Time-course of PTSD symptoms in the Australian Defence Force: a retrospective cohort study

Article


Waller, M., Charlson, F. J., Ireland, R. E. E., Whiteford, H. A. and Dobson, A. J.. 2016. "Time-course of PTSD symptoms in the Australian Defence Force: a retrospective cohort study." Epidemiology and Psychiatric Sciences. 25 (4), pp. 393-402. https://doi.org/10.1017/S2045796015000517
Article Title

Time-course of PTSD symptoms in the Australian Defence Force: a retrospective cohort study

ERA Journal ID41006
Article CategoryArticle
AuthorsWaller, M. (Author), Charlson, F. J. (Author), Ireland, R. E. E. (Author), Whiteford, H. A. (Author) and Dobson, A. J. (Author)
Journal TitleEpidemiology and Psychiatric Sciences
Journal Citation25 (4), pp. 393-402
Number of Pages10
Year2016
Place of PublicationUnited Kingdom
ISSN1121-189X
2038-1816
2045-7960
2045-7979
Digital Object Identifier (DOI)https://doi.org/10.1017/S2045796015000517
Web Address (URL)https://www.cambridge.org/core/journals/epidemiology-and-psychiatric-sciences/article/time-course-of-ptsd-symptoms-in-the-australian-defence-force-a-retrospective-cohort-study/0DB1574695C2D9832DE160B1D70E4D42
Abstract

Aims. Understanding the time-course of post-traumatic stress disorder (PTSD), and the underlying events, may help to identify those most at risk, and anticipate the number of individuals likely to be diagnosed after exposure to traumatic events.

Method. Data from two health surveys were combined to create a cohort of 1119 Australian military personnel who deployed to the Middle East between 2000 and 2009. Changes in PTSD Checklist Civilian Version (PCL-C) scores and the reporting of stressful events between the two self-reported surveys were assessed. Logistic regression was used to examine the association between the number of stressful events reported and PTSD symptoms, and assess whether those who reported new stressful events between the two surveys, were also more likely to report older events. We also assessed, using linear regression, whether higher scores on the Kessler Psychological Distress Scale or the Alcohol Use Disorder Identification Test were associated with subsequent increases in the PCL-C in those who had experienced a stressful event, but who initially had few PTSD symptoms.

Results. Overall, the mean PCL-C scores in the two surveys were similar, and 78% of responders stayed in the same PCL-C category. Only a small percentage moved from having few symptoms of PTSD (PCL-C < 30) in Survey 1 to meeting the criteria for PTSD (PCL-C ≥ 50) at Survey 2 (1% of all responders, 16% of those with PCL-C ≥ 50 at Survey 2). Personnel who reported more stressful lifetime events were more likely to score higher on the PCL-C. Only 51% reported the same stressful event on both surveys. People who reported events occurring between the two surveys were more likely to record events from before the first survey which they had not previously mentioned (OR 1.48, 95% CI (1.17, 1.88), p < 0.001), than those who did not. In people who initially had few PTSD symptoms, a higher level of psychological distress, was significantly associated with higher PCL-C scores a few years later.

Conclusions. The reporting of stressful events varied over time indicating that while the impact of some stressors endure, others may increase or decline in importance. When screening for PTSD, it is important to consider both traumatic experiences on deployment and other stressful life events, as well as other mental health problems among military personnel, even if individuals do not exhibit symptoms of PTSD on an initial assessment.

KeywordsDelayed onset, military, PTSD, traumatic events
ANZSRC Field of Research 2020420299. Epidemiology not elsewhere classified
529999. Other psychology not elsewhere classified
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Byline AffiliationsUniversity of Queensland
University of Washington, United States
Institute for Resilient Regions
Institution of OriginUniversity of Southern Queensland
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