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.
Highlights
Posttraumatic stress disorder (PTSD) among military personnel and veterans has been studied for more than 30 years, PTSD may develop after an individual experiences or witnesses a traumatic event, such as combat, a natural disaster, or a violent personal assault [1]
We examined risk factors for combat-related PTSD in military personnel based on the odds ratios (ORs) and 95% confidence intervals (CIs) reported in each study
Twenty-one (65.6%) articles in our meta-analysis looked at military personnel and veterans who were deployed to Afghanistan or/and Iraq after the year 2000; 11 (34.4%) articles focused on persons deployed to other areas (e.g., Rwanda, Bosnia, Vietnam, Gulf) before the year 2000
Summary
Posttraumatic stress disorder (PTSD) among military personnel and veterans has been studied for more than 30 years, PTSD may develop after an individual experiences or witnesses a traumatic event, such as combat, a natural disaster, or a violent personal assault [1]. PTSD is often been studied among military personnel in relation to combat trauma [2,3,4,5]. Researchers have proposed many theories to explain the development of PTSD, including biological theories, and psychological theories. The current research on the biological theory of PTSD aims to better understand the risk factor and related neurobiological mechanisms related to the illness. Neurobiological research has indicated that PTSD has distinct mechanisms that are different from the general stress response and other mental illnesses. Wong et al reported that changes in immunology may be involved in the occurrence and maintain of PTSD [17]
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