Combat Experiences and their Relationship to Post-Traumatic Stress Disorder Symptom Clusters in UK Military Personnel Deployed to Afghanistan

References

• Yehuda R, Hoge CW, McFarlane AC, Vermetten E, Lanius RA, Nievergelt CM, Hobfoll SE, Koenen KC, Neylan TC, Hyman SE. Post-traumatic stress disorder. Nature Rev Disease Primers. 2015;1:1–22.
   Web of Science ®Google Scholar
• Davidson JR, Stein DJ, Shalev AY, Yehuda R. Posttraumatic stress disorder: Acquisition, recognition, course, and treatment. J Neuropsychiatr Clin Neuroscience. 2004;16:135–47.
   PubMed Web of Science ®Google Scholar
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revised: DSM-IV-TR. Washington, DC: Author; 2000.
   Google Scholar
• Asmundson GJ, Frombach I, McQuaid J, Pedrelli P, Lenox R, Stein MB. Dimensionality of posttraumatic stress symptoms: A confirmatory factor analysis of DSM-IV symptom clusters and other symptom models. Behav Res Therapy. 2000;38:203–14.
   PubMed Web of Science ®Google Scholar
• Pietrzak RH, Tsai J, Harpaz-Rotem I, Whealin JM, Southwick SM. Support for a novel five-factor model of posttraumatic stress symptoms in three independent samples of Iraq/Afghanistan veterans: A confirmatory factor analytic study. J Psychiatr Res. 2012;46:317–22.
   PubMed Web of Science ®Google Scholar
• Harpaz-Rotem I, Tsai J, Pietrzak RH, Hoff R. The dimensional structure of posttraumatic stress symptomatology in 323,903 U.S. veterans. J Psychiatr Res. 2014;49:31–6.
   PubMed Web of Science ®Google Scholar
• Armour C, Mullerova J, Elhai JD. A systematic literature review of PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV to DSM-5. Clin Psychol Rev. 2016;44:60–74.
   PubMed Web of Science ®Google Scholar
• Elhai JD, Biehn TL, Armour C, Klopper JJ, Frueh BC, Palmieri PA. Evidence for a unique PTSD construct represented by PTSD's D1-D3 symptoms. J Anxiety Disord. 2011;25:340–5.
   PubMed Web of Science ®Google Scholar
• Elhai JD, Palmieri PA. The factor structure of posttraumatic stress disorder: A literature update, critique of methodology, and agenda for future research. J Anxiety Disord. 2011;25:849–54.
   PubMed Web of Science ®Google Scholar
• Watson D. Rethinking the mood and anxiety disorders: A quantitative hierarchical model for DSM-V. J Abnormal Psychol. 2005;114:522–36.
   PubMed Web of Science ®Google Scholar
• Breslau N, Davis GC, Andreski P. Risk factors for PTSD-related traumatic events: A prospective analysis. Am J Psychiatry. 1995;152:529–35.
   PubMed Web of Science ®Google Scholar
• Macmanus D, Jones N, Wessely S, Fear NT, Jones E, Greenberg N. The mental health of the UK Armed Forces in the 21st century: Resilience in the face of adversity. J R Army Med Corps. 2014;0:1–6.
   Google Scholar
• Fear NT, Jones M, Murphy D, Hull L, Iversen AC, Coker B, Machell L, Sundin J, Woodhead C, Jones N et al. What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK Armed Forces? A cohort study. Lancet. 2010;375:1783–97.
   PubMed Web of Science ®Google Scholar
• Woodhead C, Wessely S, Jones N, Fear NT, Hatch SL. Impact of exposure to combat during deployment to Iraq and Afghanistan on mental health by gender. Psychol Med. 2012;42:1985–96.
   PubMed Web of Science ®Google Scholar
• Hoge CW, Castro CA, Messer SC, McGurk D, Cotting DI, Koffman RL. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med. 2004;351:13–22.
   PubMed Web of Science ®Google Scholar
• Osório C, Greenberg N, Jones N, Goodwin L, Fertout M, Maia A. Combat exposure and posttraumatic stress disorder among Portuguese special operation forces deployed in Afghanistan. Mil Psychol. 2013;25:70–81.
   Web of Science ®Google Scholar
• Grinker RR, Spiegel JP. Men under stress. Philadelphia: Blakiston; 1945.
   Google Scholar
• Kardiner A, Spiegel HX. War stress and neurotic illness. New York: Paul B. Hoeber; 1947.
   Google Scholar
• Weathers F, Litz BT, Keane TM. Military trauma. In: Traumatic stress: From theory to practice. JR Freedy, SE Hobfoll, Eds. New York: Plenum; 1995: 103–128.
   Google Scholar
• Fontana A, Rosenheck R, Brett E. War zone traumas and posttraumatic stress disorder symptomatology. J Nerv Ment Dis. 1992;180:748–55.
   PubMed Web of Science ®Google Scholar
• King DW, King LA, Gudanowski DM, Vreven DL. Alternative representations of war zone stressors: Relationships to posttraumatic stress disorder in male and female Vietnam veterans. J Abnormal Psychol. 1995;104:184–95.
   PubMed Web of Science ®Google Scholar
• Fontana A, Rosenheck R. A model of war zone stressors and posttraumatic stress disorder. J Trauma Stress. 1999;12:111–26.
   PubMed Web of Science ®Google Scholar
• Killgore WD, Cotting DI, Thomas JL, Cox AL, McGurk D, Vo AH, Castro CA, Hoge CW. Post-combat invincibility: Violent combat experiences are associated with increased risk-taking propensity following deployment. J Psychiatr Res. 2008;42:1112–21.
   PubMed Web of Science ®Google Scholar
• Guyker WM, Donnelly K, Donnelly JP, Dunnam M, Warner GC, Kittleson J, Bradshaw CB, Alt M, Meier ST. Dimensionality, reliability, and validity of the combat experiences scale. Mil Med. 2013;178:377–84.
   PubMed Web of Science ®Google Scholar
• Kimbrel NA, Evans LD, Patel AB, Wilson LC, Meyer EC, Gulliver SB, Morissette SB. The critical warzone experiences (CWE) scale: Initial psychometric properties and association with PTSD, anxiety, and depression. Psychiatry Res. 2014;220:1118–24.
   PubMed Web of Science ®Google Scholar
• Sudom KA, Watkins K, Born J, Zamorski M. Stressors experienced during deployment among Canadian Armed Forces personnel: Factor structure of two combat exposure scales. Mil Psychol. 2016;28:285–95.
   Web of Science ®Google Scholar
• Watkins K, Sudom KA, Zamorski M. Association of combat experiences with post-traumatic stress disorder among Canadian military personnel deployed in support of the mission in Afghanistan. Mil Behav Health. 2016;4:285–92.
   Google Scholar
• Maguen S, Lucenko BA, Reger MA, Gahm GA, Litz BT, Seal KH, Knight SJ, Marmar CR. The impact of reported direct and indirect killing on mental health symptoms in Iraq war veterans. J Trauma Stress. 2010;23:86–90.
   PubMed Web of Science ®Google Scholar
• Maguen S, Madden E, Bosch J, Galatzer-Levy I, Knight SJ, Litz BT, Marmar CR, McCaslin SE. Killing and latent classes of PTSD symptoms in Iraq and Afghanistan veterans. J Affect Dis. 2012;145:344–8.
   PubMed Web of Science ®Google Scholar
• Maguen S, Metzler TJ, Litz BT, Seal KH, Knight SJ, Marmar CR. The impact of killing in war on mental health symptoms and related functioning. J Trauma Stress. 2009;22:435–43.
   PubMed Web of Science ®Google Scholar
• MacManus D, Dean K, Jones M, Rona RJ, Greenberg N, Hull L, Fahy T, Wessely S, Fear NT. Violent offending by UK military personnel deployed to Iraq and Afghanistan: A data linkage cohort study. Lancet. 2013;381:907–17.
   PubMed Web of Science ®Google Scholar
• Butler RW, Braff DL, Rausch JL, Jenkins MA, Sprock J, Geyer MA. Physiological evidence of exaggerated startle response in a subgroup of Vietnam veterans with combat-related PTSD. Am J Psychiatry. 1990;147:1308–1312.
   PubMed Web of Science ®Google Scholar
• Clohessy S, Ehlers A. PTSD symptoms, response to intrusive memories and coping in ambulance service workers. Br J Psychol. 1999;38:251–65.
   Web of Science ®Google Scholar
• Jones N, Thandi G, Fear NT, Wessely S, Greenberg N. The psychological effects of improvised explosive devices (IEDs) on UK military personnel in Afghanistan. Occup Environ Med. 2014;0:1–6.
   Google Scholar
• Ramasamy A, Hill AM, Clasper JC. Improvised explosive devices: Pathophysiology, injury profiles and current medical management. J R Army Med Corps. 2009;155:265–72.
   PubMedGoogle Scholar
• Elder GA, Cristian A. Blast-related mild traumatic brain injury: Mechanisms of injury and impact on clinical care. Mount Sinai J Med. 2009;76:111–8.
   PubMed Web of Science ®Google Scholar
• Mulligan K, Fear NT, Jones N, Alvarez H, Hull L, Naumann U, Wessely S, Greenberg N. Postdeployment Battlemind training for the UK armed forces: A cluster randomized controlled trial. J Consult Clin Psychol. 2012;80:331–41.
   PubMed Web of Science ®Google Scholar
• Hotopf M, Hull L, Fear NT, Browne T, Horn O, Iversen AC, Jones M, Murphy D, Bland D, Earnshaw M et al. The health of UK military personnel who deployed to the 2003 Iraq war: A cohort study. Lancet. 2006;367:1731–41.
   PubMed Web of Science ®Google Scholar
• Weathers FW, Litz BT, Herman DS, Huska JA, Keane TM. The PTSD checklist (PCL): Reliability, validity, and diagnostic utility. In: International Society of Traumatic Stress Studies; 1993.
   Google Scholar
• Iversen AC, van Staden L, Hughes JH, Browne T, Hull L, Hall J, Greenberg N, Rona RJ, Hotopf M, Wessely S et al. The prevalence of common mental disorders and PTSD in the UK military: Using data from a clinical interview-based study. BMC Psychiatry. 2009;9:1–12.
   PubMed Web of Science ®Google Scholar
• Goldberg DP, Williams P. A user's guide to the general health questionnaire. Windsor: NFER-Nelson; 1988.
   Google Scholar
• Goldberg DP, Gater R, Sartorius N, Ustun TB, Piccinelli M, Gureje O, Rutter C. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997;27:191–7.
   PubMed Web of Science ®Google Scholar
• Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. The alcohol use disorders identification test (AUDIT). Geneva: Department of mental health and substance dependence, World Health Organization; 2001.
   Google Scholar
• Field A. Discovering statistics using SPSS, 3rd edition ( and sex, and drugs and rock' n' roll). London: SAGE Publications; 2009.
   Google Scholar
• Jeong DH, Ziemkiewicz C, Ribarsky W, Chang R. Understanding principal component analysis using a visual analytics tool. Charlotte Visualization Center. 2009;0:1–10.
   Google Scholar
• Ehlers A, Hackmann A, Michael T. Intrusive re-experiencing in post-traumatic stress disorder: Phenomenology, theory, and therapy. Memory. 2004;12:403–15.
   PubMed Web of Science ®Google Scholar
• Keane TM, Zimering RT, Caddell JM. A behavioral formulation of posttraumatic stress disorder. Behav Therapist. 1985;8:9–12.
   Google Scholar
• Litz BT. Emotional numbing in combat-related post-traumatic stress disorder: A critical review and reformulation. Clin Psychol Rev. 1992;12:417–32.
   Web of Science ®Google Scholar
• Litz BT, Schlenger WE, Weathers FW, Caddell JM, Fairbank JA, LaVange LM. Predictors of emotional numbing in posttraumatic stress disorder. J Trauma Stress. 1997;10:607–18.
   PubMed Web of Science ®Google Scholar
• Dienstbier RA. Arousal and physiological toughness: Implications for mental and physical health. Psychol Rev. 1989;96:84–100.
   PubMed Web of Science ®Google Scholar
• Champion HR, Holcomb JB, Young LA. Injuries from explosions: Physics, biophysics, pathology, and required research focus. J Trauma Inj Infect Critical Care. 2009;66:1468–77.
   PubMed Web of Science ®Google Scholar
• Neville L, Dennis P. The British army in Afghanistan 2006–14: Task Force Helmand. Oxford: Osprey Publishing Company; 2015.
   Google Scholar
• National Institute for Health and Care Excellence (NICE). Post-traumatic stress disorder: Management. https://www.nice.org.uk/guidance/cg26/chapter/Key-priorities-for-implementation
   Google Scholar
• Iversen AC, Nikolaou V, Greenberg N, Unwin C, Hull L, Hotopf M, Dandeker C, Ross J, Wessely S. What happens to British veterans when they leave the Armed Forces? Europ J Public Health. 2005;15:175–84.
   PubMed Web of Science ®Google Scholar
• Cawkill P, Jones M, Fear NT, Jones N, Fertout M, Wessely S, Greenberg N. Mental health of UK Armed Forces medical personnel post-deployment. Occup Med. 2015;65:157–64.
   Google Scholar
• Thompson CV, Naumann DN, Fellows JL, Bowley DM, Suggett N. Post-traumatic stress disorder amongst surgical trainees: An unrecognised risk? Surgeon. 2015;1:1–8.
   Google Scholar
• Armstrong EL, Bryan CJ, Stephenson JA, Bryan AO, Morrow CE. Warzone stressor exposure, unit support, and emotional distress among US Air force pararescuemen. J Spec Op Med. 2014;14:26–34.
   PubMedGoogle Scholar
• Fear NT, Seddon R, Jones N, Greenberg N, Wessely S. Does anonymity increase the reporting of mental health symptoms? BMC Public Health. 2012;12:1–7.
   PubMed Web of Science ®Google Scholar
• Weisaeth L. Importance of high response rates in traumatic stress research. Acta Psychiatrica Scandinavica Suppl. 1989;355:131–7.
   PubMedGoogle Scholar