Distinct Trauma Types in Military Service Members Seeking Treatment for Posttraumatic Stress Disorder
Abstract
We examined the frequency of trauma types reported in a cohort of service members seeking treatment for posttraumatic stress disorder (PTSD) and compared symptom profiles between types. In this observational study, 999 service members (9.2% women; Mage = 32.91 years; 55.6% White) were evaluated using a standardized assessment procedure to determine eligibility for clinical trials. Participants were evaluated for DSM‐IV‐TR‐defined PTSD using the PTSD Symptom Scale–Interview; all participants reported a Criterion A event. Independent evaluators rated descriptions of Criterion A events as belonging to trauma types at a high degree of reliability, κ = 0.80. Aggregated non‐life‐threat primary trauma types were more frequently endorsed than aggregated life‐threat types, 95% CI [17.10%, 29.20%]. Participants who endorsed moral injury–self traumas had a higher level of reexperiencing (d = 0.39), guilt (hindsight bias, d = 1.06; wrongdoing, d = 0.93), and self‐blame (d = 0.58) symptoms, relative to those who reported life threat–self. Participants who experienced traumatic loss had greater reexperiencing (d = 0.39), avoidance (d = 0.22), guilt (responsibility, d = 0.39), and greater peri‐ and posttraumatic sadness (d = 0.84 and d = 0.70, respectively) symptoms, relative to those who endorsed life threat–self. Relative to life threat–self, moral injury–others was associated with greater peri‐ (d = 0.36) and posttraumatic (d = 0.33) betrayal/humiliation symptoms, and endorsement of aftermath of violence was associated with greater peri‐ (d = 0.84) and posttraumatic sadness (d = 0.57) symptoms. War zone traumas were heterogeneous, and non‐life‐threat traumas were associated with distinct symptoms and problems.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Apr 01, 2018
- Source ID
- 10.1002/jts.22276
Entities
People
- Alan L. Peterson
- Alexander H. Jordan
- Ateka A Contractor
- Brett T Litz
- Charla Rhodes
- Edna B. Foa
- For The Strong Star Consortium
- Jeffrey S. Yarvis
- Jim Mintz
- Katherine A Dondanville
- Patricia A. Resick
- Stacey Young‐mccaughan
Organizations
- Boston University
- Carl R. Darnall Army Medical Center
- Congressionally Directed Medical Research Programs
- Duke University
- University of Pennsylvania
- University of Texas at Austin
- VA Boston Healthcare System