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Article History

Received: 7 November 2019

Accepted: 15 June 2020

First Online: 1 July 2020

Ethics approval and consent to participate

: The protocol was approved by the Veterans Affairs New Jersey Healthcare System Institutional Review Board and all relevant ethics committees. Study personnel obtained written consent for all participants. This study analyzed self-reported data from the HEROES project. The HEROES project was a prospective longitudinal observational cohort study of U.S. soldiers who were preparing for deployment to Iraq or Afghanistan at Fort Dix, NJ or Camp Shelby, MS. The HEROES project collected data from 4 time points: pre-deployment (Phase 1, 2005–2008), immediately post-deployment (Phase 2, 2007–2009), 3 months after return from deployment (Phase 3, 2007–2010), and 1 year after return (Phase 4, 2008–2011). The current study uses data from two time points: phase 1 (pre-deployment) and phase 4 (post-deployment). The study recruited 790 Army National Guard and Army Reserve Enlisted Soldiers (ages 18–60 years) at the time of their on-base pre-deployment medical processing. To focus on new symptoms in a relatively healthy cohort, exclusion criteria (pre-deployment) included current self-reported depression, taking medications with cardiovascular and/or autonomic effects, history of schizophrenia or bipolar disorder, or current cancer, high blood pressure, or pregnancy. Deployments typically lasted 12–13 months. Four hundred twenty-two soldiers (53%) were available for post-deployment assessment and completed Phase 2; 23 declined to continue and 345 could not be located.

: Not applicable.

: The authors declare that they have no competing interests.