OBJECTIVE: This study was a 2-year follow-up in an ongoing prospective
examination of development of trauma-related symptoms over time in a
community group of veterans of Operation Desert Storm. METHOD: Sixty- two
National Guard reservists, from one medical and one military police unit,
completed the Mississippi Scale for Combat-Related Posttraumatic Stress
Disorder and a DSM-III-R-based posttraumatic stress disorder (PTSD) symptom
scale 1 month, 6 months, and 2 years after returning from the Middle East.
Differences in symptom severity over time were analyzed by using repeated
measure analyses of variance. RESULTS: Scores on the Mississippi scale, but
not the DSM-III-R PTSD scale, increased significantly over time. Symptoms
of hyperarousal were more severe at all time points than were symptoms of
reexperiencing or avoidance. Level of combat exposure, as reflected by the
Desert Storm trauma questionnaire, was significantly associated with the
score on the Mississippi scale at 2 years but not at 1 month or 6 months.
All subjects who met the Mississippi scale's diagnostic criteria for PTSD
at 1 or 6 months still met the criteria at 2 years. CONCLUSIONS: Although
symptoms were relatively mild, there was an overall increase in PTSD
symptoms over 2 years. The statistical relationship between level of combat
exposure and PTSD symptoms at 2 years, and not before, suggests that it may
take time for the consequences of traumatic exposure to become apparent.
Moreover, degree of exposure may be important in predicting the eventual
development of symptoms. Continued follow-up will address the evolution of
PTSD symptoms in Gulf War veterans.