The Relationship Between Course of PTSD Symptoms in Deployed U.S. Marines and Degree of Combat Exposure

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DOI: https://doi.org/10.1002/jts.21988

Abstract

Large cohort studies suggest that most military personnel experience minimal posttraumatic stress disorder (PTSD) symptoms following warzone deployment, an outcome often labeled resilience. Very low symptom levels, however, may be a marker for low exposure, not resilience, which requires relatively high-magnitude or high-frequency stress exposure as a precondition. We used growth mixture modeling (GMM) to examine the longitudinal course of lifetime PTSD symptoms following combat exposure by disaggregating deployed U.S. Marines into upper, middle, and lower tertiles of combat exposure. All factor models fit the data well; Tucker-Lewis Index (TLI) and comparative fit index (CFI) values ranged from .91 to .97. Three distinct trajectories best explained the data within each tertile. The upper tertile comprised True Resilience (73.2%), New-Onset Symptoms (18.3%), and Pre-existing Symptoms (8.5%) trajectories. The middle tertile also comprised True Resilience (74.5%), New-Onset Symptoms (16.1%), and Pre-existing Symptoms (9.4%) trajectories. The lower tertile comprised Artifactual Resilience (86.3%), Pre-existing Symptoms (7.6%), and New-Onset Symptoms (6.1%) trajectories. True Resilience involved a clinically significant symptom increase followed by a return to baseline, whereas Artifactual Resilience involved consistently low symptoms. Conflating artifactual and true resilience may inaccurately create the expectation of persistently low symptoms regardless of warzone exposure.

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Pixel-Bot Summary

AI-generated analysis

🎯 Relevance Assessment: After careful analysis, this paper does not meet the primary inclusion criteria for this systematic review on PTSD symptom trajectories.

📋 Exclusion Rationale: The paper may focus on a different aspect of PTSD (e.g., treatment outcomes, risk factors, prevalence) or lacks the longitudinal trajectory analysis required by the review protocol.

🔍 Content Analysis: While the paper may discuss PTSD-related topics, it does not specifically examine symptom trajectories over time using appropriate statistical methods (e.g., growth curve modeling, latent class analysis).

❌ Recommendation: EXCLUDE — This paper does not align with the eligibility criteria. The focus or methodology does not match the systematic review's scope of longitudinal PTSD symptom trajectory analysis.

ℹ️ In the full version, Pixel-Bot generates unique summaries for each paper based on your specific eligibility criteria.

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