Distinct Trauma Types in Military Service Members Seeking Treatment for Posttraumatic Stress Disorder.

Journal Article (Journal Article)

We examined the frequency of trauma types reported in a cohort of service members seeking treatment for posttraumatic stress disorder (PTSD) and compared symptom profiles between types. In this observational study, 999 service members (9.2% women; Mage = 32.91 years; 55.6% White) were evaluated using a standardized assessment procedure to determine eligibility for clinical trials. Participants were evaluated for DSM-IV-TR-defined PTSD using the PTSD Symptom Scale-Interview; all participants reported a Criterion A event. Independent evaluators rated descriptions of Criterion A events as belonging to trauma types at a high degree of reliability, κ = 0.80. Aggregated non-life-threat primary trauma types were more frequently endorsed than aggregated life-threat types, 95% CI [17.10%, 29.20%]. Participants who endorsed moral injury-self traumas had a higher level of reexperiencing (d = 0.39), guilt (hindsight bias, d = 1.06; wrongdoing, d = 0.93), and self-blame (d = 0.58) symptoms, relative to those who reported life threat-self. Participants who experienced traumatic loss had greater reexperiencing (d = 0.39), avoidance (d = 0.22), guilt (responsibility, d = 0.39), and greater peri- and posttraumatic sadness (d = 0.84 and d = 0.70, respectively) symptoms, relative to those who endorsed life threat-self. Relative to life threat-self, moral injury-others was associated with greater peri- (d = 0.36) and posttraumatic (d = 0.33) betrayal/humiliation symptoms, and endorsement of aftermath of violence was associated with greater peri- (d = 0.84) and posttraumatic sadness (d = 0.57) symptoms. War zone traumas were heterogeneous, and non-life-threat traumas were associated with distinct symptoms and problems.

Full Text

Duke Authors

Cited Authors

  • Litz, BT; Contractor, AA; Rhodes, C; Dondanville, KA; Jordan, AH; Resick, PA; Foa, EB; Young-McCaughan, S; Mintz, J; Yarvis, JS; Peterson, AL; STRONG STAR Consortium,

Published Date

  • April 2018

Published In

Volume / Issue

  • 31 / 2

Start / End Page

  • 286 - 295

PubMed ID

  • 29669185

Electronic International Standard Serial Number (EISSN)

  • 1573-6598

Digital Object Identifier (DOI)

  • 10.1002/jts.22276


  • eng

Conference Location

  • United States