Open Access Research article

Predictors of psychiatric disorders in combat veterans

Stephanie Booth-Kewley1*, Emily A Schmied1, Robyn M Highfill-McRoy1, Gerald E Larson1, Cedric F Garland12 and Lauretta A Ziajko3

Author Affiliations

1 Behavioral Science and Epidemiology Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106-3521, USA

2 Department of Family and Preventive Medicine and Moores UCSD Cancer Center, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093-0631, USA

3 Naval Medical Center, San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134, USA

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BMC Psychiatry 2013, 13:130  doi:10.1186/1471-244X-13-130

Published: 7 May 2013



Most previous research that has examined mental health among Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) combatants has relied on self-report measures to assess mental health outcomes; few studies have examined predictors of actual mental health diagnoses. The objective of this longitudinal investigation was to identify predictors of psychiatric disorders among Marines who deployed to combat in Iraq and Afghanistan.


The study sample consisted of 1113 Marines who had deployed to Iraq or Afghanistan. Demographic and psychosocial predictor variables from a survey that all Marines in the sample had completed were studied in relation to subsequent psychiatric diagnoses. Univariate and multivariate logistic regression were used to determine the influence of the predictors on the occurrence of psychiatric disorders.


In a sample of Marines with no previous psychiatric disorder diagnoses, 18% were diagnosed with a new-onset psychiatric disorder. Adjusting for other variables, the strongest predictors of overall psychiatric disorders were female gender, mild traumatic brain injury symptoms, and satisfaction with leadership. Service members who expressed greater satisfaction with leadership were about half as likely to develop a mental disorder as those who were not satisfied. Unique predictors of specific types of mental disorders were also identified.


Overall, the study’s most relevant result was that two potentially modifiable factors, low satisfaction with leadership and low organizational commitment, predicted mental disorder diagnoses in a military sample. Additional research should aim to clarify the nature and impact of these factors on combatant mental health.

Psychiatric disorders; Military populations; Marines; Iraq/Afghanistan wars; Veterans; Combat