1. Initial Validation of Self-Reported Trajectories in Military Veterans
Steven L. Lancaster1 & Roland P. Hart2
1Drake University, Des Moines, IA, 2 NYU School of Medicine, Steven & Alexandra Cohen Veterans Center for the Study of Post-Traumatic Stress Disorder and Traumatic Brain Injury, New York, NY
Results
Means, Standard Deviations, and Correlations for all measures are presented in Table 1. As expected, PTSD symptoms were significantly correlated with negative affect, perceived social support, and symptoms of depression. Further, life satisfaction was negatively related to symptoms of depression and PTSD as well as negative affect. Surprisingly, social support was unrelated to current general life satisfaction in the current study. As expected, significant differences were found between trajectories on the PTSD Checklist, F(1,77) = , p < Post hoc analyses indicate those who reported current struggle had significantly higher symptoms of PTSD than those who reported currently being “OK.” Further, those who reported past struggle but who reported currently being OK reported significantly higher symptoms than those who reported being OK at both time points.
Similarly, the group that reported struggling at both time points reported significantly higher levels of depression than the other three trajectories, and the two “current struggle” groups reported higher symptoms of depression than the two “currently OK” groups.
Results for the other measures of interest are generally consistent with these findings in that those who report struggling at both time points report more distress, less life satisfaction, and less social support than those reporting other trajectories, while those who report being OK at both or one time point showed opposite patterns.
Introduction
Research on functioning following potentially traumatic events has shown that veterans prototypically follow one of four discrete trajectories following deployment: chronic dysfunction, delayed reaction, recovery, and resilience (Bonanno et al., 2012). Trajectory research typically employs latent growth mixture modeling techniques (LGMM: Muthen, 2004), which allow for the identification of heterogeneous pathways in longitudinal samples. Longitudinally collected data of this kind is limited in the fact that it can take months, or years to collect and requires multiple reports from participants. Additionally, trauma survivors in particular are often difficult samples to manage due to attrition (Bonanno & Mancini, 2012). Thus, being able to assign a trajectory using one time point would likely lead to more participant completion. The purpose of this study is to assess the ability of veterans to retrospectively place themselves into one of the aforementioned trajectories at one single time point. We predicted that the trajectory chosen by veterans will be associated with the measures of functioning in the following ways: those who place themselves on the chronic dysfunction trajectory will endorse the most symptoms related to impaired functioning; those whose self-reports place them on the resilient path will endorse the fewest symptoms; those who select the intermediate trajectories will fall between the two more extreme options in terms of functioning.
Table 1. Means and Simple Correlations
M (SD) 1 2 3 4 5
1. PTSD Symptoms
42.00 (19.19) --
.62**
.81**
-.48**
-.40**
2. Negative Affect
16.89 (8.06)
.71**
.46**
-.34**
3. Depression
9.95 (7.60)
-.55**
-.33**
4. Satisfaction with Life
20.62 (6.05)
.19
5. Social Support
51.24 (9.22)
Method
Participants
Participants were 90 military veterans. Deployments were primarily related to Operation Iraqi Freedom and Operation Enduring Freedom (N = 62) with other commonly reported deployments to Vietnam (N = 12), the Balkan Conflict (N = 4), other conflicts (N = 3), and nine participants who did not report location of deployments.
Sample Description: 80% male (n = 94); 79% White, non-Hispanic.
Data Collection and Measures
Participants were recruited using a variety of online methods including posting to listservs, forums, Twitter, and Facebook as well as being distributed electronically by military related organizations. Participants accessed an encrypted server via a hyperlink attached to the announcement.
Participants were asked to complete the PTSD Checklist, Center of Epidemiological Studies Depression Scale – Short Form, Positive and Negative Affect Schedule, Satisfaction with Life Scale, the Post-Deployment social support scale from the DRRI, the Combat Experiences Scale and a number of measures not reported in the current study.
Participants were further asked to retrospectively evaluate their functioning (OK or struggling) immediately post-deployment as well as currently.
Data Analysis Plan
A series of ANOVAs were estimated to examine mean differences between self-reported trajectories (see Table 2 for full results). All analyses were conducted using SPSS statistical software.
Table 2. Group Differences Between Trajectories
Discussion
The goal of this study was to examine the ability of veterans to identify their own traumatic stress trajectory following military service. As predicted, participants who reported struggling immediately after deployment and experiencing current struggle reported the most impaired functioning. Those in the resilient group (OK then - OK now) showed the least impaired functioning. Participants in the delayed reaction and recovery groups scored between the more extreme groups with the recovery group showing less impairment than the delayed reaction group. Our results, like studies that have come before ours, display distinct levels of post-traumatic stress related symptomology among each of the self-reported trajectory groups. We believe that a validated, short version of trajectory assessment will provide more opportunities for research of this kind and would allow for non-longitudinally based trajectory research, making post-traumatic adjustment research more feasible for the study of populations who are difficult to retain and follow over time. This could open the door to researching trajectories on historically hard to research populations such as veterans and victims of child abuse, sexual assault, and torture.
Trajectory 
PCL-M
CESD NA
SWLS
PDSS
OK-OK (n = 24)
24.33
4.89
13.00
23.21
52.82
OK-Struggle (n = 15)
50.99a
12.20a
16.66
19.47
51.60
Struggle-OK (n = 19)
34.68a,b
5.90b
14.00
22.65
54.78
Struggle-Struggle (n = 23)
60.96a,c
18.30a,b,c
24.17a,b,c
16.39a,c
51.24a,c
Note. First term (OK or Struggle) refers to participant’s retrospective report of their overall functioning when the first returned home from deployment, while the second term refers to the assessment of their current functioning. Subscript a indicates the value is significantly different (p < .05) from “OK-OK,” b indicates significantly different from “Struggle-OK,” and c indicates value is significantly different from “Struggle-Struggle.” Only those who reported military related traumatic events were included in analysis for the PCL-M (N = 81).
Author’s Note: The first and second authors contributed equally to this project. The presentation of this poster was funded by the NYU Steven and Alexandra Cohen Veterans Center for the Study of PTSD and TBI.