The Roles of Combat Exposure, Personal Vulnerability, and Involvement in Harm to Civilians or Prisoners in War-Related Post-Traumatic Stress Disorder

2018 ◽  
pp. 141-160
Author(s):  
Bruce P. Dohrenwend ◽  
Thomas J. Yager ◽  
Melanie M. Wall ◽  
Ben G. Adams
Keyword(s):  
Risk Factors ◽  
Traumatic Stress ◽  
Combat Exposure ◽  
Post Traumatic Stress ◽  
Independent Contribution ◽  
Post Traumatic ◽  
Dsm Iv ◽  
Personal Vulnerability ◽  
Traumatic Stressors

This chapter examines the central assumption in the DSM-III, DSM-III-R, and DSM-IV that potentially traumatic stressors are more important than personal vulnerability in causing PTSD. This chapter tests this assumption with data from a rigorously diagnosed male subsample (n = 260) from the NVVRS. It concludes that, of the three risk factors, only combat exposure proved necessary for disorder onset. Although none of the three risk factors proved sufficient, estimated onset reached 97% for veterans high on all three, with harm to civilians or prisoners showing the largest independent contribution. Severity of combat exposure proved more important than pre-war vulnerability in onset; pre-war vulnerability was as least as important in long-term persistence. Implications for the primacy of the stressor assumption are discussed.

scholarly journals Women's experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: a retrospective study

BMJ Open ◽  
2013 ◽  
Vol 3 (10) ◽  
pp. e003323 ◽  
Author(s):  
Ida Kathrine Gravensteen ◽  
Linda Björk Helgadóttir ◽  
Eva-Marie Jacobsen ◽  
Ingela Rådestad ◽  
Per Morten Sandset ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Traumatic Stress ◽  
Post Traumatic Stress ◽  
Women’S Experiences ◽  
Women's Experiences ◽  
Stress Symptoms ◽  
Post Traumatic

scholarly journals Risk factors of post-traumatic stress disorder 10 years after Wenchuan earthquake: a population-based case–control study

2021 ◽  
Vol 30 ◽  
Author(s):  
Bingqing Lu ◽  
Wenqi Zeng ◽  
Zhuyue Li ◽  
Jin Wen
Keyword(s):  
Risk Factors ◽  
Wenchuan Earthquake ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
The Wenchuan Earthquake ◽  
Post Traumatic ◽  
Control Study

Abstract Aims To investigate the prevalence of post-traumatic stress disorder (PTSD) symptoms in the hard-hit areas 10 years after the Wenchuan earthquake, and explore the risk factors of long-term PTSD among Wenchuan earthquake survivors. Methods A matched case–control study was conducted. The involving participants were from the hard-hit areas 10 years after the Wenchuan earthquake. The collected information includes demographic characteristics, socioeconomic status, behaviour habits, earthquake exposure, perceived social support, physical health and mental health. Mental health status was measured using the PTSD Checklist-Civilian Version (PCL-C). Respondents with PCL-C score ⩾38 were classified as cases, and then the cases and controls were matched based on age (±3 years) and community location according to a ratio of 1:3. Results We obtained 86 cases and 258 controls. After controlling for confounding factors, it was found that lower income (OR 2.42; 95% CI 1.16–5.03), chronic diseases (OR 3.00; 95% CI 1.31–6.88) and death of immediate families in the earthquake (OR 7.30; 95% CI 2.36–22.57) were significantly associated with long-term PTSD symptoms. Conclusion Even 10 years after the Wenchuan earthquake, the survivors in the hard-hit areas still suffered from severe mental trauma. Low income, chronic diseases and death of immediate families in the earthquakes are significantly associated with long-term PTSD symptoms. Interventions by local governments and health institutions to address these risk factors should be undertaken to promote the health of survivors.

scholarly journals Long covid—mechanisms, risk factors, and management

BMJ ◽  
2021 ◽  
pp. n1648
Author(s):  
Harry Crook ◽  
Sanara Raza ◽  
Joseph Nowell ◽  
Megan Young ◽  
Paul Edison
Keyword(s):  
Risk Factors ◽  
Traumatic Stress ◽  
Sleep Disturbances ◽  
Long Term Effects ◽  
Post Traumatic Stress ◽  
Persistent Symptoms ◽  
Multiple Organs ◽  
Post Traumatic ◽  
Musculoskeletal Systems

Abstract Since its emergence in Wuhan, China, covid-19 has spread and had a profound effect on the lives and health of people around the globe. As of 4 July 2021, more than 183 million confirmed cases of covid-19 had been recorded worldwide, and 3.97 million deaths. Recent evidence has shown that a range of persistent symptoms can remain long after the acute SARS-CoV-2 infection, and this condition is now coined long covid by recognized research institutes. Studies have shown that long covid can affect the whole spectrum of people with covid-19, from those with very mild acute disease to the most severe forms. Like acute covid-19, long covid can involve multiple organs and can affect many systems including, but not limited to, the respiratory, cardiovascular, neurological, gastrointestinal, and musculoskeletal systems. The symptoms of long covid include fatigue, dyspnea, cardiac abnormalities, cognitive impairment, sleep disturbances, symptoms of post-traumatic stress disorder, muscle pain, concentration problems, and headache. This review summarizes studies of the long term effects of covid-19 in hospitalized and non-hospitalized patients and describes the persistent symptoms they endure. Risk factors for acute covid-19 and long covid and possible therapeutic options are also discussed.

scholarly journals Violent behaviour and post-traumatic stress disorder in US Iraq and Afghanistan veterans

2014 ◽  
Vol 204 (5) ◽  
pp. 368-375 ◽  
Author(s):  
Eric B. Elbogen ◽  
Sally C. Johnson ◽  
H. Ryan Wagner ◽  
Connor Sullivan ◽  
Casey T. Taft ◽  
...  
Keyword(s):  
Risk Factors ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Physical Aggression ◽  
Alcohol Misuse ◽  
Stress Disorder ◽  
Combat Exposure ◽  
Post Traumatic Stress ◽  
Violent Behaviour ◽  
Post Traumatic

BackgroundViolence towards others in the community has been identified as a significant problem for a subset of Iraq and Afghanistan veterans.AimsTo investigate the extent to which post-traumatic stress disorder (PTSD) and other risk factors predict future violent behaviour in military veterans.MethodA national, multiwave survey enrolling a random sample of all US veterans who served in the military after 11 September 2001 was conducted. A total of 1090 veterans from 50 US states and all military branches completed two survey waves mailed 1 year apart (retention rate = 79%).ResultsOverall, 9% endorsed engaging in severe violence and 26% in other physical aggression in the previous year, as measured at Wave 2. Younger age, financial instability, history of violence before military service, higher combat exposure, PTSD, and alcohol misuse at Wave 1 were significantly associated with higher severe violence and other physical aggression in the past year at Wave 2. When combinations of these risk factors were present, predicted probability of violence in veterans rose sharply. Veterans with both PTSD and alcohol misuse had a substantially higher rate of subsequent severe violence (35.9%) compared with veterans with alcohol misuse without PTSD (10.6%), PTSD without alcohol misuse (10.0%) or neither PTSD nor alcohol misuse (5.3%). Using multiple regression, we found that veterans with PTSD and without alcohol misuse were not at significantly higher risk of severe violence than veterans with neither PTSD nor alcohol misuse. There was a trend for other physical aggression to be higher in veterans with PTSD without alcohol misuse.ConclusionsCo-occurring PTSD and alcohol misuse was associated with a marked increase in violence and aggression in veterans. Compared with veterans with neither PTSD nor alcohol misuse, veterans with PTSD and no alcohol misuse were not significantly more likely to be severely violent and were only marginally more likely to engage in other physical aggression. Attention to cumulative effects of multiple risk factors beyond diagnosis – including demographics, violence history, combat exposure, and veterans' having money to cover basic needs like food, shelter, transportation, and medical care – is crucial for optimising violence risk management.

scholarly journals DSM-IV post-traumatic stress disorder among World Trade Center responders 11–13 years after the disaster of 11 September 2001 (9/11)

2015 ◽  
Vol 46 (4) ◽  
pp. 771-783 ◽  
Author(s):  
E. J. Bromet ◽  
M. J. Hobbs ◽  
S. A. P. Clouston ◽  
A. Gonzalez ◽  
R. Kotov ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
World Trade ◽  
World Trade Center ◽  
Well Being ◽  
Post Traumatic Stress ◽  
Trade Center ◽  
Post Traumatic ◽  
Dsm Iv

BackgroundPost-traumatic symptomatology is one of the signature effects of the pernicious exposures endured by responders to the World Trade Center (WTC) disaster of 11 September 2001 (9/11), but the long-term extent of diagnosed Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) and its impact on quality of life are unknown. This study examines the extent of DSM-IV PTSD 11–13 years after the disaster in WTC responders, its symptom profiles and trajectories, and associations of active, remitted and partial PTSD with exposures, physical health and psychosocial well-being.MethodMaster's-level psychologists administered sections of the Structured Clinical Interview for DSM-IV and the Range of Impaired Functioning Tool to 3231 responders monitored at the Stony Brook University World Trade Center Health Program. The PTSD Checklist (PCL) and current medical symptoms were obtained at each visit.ResultsIn all, 9.7% had current, 7.9% remitted, and 5.9% partial WTC-PTSD. Among those with active PTSD, avoidance and hyperarousal symptoms were most commonly, and flashbacks least commonly, reported. Trajectories of symptom severity across monitoring visits showed a modestly increasing slope for active and decelerating slope for remitted PTSD. WTC exposures, especially death and human remains, were strongly associated with PTSD. After adjusting for exposure and critical risk factors, including hazardous drinking and co-morbid depression, PTSD was strongly associated with health and well-being, especially dissatisfaction with life.ConclusionsThis is the first study to demonstrate the extent and correlates of long-term DSM-IV PTSD among responders. Although most proved resilient, there remains a sizable subgroup in need of continued treatment in the second decade after 9/11.

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