Psychiatric diagnoses and punishment for misconduct the effects of PTSD in combat-deployed Marines 英文参考文献.docVIP

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Psychiatric diagnoses and punishment for misconduct the effects of PTSD in combat-deployed Marines 英文参考文献.doc

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Psychiatric diagnoses and punishment for misconduct the effects of PTSD in combat-deployed Marines 英文参考文献

Highfill-McRoyetal.BMCPsychiatry2010,10:88 /1471-244X/10/88 RESEARCH ARTICLE OpenAccess Psychiatricdiagnosesandpunishmentfor misconduct:theeffectsofPTSDincombat- deployedMarines RobynMHighfill-McRoy1*?,GeraldELarson1?,StephanieBooth-Kewley1?,CedricFGarland1,2? Abstract Background:ResearchonVietnamveteranssuggestsanassociationbetweenpsychologicalproblems,including posttraumaticstressdisorder(PTSD),andmisconduct;however,thishasrarelybeenstudiedinveteransof OperationIraqiFreedomorOperationEnduringFreedom.Theobjectiveofthisstudywastoinvestigatewhether psychologicalproblemswereassociatedwiththreetypesofmisconductoutcomes(demotions,drug-related discharges,andpunitivedischarges.) Methods:Apopulation-basedstudywasconductedonallU.S.MarineswhoenteredthemilitarybetweenOctober 1,2001,andSeptember30,2006,anddeployedoutsideoftheUnitedStatesbeforetheendofthestudyperiod, September30,2007.Demographic,psychiatric,deployment,andpersonnelinformationwascollectedfrommilitary records.Coxproportionalhazardsregressionanalysiswasconductedtoinvestigateassociationsbetweenthe independentvariablesandthethreetypesofmisconductinwar-deployed(n=77998)andnon-war-deployed (n=13944)Marines. Results:Marinesinboththewar-deployedandnon-war-deployedcohortswithanon-PTSDpsychiatricdiagnosis hadanelevatedriskforallthreemisconductoutcomes(hazardratiosrangedfrom3.93to5.65).PTSDwasa significantpredictorofdrug-relateddischargesinboththewar-deployedandnon-war-deployedcohorts.Inthe war-deployedcohortonly,aspecificdiagnosisofPTSDwasassociatedwithanincreasedriskforbothdemotions (hazardratio,8.60;95%confidenceinterval,6.95to10.64)andpunitivedischarges(HR,11.06;95%CI,8.06to15.16). Conclusions:TheseresultsprovideevidenceofanassociationbetweenPTSDandbehaviorproblemsinMarines deployedtowar.Moreover,becausemisconductcanleadtodisqualificationforsomeVeteransAdministration benefits,personnelwiththemostseriousmanifestationsofPTSDmayfaceadditionalbarrierstocare. Background Research onVietnam Warveterans strongly suggests Num