Psychiatric diagnoses and punishment for misconduct: the effects of PTSD in combat-deployed Marines

BMC Psychiatry

Research Article

Robyn M Highfill-McRoy¹  Stephanie Booth-Kewley¹  Gerald E Larson¹  Cedric F Garland² 

[1] Behavioral Science and Epidemiology Program, Naval Health Research Center, San Diego, California, USA;Behavioral Science and Epidemiology Program, Naval Health Research Center, San Diego, California, USA;Department of Family and Preventive Medicine and Moores UCSD Cancer Center, University of California, San Diego, California, USA;

关键词: Psychiatric Diagnosis;    Ptsd Symptom;    Ptsd Diagnosis;    Vietnam Veteran;    Combat Exposure;   

DOI  :  10.1186/1471-244X-10-88

 received in 2009-11-11, accepted in 2010-10-25,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundResearch on Vietnam veterans suggests an association between psychological problems, including posttraumatic stress disorder (PTSD), and misconduct; however, this has rarely been studied in veterans of Operation Iraqi Freedom or Operation Enduring Freedom. The objective of this study was to investigate whether psychological problems were associated with three types of misconduct outcomes (demotions, drug-related discharges, and punitive discharges.)MethodsA population-based study was conducted on all U.S. Marines who entered the military between October 1, 2001, and September 30, 2006, and deployed outside of the United States before the end of the study period, September 30, 2007. Demographic, psychiatric, deployment, and personnel information was collected from military records. Cox proportional hazards regression analysis was conducted to investigate associations between the independent variables and the three types of misconduct in war-deployed (n = 77 998) and non-war-deployed (n = 13 944) Marines.ResultsMarines in both the war-deployed and non-war-deployed cohorts with a non-PTSD psychiatric diagnosis had an elevated risk for all three misconduct outcomes (hazard ratios ranged from 3.93 to 5.65). PTSD was a significant predictor of drug-related discharges in both the war-deployed and non-war-deployed cohorts. In the war-deployed cohort only, a specific diagnosis of PTSD was associated with an increased risk for both demotions (hazard ratio, 8.60; 95% confidence interval, 6.95 to 10.64) and punitive discharges (HR, 11.06; 95% CI, 8.06 to 15.16).ConclusionsThese results provide evidence of an association between PTSD and behavior problems in Marines deployed to war. Moreover, because misconduct can lead to disqualification for some Veterans Administration benefits, personnel with the most serious manifestations of PTSD may face additional barriers to care.

【 授权许可】

CC BY   
© Highfill-McRoy et al; licensee BioMed Central Ltd. 2010