0273 Residual Sleep Difficulties During Reset Operations Predict Greater Post-Deployment Mental Health Difficulties in U.S. Soldiers: A Cross-Lagged Analysis

Introduction Military service is associated with a number of occupational stressors, including non-conducive sleeping environments, shift schedules, and extended deployments overseas. Service members who undergo combat deployments are at increased risk for mental health and sleep difficulties. Bidirectional associations between sleep and mental health difficulties are routinely observed, but the directional association of these difficulties from one deployment to the next has not been addressed. The purpose of this study was to examine whether residual sleep problems or mental health difficulties after a 12-month period of reset operations following an initial deployment were associated with changes in sleep and mental health following a subsequent deployment. Methods Data from 74 U.S. Soldiers were case-matched across three time points. Participants were assessed 6 months (T1) and 12 months (T2) following an initial deployment. Participants were then assessed 3 months (T3) following a subsequent deployment. Symptoms of PTSD, anxiety, depression, and sleep difficulties were assessed at all three time points. Results Cross-lagged hierarchical regression models revealed that residual sleep difficulties across the time points uniquely predicted later changes in PTSD and anxiety symptoms, but not depressive symptoms, following a subsequent deployment. Conversely, residual mental health difficulties were not unique predictors of later changes in sleep difficulties. Conclusion These findings suggest that higher levels of residual sleep difficulties 12 months following a prior deployment are associated with larger increases in mental health problems following a subsequent deployment. Moreover, and importantly, the converse association was not supported. Residual mental health difficulties prior to deployment were not associated with changes in sleep difficulties. These data provide a viable target for intervention during reset operations to mitigate mental health difficulties associated with combat deployments. They might also help inform return-to-duty decisions. Support N/A.

Correlates of Depression in U.S. Military Service Members With a History of Mild Traumatic Brain Injury

ObjectivesPost-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) are identified as signature injuries of the Wars in Iraq and Afghanistan. Statistics have confirmed a high incidence of PTSD among military personnel with mild TBI (mTBI) who served in these conflicts. Although receiving less attention, individuals with a history of mTBI are also at increased risk for depressive disorders. This study examines the incidence and correlates of depression in service members with a history of mTBI received an average of 4–1/2 years prior to evaluation.MethodsRetrospective analysis of 184 service members with a history of mTBI extracted from a data repository maintained at a military medical center.ResultsOne-third of the sample (34.2%) was clinically diagnosed with a depressive disorder in the month preceding evaluation. Of those with depression, 81% (51 of 63) were also diagnosed with PTSD. Proportionately more women than men had depression. Depression was more common among those who were undergoing a Military Evaluation Board and those who served in more than three combat deployments.ConclusionsResults confirm chronically elevated the rates of depressive disorders and PTSD comorbidity among service members with a history of mTBI. Depression screening and treatment within the Military Health System should remain a priority for service members reporting a remote history of mTBI. Individuals with chronic PTSD, women, service members undergoing MEB and those who served in greater than three combat deployments are at particular risk.

Gender and Deployment Effects on Pro-Organizational Behaviors of U.S. Soldiers

This study examines whether gender moderates the relationships between deployment and both organizational identification and pro-organizational behaviors. The broader context motivating this study is the U.S. military’s 2016 rescission of the ground combat exclusion, accomplishing full gender integration in the armed forces. Structural equation modeling is used to test for gender moderation effects. Results reveal deployment frequency, but not current deployment, has small effects on several pro-organizational behaviors. Results also show that gender does not moderate the effects of deployment frequency on soldiers’ perceptions of the organization or economic or social satisfaction. Gender does moderate the effects of deployment frequency on soldiers’ identification with the army. Additionally, while gender was not found to moderate the relationship between combat deployments and overall pro-organizational behaviors among soldiers, it does moderate the effect of deployments on one pro-organizational item: sacrificing behavior. Implications are discussed with an eye toward full gender inclusion in the U.S. military.

Acupuncture

People who acquire posttraumatic stress disorder (PTSD) after experiencing a traumatic event endure a constellation of debilitating symptoms, including intrusion, avoidance, negative mood alteration, and marked increases in reactivity. They have difficulty falling or staying asleep, and often have comorbid physical and pain-related diagnoses secondary to their trauma. Despite evolving definitions and measures, estimates of prevalence of lifetime PTSD in U.S. population have remained quite consistent since the advent of theDiagnostic and Statistical Manual of Mental Disorders(DSM), third edition, revised (III-R). In civilian populations, lifetime DSM-III-R PTSD prevalence rates of 9.2%; DSM, fourth edition, PTSD prevalence rates of 6.8%; and DSM, fifth edition, PTSD estimate rates of 5.4% have been reported. In U.S. military populations, prevalence rates as high as 17% after combat deployments have been reported. Importantly, persons with PTSD experience higher prevalence of other psychiatric and physical comorbid conditions, including mood, substance use, and pain disorders.