SOCIAL STATUS AND PTSD IN U.S. VIETNAM VETERANS

美国越南退伍军人的社会地位和创伤后应激障碍

基本信息

批准号：
6392610
负责人：
BRUCE P DOHRENWEND
金额：
$ 36.38万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
1999
资助国家：
美国
起止时间：
1999-09-28 至 2003-12-01
项目状态：
已结题

项目摘要

The broad objective is to explain differences in rates of Post-Traumatic Stress Disorder (PTSD) and comorbid disorders in U.S. Vietnam veterans from different social statuses indicated by gender, ethnic/racial background, and parental socioeconomic status (SES). The specific aims involve tests of alternative hypotheses about the primacy of exposure to environmental war- zone stressors, the role of antecedent personal predispositions, and the influence of endogenous cultural factors associated with the differing social statuses. The data for these tests come from the National Vietnam Veterans Readjustment Study (NVVRS). The NVVRS was conducted by the Research Triangle Institute (RTI) in response to a Congressional mandate to investigate PTSD and other psychological problems in the U.S. veterans. The study of nationwide samples of 3,016 Vietnam Theater veterans other Vietnam Era veterans, and non-veterans began in 1984, and the intensive data collection continued over the next several years. The veteran samples were drawn from military records and interviewed in detail about their premilitary lives, their military experiences, and their lives following the war as well as a wide variety of psychological symptoms and problems. In addition, a subsample of respondents consisting of 343 Theater veterans and 93 Era veterans were given intensive research diagnostic examinations by experienced clinicians. These subsample diagnoses contain the only data in the study on onset and course of PTSD, and reports of results of the study thus far have focused on current PTSD in the larger samples. The rate of current PTSD (present 15 to 20 years after the war) was 15.2 percent in male Theater veterans, six times as high as for the Era comparison sample. This rate of persistent or recurrent PTSD was especially high in Hispanics (27.9 percent) and African-Americans (20.6 percent) compared to nonHispanic whites (13.7 percent). These ethnic/racial differences are reduced but do not disappear when parental socioeconomic status (SES) is controlled. Among female Theater veterans, mainly nonHispanic white nurses, the 8.5 percent rate of current PTSD is substantially lower than for males. Very large majorities of both male and female Theater veterans with current PTSD were diagnosed with other concomitant psychiatric disorders. The reasons for these gender and racial/ethnic differences are unknown. The proposed study will focus almost exclusively on the diagnosed subsample in order to investigate alternative explanations of the group differences as the hypotheses apply to initial onset and to course of PTSD and comorbid disorders. Plans are set forth for utilizing existing measures and developing new ones necessary for the task from the NVVRS data, and for a variety of statistical analyses using descriptive statistics, graphical methods, and logistic and Gaussian multivariate regression. The long term goal is to increase knowledge of how humans adapt or fail to adapt to adversity and stress, and to contribute to the account of an historic event in the life of this nation.

广泛的目的是解释美国越南退伍军人的创伤后应激障碍（PTSD）和合并症的差异，这些疾病来自不同社会地位，以性别，种族/种族背景和父母的社会经济地位（SES）指示的不同社会地位。具体的目的涉及关于暴露于环境战区压力源的首要地位的替代假设，前身个人倾向的作用以及与不同社会地位相关的内源性文化因素的影响。这些测试的数据来自国家越南退伍军人调整研究（NVVRS）。 NVVR是由研究三角研究所（RTI）对国会授权进行了调查美国退伍军人PTSD和其他心理问题的授权进行的。对3,016个越南剧院退伍军人的其他越南时代的退伍军人和非退伍军人的全国样本的研究始于1984年，在未来几年中，密集数据收集仍在继续。从军事记录中汲取了资深样本，并详细采访了他们的前期生活，军事经历以及战后的生活以及各种各样的心理症状和问题。此外，经验丰富的临床医生对由343名剧院退伍军人和93名ERA退伍军人组成的受访者进行了深入研究诊断检查。这些子样本诊断包含有关PTSD发作和过程的唯一数据，迄今为止，研究结果的报告集中在较大样本中的当前PTSD上。男性剧院退伍军人的当前PTSD率（战后15至20年）为15.2％，是ERA比较样本的六倍。与非希西兰人白人（13.7％）相比，这种持续或复发性PTSD的持续性PTSD率（27.9％）和非洲裔美国人（20.6％）特别高（20.6％）。这些种族/种族差异减少了，但在控制父母的社会经济地位（SES）时不会消失。在女性剧院退伍军人（主要是非西班牙裔白人护士）中，当前PTSD的8.5％的比率大大低于男性。当前有PTSD的男性和女性剧院退伍军人中，大多数人都被诊断出患有其他伴随的精神疾病。这些性别和种族/种族差异的原因尚不清楚。拟议的研究将几乎完全关注所诊断的子样本，以研究该组差异的替代解释，因为假设适用于初始发作和PTSD和合并症的过程。规定了利用现有措施的计划，并从NVVRS数据中开发了为任务所需的新措施，以及使用描述性统计，图形方法以及物流和高斯多元回归的各种统计分析。长期目标是增加对人类如何适应或不适应逆境和压力的知识，并为这个国家生活中的历史事件做出贡献。