A Dynamic Model for Posttraumatic Stress Disorder Among US Troops in Operation Iraqi Freedom

• 成果类型: Article
• 署名作者: Atkinson, Michael P.; Guetz, Adam; Wein, Lawrence M.
• 署名单位: United States Department of Defense; United States Navy; Naval Postgraduate School; Stanford University; Stanford University
• 刊物名称: MANAGEMENT SCIENCE
• ISSN/ISSBN: 0025-1909
• DOI: 10.1287/mnsc.1090.1042
• 发表日期: 2009
• 页码: 1454-1468
• 关键词: Health care; military; reliability; FAILURE MODELS

摘要

We develop a dynamic model in which Operation Iraqi Freedom (OIF) servicemembers incur a random amount of combat stress during each month of deployment, develop posttraumatic stress disorder (PTSD) if their cumulative stress exceeds a servicemember-specific threshold, and then develop symptoms of PTSD after an additional time lag. Using Department of Defense deployment data and Mental Health Advisory Team PTSD survey data to calibrate the model, we predict that-because of the long time lags and the fact that some surveyed servicemembers experience additional combat after being surveyed-the fraction of Army soldiers and Marines who eventually suffer from PTSD will be approximately twice as large as in the raw survey data. We cannot put a confidence interval around this estimate, but there is considerable uncertainty (perhaps +/-30%). The estimated PTSD rate translates into approximate to 300,000 PTSD cases among all Army soldiers and Marines in OIF, with approximate to 20,000 new cases each year the war is prolonged. The heterogeneity of threshold levels among servicemembers suggests that although multiple deployments raise an individual's risk of PTSD, in aggregate, multiple deployments lower the total number of PTSD cases by approximate to 30% relative to a hypothetical case in which the war was fought with many more servicemembers (i.e., a draft) deploying only once. The time lag dynamics suggest that, in aggregate, reserve servicemembers show symptoms approximate to 1-2 years before active servicemembers and predict that >75% of OIF servicemembers who self-reported symptoms during their second deployment were exposed to the PTSD-generating stress during their first deployment.