Indirect associations of combat exposure with post-deployment physical symptoms in U.S. soldiers: roles of post-traumatic stress disorder, depression and insomnia.
Publication Status: Published
Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
Sponsoring Office: Walter Reed National Military Medical Center
Congressionally Mandated: No
Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
Release Date/Publication: May 01, 2015
Principle Investigator Status: Government
Primary DoD Data Source: Other Survey
Secondary DoD Data Source:
Abstract
OBJECTIVE:
To characterize the indirect associations of combat exposure with post-deployment physical symptoms through shared associations with post-traumatic stress disorder (PTSD), depression and insomnia symptoms.
METHODS:
Surveys were administered to a sample of U.S. soldiers (N = 587) three months after a 15-month deployment to Iraq. A multiple indirect effects model was used to characterize direct and indirect associations between combat exposure and physical symptoms.
RESULTS:
Despite a zero-order correlation between combat exposure and physical symptoms, the multiple indirect effects analysis did not provide evidence of a direct association between these variables. Evidence for a significant indirect association of combat exposure and physical symptoms was observed through PTSD, depression, and insomnia symptoms. In fact, 92% of the total effect of combat exposure on physical symptoms scores was indirect. These findings were evident even after adjusting for the physical injury and relevant demographics.
CONCLUSION:
This is the first empirical study to suggest that PTSD, depression and insomnia collectively and independently contribute to the association between combat exposure and post-deployment physical symptoms. Limitations, future research directions, and potential policy implications are discussed.
Citation:
Quartana PJ, Wilk JE, Balkin TJ, Hoge CW. Indirect associations of combat exposure with post-deployment physical symptoms in U.S. soldiers: roles of post-traumatic stress disorder, depression and insomnia. J Psychosom Res. 2015 May;78(5):478-83.