アメリカの退役軍人のためのベトナム戦争の心理的リスク:新しいデータと方法による再考
Bruce P Dohrenwend1, J Blake Turner, Nicholas A Turse
1New York State Psychiatric Institute, New York, NY 10032, USA. dohrenw@pi.cpmc.columbia.edu
まとめ
この研究では,ベトナム退役軍人のトラウマ後ストレス障害 (PTSD) 率を軍事記録を使用して検証し,より低いが依然として実質的な寿命と現在のPTSDの有病率を発見しました. 戦闘曝露はPTSDと強く相関しており,膨張された結果の主張を否定しています.
科学分野:
- 精神科医は精神病を患っている.
- 軍事医学は軍事医学でした.
- エピデミオロジー エピデミオロジー
背景:
- ベトナム退役軍人再調整研究 (NVVRS) は,退役軍人の高い寿命 (30.9%) と現在の (15.2%) 創傷後ストレス障害 (PTSD) 率を推定した.
- リコールバイアスやその他の方法論的欠陥によるNVVRS PTSD推定値の潜在的膨張に関する懸念が提起されました.
研究 の 目的:
- ベトナムの退役軍人のPTSDの罹患率を再評価するために,自己報告された戦闘被曝を軍事記録とクロスチェックする.
- NVVRSの発見の妥当性,および戦闘曝露とPTSDの投与量反応関係を評価する.
主な方法:
- 260人のNVVRS参加者のサブセットの戦闘曝露の新しい客観的な尺度を作成するために,軍務記録を利用しました.
- 軍から得られた被曝データを,退役軍人の自己報告とPTSDの診断評価と比較した.
主要な成果:
- 退役軍人の自己報告による暴露における偽造の証拠はほとんどありませんでした.
- 戦闘曝露とPTSDの間の強固な投与量-反応関係が確認され,以前に推定されたよりもさらに強くなりました.
- 推定調整された生涯PTSDは18.7%で,現在のPTSDは9.1%で,戦後11〜12年,通常現在のPTSDと関連付けられている中程度の障害があります.
結論:
- この研究は,ベトナム退役軍人の戦闘暴露とPTSDの間の重要な関連性を検証しています.
- 改訂されたPTSDの罹患率は,実質的,持続的な心理的コストを示唆しているが,初期NVVRSの推定値より潜在的に低い.
- 客観的な検証は,戦闘暴露の結果としてのPTSDの妥当性を支持しています.
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