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. 2023 Jul;58(7):1009-1018.
doi: 10.1007/s00127-023-02445-9. Epub 2023 Mar 10.

Stressful life events and incident depression among U.S. military personnel

Laura Sampson  1 , Jaimie L Gradus  2 , Howard J Cabral  3 , Anthony J Rosellini  2   4 , David S Fink  5 , Gregory H Cohen  2 , Israel Liberzon  6 , Sandro Galea  2   7
Affiliations

Stressful life events and incident depression among U.S. military personnel

Laura Sampson et al. Soc Psychiatry Psychiatr Epidemiol. 2023 Jul.

Abstract

Purpose: Although stressful life events (i.e., stressors) and depression are often assumed to be linked, the relation between stressors and incident depression is rarely studied, particularly in the military. The National Guard is a part-time subset of the U.S. military for whom civilian life stressors may be particularly salient, due to the soldiers' dual roles and frequent transitions between military and civilian life.

Methods: We used a dynamic cohort study of National Guard members from 2010 to 2016 to investigate the relationship between recent stressful experiences (e.g., divorce) and incident depression, with an exploratory analysis of effect modification by income.

Results: Respondents endorsing at least one of nine past-year stressful events (a time-varying exposure, lagged by 1 year) had almost twice the adjusted rate of incident depression compared to those with no stressful events (HR = 1.8; 95% CI 1.4, 2.4). This association may be modified by income: among individuals making under $80,000 per year, those with past-year stressors had twice the rate of depression compared to those with no stressors, but among those making over $80,000, past-year stressors were associated with only 1.2 times the rate of depression.

Conclusion: Stressful life events outside of deployment are important determinants of incident depression among National Guard servicemembers, but the effect of these events may be buffered by higher income.

Keywords: Depressive disorders; Income; Military health; Stress.

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Conflict of interest statement

Conflicts of interest: None.

Figures

Fig 1
Fig 1
Study design diagram of exposure and outcome assessment for lagged, time-varying stressors as they predict depression. b/w = between. w = wave.
Fig 2
Fig 2
Diagram of time-on-study design. * = 2014–2015, shorter interviews, only 2 stressors assessed. Dashed boxes = imputed data.
Fig 3.
Fig 3.
Adjusted relationship between one or more past-year stressful events (time-varying) and time to incident depression, adjusted and stratified by baseline income category, graphed on the log scale. aHR = adjusted hazard ratio. Adjusted for gender, race, age group, and time-varying past-year PTSD.
See this image and copyright information in PMC

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