Military Preparedness During and After Deployment Can Help Protect Veterans From the Development of Postraumatic Stress Disorder

Objectives:Between 11-24% of veterans from Iraq and Afghanistan have been diagnosed with posttraumatic stress disorder (PTSD). High rates of PTSD in this population have resulted in poor quality of life for veterans and their families as well as a high financial cost the United States government.  Emerging research is being conducted on the primary prevention of PTSD in soldiers during deployment. The purpose of this study was to investigate the relationships between military preparedness on combat exposure to predict the development of symptoms of PTSD among Iraq and Afghanistan veterans.

Methods:This study was a secondary data analysis where hierarchical multiple regression was conducted to test a curvilinear relationship of military preparedness and combat exposure to predict the development of symptoms of PTSD in a sample of 418 veterans seen for evaluation at the War Related Injury and Illness Center (WRIISC).  Data used in study was extracted from the Health Assessment Questionnaire, a self-report questionnaire completed by all veterans seen at the WRIISC. Demographic data were collected including age, gender, branch, race, marital status and number of deployments.   PTSD was measured by Posttraumatic Check List-Civilian Version (PCL-C).  Military preparedness was measured by aggregate of five items (including training prior and during deployment and physical, emotional and adjustment to civilian life support) and combat exposure) was measured by aggregate of four items (including participating in combat patrols, being under enemy fire, percentage of unit killed/missing/wounded/missing in action and being in imminent danger)from Combat Exposure Scale (CES).

Results: The average score of the development of symptoms of PTSD as measure by the PCL was 45.01 with a range from 16-81. The prevalence of subjects with a PCL score over 50, average cutoff for PTSD diagnosis was 42%. Both combat exposure (β =.32, p < .001) and military preparedness (β = -.36, p < .05) exhibit approximately equally strong, but oppositely signed relationships to the development of symptoms of PTSD. Only one deployment was a statistically significant predictor of the development of symptoms of PTSD (β = -.13, p < .05). Veterans with greater combat exposure, lower levels of military preparedness and only one deployment report higher levels of the development of symptoms of PTSD (R²= .23 (2,374), p < .001).  

Conclusions & Implications: Veterans with higher levels of combat exposure, lower levels of military preparedness and only deployment report greater levels of the development of symptoms of PTSD. Both military preparedness and combat exposure are predictive of the development of symptoms of PTSD but are separate mechanisms. Support of adjustment to civilian lifewas the most predictive military preparedness item and being under imminent danger was the most predictive combat exposure item in the development of symptoms of PTSD. Improved and targeted social work intervention during civilian transition of veterans may decrease the rate of PTSD and thereby improve the quality of life for veterans and their families and lower cost to the United States government.