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A Meta-Analysis of Risk Factors for Combat-Related PTSD among Military Personnel and Veterans

Author

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  • Chen Xue
  • Yang Ge
  • Bihan Tang
  • Yuan Liu
  • Peng Kang
  • Meng Wang
  • Lulu Zhang

Abstract

Post-traumatic stress disorder (PTSD), a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) were used to search for observational studies (cross-sectional, retrospective, and cohort studies) about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility to PTSD.

Suggested Citation

  • Chen Xue & Yang Ge & Bihan Tang & Yuan Liu & Peng Kang & Meng Wang & Lulu Zhang, 2015. "A Meta-Analysis of Risk Factors for Combat-Related PTSD among Military Personnel and Veterans," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-21, March.
    • Handle: RePEc:plo:pone00:0120270
    DOI: 10.1371/journal.pone.0120270
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    References listed on IDEAS

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    1. MacGregor, A.J. & Han, P.P. & Dougherty, A.L. & Galarneau, M.R., 2012. "Effect of dwell time on the mental health of US military personnel with multiple combat tours," American Journal of Public Health, American Public Health Association, vol. 102(S1), pages 55-59.
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    3. Mareike Hofmann & Birgit Köhler & Falk Leichsenring & Johannes Kruse, 2013. "Depression as a Risk Factor for Mortality in Individuals with Diabetes: A Meta-Analysis of Prospective Studies," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-7, November.
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    1. Gabriela Petereit-Haack & Ulrich Bolm-Audorff & Karla Romero Starke & Andreas Seidler, 2020. "Occupational Risk for Post-Traumatic Stress Disorder and Trauma-Related Depression: A Systematic Review with Meta-Analysis," IJERPH, MDPI, vol. 17(24), pages 1-21, December.
    2. Stanisław Fel & Krzysztof Jurek & Katarzyna Lenart-Kłoś, 2022. "Relationship between Socio-Demographic Factors and Posttraumatic Stress Disorder: A Cross Sectional Study among Civilian Participants’ Hostilities in Ukraine," IJERPH, MDPI, vol. 19(5), pages 1-13, February.
    3. Bäckström, Peter, 2023. "Empirical Essays on Military Service and the Labour Market," Umeå Economic Studies 1012, Umeå University, Department of Economics.
    4. Lubens, Pauline & Silver, Roxane Cohen, 2019. "U.S. combat veterans’ responses to suicide and combat deaths: A mixed-methods study," Social Science & Medicine, Elsevier, vol. 236(C), pages 1-1.
    5. Gloria Obuobi-Donkor & Folajinmi Oluwasina & Nnamdi Nkire & Vincent I.O. Agyapong, 2022. "A Scoping Review on the Prevalence and Determinants of Post-Traumatic Stress Disorder among Military Personnel and Firefighters: Implications for Public Policy and Practice," IJERPH, MDPI, vol. 19(3), pages 1-19, January.
    6. Ana Vianez & António Marques & Raquel Simões de Almeida, 2022. "Virtual Reality Exposure Therapy for Armed Forces Veterans with Post-Traumatic Stress Disorder: A Systematic Review and Focus Group," IJERPH, MDPI, vol. 19(1), pages 1-16, January.

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