Course and Predictors of Posttraumatic Stress Disorder in the Canadian Armed Forces: A Nationally Representative, 16-Year Follow-up Study: Cours et prédicteurs du trouble de stress post-traumatique dans les Forces armées canadiennes: une étude de suivi de 16 ans nationalement représentative. (November 2021)

• Record Type: Journal Article
• Authors: Mota, Natalie; Bolton, Shay-Lee; Enns, Murray W.; Afifi, Tracie O.; El-Gabalawy, Renée; Sommer, Jordana L.; Pietrzak, Robert H.; Stein, Murray B.; Asmundson, Gordon J. G.; Sareen, Jitender
• Is Part Of: Canadian journal of psychiatry =. Volume 66:Number 11(2021)
• Page Start: 982
• Page End: 995
• Publication Date: 2021-11
• Subjects: posttraumatic stress disorder (PTSD) -- military -- veterans -- Canadian Armed Forces -- epidemiology -- risk factors -- protective factors -- longitudinal; Psychiatry -- Periodicals; Psychiatry -- Canada -- Periodicals; 616.8900971
• DOI: 10.1177/0706743721989167
• Languages: English
• ISSNs: 0706-7437

Abstract

Objective: This study examined baseline risk and protective predictors and interim correlates of the persistence/recurrence, remission, and onset of posttraumatic stress disorder (PTSD) in a 16-year prospective, nationally representative sample of Canadian Forces members and veterans. Methods: The 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey is a prospective study of 2, 941 regular force service members and veterans who participated in the 2002 Canadian Community Health Survey on Mental Health and Wellbeing: Canadian Forces Supplement ( n = 5, 155; ages 15 to 64 years; response rate 68%). PTSD diagnoses in 2002 and 2018 were used to create 4 groups: (1) no lifetime, (2) remitted, (3) new onset, and (4) persistent/recurrent PTSD. Multinomial regressions were conducted to identify predictors of PTSD courses. Results: Female sex, being a junior noncommissioned member (vs. officer), and land (vs. air) operations in 2002 were associated with all PTSD courses relative to no lifetime PTSD (relative risk ratio [RRR] range: 1.28 to 3.65). After adjusting for sociodemographic variables, baseline predictors of all PTSD courses included lifetime mental disorder, history of mental health care utilization, all trauma type categories (deployment-associated, sexual, "other"), and the number of lifetime traumatic events (RRR range: 1.14 to 8.95). New ("since 2002") traumas, transitioning to veteran status, and alcohol dependence were mostly associated with the new onset and persistent/recurrent PTSD courses (RRR range: 1.79 to 4.31), while mental health care utilization and greater avoidance coping were associated with all PTSD courses (RRR range: 1.10 to 17.87). Protective factors for several PTSD courses at one or both time points included social support, social network size, and problem-focused coping (RRR range: 0.71 to 0.98). Conclusions: This is the first population-based survey to examine the longitudinal course of PTSD in Canadian Forces members. Prevention and intervention programs focused on bolstering social support and active coping strategies as possible protective factors/correlates may help mitigate the development and persistence of PTSD.