.10; 95% CI, 1.00-1.21], and earlier traumas [OR = 1.09; 95% CI, 1.03-1.16]) and deployment-related stressors (danger/injury exposure [OR = 1.20; 95% CI, 1.04-1.40]), but not by postdeployment stressors.

DISCUSSION

The results confirm earlier findings of stress response heterogeneity following military deployment and highlight the impact of predeployment, perideployment, and postdeployment risk factors in predicting PTSD symptomatology and late-onset PTSD symptoms.

Authors+Show Affiliations

Research and Knowledge Center, The Danish Veteran Center, Garnisonen 1, 4100 Ringsted, Denmark vetc-chvic@mil.dk.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25188895

Citation

Andersen, Søren Bo, et al. "Latent Trajectories of Trauma Symptoms and Resilience: the 3-year Longitudinal Prospective USPER Study of Danish Veterans Deployed in Afghanistan." The Journal of Clinical Psychiatry, vol. 75, no. 9, 2014, pp. 1001-8.
Andersen SB, Karstoft KI, Bertelsen M, et al. Latent trajectories of trauma symptoms and resilience: the 3-year longitudinal prospective USPER study of Danish veterans deployed in Afghanistan. J Clin Psychiatry. 2014;75(9):1001-8.
Andersen, S. B., Karstoft, K. I., Bertelsen, M., & Madsen, T. (2014). Latent trajectories of trauma symptoms and resilience: the 3-year longitudinal prospective USPER study of Danish veterans deployed in Afghanistan. The Journal of Clinical Psychiatry, 75(9), 1001-8. https://doi.org/10.4088/JCP.13m08914
Andersen SB, et al. Latent Trajectories of Trauma Symptoms and Resilience: the 3-year Longitudinal Prospective USPER Study of Danish Veterans Deployed in Afghanistan. J Clin Psychiatry. 2014;75(9):1001-8. PubMed PMID: 25188895.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Latent trajectories of trauma symptoms and resilience: the 3-year longitudinal prospective USPER study of Danish veterans deployed in Afghanistan. AU - Andersen,Søren Bo, AU - Karstoft,Karen-Inge, AU - Bertelsen,Mette, AU - Madsen,Trine, PY - 2013/12/02/received PY - 2014/04/28/accepted PY - 2014/9/5/entrez PY - 2014/9/5/pubmed PY - 2014/12/17/medline SP - 1001 EP - 8 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 75 IS - 9 N2 - OBJECTIVE: To identify trajectories of posttraumatic stress disorder (PTSD) symptoms from before to 2.5 years after deployment and to assess risk factors for symptom fluctuations and late-onset PTSD. METHOD: 743 soldiers deployed to Afghanistan in 2009 were assessed for PTSD symptoms using the PTSD Checklist (PCL) at 6 occasions from predeployment to 2.5 years postdeployment (study sample = 561). Predeployment vulnerabilities and deployment and postdeployment stressors were also assessed. RESULTS: Six trajectories were identified: a resilient trajectory with low symptom levels across all assessments (78.1%) and 5 trajectories showing symptom fluctuations. These included a trajectory of late onset (5.7%), independently predicted by earlier emotional problems (OR = 5.59; 95% CI, 1.57-19.89) and predeployment and postdeployment traumas (OR = 1.10; 95% CI, 1.04-1.17 and OR = 1.13; 95% CI, 1.00-1.26). Two trajectories of symptom fluctuations in the low-to-moderate range (7.5% and 4.1%); a trajectory of symptom relief during deployment, but with a drastic increase at the final assessments (2.0%); and a trajectory with mild symptom increase during deployment followed by relief at return (2.7%) were also found. Symptom fluctuation was predicted independently by predeployment risk factors (depression [OR = 1.27; 95% CI, 1.16-1.39], neuroticism [OR = 1.10; 95% CI, 1.00-1.21], and earlier traumas [OR = 1.09; 95% CI, 1.03-1.16]) and deployment-related stressors (danger/injury exposure [OR = 1.20; 95% CI, 1.04-1.40]), but not by postdeployment stressors. DISCUSSION: The results confirm earlier findings of stress response heterogeneity following military deployment and highlight the impact of predeployment, perideployment, and postdeployment risk factors in predicting PTSD symptomatology and late-onset PTSD symptoms. SN - 1555-2101 UR - https://www.unboundmedicine.com/medline/citation/25188895/Latent_trajectories_of_trauma_symptoms_and_resilience:_the_3_year_longitudinal_prospective_USPER_study_of_Danish_veterans_deployed_in_Afghanistan_ L2 - http://www.psychiatrist.com/jcp/article/pages/2014/v75n09/v75n0920.aspx DB - PRIME DP - Unbound Medicine ER -