A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 25793582 · doi:10.1371/journal.pone.0120270
What was done
Authors searched four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) for observational studies (cross-sectional, retrospective, and cohort) on post-traumatic stress disorder (PTSD) among military personnel and veterans deployed to combat zones. Study selection and data extraction were performed independently by two authors. Random-effects models were used to synthesize summary estimates, alongside subgroup, sensitivity, and publication bias analyses, across 32 included articles.
What was found
Combat-related PTSD prevalence across included studies ranged from 1.09% to 34.84%. The analysis identified 18 significant risk factors categorized across three phases: - Pre-trauma: female sex, ethnic minority status, lower education, non-officer rank, army service, combat specialization, higher number of deployments, longer cumulative deployment duration, prior adverse life events, prior trauma exposure, and prior psychological difficulties. - Peri-trauma: increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. - Post-trauma: lack of post-deployment support. Specific pooled effect sizes, odds ratios, and confidence intervals for individual predictors were not reported in the abstract.
Why it matters
This review provides a structured overview of pre-, peri-, and post-deployment characteristics that increase vulnerability to combat-related PTSD, helping inform screening and post-deployment support allocation.
Limits
The abstract does not provide specific numerical effect sizes, confidence intervals, or heterogeneity statistics for the identified predictors. The underlying evidence relies entirely on observational designs (cross-sectional, retrospective, and cohort), which carry inherent risks of recall bias and residual confounding. Total participant sample size is not stated in the abstract.
Cited by
- supports Individuals with complex post-traumatic stress or chronic childhood trauma are at a significantly higher risk of developing acute PTSD episodes after subsequent traumatic events.