Modern model of formation for post-stress disorders among military service members and veterans

Abstract

The clinical phenomenology of post-stress disorders was studied in combatants. We observed 150 servicemen of the Armed Forces of Ukraine, who took a direct part in the fighting in the ATO zone, in accordance with the principles of bioethics and deontology on the basis of the National Military Medical Clinical Center «Main Military Clinical Hospital» and the Military Medical Center of the Northern Region. It is shown, that the clinical structure of post-stress disorders in combatants is represented by posttraumatic stress disorder (PTSD), acute stress response and adjustment disorders. The clinical structure of PTSD in combatants is represented by anxious (35.2 % of men and 44.2 % of women), dysphoric (33.5 % and 9.4 %), asthenic (25.4 % and 32.6 %) and somatoform (5.9 % and 13.8 %) syndrome complexes. Adjustment disorders included prolonged depressive reaction (10.1 % of men and 15.7 % of women), mixed anxiety-depressive reaction (16.5 % and 10.2 %), adjustment disorders with a predominance of disturbances of other emotions (9.8 % and 7.4 %). The major risk factors for the development of stress-related disorders in combatants were identified: prolonged participation in combat, the need to see and touch the bodies of the dead, the threat of death from sniper’s fire, the death of friends in their own eyes, the impact of harmful combat factors, family conflicts, adverse social and economic circumstances. The correlation analysis was carried out. It was found, that the severity of psychopathological symptoms is determined by the severity of combat mental trauma. High scores on the Mississippi scale are associated with prolonged mental trauma (rxy=0.64), threat of death (rxy=0.58), death of comrades (rxy=0.54), participation in close combat (rxy=0.50), the offensive (rxy=0.41), the need to touch the bodies of the dead (rxy=0.46), with the killing of opponents (rxy=0.45). There is a strong correlation of combat mental trauma with anxiety intensity (rxy=0.78), fear (rxy=0.71), sense of internal tension (rxy=0.70), disturbance of the sleep-wake cycle (rxy=0.70), incontinence of affect (rxy=0.69) and depression (rxy=0.66). Keywords: post-traumatic stress disorder, adjustment disorders, acute stress response, combat mental trauma, correlation analysis.