The DOI matches its Crossref record; 33 of the 33 references it cites were found in a registry or an index.
Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care
Abstract
BACKGROUND: The current combat operations in Iraq and Afghanistan have involved U.S. military personnel in major ground combat and hazardous security duty. Studies are needed to systematically assess the mental health of members of the armed services who have participated in these operations and to inform policy with regard to the optimal delivery of mental health care to returning veterans. METHODS: We studied members of four U.S. combat infantry units (three Army units and one Marine Corps unit) using an anonymous survey that was administered to the subjects either before their deployment to Iraq (n=2530) or three to four months after their return from combat duty in Iraq or Afghanistan (n=3671). The outcomes included major depression, generalized anxiety, and post-traumatic stress disorder (PTSD), which were evaluated on the basis of standardized, self-administered screening instruments. RESULTS: Exposure to combat was significantly greater among those who were deployed to Iraq than among those deployed to Afghanistan. The percentage of study subjects whose responses met the screening criteria for major depression, generalized anxiety, or PTSD was significantly higher after duty in Iraq (15.6 to 17.1 percent) than after duty in Afghanistan (11.2 percent) or before deployment to Iraq (9.3 percent); the largest difference was in the rate of PTSD. Of those whose responses were positive for a mental disorder, only 23 to 40 percent sought mental health care. Those whose responses were positive for a mental disorder were twice as likely as those whose responses were negative to report concern about possible stigmatization and other barriers to seeking mental health care. CONCLUSIONS: This study provides an initial look at the mental health of members of the Army and the Marine Corps who were involved in combat operations in Iraq and Afghanistan. Our findings indicate that among the study groups there was a significant risk of mental health problems and that the subjects reported important barriers to receiving mental health services, particularly the perception of stigma among those most in need of such care.
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“post-traumatic stress disorder (PTSD) has been identified as the ‘signature injury’ of United States service men and women deployed to Afghanistan and Iraq.4”
From Factors associated with self-reported health among New Zealand military veterans: A cross-sectional study (2022) · cites this paper as [4]
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
Kessler, R. C. (1994) · Archives of General Psychiatry · doi:10.1001/archpsyc.1994.03950010008002 · Cited by 12,370
Posttraumatic Stress Disorder in the National Comorbidity Survey
Kessler, R. C. (1995) · Archives of General Psychiatry · doi:10.1001/archpsyc.1995.03950240066012 · Cited by 10,379
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., Rush, A. J., Walters, E. E., & Wang, P. S. (2003) · JAMA · doi:10.1001/jama.289.23.3095 · Cited by 7,988
Psychometric properties of the PTSD checklist (PCL)
Blanchard, E. B., Jones-Alexander, J., Buckley, T. C., & Forneris, C. A. (1996) · Behaviour Research and Therapy · doi:10.1016/0005-7967(96)00033-2 · Cited by 3,997
Applied Logistic Regression Analysis
Ziegel, E. R., & Menard, S. (1996) · Technometrics · doi:10.1080/00401706.1996.10484485 · Cited by 3,923
Applied Logistic Regression Analysis
Menard, S. (2002) · Sage eBooks · doi:10.4135/9781412983433 · Cited by 3,011
Epidemiologic Research: Principles and Quantitative Methods.
Mayer, L. S., Kleinbaum, D. G., Kupper, L. L., & Morgenstern, H. (1984) · Journal of the American Statistical Association · doi:10.2307/2288427 · Cited by 2,905
The de Facto US Mental and Addictive Disorders Service System
Regier, D. A. (1993) · Archives of General Psychiatry · doi:10.1001/archpsyc.1993.01820140007001 · Cited by 1,988
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Research works printed but not linked: 3
- 10.1001/jama.277.3.238 · DOI · Paper page
- Brown RL, 2001, J Am Board Fam Pract, 14, 95
- Castro CA, 2000, Int Rev Armed Forces Med Serv, 73, 191
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Mild traumatic brain injury in U.S. soldiers returning from Iraq
Hoge, C. W., McGurk, D., Thomas, J. L., Cox, A. L., Engel, C. C., & Castro, C. A. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa072972 · Cited by 2,775
Self-citationMoral injury and moral repair in war veterans: A preliminary model and intervention strategy
Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.07.003 · Cited by 2,738
Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006) · JAMA · doi:10.1001/jama.295.9.1023 · Cited by 2,027
Self-citationThe Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014) · Psychological Science in the Public Interest · doi:10.1177/1529100614531398 · Cited by 1,642
Milliken, C. S., Auchterlonie, J. L., & Hoge, C. W. (2007) · JAMA · doi:10.1001/jama.298.18.2141 · Cited by 1,640
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Metadata
- Authors
- Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L.
- Affiliations
- United States Army Medical Research and Development Command (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2004-07
- Volume
- 351
- Issue
- 1
- Pages
- 13-22
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2150261153
- Cited by
- 4,778
- References
- 33
- Citations by year
- 2026: 109 · 2025: 113 · 2024: 136 · 2023: 130 · 2022: 163 · 2021: 195 · 2020: 205 · 2019: 219 · 2018: 237 · 2017: 307 · 2016: 299 · 2015: 330 · 2014: 395 · 2013: 367 · 2012: 310
- FWCI
- 113.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- NSUWorks (Nova Southeastern University) (submittedVersion)
- U.S. Army Academy of Health Sciences, Stimson Library (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- combat veterans, mental health, post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder, barriers to mental health care, stigma, Iraq War, Afghanistan War, military deployment, combat exposure, returning veterans
- MeSH terms
- Adolescent, Adult, Afghanistan, Anxiety, Mental Disorders, Combat Disorders, Data Collection, Delivery of Health Care, Depressive Disorder, Female, Health Services Accessibility, Humans, Iraq, Male, Mental Health Services, Military Personnel, Patient Acceptance of Health Care, Prejudice, Socioeconomic Factors, Stress Disorders, Post-Traumatic, United States, Warfare, Prevalence
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