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

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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.

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Funding

This study was supported by the Department of Defense [W81XWH-15-1-0080]. L. Sampson is supported by the National Institutes of Health [T32 HL098048].

Author information

Authors and Affiliations

  1. Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA

    Laura Sampson

  2. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA

    Jaimie L. Gradus, Anthony J. Rosellini, Gregory H. Cohen & Sandro Galea

  3. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

    Howard J. Cabral

  4. Center for Anxiety and Related Disorders, Department of Psychological and Brain Science, Boston University, Boston, MA, USA

    Anthony J. Rosellini

  5. New York State Psychiatric Institute, New York, NY, USA

    David S. Fink

  6. Department of Psychiatry, College of Medicine, Texas A&M, College Station, TX, USA

    Israel Liberzon

  7. Office of the Dean, Boston University School of Public Health, 715 Albany Street, Boston, MA, USA

    Sandro Galea

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  1. Laura Sampson
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  2. Jaimie L. Gradus
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Contributions

LS coded the raw data, designed and performed the statistical analyses, and wrote the first draft of the manuscript. SG, JG, and HC supervised the analyses. LS, SG, GC, and IL facilitated collection of the raw data. All authors contributed to the interpretation of the results, critically reviewed all manuscript drafts, and approved the final version.

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Correspondence to Laura Sampson.

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The authors report no competing interests.

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Sampson, L., Gradus, J.L., Cabral, H.J. et al. Stressful life events and incident depression among U.S. military personnel. Soc Psychiatry Psychiatr Epidemiol 58, 1009–1018 (2023). https://doi.org/10.1007/s00127-023-02445-9

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