Post-deployment Mental Health in Reserve and National Guard Service Members: Deploying With or Without One's Unit and Deployment Preparedness.
Post-deployment Mental Health in Reserve and National Guard Service Members: Deploying With or Without One's Unit and Deployment Preparedness.
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预备役和国民警卫队服役人员部署后的心理健康：随部队或不随部队部署以及部署准备。
DOI：
10.1093/milmed/usx002
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发表时间：
2018
影响因子：
1.2
通讯作者：
Galea,Sandro
中科院分区：
文献类型：
--
作者：
Ursano,RobertJ;Wang,Jing;Fullerton,CarolS;Ramsawh,Holly;Gifford,RobertK;Russell,Dale;Cohen,GregoryH;Sampson,Laura;Galea,Sandro
背景考虑到预备役军人中部署后心理健康问题的普遍程度，在没有正规部队的情况下部署的可能性更高，部署准备的可能性更低，我们在一个具有全国代表性的后备分队(RC)陆军和海军陆战队应征男性(n=705)样本中，研究了在有或没有正规部队(个人增援状态，IAS)的情况下部署、部署准备和心理健康问题之间的关联，包括创伤后应激障碍(PTSD)、抑郁(MDD)和酗酒。为了检验部署准备是否因IAS而异，纳入了IAS×部署准备交互作用。发现在调整后的模型中，作为个体受试者和部署准备较低与任何心理健康问题(PTSD、MDD、酗酒或三者的任何组合筛查阳性)相关。有一个重要的IAS×部署准备互动。心理健康问题并不因个体受试者的准备情况而异。与高准备的参与者相比，低-中等准备的常规部队的参与者发生心理健康问题的风险更大(优势比[OR]=3.69，95%可信区间[CI]=1.78-7.62，OR=2.29，95%CI=1.12-4.71)。在没有正规部队的情况下服役的RC应征男性人员出现心理健康问题的可能性是普通人的五倍，报告酗酒的可能性高出61%。此外，部署准备程度较低的人出现心理健康问题的可能性高出三倍，报告PTSD的可能性高达六倍。讨论目前的调查发现，在以前部署的RC应征男性人员中，具有代表性的大样本中，IAS和部署准备都与消极的心理健康结果相关。特别是，部署准备不足与患创伤后应激障碍的可能性增加有关，而在没有正规部队的情况下部署与酗酒发生率增加有关。IAS和部署准备对心理健康问题也有显著的主要影响和交互作用。限制在没有正规部队的情况下部署的RC人员的数量可能有助于减少美国武装部队预备役人员在未来冲突期间和之后的酒精滥用。此外，鉴于部署准备是一个可更改的风险因素，今后的研究应审查增加部署准备是否可以减轻与部署有关的创伤暴露的某些相关性。最后，需要进行未来的调查，以解释为什么那些在没有正规部队的情况下部署，但报告高度部署准备的人，精神健康问题的风险仍然增加。个别增援对象有可能受益于具体的部署准备工作。那些在没有正规部队的情况下部署的人，无论准备情况如何，心理健康问题的发生率都更高。这些调查结果对那些在没有正规部队的情况下部署的人员进行部署准备培训有影响。
BackgroundGiven the greater prevalence of post-deployment mental health concerns among reservists, the higher likelihood of deploying without their regular unit, and potentially lower rates of deployment preparedness, we examined associations between deploying with or without one’s regular unit (individual augmentee status, IAS), deployment preparedness, and mental health problems including post-traumatic stress disorder (PTSD), depression (MDD), and binge drinking in a nationally representative sample of Reserve Component (RC) Army and Marine-enlisted males (n= 705).MethodsA series of multivariate regressions examined the association of mental health with IAS and deployment preparedness, adjusting for demographics. To examine whether deployment preparedness varied by IAS, an IAS × deployment preparedness interaction was included.FindingsIn an adjusted model, being an individual augmentee and low deployment preparedness were associated with any mental health problem (screening positive for PTSD, MDD, binge drinking, or any combination of the three). There was a significant IAS × deployment preparedness interaction. Mental health problems did not vary by preparedness among individual augmentees. Participants deploying with regular units with low–medium preparedness had greater risk for mental health problems (odds ratio [OR] = 3.69, 95% confidence interval [CI] = 1.78–7.62 and OR = 2.29, 95% CI = 1.12–4.71), than those with high preparedness. RC-enlisted male personnel who deployed without their regular unit were five times more likely to have a mental health problem, and were 61% more likely to report binge drinking. Additionally, those with lower levels of deployment preparedness were up to three times more likely to have a mental health problem and up to six times more likely to report PTSD.DiscussionThe current investigation found that both IAS and deployment preparedness were associated with negative mental health outcomes in a large representative sample of previously deployed RC-enlisted male personnel. In particular, low deployment preparedness was associated with an increased likelihood of PTSD, and deploying without one’s regular unit was associated with increased rates of binge drinking. There were also significant main and interaction effects of IAS and deployment preparedness on having a mental health problem. It is possible that limiting the number of RC personnel deploying without their regular unit may help to decrease alcohol misuse among U.S. Armed Services reservists during and after future conflicts. Also, to the extent that deployment preparedness is a modifiable risk factor, future studies should examine whether increasing deployment preparedness could mitigate some of the correlates of deployment-related trauma exposure. Finally, future investigation is needed to explain why those who deploy without their regular unit, but who report high deployment preparedness, remain at elevated risk for mental health problems. It is possible that individual augmentees can benefit from a specific preparation for deployment. Those deploying without their regular unit had higher rates of mental health problems regardless of preparedness. These findings have implications for deployment preparedness training for those deploying without their regular unit.