https://aub.ie/MilitaryREACH-Goetter2020

Goetter, E. M., Hoeppner, S. S., Khan, A. J., Charney, M. E., Wieman, S., Venners, M. R., Avallone, K. M., Rauch, S. A. M., & Simon, N. M. (2020). Combat-related posttraumatic stress disorder and comorbid major depression in U.S. veterans: The role of deployment cycle adversity and social support. Journal of Traumatic Stress, 33, 276-284. https://doi.org/10.1002/jts.22496

Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) often cooccur for Service members and Veterans who have experienced combat. Those with this comorbidity may experience higher levels of distress and lower levels of social support compared to those with only PTSD. This study examined deployment-related factors and their associations with both clinician-diagnosed MDD and self-reported depressive symptoms in a sample of U.S. Veterans (N = 223) with Operation Enduring Freedom/Operation Iraqi Freedom combat-related PTSD. The deployment-related factors included adversity and systems of support during predeployment (i.e., prior stressors, childhood family environment), deployment (i.e., concerns about life and family disruptions, social support, general harassment, and sexual harassment), and postdeployment (i.e., social support and stressors). For Veterans with combat-related PTSD, deployment (i.e., concerns about family disruptions, general harassment) and postdeployment factors (i.e., social support) were associated with more severe depressive symptoms.

https://doi.org/10.1002/jts.22496

Deployment
Mental health
Trauma
Veterans

Multiple branches

Veteran

Veteran

Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)

Cross-Sectional Study
Quantitative Study
Secondary Analysis

Goetter, Elizabeth M., Hoeppner, Susanne S., Khan, Amanda J., Charney, Meredith E., Wieman, Sarah, Venners, Margaret R., Avallone, Kimberly M., Rauch, Sheila A. M., Simon, Naomi M.

Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) commonly co-occur in combat veterans, and this comorbidity has been associated with higher levels of distress and more social and economic costs compared to one disorder alone. In a secondary analysis of a multisite randomized controlled trial of a sample of veterans with combat-related PTSD, we examined the associations among pre-, peri-, and postdeployment adversity, social support, and clinician-diagnosed comorbid MDD. Participants completed the Deployment Risk and Resilience Inventory and the Beck Depression Inventory–II as well as structured clinical interviews for diagnostic status. Among 223 U.S. veterans of the military operations in Iraq and Afghanistan (86.9% male) with primary combat-related PTSD, 69.5% had current comorbid MDD. After adjustment for sex, a linear regression model indicated that more concerns about family disruptions during deployment, f2 = 0.065; more harassment during deployment, f2 = 0.020; and lower ratings of postdeployment social support, f2 = 0.154, were associated with more severe self-reported depression symptoms. Interventions that enhance social support as well as societal efforts to foster successful postdeployment reintegration are critical for reducing the mental health burden associated with this highly prevalent comorbidity in veterans with combat-related PTSD.

John Wiley & Sons

Article
REACH Publication

Department of Psychiatry, Massachusetts General Hospital, EMG
Department of Psychiatry, Harvard Medical School, EMG
Department of Psychiatry, Massachusetts General Hospital, SSH
Department of Psychiatry, Harvard Medical School, SSH
San Francisco VA Medical Center, AJK
Department of Psychology, Suffolk University, AJK
Department of Psychiatry, Massachusetts General Hospital, MEC
Department of Psychiatry, Harvard Medical School, MEC
Department of Psychiatry, Massachusetts General Hospital, SW
Department of Psychology, Suffolk University, SW
VA Ann Arbor Healthcare System, MRV
Department of Psychiatry, University of Michigan, KMA
VA Atlanta Healthcare System, SAMR
Department of Psychiatry, Emory University School of Medicine, SAMR
Department of Psychiatry, New York University School of Medicine, NMS
NYU Langone Health, New York, NMS