Posttraumatic Stress Disorder in the US Veteran Population

TLDR

Protective psychosocial factors such as resilience and community integration may reduce PTSD risk among veterans. The study aimed to estimate the prevalence of lifetime and current PTSD and identify its correlates in a nationally representative sample of US veterans. Using a cross‑sectional web‑based survey of 3,157 veterans, probable lifetime PTSD was assessed with a DSM‑IV PTSD Checklist and data were weighted to reflect national representation. Lifetime PTSD prevalence was 8.0% and current 4.8%; 87% of veterans experienced at least one traumatic event, with sexual abuse carrying the highest PTSD risk, and PTSD was linked to markedly higher odds of mood, anxiety, substance use disorders, suicidal ideation, and attempts, while resilience and community integration lowered these odds.

Abstract

To describe the prevalence of posttraumatic stress disorder (PTSD) and comorbid psychiatric disorders and identify correlates of PTSD in a contemporary, nationally representative sample of US veterans.Data were analyzed from Wave 1 of the National Health and Resilience in Veterans Study, a cross-sectional, retrospective, web-based survey of a population-based sample of 3,157 US veterans conducted between October and December 2011. The main outcome measure was probable lifetime PTSD, which was assessed by using a DSM-IV version of the PTSD Checklist (PCL), the PCL-Specific Stressor version.The weighted lifetime and current prevalence of probable PTSD was 8.0% (standard error [SE] = 0.48) and 4.8% (SE = 0.40), respectively. 87.0% of veterans reported exposure to at least 1 potentially traumatic event (PTE); veterans reported a mean of 3.4 (SD = 2.8) different PTE types in their lifetime. Sudden death of a loved one was the most frequently endorsed PTE (61.3%), and sexual abuse in adulthood had the highest conditional probability of PTSD (37.3%). PTSD was associated with increased odds of mood, anxiety, and substance use disorders (odds ratios [ORs] = 2.2-19.1, P values < .001); suicidal ideation (OR = 9.7, P < .001); and suicide attempts (OR = 11.8, P < .001). Psychosocial factors, including resilience, community integration, and secure attachment, were associated with decreased odds of PTSD (ORs = 0.5-0.7, P values < .05).In a nationally representative sample of US veterans, the prevalence of lifetime and current PTSD was 8.0% and 4.8%, respectively, and PTSD was associated with elevated risk for several psychiatric conditions and suicidality. Veterans reported exposure to many PTE types in addition to combat, and conditional risk for PTSD was high for noncombat-related trauma. Prevention and treatment efforts designed to bolster protective psychosocial factors may help mitigate PTSD risk in this population.