The impact of combat intensity and deployment stressors on Veteran post-traumatic stress

Abstract: BACKGROUND: Veteran trauma is central to trauma research. Combat exposure, perceived threat, and concerns about disruptions to life and family are key predictors of posttraumatic stress symptoms (PTSS) in veterans. This study examines how various deployment stressors relate to PTSS and other psychological outcomes. METHODS: Eighty-six Israeli combat veterans (active duty=60; reserve duty=26) with intense combat exposure reported their combat experiences and deployment-related concerns and completed mental health measures. A cluster analysis identified clusters of co-occurring deployment stressors. Bayesian Graphical Gaussian Models (BGGM) mapped the interrelationships between combat stressors, PTSS, and other psychological outcomes. A subsample of 66 completed a two-month follow-up, enabling analysis of symptom change trajectories. RESULTS: Active-duty soldiers reported more combat exposures, whereas reservists expressed greater concerns about disruptions to life and family. The strongest correlate of PTSS and anxiety was concern over a partner during deployment. Urban operations were also linked to PTSS and specific symptom clusters and vivid trauma memory. Sustaining an injury was associated with more vivid traumatic memories. Longitudinal analyses revealed three symptom trajectories: stable, improvement, and exacerbation, but these were unrelated to sociodemographic factors and unaffected by post-deployment support, unit cohesion, or family functioning. CONCLUSIONS: Deployment-related stressors differentially affect veteran mental health. Chronic concerns over partner and family, as well as stressors and exposures involving uncertainty and threat, warrant special attention in clinical and research settings.