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. 2022 Jun 28;17(6):e0270515.
doi: 10.1371/journal.pone.0270515. eCollection 2022.

Combat exposure and behavioral health in U.S. Army Special Forces

Anna C Rivera  1   2 , Cynthia A LeardMann  1   2 , Rudolph P Rull  1 , Adam Cooper  1   3 , Steve Warner  1   2 , Dennis Faix  4 , Edwin Deagle  5 , Rob Neff  5 , Ryan Caserta  5 , Amy B Adler  6 ; Millennium Cohort Study Team
Affiliations

Combat exposure and behavioral health in U.S. Army Special Forces

Anna C Rivera et al. PLoS One. .

Abstract

Although combat has been found to be associated with adverse health outcomes, little is known about the impact of specific combat exposures, particularly among specialized personnel. This study examined the association of different types of combat exposures with behavioral health outcomes, and whether these associations differed by Army occupational specialization: General Purpose Forces infantrymen (n = 5,361), Ranger Qualified infantrymen (n = 308), and Special Forces personnel (n = 593). Multivariable regression models estimated the association of combat severity, type of combat event (fighting, killing, threat to oneself, death/injury of others), and type of killing with mental health disorders, trouble sleeping, and problem drinking. Combat severity, each type of combat event, and killing noncombatants were associated with adverse health outcomes after adjusting for covariates and other combat exposures. Except for trouble sleeping, these associations did not differ by occupational specialization, though the prevalence and odds of outcomes were generally lower for Special Forces personnel.

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Conflict of interest statement

Leidos, Inc and Innovative Employee Solutions provided financial support in the form of salaries for some authors. This does not alter our adherence to PLOS ONE policies on sharing data and materials. The authors have declared that no competing interests exist.

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