Associations of Stress Exposures and Social Support With Long-Term Mental Health Outcomes Among US Iraq War Veterans
Associations of Stress Exposures and Social Support With Long-Term Mental Health Outcomes Among US Iraq War Veterans
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DOI：
10.1016/j.beth.2018.01.002
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发表时间：
2018-09-01
期刊：
影响因子：
3.7
通讯作者：
Vasterling, Jennifer J.
中科院分区：
文献类型：
--
作者：
Ciarleglio, Maria M.;Aslan, Mihaela;Vasterling, Jennifer J.
在伊拉克和阿富汗战争的战区部署对军事人员的长期心理健康影响是一个重大的公共卫生问题。作为神经认知部署健康研究和VA合作研究计划研究#566的一部分，我们使用2003-2014年期间在三个不同评估中前瞻性收集的数据，探讨了从部署返回之前，期间和之后的压力暴露如何影响创伤后应激障碍（PTSD），抑郁症，焦虑症和饮酒问题的长期心理健康结果。对375名服役人员和退伍军人的长期心理健康结果进行了评估，平均在首次（即“指数”）伊拉克部署后7.5年（标准差=1.0年）。焦虑症是最常见的长期心理健康结果（36.0%），其次是抑郁症（24.5%）、创伤后应激障碍（24.3%）和饮酒问题（21.0%）。多变量回归模型显示，通过部署后生活事件量表测量的部署后压力源越大，抑郁、焦虑障碍和酗酒问题的风险就越大。焦虑障碍是唯一受部署前压力担忧影响的结果。此外，更大的部署后社会支持与所有结果的风险降低有关，除了饮酒问题。这些发现强调了评估部署后压力暴露的重要性，例如压力或创伤性生活事件，考虑到这些压力源对长期心理健康结果的潜在影响。本研究还强调了部署后社会支持作为一种可改变的保护因素的重要性，可用于帮助减轻战区暴露后长期不良心理健康结果的风险。
The long-term mental health effects of war-zone deployment in the Iraq and Afghanistan wars on military personnel are a significant public health concern. Using data collected prospectively at three distinct assessments during 2003-2014 as part of the Neurocognition Deployment Health Study and VA Cooperative Studies Program Study #566, we explored how stress exposures prior, during, and after return from deployment influence the long-term mental health outcomes of posttraumatic stress disorder (PTSD), depression, anxiety disorders, and problem drinking. Longer-term mental health outcomes were assessed in 375 service members and military veterans an average of 7.5 years (standard deviation =1.0 year) after the initial (i.e., "index") Iraq deployment following their predeployment assessment. Anxiety disorder was the most commonly observed long-term mental health outcome (36.0%), followed by depression (24.5%), PTSD (24.3%), and problem drinking (21.0%). Multivariable regression models showed that greater postdeployment stressors, as measured by the Post-Deployment Life Events scale, were associated with greater risk of depression, anxiety disorders, and problem drinking. Anxiety disorder was the only outcome affected by predeployment stress concerns. In addition, greater postdeployment social support was associated with lower risk of all outcomes except problem drinking. These findings highlight the importance of assessing postdeployment stress exposures, such as stressful or traumatic life events, given the potential impact of these stressors on long-term mental health outcomes. This study also highlights the importance of postdeployment social support as a modifiable protective factor that can be used to help mitigate risk of long-term adverse mental health outcomes following war-zone exposure.