Trajectories of trauma symptoms and resilience in deployed U.S. military service members: prospective cohort study

Br J Psychiatry. 2012 Apr;200(4):317-23. doi: 10.1192/bjp.bp.111.096552. Epub 2012 Feb 23.


Background: Most previous attempts to determine the psychological cost of military deployment have been limited by reliance on convenience samples, lack of pre-deployment data or confidentiality and cross-sectional designs.

Aims: This study addressed these limitations using a population-based, prospective cohort of U.S. military personnel deployed in support of the operations in Iraq and Afghanistan.

Method: The sample consisted of U.S. military service members in all branches including active duty, reserve and national guard who deployed once (n = 3393) or multiple times (n = 4394). Self-reported symptoms of post-traumatic stress were obtained prior to deployment and at two follow-ups spaced 3 years apart. Data were examined for longitudinal trajectories using latent growth mixture modelling.

Results: Each analysis revealed remarkably similar post-traumatic stress trajectories across time. The most common pattern was low-stable post-traumatic stress or resilience (83.1% single deployers, 84.9% multiple deployers), moderate-improving (8.0%, 8.5%), then worsening-chronic post-traumatic stress (6.7%, 4.5%), high-stable (2.2% single deployers only) and high-improving (2.2% multiple deployers only). Covariates associated with each trajectory were identified.

Conclusions: The final models exhibited similar types of trajectories for single and multiple deployers; most notably, the stable trajectory of low post-traumatic stress preto post-deployment, or resilience, was exceptionally high. Several factors predicting trajectories were identified, which we hope will assist in future research aimed at decreasing the risk of post-traumatic stress disorder among deployers.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Afghanistan
  • Female
  • Follow-Up Studies
  • Humans
  • Iraq War, 2003-2011
  • Male
  • Military Personnel / psychology*
  • Prospective Studies
  • Risk Factors
  • Self Report
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / epidemiology
  • United States / epidemiology
  • Warfare