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Original Research September 17, 2025

Identifying Factors Linked to a Higher Prevalence of Posttraumatic Stress Disorder Among Younger US Military Veterans

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J Clin Psychiatry 2025;86(4):25m15939

Abstract

Objectives: Posttraumatic stress disorder is a significant public health concern in the US, with military veterans disproportionately affected. Although younger veterans exhibit a higher prevalence of posttraumatic stress disorder (PTSD) compared to their older counterparts, the mechanisms driving this age-related difference remain unclear. This study examined sociodemographic, trauma-specific, and psychosocial factors that may contribute to the elevated prevalence of PTSD in younger (age <50) vs older (age 50 and older) veterans.

Methods: Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of US military veterans (n=4,069).

Results: Younger veterans were 3 times more likely to screen positive for PTSD compared to older veterans (weighted 14.7% vs 4.9%, P<.001). Mediation analysis revealed that 90% of the association between younger age and PTSD was indirectly mediated by psychosocial and trauma-specific factors. Psychosocial difficulties contributed the most to accounting for this association (42.9%), followed by loneliness (23.6%), avoidance coping (9.7%), adverse childhood experiences (9.5%), and combat exposure severity (4.2%). Secondary analyses identified interpersonal relationship challenges, substance use and self-blame coping strategies, and childhood physical abuse as key mediators of this association.

Conclusion: Psychosocial and trauma-specific factors may mediate the link between younger age and higher rates of PTSD among US military veterans. These findings underscore the importance of targeted interventions designed to address psychosocial challenges, strengthen social connections, and promote adaptive coping strategies among younger veterans who are at risk for or currently living with PTSD.

J Clin Psychiatry 2025;86(4):25m15939

Author affiliations are listed at the end of this article.

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