ابعاد کنترل روانشناختی والدین: ارتباطات با پرخاشگری فیزیکی و رابطه پیش دبستانی در روسیه

Objective 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. Method 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. Results 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. Conclusions 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.

Deployment to a combat zone is known to have psychological effects on military personnel (Tanielian and Jaycox, 2008). Stressors faced by deployed service members include exposure to combat situations, witnessing human suffering and deprivation, difficult living and working conditions, separation from home and family, and conflict with military peers or supervisors (King et al., 2006). In the current conflict in Iraq, the vast majority of service members report exposure to stressor events with likely consequences for emotional functioning (Hoge et al., 2006). Although most military personnel do not develop mental disorders as a result of combat zone stressors, emotional distress may impair functioning in a combat zone and increase risk for future development of psychological disorders or poor readjustment after deployment. Growing awareness of the potential for violence within units of deployed United States (US) troops and the climbing suicide rate in deployed troops (Kennedy, 2009 and US Army Surgeon General, 2008) has led to increased need to assess and treat distress in a combat zone. Most studies describe psychological symptoms several months following deployment and report rates of probable posttraumatic stress disorder (PTSD) between 8% and 15% and rates of depression between 5% and 10% (Hoge et al., 2004, Seal et al., 2007 and Tanielian and Jaycox, 2008). Although helpful in describing the psychological aftereffects of combat, characterization of emotional distress after deployment may fail to capture the range and severity of distress during a combat deployment. Assessing psychological distress during, rather than after, deployment may also be important because emotional distress in a combat zone could impact soldiers’ abilities to perform duties and carry out missions. Finally, a better understanding of the nature of distress experienced in a combat zone may also guide interventions to improve troop resilience. Preliminary data regarding the prevalence of psychological distress of deployed US Army soldiers were obtained in a series of studies conducted by the Mental Health Advisory Team (MHAT). In 2008, 18% of these deployed soldiers reported some psychological problems, 16% met criteria for PTSD as assessed by the PTSD Checklist (PCL; Weathers et al., 1993), and 7% reported depression (US Army Surgeon General, 2008). We sought to characterize and predict emotional distress of soldiers in the combat zone by assessing the psychological functioning of US Army National Guard soldiers during deployment to Operation Iraqi Freedom (OIF). While studies of distress during combat deployment are limited, research on service members who have recently returned from deployment has suggested possible risk factors for conditions such as PTSD and depression. Exposure to blasts from improvised explosive devices may result in traumatic brain injury (TBI). Mild TBI (mTBI), also known as concussion, has been reported in as many as 15–20% of OIF soldiers (Hoge et al., 2008 and Tanielian and Jaycox, 2008). Higher levels of combat exposure are consistently associated with greater emotional distress (Hoge et al., 2004 and Tanielian and Jaycox, 2008), and some research suggests that the presence of mTBI increases likelihood of psychological distress beyond what combat exposure predicts (Belanger et al., 2009, Chemtob et al., 1998 and Vasterling et al., 2000). Importantly, certain “resilience factors” may mitigate the effects of stressors during deployment. Military personnel who perceive their missions as important and meaningful and who maintain regular contact with friends and family back home may experience less psychological distress during deployment (Gray et al., 2004). Self-report measures are frequently used to characterize and study mental health of military personnel in a combat zone. Unfortunately, shared variance of self-report measures of different syndromes, such as PTSD and depression, confounds assessment of these problems in traumatized samples (O’Donnell et al., 2004) and can lead to inflated estimates of correlations between constructs. Prior studies in this area have not accounted for overlap between measures of emotional distress and thus may not fully address correlates of specific dimensions of distress. The goal of the present study was to better characterize and predict the emotional distress of military personnel within the combat environment to determine factors that could mitigate risk for psychological disruption in deployed troops. First, we examined rates of probable PTSD and depression in deployed National Guard soldiers using standard survey-based criteria for each “diagnosis.” Second, we sought to better understand the distress reported by soldiers in the combat zone by identifying separate dimensions of emotional distress. Finally, we sought to determine which events and characteristics of deployment most strongly predicted the unique facets of emotional distress. We were interested specifically in how distinct aspects of distress in a combat zone are predicted by (a) recent prior deployment, current combat operations, exposure to explosive blast, and mild TBI, and (b) attitudes and experiences during deployment (e.g., unit support, contact with home, and meaningfulness of the mission).