A Longitudinal Study on Post-Traumatic Stress Symptoms Using Health Care Data from the Japan Self-Defense Forces: Findings and Application to Digital Tools

NATO science for peace and security series. Sub-series E, Human and societal dynamics

Abstract

Japan Self-Defense Forces (JSDF) personnel can be exposed to various traumatic stresses, as they are responsible for national defense and emergency responses. Therefore, the JSDF conducts annual mental health surveys for all personnel and pre-deployment medical checks for deployed personnel as part of its health management measures. This paper presents a longitudinal study on post-traumatic stress disorder (PTSD) symptoms among JSDF personnel deployed to the United Nations Mission in South Sudan (UNMISS). The study used pre-deployment general health and longitudinal data on PTSD symptoms for up to six years post-deployment for 2962 peacekeepers deployed to UNMISS. A latent growth mixture model identified four symptom trajectories: resilient (72.3%), recovery (16.2%), protracted (6.1%), and delayed (5.3%). Multinomial logistic regression with the resilient trajectory as reference identified “sleep disturbance” as a common predictor for the two most severe trajectories (protracted: odds ratio [OR] = 1.29; 95% confidence interval [CI] 1.08–1.54, delayed: OR = 1.26; 95% CI 1.03–1.53). Subsequently, we focused on “sleep disturbance” as a target symptom for PTSD prevention and discussed its application to digital tools. Cognitive behavioral therapy for insomnia (CBT-I) is strongly recommended for the treatment of insomnia, and digital CBT-I (dCBT-I), which provides services via smartphones or the Internet, has already been developed. Considering the enormous advantages of digital tools, such as accessibility, scalability, and anonymity, dCBT-I is a promising tool for early intervention to prevent PTSD.

Authors 7

1. Masanori Nagamine

   National Defense Medical College

   Affiliation as printed

   Division of Behavioral Science, National Defense Medical College Research Institute, Saitama, Japan

2. Masato Kitano

   National Defense Medical College

   Affiliation as printed

   Division of Behavioral Science, National Defense Medical College Research Institute, Saitama, Japan

3. Taku Saito

   National Defense Medical College

   Affiliation as printed

   Division of Behavioral Science, National Defense Medical College Research Institute, Saitama, Japan

4. Florentine H. S. van der Does Aachen Department of Psychiatry, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Psychiatry, Leiden University Medical Center (LUMC), Leiden, the Netherlands

5. Erik J. Giltay Aachen Department of Psychiatry, Leiden University Medical Center Health Campus The Hague

   Leiden University · University of Antwerp · Leiden University Medical Center

   Affiliation as printed

   Collaborative Antwerp Psychiatric Research Institute (CAPRI), Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium

   Department of Psychiatry, Leiden University Medical Center (LUMC), Leiden, the Netherlands

   Health Campus The Hague, Leiden University, The Hague, The Netherlands

6. Jun Shigemura

   Uniformed Services University of the Health Sciences · Mejiro University

   Affiliation as printed

   Department of Psychiatry, Uniformed Services University of the Health Sciences

   Faculty of Health Sciences, Mejiro University, Japan

7. Eric H. G. J. M. Vermetten Aachen Department of Psychiatry, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Psychiatry, Leiden University Medical Center (LUMC), Leiden, the Netherlands