Predictors of emotional distress reported by soldiers in the combat zone

Few studies have examined rates of distress of military personnel during deployment to a war zone. Our study sought to (a) identify rates of self-reported posttraumatic stress disorder (PTSD) and depression symptoms during combat deployment, (b) characterize higher order dimensions of emotional distress experienced by soldiers during deployment, and (c) identify predictors of these dimensions of emotional distress.

Participants were 2677 National Guard soldiers deployed as part of Operation Iraqi Freedom in 2006-07. We performed a principal components factor analysis on items of the PTSD Checklist - Military Version and the Beck Depression Inventory to identify dimensions of emotional distress, followed by multiple regression analyses to identify factors that predicted these dimensions of distress.

Rates of PTSD and depression in our sample were 7% and 9%, respectively. Five dimensions of emotional distress emerged: negative affect/cognitions, trauma-specific re-experiencing and avoidance, vegetative symptoms, loss of interest/numbing symptoms, and arousal/irritability. Two dimensions, trauma-specific symptoms and arousal/irritability, appeared to be more indicative of trauma sequelae, while the other three dimensions were more indicative of depressive symptoms. Demographic factors, combat exposure (including injury and exposure to explosive blast), and attitudinal variables predicted trauma-specific aspects of distress. Symptoms characteristic of depression or generalized distress were predicted by female gender, recent prior deployment, and attitudinal factors but were not predicted by blast exposure or injury.

These findings suggest specific targets for contextual and individual interventions to reduce deployment-related distress and point out the need for longitudinal follow-up to determine long-term implications for post-deployment functioning.