Combat Experience, New-Onset Mental Health Conditions, and Posttraumatic Growth in U.S. Service Members

Psychiatry. 2021 Fall;84(3):276-290. doi: 10.1080/00332747.2021.1929770. Epub 2021 Aug 2.


Objective: Studies examining posttraumatic growth (PTG) rely on surveys evaluating PTG in relation to prior traumatic experiences, resulting in psychometric problems due to the linkage of the dependent and independent variables. Few studies have assessed PTG following combat deployment while also controlling for mental health problems.Method: Longitudinal data on PTG, combat experience, and mental health were examined among U.S. Millennium Cohort Study deployers (n = 8732). Scores from a short-form (SF) version of the PTG inventory assessing current-state beliefs (C-PTGI-SF) independent of any predictor variables were assessed at time 1 (T1), before deployment, and change in scores were assessed approximately 3 years later after deployment at time 2 (T2). All participants screened negative for posttraumatic stress disorder (PTSD) and depression at T1.Results: Combat deployment severity was associated with a worsening of C-PTGI-SF scores at T2 among participants with moderate C-PTGI-SF scores at T1. A positive screen for comorbid PTSD/depression was associated with a worsening of C-PTGI-SF scores at T2 among participants with moderate or high C-PTGI-SF scores at T1. At T2, a strong inverse correlation was found between C-PTGI-SF scores and PTSD (r = -0.38) and depression (-0.41). Only 5% of participants who screened positive for a mental health problem at T2 (23/517) also experienced positive growth.Conclusions: These results challenge the clinical utility of the PTG construct. While PTG may be a useful framework for supporting trauma recovery on an individual basis, PTG does not appear to be distinct and independent from the negative psychological impact of traumatic experiences.

Publication types

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

MeSH terms

  • Adaptation, Psychological
  • Cohort Studies
  • Humans
  • Mental Health
  • Posttraumatic Growth, Psychological*
  • Psychometrics
  • Stress Disorders, Post-Traumatic* / epidemiology
  • Stress Disorders, Post-Traumatic* / psychology