越南对美国退伍军人的心理风险:用新的数据和方法重新审视
Bruce P Dohrenwend1, J Blake Turner, Nicholas A Turse
1New York State Psychiatric Institute, New York, NY 10032, USA. dohrenw@pi.cpmc.columbia.edu
概括
这项研究使用军事记录验证了越南退伍军人的创伤后应激障碍 (PTSD) 率,发现较低但仍然相当大的寿命和当前PTSD患病率. 战斗暴露与PTSD有很强的相关性,反驳了夸张结果的说法.
科学领域:
- 精神病学是一个精神病学.
- 军事医学 军事医学
- 流行病学 流行病学
背景情况:
- 国家越南退伍军人再调整研究 (NVVRS) 估计退伍军人中高寿命 (30.9%) 和当前 (15.2%) 的创伤后应激障碍 (PTSD) 率.
- 由于回忆偏差和其他方法上的缺陷,人们对NVVRS PTSD估计的潜在膨胀表示担忧.
研究的目的:
- 重新评估越南退伍军人中PTSD患病率,通过交叉检查自我报告的战斗暴露与军事记录.
- 评估NVVRS发现的有效性和战斗暴露和PTSD之间的剂量反应关系.
主要方法:
- 利用军事服务记录,为260名NVVRS参与者的子集创建一个新的,客观的战斗暴露度.
- 将来自军事的暴露数据与退伍军人的自我报告和PTSD诊断评估进行了比较.
主要成果:
- 在退伍军人自我报告的曝光中发现了极少的伪造证据.
- 证实了战斗暴露和PTSD之间的强有力的剂量反应关系,甚至比之前估计的更强.
- 预计调整后终身PTSD为18.7%,当前PTSD为9.1%,战后11-12年,通常与当前PTSD相关的中度损伤.
结论:
- 这项研究证实了越南退伍军人的战斗暴露和PTSD之间的重要联系.
- 经过修订的PTSD患病率表明大量,持续的心理成本,尽管可能低于最初的NVVRS估计.
- 客观验证支持PTSD作为战斗暴露的结果的有效性.
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