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Objective predictors of delayed-onset post-traumatic stress disorder occurring after military discharge

Published online by Cambridge University Press:  21 February 2012

C. R. Brewin ,
B. Andrews ,
J. Hejdenberg  and
L. Stewart
C. R. Brewin*
Affiliation:
Clinical, Educational and Health Psychology, University College London, London, UK
B. Andrews
Affiliation:
Department of Psychology, Royal Holloway University of London, London, UK
J. Hejdenberg
Affiliation:
Department of Psychology, Royal Holloway University of London, London, UK
L. Stewart
Affiliation:
Clinical, Educational and Health Psychology, University College London, London, UK
*
*Address for correspondence: C. R. Brewin, Ph.D., Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E 6BT, UK. (Email: [email protected])
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Abstract

Background

Post-traumatic stress disorder (PTSD) that develops after military personnel have been discharged may lead to severe impairment. We investigated whether personnel who develop PTSD after discharge can be identified by independent evidence of internalizing signs such as depression or of externalizing signs such as disciplinary offences while still serving.

Method

Veterans in receipt of a war pension who only developed PTSD post-discharge were compared with matched veterans who developed PTSD in service or never suffered from PTSD. Contemporaneous medical and personnel records were searched for objective evidence of internalizing and externalizing disorder.

Results

Service personnel who developed PTSD post-discharge were indistinguishable from controls with no PTSD on their psychiatric presentation in service. Those with post-discharge PTSD had significantly more disciplinary offences, specifically absence without leave, disobedience, and dishonesty, than the no-PTSD group, and this excess of offences was present before any exposure to trauma.

Conclusions

This is the first study to find objective evidence independent of self-report for the claimed link between externalizing disorder and vulnerability to PTSD. Early signs of externalizing disorders may play an important role in helping to identify service personnel at risk of PTSD after military discharge.

Keywords

Delayed onsetmilitarypost-traumatic stress disorderpredictorstrauma
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 10 , October 2012 , pp. 2119 - 2126
Copyright
Copyright © Cambridge University Press 2012

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