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Posttraumatic Stress Disorder in the US Veteran Population: Results From the National Health and Resilience in Veterans Study

J Clin Psychiatry 2014;75(12):1338–1346
10.4088/JCP.14m09328

Objective: To describe the prevalence of posttraumatic stress disorder (PTSD) and comorbid psychiatric disorders and identify correlates of PTSD in a contemporary, nationally representative sample of US veterans.

Method: Data were analyzed from Wave 1 of the National Health and Resilience in Veterans Study, a cross-sectional, retrospective, web-based survey of a population-based sample of 3,157 US veterans conducted between October and December 2011. The main outcome measure was probable lifetime PTSD, which was assessed by using a DSM-IV version of the PTSD Checklist (PCL), the PCL-Specific Stressor version.

Results: The weighted lifetime and current prevalence of probable PTSD was 8.0% (standard error [SE] = 0.48) and 4.8% (SE = 0.40), respectively. 87.0% of veterans reported exposure to at least 1 potentially traumatic event (PTE); veterans reported a mean of 3.4 (SD = 2.8) different PTE types in their lifetime. Sudden death of a loved one was the most frequently endorsed PTE (61.3%), and sexual abuse in adulthood had the highest conditional probability of PTSD (37.3%). PTSD was associated with increased odds of mood, anxiety, and substance use disorders (odds ratios [ORs] = 2.2–19.1, P values < .001); suicidal ideation (OR = 9.7, P < .001); and suicide attempts (OR = 11.8, P < .001). Psychosocial factors, including resilience, community integration, and secure attachment, were associated with decreased odds of PTSD (ORs = 0.5–0.7, P values < .05).

Conclusions: In a nationally representative sample of US veterans, the prevalence of lifetime and current PTSD was 8.0% and 4.8%, respectively, and PTSD was associated with elevated risk for several psychiatric conditions and suicidality. Veterans reported exposure to many PTE types in addition to combat, and conditional risk for PTSD was high for noncombat-related trauma. Prevention and treatment efforts designed to bolster protective psychosocial factors may help mitigate PTSD risk in this population.