Distinguishing the Effects of Life Threat, Killing Enemy Combatants, and Unjust War Events in U.S. Service Members. Issue 2 (10th December 2020)

• Record Type: Journal Article
• Authors: Krauss, Stephen W.; Zust, Jeffrey; Frankfurt, Sheila; Kumparatana, Pam; Riviere, Lyndon A.; Hocut, Joy; Sowden, Walter J.; Adler, Amy B.
• Is Part Of: Journal of traumatic stress. Volume 34:Issue 2(2021)
• Page Start: 357
• Page End: 366
• Publication Date: 2020-12-10
• Subjects: Post-traumatic stress disorder -- Periodicals; 616.8521
• DOI: 10.1002/jts.22635
• Languages: English
• ISSNs: 0894-9867

Abstract

Abstract: Although previous studies have identified behavioral health risks associated with combat exposure, it is unclear which types of combat events are associated with these risks, particularly regarding contrasts among the risks associated with life‐threatening experiences, killing combatants, and exposure to unjust war events, such as killing a noncombatant or being unable to help civilian women and children. In the present study, we examined surveys from 402 soldiers following deployment (i.e., baseline) and again 13 months later (i.e., Year 1). Regression analyses were conducted across a range of behavioral health (e.g., posttraumatic stress disorder, depression, suicide ideation, anxiety, somatic, insomnia, aggression) and benefit‐finding measures, each controlling for two combat event categories while assessing the predictive utility of a third. The results suggested that life‐threatening events were associated with poor behavioral health at baseline, relative risk ( RR ) = 10.00, but not at Year 1, RR = 2.67. At both baseline and Year 1, killing enemy combatants was not associated with behavioral health, RR s = 1.67–3.33, but was positively associated with benefit‐finding, RR s = 26.67–40.00. Exposure to unjust war events was associated with a transdiagnostic pattern of behavioral health symptoms at baseline, RR = 40.00, and Year 1, RR = 23.33. Overall, the results suggest unjust war event exposure is particularly injurious, above and beyond exposure to other combat‐related events. Future research can build on these findings to develop clearer descriptions of the combat events that might place service members at risk for moral injury and inform the development of assessment and treatment options. 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯: JOTS‐20‐0165.R2_Krauss_cantonese Traditional Chinese 區分生命威脅、殺死敵方戰鬥人員及非正義戰爭事件對美國軍人的影響 摘要: 雖然先前的研究已經確定了與戰鬥暴露有關的行為健康風險, 但目前還不清楚哪些類型的戰鬥事件與這些風險有關, 特別是與危及生命的經歷、殺死戰鬥人員以及暴露於不公正的戰爭事件相關的風險之間的對比, 比如殺害非戰鬥人員或無法幫助平民婦女和兒童。在本研究中, 我們檢查了402名士兵在部署後(即基線)和13個月後(即第一年)的調查。我們對一系列行為健康(如創傷後壓力症、抑鬱症、自殺意念、焦慮、軀體、失眠、攻擊性)以及尋求利益的措施進行了回歸分析, 每項分析都控制了兩個戰鬥事件類別, 同時評估了第三個事件的預測效用。結果表明, 危及生命事件在基線時與不良行為健康有關, 相對風險( RR )=10.00 , 但在第1年時則沒有, RR =2.67 。在基線和第一年, 殺害敵方戰鬥人員與行為健康無關, RRs=1.67‐3.33 , 但與尋求利益呈正相關, RRs=26.67‐40.00 。暴露於不公正的戰爭事件與基線的行為健康症狀的跨診斷模式有關。 RR =40.00 , 第一年, RR =23.33 。總的來說, 結果表明, 不公正的戰爭事件暴露特別具有傷害性, 超過了其他與戰鬥有關的事件暴露。未來的研究可以在這些發現的基礎上, 對可能使服役人員處於精神傷害風險的戰鬥事件進行更清晰的描述, 並為評估和治療方案的制定提供依據。 Simplified Chinese 区分生命威胁、杀死敌方战斗人员及非正义战争事件对美国军人的影响 摘要: 虽然先前的研究已经确定了与战斗暴露有关的行为健康风险, 但目前还不清楚哪些类型的战斗事件与这些风险有关, 特别是与危及生命的经历、杀死战斗人员以及暴露于不公正的战争事件相关的风险之间的对比, 比如杀害非战斗人员或无法帮助平民妇女和儿童。在本研究中, 我们检查了402名士兵在部署后(即基线)和13个月后(即第一年)的调查。我们对一系列行为健康(如创伤后压力症、抑郁症、自杀意念、焦虑、躯体、失眠、攻击性)以及寻求利益的措施进行了回归分析, 每项分析都控制了两个战斗事件类别, 同时评估了第三个事件的预测效用。结果表明, 危及生命事件在基线时与不良行为健康有关, 相对风险( RR )=10.00 , 但在第1年时则没有, RR =2.67 。在基线和第一年, 杀害敌方战斗人员与行为健康无关, RRs=1.67‐3.33 , 但与寻求利益呈正相关, RRs=26.67‐40.00 。暴露于不公正的战争事件与基线的行为健康症状的跨诊断模式有关。 RR =40.00 , 第一年, RR =23.33 。总的来说, 结果表明, 不公正的战争事件暴露特别具有伤害性, 超过了其他与战斗有关的事件暴露。未来的研究可以在这些发现的基础上, 对可能使服役人员处于精神伤害风险的战斗事件进行更清晰的描述, 并为评估和治疗方案的制定提供依据。