TY - JOUR
T1 - The evolution of PTSD symptoms in serving and ex-serving personnel of the UK armed forces from 2004 to 16: A longitudinal examination
AU - Palmer, Laura
AU - Norton, Sam
AU - Rona, Roberto
AU - Fear, Nicola
AU - Stevelink, Sharon
N1 - Funding Information:
The KCMHR cohort study was funded by the UK Ministry of Defence (MoD) and secondary data analyses was funded by the UK military charity Forces in Mind Trust (FiMT; grant number FiMT18/0420KCL ) via a £35 million funding scheme run by the FiMT using an endowment awarded by The National Lottery Community Fund.
Funding Information:
This paper represents research conducted independently to the MoD and FiMT. Views expressed are those of the authors and not necessarily of the funding bodies. NTF is funded by a grant from the UK MoD and is a trustee of a charity supporting the wellbeing of service personnel and veterans. SAMS is supported by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and the National Institute for Health Research , NIHR Advanced Fellowship, NIHR300592 .
Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Whilst most military personnel do not develop Post-Traumatic Stress Disorder (PTSD), ex-serving personnel exhibit higher levels compared to those in service. The heterogeneity of symptom development for serving and ex-serving personnel has not yet been examined in the UK Armed Forces (UK AF). Latent class growth modelling was employed to estimate the trajectories of PTSD symptoms from three waves of data from the PTSD Checklist (PCL-C) from a UK AF sample (N = 7357). Regression mixture models were conducted to investigate covariates of class membership. Five trajectory classes were identified. Most of the sample reported no-low symptoms (71.3%). Of those reporting probable PTSD during the 12 year-period, 4.6% showed improvements, 4.9% worsened, and 1.8% displayed chronic symptoms. A class with subthreshold elevated symptoms (18.2%) was also identified. Trajectories of serving and ex-serving personnel did not differ, but more ex-serving personnel were symptomatic and those with chronic symptoms worsened over time. Chronic disorder was associated with lower rank, experiencing violent combat, and proximity to wounding/death on deployment. Worsening symptoms were associated with childhood stress/violence, lower rank, not being in a relationship, inconsistent post-deployment social support, proximity to wounding/death, and voluntary, or medical discharge. The present study found most UKAF personnel did not report PTSD symptoms between 2004 and 16 but, among those experiencing probable PTSD, more participants reported deteriorating/persistent symptoms than who improved. PTSD-onset was related to adversities across childhood and deployment, and lack of social support. Findings underscore the importance of addressing the through-life contributors of PTSD in order to prevent ingrained disorder.
AB - Whilst most military personnel do not develop Post-Traumatic Stress Disorder (PTSD), ex-serving personnel exhibit higher levels compared to those in service. The heterogeneity of symptom development for serving and ex-serving personnel has not yet been examined in the UK Armed Forces (UK AF). Latent class growth modelling was employed to estimate the trajectories of PTSD symptoms from three waves of data from the PTSD Checklist (PCL-C) from a UK AF sample (N = 7357). Regression mixture models were conducted to investigate covariates of class membership. Five trajectory classes were identified. Most of the sample reported no-low symptoms (71.3%). Of those reporting probable PTSD during the 12 year-period, 4.6% showed improvements, 4.9% worsened, and 1.8% displayed chronic symptoms. A class with subthreshold elevated symptoms (18.2%) was also identified. Trajectories of serving and ex-serving personnel did not differ, but more ex-serving personnel were symptomatic and those with chronic symptoms worsened over time. Chronic disorder was associated with lower rank, experiencing violent combat, and proximity to wounding/death on deployment. Worsening symptoms were associated with childhood stress/violence, lower rank, not being in a relationship, inconsistent post-deployment social support, proximity to wounding/death, and voluntary, or medical discharge. The present study found most UKAF personnel did not report PTSD symptoms between 2004 and 16 but, among those experiencing probable PTSD, more participants reported deteriorating/persistent symptoms than who improved. PTSD-onset was related to adversities across childhood and deployment, and lack of social support. Findings underscore the importance of addressing the through-life contributors of PTSD in order to prevent ingrained disorder.
KW - Cohort study
KW - Post-traumatic stress disorder
KW - Longitudinal data
KW - Trajectories
KW - Armed forces
KW - Military
UR - http://www.scopus.com/inward/record.url?scp=85142467918&partnerID=8YFLogxK
U2 - 10.1016/j.jpsychires.2022.11.007
DO - 10.1016/j.jpsychires.2022.11.007
M3 - Article
SN - 0022-3956
VL - 157
SP - 18
EP - 25
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
ER -