Page 42 - Journal of Special Operations Medicine - Summer 2014

Table 4 Regression Coefficients Predicting PTSD and In terms of medical exposure levels, PJs reported rates
Depression Symptom Severity Among USAF PJs of direct exposure to personnel being wounded or
Zero-order Partial Structure killed similar to those reported among military medical
33
β p r r Coefficient professionals. However, PJs are much more likely to
PTSD (R = 0.587, R = 0.345) have discharged their weapons (20%) than are other
2
Unit military medical professionals (2%) when deployed to
33
support –.402 <.001 –0.353 –0.442 –0.601 combat. This supports the notion that PJs are part of
CES .136 .373 0.351 0.114 0.598 a unique career field similar to their branch-specific
Special Operations counterparts, in that they are medi-
ABS .365 .018 0.427 0.296 0.727
cal professionals who are also engaged in traditional
2
Depression (R = 0.347, R = 0.120) combat roles.
Unit
support –.259 .062 –0.213 –0.262 –0.614 Results indicate that different types of deployment-
CES .296 .164 0.232 0.217 0.669 related trauma exposure are differentially related to
ABS –.028 .862 0.139 –0.021 0.401 PTSD and depression symptom severity. Specifically,
Note: CES, Combat Exposure Scale; ABS, Aftermath of Battle Scale. combat exposure was associated with significantly more
severe depression, whereas medical-related exposure was
Figure 1 Standardized regression coefficients demonstrating associated with significantly more severe PTSD symp-
the relative magnitude of the relationships of unit support, toms. This is consistent with previous studies that have
combat exposure score (CES), and aftermath of battle score found more severe PTSD and depression among military
(ABS) with severity of PTSD and depression symptoms personnel with more intense combat exposure. 21,40,41
among 194 U.S. Air Force pararescumen. Positive values These studies did not differentiate between subtypes of
indicate relationships associated with increased symptom deployment-related traumas. The present findings there-
severity, whereas negative values indicate relationships fore add new information about how different types of
associated with decreased symptom severity.
deployment-related stressors may lead to negative out-
comes among military personnel, although conclusions
about the generalizability of results from the current
sample of PJs, a highly unique subgroup of military per-
sonnel selected from the larger military based on rigor-
ous qualification standards and training requirements,
should be made with caution until these findings can be
replicated in other, more-diverse samples. Specific to the
PJs, results of the current study suggest that the preven-
tion and treatment of postdeployment PTSD may need
to focus more on medical trauma exposure, whereas the
treatment of postdeployment depression may need to fo-
cus more on combat exposure.

Results also suggest that unit support is associated with
Notes: *p < .05, **p < .001, †p = .06. less severe PTSD and depression symptoms among PJs,
but, contrary to expectations, the interactions of unit
of trauma exposure on emotional distress in this popu- support with combat exposure and medical traumas
lation. Results indicate that PJs report relatively high were not significant for either depression or PTSD, sug-
levels of exposure to combat and aftermath of battle gesting that unit support does not moderate the effects
experiences that are comparable to military personnel of deployment-related trauma on emotional distress in
in both the combat arms and medical professions. For this population. Instead, unit support was related to
example, Vogt et al. found a mean CES score of 31.98 less-severe symptoms regardless of trauma exposure
40
among combat infantry personnel who had deployed to level. This diverges from previous research suggesting
Iraq, compared with a mean score of 33.37 on the same that unit support moderates the relationship between
scale in the current sample, which suggests that PJs’ combat exposure and PTSD and depression among U.S.
level of combat exposure was comparable to that of in- Marines. In contrast, our current results are consistent
29
fantry units. Rates of endorsement of specific combat with other research suggesting unit support protects
experiences among the current sample of PJs were also against PTSD regardless of warzone stress exposure
comparable to rates of exposure among combat arms level among Air Force medical personnel and UK mil-
16
personnel in the Army and Marines deployed to Iraq itary personnel. Du Preez et al. additionally found
41
42
21
and to Connecticut veterans of Iraq and Afghanistan. that greater unit support is associated with decreased
27
32 Journal of Special Operations Medicine Volume 14, Edition 2/Summer 2014