IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0120270.html
   My bibliography  Save this article

A Meta-Analysis of Risk Factors for Combat-Related PTSD among Military Personnel and Veterans

Author

Listed:
  • Chen Xue
  • Yang Ge
  • Bihan Tang
  • Yuan Liu
  • Peng Kang
  • Meng Wang
  • Lulu Zhang

Abstract

Post-traumatic stress disorder (PTSD), a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) were used to search for observational studies (cross-sectional, retrospective, and cohort studies) about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility to PTSD.

Suggested Citation

  • Chen Xue & Yang Ge & Bihan Tang & Yuan Liu & Peng Kang & Meng Wang & Lulu Zhang, 2015. "A Meta-Analysis of Risk Factors for Combat-Related PTSD among Military Personnel and Veterans," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-21, March.
    • Handle: RePEc:plo:pone00:0120270
    DOI: 10.1371/journal.pone.0120270
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0120270
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0120270&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0120270?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. MacGregor, A.J. & Han, P.P. & Dougherty, A.L. & Galarneau, M.R., 2012. "Effect of dwell time on the mental health of US military personnel with multiple combat tours," American Journal of Public Health, American Public Health Association, vol. 102(S1), pages 55-59.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    3. Mareike Hofmann & Birgit Köhler & Falk Leichsenring & Johannes Kruse, 2013. "Depression as a Risk Factor for Mortality in Individuals with Diabetes: A Meta-Analysis of Prospective Studies," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-7, November.
    4. Fontana, A. & Schwartz, L.S. & Rosenheck, R., 1997. "Posttraumatic stress disorder among female Vietnam veterans: A causal model of etiology," American Journal of Public Health, American Public Health Association, vol. 87(2), pages 169-175.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Gabriela Petereit-Haack & Ulrich Bolm-Audorff & Karla Romero Starke & Andreas Seidler, 2020. "Occupational Risk for Post-Traumatic Stress Disorder and Trauma-Related Depression: A Systematic Review with Meta-Analysis," IJERPH, MDPI, vol. 17(24), pages 1-21, December.
    2. Lubens, Pauline & Silver, Roxane Cohen, 2019. "U.S. combat veterans’ responses to suicide and combat deaths: A mixed-methods study," Social Science & Medicine, Elsevier, vol. 236(C), pages 1-1.
    3. Stanisław Fel & Krzysztof Jurek & Katarzyna Lenart-Kłoś, 2022. "Relationship between Socio-Demographic Factors and Posttraumatic Stress Disorder: A Cross Sectional Study among Civilian Participants’ Hostilities in Ukraine," IJERPH, MDPI, vol. 19(5), pages 1-13, February.
    4. Gloria Obuobi-Donkor & Folajinmi Oluwasina & Nnamdi Nkire & Vincent I.O. Agyapong, 2022. "A Scoping Review on the Prevalence and Determinants of Post-Traumatic Stress Disorder among Military Personnel and Firefighters: Implications for Public Policy and Practice," IJERPH, MDPI, vol. 19(3), pages 1-19, January.
    5. Ana Vianez & António Marques & Raquel Simões de Almeida, 2022. "Virtual Reality Exposure Therapy for Armed Forces Veterans with Post-Traumatic Stress Disorder: A Systematic Review and Focus Group," IJERPH, MDPI, vol. 19(1), pages 1-16, January.
    6. Bäckström, Peter, 2023. "Empirical Essays on Military Service and the Labour Market," Umeå Economic Studies 1012, Umeå University, Department of Economics.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. İlkay Unay-Gailhard & Mark A. Brennen, 2022. "How digital communications contribute to shaping the career paths of youth: a review study focused on farming as a career option," Agriculture and Human Values, Springer;The Agriculture, Food, & Human Values Society (AFHVS), vol. 39(4), pages 1491-1508, December.
    2. Mahin Ghafari & Vali Baigi & Zahra Cheraghi & Amin Doosti-Irani, 2016. "The Prevalence of Asymptomatic Bacteriuria in Iranian Pregnant Women: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-10, June.
    3. Elizabeth T Cafiero-Fonseca & Andrew Stawasz & Sydney T Johnson & Reiko Sato & David E Bloom, 2017. "The full benefits of adult pneumococcal vaccination: A systematic review," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-23, October.
    4. Santos Urbina & Sofía Villatoro & Jesús Salinas, 2021. "Self-Regulated Learning and Technology-Enhanced Learning Environments in Higher Education: A Scoping Review," Sustainability, MDPI, vol. 13(13), pages 1-12, June.
    5. Oded Berger-Tal & Alison L Greggor & Biljana Macura & Carrie Ann Adams & Arden Blumenthal & Amos Bouskila & Ulrika Candolin & Carolina Doran & Esteban Fernández-Juricic & Kiyoko M Gotanda & Catherine , 2019. "Systematic reviews and maps as tools for applying behavioral ecology to management and policy," Behavioral Ecology, International Society for Behavioral Ecology, vol. 30(1), pages 1-8.
    6. Nadine Desrochers & Adèle Paul‐Hus & Jen Pecoskie, 2017. "Five decades of gratitude: A meta‐synthesis of acknowledgments research," Journal of the Association for Information Science & Technology, Association for Information Science & Technology, vol. 68(12), pages 2821-2833, December.
    7. Alene Sze Jing Yong & Yi Heng Lim & Mark Wing Loong Cheong & Ednin Hamzah & Siew Li Teoh, 2022. "Willingness-to-pay for cancer treatment and outcome: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(6), pages 1037-1057, August.
    8. Xue-Ying Xu & Hong Kong & Rui-Xiang Song & Yu-Han Zhai & Xiao-Fei Wu & Wen-Si Ai & Hong-Bo Liu, 2014. "The Effectiveness of Noninvasive Biomarkers to Predict Hepatitis B-Related Significant Fibrosis and Cirrhosis: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-16, June.
    9. Vicente Miñana-Signes & Manuel Monfort-Pañego & Javier Valiente, 2021. "Teaching Back Health in the School Setting: A Systematic Review of Randomized Controlled Trials," IJERPH, MDPI, vol. 18(3), pages 1-18, January.
    10. Agnieszka A. Tubis & Katarzyna Grzybowska, 2022. "In Search of Industry 4.0 and Logistics 4.0 in Small-Medium Enterprises—A State of the Art Review," Energies, MDPI, vol. 15(22), pages 1-26, November.
    11. Obsa Urgessa Ayana & Jima Degaga, 2022. "Effects of rural electrification on household welfare: a meta-regression analysis," International Review of Economics, Springer;Happiness Economics and Interpersonal Relations (HEIRS), vol. 69(2), pages 209-261, June.
    12. Caloffi, Annalisa & Colovic, Ana & Rizzoli, Valentina & Rossi, Federica, 2023. "Innovation intermediaries' types and functions: A computational analysis of the literature," Technological Forecasting and Social Change, Elsevier, vol. 189(C).
    13. García-Poole, Chloe & Byrne, Sonia & Rodrigo, María José, 2019. "How do communities intervene with adolescents at psychosocial risk? A systematic review of positive development programs," Children and Youth Services Review, Elsevier, vol. 99(C), pages 194-209.
    14. Jie Zhao & Ji Chen & Damien Beillouin & Hans Lambers & Yadong Yang & Pete Smith & Zhaohai Zeng & Jørgen E. Olesen & Huadong Zang, 2022. "Global systematic review with meta-analysis reveals yield advantage of legume-based rotations and its drivers," Nature Communications, Nature, vol. 13(1), pages 1-9, December.
    15. Qing Ye & Bao-Xin Qian & Wei-Li Yin & Feng-Mei Wang & Tao Han, 2016. "Association between the HFE C282Y, H63D Polymorphisms and the Risks of Non-Alcoholic Fatty Liver Disease, Liver Cirrhosis and Hepatocellular Carcinoma: An Updated Systematic Review and Meta-Analysis o," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-17, September.
    16. Bishal Mohindru & David Turner & Tracey Sach & Diana Bilton & Siobhan Carr & Olga Archangelidi & Arjun Bhadhuri & Jennifer A. Whitty, 2020. "Health State Utility Data in Cystic Fibrosis: A Systematic Review," PharmacoEconomics - Open, Springer, vol. 4(1), pages 13-25, March.
    17. Subramaniam, Mega & Pang, Natalie & Morehouse, Shandra & Asgarali-Hoffman, S. Nisa, 2020. "Examining vulnerability in youth digital information practices scholarship: What are we missing or exhausting?," Children and Youth Services Review, Elsevier, vol. 116(C).
    18. Neal R. Haddaway & Matthew J. Page & Chris C. Pritchard & Luke A. McGuinness, 2022. "PRISMA2020: An R package and Shiny app for producing PRISMA 2020‐compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis," Campbell Systematic Reviews, John Wiley & Sons, vol. 18(2), June.
    19. Ding Zhu & Mindan Wu & Yuan Cao & Shihua Lin & Nanxia Xuan & Chen Zhu & Wen Li & Huahao Shen, 2018. "Heated humidification did not improve compliance of positive airway pressure and subjective daytime sleepiness in obstructive sleep apnea syndrome: A meta-analysis," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-16, December.
    20. Pelai, Ricardo & Hagerman, Shannon M. & Kozak, Robert, 2020. "Biotechnologies in agriculture and forestry: Governance insights from a comparative systematic review of barriers and recommendations," Forest Policy and Economics, Elsevier, vol. 117(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0120270. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.