目的:在过去的50年中,兵役发生了重大变化。大多数关于战斗退伍军人的创伤后应激障碍(PTSD)的研究来自寻求帮助的越南和第二次世界大战的队列;最近的队列比较的结果喜忧参半。本研究通过探索越南之间的队列差异来解决这些差距,波斯湾,从生命历程的角度来看,9/11后的战斗退伍军人。
方法:我们招募了居住在社区的战斗和战区退伍军人(N=167),主要来自俄勒冈州的退伍军人协会,来自三个队列:越南,波斯湾,911后。在线调查评估了当前的PTSD症状,生命历程(人口统计和队列成员),和经验变量(战斗严重性,兵役评估,返校节,和社会支持)。
结果:队列在人口统计和战争经历方面具有可比性。分层回归的第一步发现,有色人种退伍军人和低收入人群的PTSD症状较高,R2=0.37,p<.001。当添加队列时,越南退伍军人的症状高于9/11后;收入和种族/民族仍然很重要,ΔR2=0.01,p=.13。最终模型增加了经验变量,ΔR2=0.38,p<.001;队列和收入不再显著,虽然退伍军人的颜色仍然报告更高的症状。那些有更多不良服务评估和寻求社会支持的人有更高的症状,而理想的评估是保护性的。
结论:从生命历程的角度来看,退伍军人服务的特定战区不如人口统计学以及服务和服役后的经历重要,提示风险和保护因素的普遍性,以及治疗方式,跨队列。
There have been major changes in military service over the past 50 years. Most research on posttraumatic stress disorder (PTSD) among combat Veterans comes from help-seeking Vietnam and WWII cohorts; results from more recent cohort comparisons are mixed. The present study addressed these gaps by exploring cohort differences among Vietnam, Persian Gulf, and Post-9/11 combat Veterans from a life course perspective.
We recruited community-dwelling combat and war zone Veterans (N = 167), primarily from Veterans\' associations in Oregon from three cohorts: Vietnam, Persian Gulf, and Post-911. Online surveys assessed current PTSD symptoms, life course (demographics and cohort membership), and experiential variables (combat severity, appraisals of military service, homecoming, and social support).
Cohorts were comparable in demographics and war experiences. Step one of a hierarchical regression found that PTSD symptoms were higher among Veterans of color and those with lower incomes, R2 = 0.37, p < .001. When cohort was added, Vietnam Veterans had higher symptoms than Post-9/11; income and race/ethnicity remained significant, ΔR2 = 0.01, p = .13. The final model added experiential variables, ΔR2 = 0.38, p < .001; cohort and income were no longer significant, although Veterans of color still reported higher symptoms. Those with more undesirable service appraisals and who sought social support had higher symptoms, while desirable appraisals were protective.
From a life course perspective, the particular war zone that Veterans served in was less important than demographics and both service and postservice experiences, suggesting generalizability of risk and protective factors, as well as treatment modalities, across cohorts.