1
|
Khan AR, Altalbe A. Potential impacts of Russo-Ukraine conflict and its psychological consequences among Ukrainian adults: the post-COVID-19 era. Front Public Health 2023; 11:1280423. [PMID: 37841733 PMCID: PMC10568327 DOI: 10.3389/fpubh.2023.1280423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/15/2023] [Indexed: 10/17/2023] Open
Abstract
Background Since February 2022, the nation of Ukraine has become entangled in an escalating conflict that erupted after coronavirus outbreak fostering a situation of indeterminacy and precariousness, which adversely affected several facets, especially psychological well-being. However, there is a lack of empirical evidence on the psychological well-being of Ukrainians during the Russo-Ukraine war, as well as their coping strategies in response to the war's repercussions. Consequently, this investigation endeavors to explore the prevalence of symptoms associated with depression, anxiety, stress, and insomnia and to correlate these symptoms with Ukrainians' effective coping mechanisms during the ongoing war. Methods An online survey was administered in Ukraine from June to August 2022 due to the ongoing Russo-Ukraine conflict. The survey employed a quota sampling technique, targeting 2,664 individuals (≥18 years). Out of the total sample, 1,833 valid responses were obtained, yielding a response rate of 68. 81%. Depression, anxiety, and stress were measured using the depression, anxiety, and stress scale-21 (DASS-21), while the Pittsburgh sleep quality index (PSQI) was utilized to evaluate insomnia symptoms. In addition, Brief-COPE was adopted to evaluate the coping mechanisms of the selected study participants. Results Of 1,833 Ukrainian adults, 60.5% had symptoms of stress; 62.4% of them reported symptoms of anxiety; and 58.2% reported symptoms of depression. Symptom criteria for insomnia were found in about 21.8% of the study sample. The factors of sex, living area, area occupied by Russian forces, and having older adults and children in the house were statistically significant with symptoms of depression, anxiety, stress, and insomnia. The productive coping strategies of self-distraction, using instrumental support, planning, and behavioral disengagement, were observed as statistically significant with four psychological constructs. Conclusion The study outcomes highlight a substantial prevalence of symptoms related to depression, anxiety, stress, and insomnia attributed to the accumulated consequences of ongoing conflict and the COVID-19 outbreak. The aforementioned findings emphasize the imperative of providing healthcare services and facilitating effective coping strategies among Ukrainians amid the ongoing war.
Collapse
Affiliation(s)
- Ahsan Riaz Khan
- Department of Interventional and Vascular Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic and Development Zone, Dezhou, China
| | - Ali Altalbe
- Department of Computer Engineering, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
2
|
Lucier-Greer M, Frye-Cox N, Reed-Fitzke K, Ferraro AJ, Mancini JA. Military-related stress, self-efficacy, and anxiety: Investigating the role of marital quality in military couples. FAMILY PROCESS 2023; 62:1253-1271. [PMID: 36305360 DOI: 10.1111/famp.12833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 08/05/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
This study utilizes a stress process framework in conjunction with a crossover perspective to conceptualize how stress, specifically military-related stress, manifests within individuals and couples. An actor-partner interdependence mediation modeling approach was used in a cross-sectional sample of 243 military couples to examine whether difficulties managing military-related stress may erode one's own self-efficacy and, in turn, contribute to greater anxiety (actor effects) and/or one's partner's self-efficacy and, in turn, anxiety (partner effects). Further, the potential moderating impact of marital quality was explicated in the model to understand if greater marital quality might buffer the impact of military-related stress. There was support for the stress process model primarily regarding actor effects; fewer partner effects emerged. One's own perceptions of military-related stress, specifically higher stress, were related to lower levels of their own self-efficacy, and, consequently, higher anxiety, but military-related stress did not directly affect the partner's self-efficacy or anxiety. Both service members' and civilian spouses' marital quality had ramifications for civilian spouses' self-efficacy, specifically a buffering effect; that was not the case regarding civilian spouse effects on the military member. Findings point to specific ways in which military stressors have implications for personal well-being, the role of a strong couple relationship in buffering stress, especially for civilian spouses, and concomitant leverage points for supporting both individual and couple well-being.
Collapse
Affiliation(s)
| | - Nick Frye-Cox
- Human Sciences and Design, Baylor University, Waco, Texas, USA
| | | | - Anthony J Ferraro
- Applied Human Sciences, Kansas State University, Manhattan, Kansas, USA
| | - Jay A Mancini
- Human Development, Virginia Tech, Blacksburg, Virginia, USA
- Human Development and Family Science, The University of Georgia, Athens, Georgia, USA
| |
Collapse
|
3
|
Xu W, Pavlova I, Chen X, Petrytsa P, Graf-Vlachy L, Zhang SX. Mental health symptoms and coping strategies among Ukrainians during the Russia-Ukraine war in March 2022. Int J Soc Psychiatry 2023:207640221143919. [PMID: 36598090 DOI: 10.1177/00207640221143919] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
CONTEXT The Russian attack on Ukraine has been ongoing since February 24, 2022. Nevertheless, no research has documented the mental health of Ukrainians during the biggest land war in Europe after the Second World War, or how Ukrainians cope with the impact of the war. OBJECTIVES To provide the prevalence rates of symptoms of psychological distress, anxiety, depression, and insomnia; and to link them with Ukrainians' productive coping strategies during the war. DESIGN, SETTING, AND PARTICIPANTS Online survey conducted in Ukraine during the initial period of the Russian invasion (March 19-31, 2022), using a quota sampling method, of 1,400 Ukrainians aged 18 years or older, with a total of 801 valid responses for a response rate of 57.2%. MAIN OUTCOME MEASURES Psychological distress assessed by the Kessler Psychological Distress scale (K6); anxiety assessed by Generalized Anxiety Disorder-2 (GAD-2) scale; depression assessed by Patient Health Questionnaire-2 (PHQ-2); insomnia assessed by Insomnia Severity Index-4 (ISI-4); modes of coping assessed by Brief COPE. RESULTS Of 801 Ukrainian adults, 52.7% had symptoms of psychological distress (mean = 13.3 [SD = 4.9]); 54.1% of them reported symptoms of anxiety (mean = 2.9 [SD = 1.7]); 46.8% reported symptoms of depression (mean = 2.6 [SD = 1.6]). Symptom criteria for insomnia were met by 97 respondents (12.1%) (mean = 10.4 [SD = 4.2]). Demographic variables (including gender, living in an urban area, having children or elderly persons in the household, living in an area occupied by Russian forces) were associated with symptoms of distress, anxiety, depression, and insomnia. The productive coping strategies of using instrumental support, behavioral disengagement, self-distraction, and planning were significantly associated with mental health symptoms. CONCLUSIONS Prevalence rates of symptoms of psychological distress, anxiety, depression, and insomnia were high. These findings underscore the need for healthcare and productive coping strategies for Ukrainians during the war.
Collapse
Affiliation(s)
- Wen Xu
- University of Nottingham, Ningbo, China
| | | | - Xi Chen
- University of Nottingham, Ningbo, China
| | - Petro Petrytsa
- Ternopil Volodymyr Hnatiuk National Pedagogical University, Ukraine
| | | | | |
Collapse
|
4
|
Little MA, Bonilla G, McMurry T, Pebley K, Klesges RC, Talcott GW. The Feasibility of Using Self-Generated Identification Codes in Longitudinal Research With Military Personnel. Eval Health Prof 2022; 45:354-361. [PMID: 34308666 DOI: 10.1177/01632787211031625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Self-generated identification codes (SGICs) are strings of information based on stable participant characteristics. They are often used in longitudinal research to match data between time points while protecting participant anonymity. However, the use of SGICs with military personnel has been infrequent, even though military personnel do not have the same privacy protections as civilians. The current paper reports results from two studies that tested the feasibility, reliability, and validity of using a SGIC to collect sensitive longitudinal data among military personnel. In study one, a team of 105 participants was tracked three times over a period of 12 weeks. The 10-item SGIC produced optimal matching over the 12-weeks. In study two, 1,844 participants were randomly assigned to a SGIC group or an anonymous control group, and then were asked to provide information about their alcohol use. Although match rates declined over time, there were no observed differences between study groups in participants' beliefs about the use of a SGIC. However, differences were identified in reported alcohol use behaviors between the groups, with controls reporting significantly more drinks per week and higher AUDIT-10 scores. While these findings raise potential concerns about using SGICs for epidemiological assessments of highly sensitive problem behaviors, these codes may still be useful in determining group differences in behavior change in randomized studies.
Collapse
Affiliation(s)
- Melissa A Little
- School of Medicine Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.,UVA Cancer Center, Univeristy of Virginia, Charlottesville, VA, USA
| | - Gloribel Bonilla
- School of Medicine Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.,UVA Cancer Center, Univeristy of Virginia, Charlottesville, VA, USA
| | - Timothy McMurry
- School of Medicine Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Kinsey Pebley
- Department of Psychology, The University of Memphis, TN, USA
| | - Robert C Klesges
- School of Medicine Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.,UVA Cancer Center, Univeristy of Virginia, Charlottesville, VA, USA
| | - G Wayne Talcott
- School of Medicine Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.,UVA Cancer Center, Univeristy of Virginia, Charlottesville, VA, USA.,Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland AFB, TX, USA
| |
Collapse
|
5
|
Riviere LA, Sinclair RR. Validation and Reliability Estimation of the Brief Marital Satisfaction Screening Tool. CONTEMPORARY FAMILY THERAPY 2022. [DOI: 10.1007/s10591-022-09638-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
6
|
Chalker SA, Khalifian CE, Milano R, Dende J, Jobes DA. The influence of romantic relationships in assessment of suicide risk in U.S. Army Soldiers. MILITARY PSYCHOLOGY 2022. [DOI: 10.1080/08995605.2022.2028532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Samantha A. Chalker
- Department of Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- University of California San Diego Department of Psychiatry, San Diego, California, USA
| | - Chandra E. Khalifian
- Department of Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- University of California San Diego Department of Psychiatry, San Diego, California, USA
| | - Robert Milano
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | - Jacqueline Dende
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | - David A. Jobes
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| |
Collapse
|
7
|
Sherman H, Frye-Cox N, Lucier-Greer M. Combat Deployment Experiences and Soldier Mental Health: Examining the Factor Structure of a Combat Experiences Scale. Mil Med 2021; 188:e1156-e1165. [PMID: 34755866 DOI: 10.1093/milmed/usab456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/11/2021] [Accepted: 11/08/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Researchers and practitioners are invested in understanding how deployment experiences impact the nearly 193,000 U.S. service members who deploy in a given year. Yet, there remains a need to adequately identify salient deployment experiences through survey measurement tools and understand how differential experiences are uniquely related to mental health outcomes. Therefore, this study examined the factor structure of an established combat experiences measure from the Army Study to Assess Risk and Resilience in Service members (Army STARRS) dataset to identify underlying survey constructs that reflect nuanced deployment experiences. Then, we examined the association between diverse combat experiences and current mental health symptoms (i.e., anxiety and depressive symptoms) and the mediating role of coping. MATERIALS AND METHODS Data were drawn from the Army STARRS data (N = 14,860 soldiers), specifically the All Army Study component. A principal component analysis (PCA) was conducted to examine the dimensionality of the combat experiences scale, and then a path model was conducted to examine the relationships between combat experiences, coping with stress following a deployment, and mental health symptoms while controlling for relevant individual and interpersonal factors. RESULTS Results from the principal component analysis suggested that the Army STARRS combat experiences scale encompasses two components, specifically: "Expected combat experiences" and "Responsible for non-enemy deaths." Both "Expected combat experiences" and "Responsible for non-enemy deaths" were associated with higher levels of anxiety and depressive symptoms, respectively, and "Responsible for non-enemy deaths" was also indirectly linked to these mental health outcomes through coping with stress after deployment. CONCLUSIONS These findings provide insight into the dimensionality of combat experiences and offer practitioners a more nuanced understanding of how to process unique combat experiences that differentially relate to mental health symptoms.
Collapse
Affiliation(s)
- Haley Sherman
- Department of Human Development and Family Science, Auburn University, Auburn, AL 36830, USA
| | - Nicky Frye-Cox
- Department of Human Development and Family Science, Auburn University, Auburn, AL 36830, USA
| | - Mallory Lucier-Greer
- Department of Human Development and Family Science, Auburn University, Auburn, AL 36830, USA
| |
Collapse
|
8
|
Angel CM, Woldetsadik MA, Armstrong NJ, Young BB, Linsner RK, Maury RV, Pinter JM. The Enriched Life Scale (ELS): Development, exploratory factor analysis, and preliminary construct validity for U.S. military veteran and civilian samples. Transl Behav Med 2021; 10:278-291. [PMID: 30590831 DOI: 10.1093/tbm/iby109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The U.S. military veteran serving nonprofit, Team Red, White & Blue (RWB), defined an "enriched life" as having physical, mental, and emotional health; supportive relationships; and a sense of purpose. Until now, no corresponding measure of an "enriched life" existed for the purposes of clinical assessment and research. The primary objective of this study was to explore the psychometric properties of the Enriched Life Scale (ELS) in veteran and civilian samples. Our secondary objective was to examine differences in ELS scores in subgroups of veterans who had combat deployments and service-related injuries. Veteran thought leaders working with social scientists developed the ELS and implemented exploratory factor analysis to determine the underlying dimensions of the "enriched life" construct. One thousand one hundred and eighty-seven veterans and 598 civilians participated in the study. This article describes the development of the ELS, reliability, exploratory factor analysis, and preliminary construct validity. The final ELS had 40 items and consisted of five constructs that were labeled "Genuine Relationships"; "Sense of Purpose"; "Engaged Citizenship"; "Mental Health"; and "Physical Health." Measures had high internal consistency (α = 0.82-0.94). Civilians scored higher than veterans on every ELS item, subscales, and total score, with small to large effect size differences noted between groups. In the veteran subsample, individuals with combat experience scored lower on every ELS subscale than those without combat experience (small effect sizes), as did veterans with service-related injuries in comparison to those without them (small to large effect sizes). This article establishes preliminary psychometric properties of the ELS-a promising instrument to measure an enriched life. Further study is currently underway to establish confirmatory factor analyses and explore extending its usage to diverse military and civilian samples.
Collapse
Affiliation(s)
- Caroline M Angel
- Team Red, White and Blue, Tampa, FL, USA.,Eagle Research and Innovation Center, Team Red, White and Blue, Tampa, FL, USA.,The Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, USA
| | | | - Nicholas J Armstrong
- The Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, USA
| | - Brandon B Young
- Team Red, White and Blue, Tampa, FL, USA.,Eagle Research and Innovation Center, Team Red, White and Blue, Tampa, FL, USA.,Tennyson Center for Children, Denver, CO, USA
| | - Rachel K Linsner
- The Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, USA
| | - Rosalinda V Maury
- The Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, USA
| | | |
Collapse
|
9
|
Abstract
Abstract. The threat of terrorism and rise of extremist movements across the globe pose some of the greatest challenges the world currently faces. While there have been serious conceptual and methodological problems within the psychological study of terrorism, the nascent field has advanced and the evidence, theories, and models have developed in their sophistication. The current article explores the role of social or collective identity in instigating, propagating, and diminishing engagement in violent extremism. Specifically examining how when a fundamental need to belong is challenged through threats and uncertainty this can lead to the people joining entitative groups which can fuse personal and social identities. These identities can be further amplified through ingroup and outgroup processes leading to involvement in violent extremism. The paper also explores how identity can mediate the stress of this extremist lifestyle and sustain engagement in violence. In order to illustrate these processes the article draws on interviews with Northern Irish paramilitaries. Finally, the paper explores the role of identity in moderating violent extremism, and provides suggestions of approaches to promote desistence from violent extremism.
Collapse
Affiliation(s)
- Neil Ferguson
- Department of Psychology, Liverpool Hope University, Liverpool, UK
| | - James W. McAuley
- Department of Behavioural and Social Sciences, University of Huddersfield, UK
| |
Collapse
|
10
|
Ferguson N, McAuley JW. Staying Engaged in Terrorism: Narrative Accounts of Sustaining Participation in Violent Extremism. Front Psychol 2020; 11:1338. [PMID: 32625152 PMCID: PMC7313378 DOI: 10.3389/fpsyg.2020.01338] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 05/20/2020] [Indexed: 11/13/2022] Open
Abstract
Research exploring radicalization pathways and how and why people become involved in terrorism has expanded since the 9/11 attacks. Likewise, over the last decade research exploring de-radicalization and desistence from terrorism has grown and expanded in an attempt to promote exit from extremist or terror groups. However, research studies on how individuals sustain engagement in terrorism and their involvement with extremist organizations, often in the face of great adversity, are absent from the body of research. To address this scarcity of research this study analyzed accounts of engagement in violent extremism produced by Northern Irish loyalist and republican paramilitaries in order to explore how their paramilitary lifestyle, perpetration of acts of political violence and the pressure from countering threats posed by rival groups, and the State security forces impacted on them. The analysis utilized a hybrid of thematic analysis and interpretative phenomenological analysis (IPA). The themes raised through the analysis reflected the psychological, social and economic hardship associated with this lifestyle. The narrative accounts also illustrated psychological changes associated to engagement in violence and from insulation within tightly knit extremist groups. As most of the participants faced incarceration during their paramilitary careers, themes also reflected on the impact imprisonment had on them. The themes explored factors that sustained their involvement, including the role of identity development and identity fusion in sustaining their extremism, the impact of insulated group membership, feelings of efficacy, dehumanization processes, community support, and beliefs in the utility of violence.
Collapse
Affiliation(s)
- Neil Ferguson
- Department of Psychology, Liverpool Hope University, Liverpool, United Kingdom
| | - James W McAuley
- Department of Behavioural and Social Sciences, University of Huddersfield, Huddersfield, United Kingdom
| |
Collapse
|
11
|
Jenkins EN, Allison P, Innes K, Violanti JM, Andrew ME. Depressive Symptoms Among Police Officers: Associations with Personality and Psychosocial Factors. JOURNAL OF POLICE AND CRIMINAL PSYCHOLOGY 2019; 34:67-77. [PMID: 31031522 PMCID: PMC6477691 DOI: 10.1007/s11896-018-9281-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Protective psychosocial factors may reduce the risk of stress-related illnesses in policing. We assessed the association between protective factors and depressive symptoms among 242 police officers. Participants were from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study (2004-2014). Coping, hardiness, personality traits, and social support were assessed at baseline. Depressive symptoms were measured at baseline and follow-up using the Center for Epidemiologic Studies-Depression (CES-D) scale. The relationship between protective factors and the rate of change in depressive symptoms was assessed using linear regression. Logistic regression evaluated associations between protective factors and new-onset depression. Of participants free of depression at baseline, 23 (10.7%) developed probable depression during the follow-up. Odds of new-onset depression increased with increasing neuroticism (adjusted odds ratio [ORADJ] = 1.22, 95% confidence interval [CI], 1.11-1.35) and passive coping (ORADJ = 2.07, 95% CI, 1.06-4.03). Increasing agreeableness (ORADJ = 0.87, 95% CI, 0.78-0.96) and conscientiousness (ORADJ = 0.90, 95% CI, 0.84-0.98) were associated with decreased odds of new-onset depression. New-onset depression was not significantly associated with other coping subscales, hardiness, or social support. There were no significant associations between protective factors and change in depressive symptom scores. This study suggests certain personality characteristics and passive coping may be associated with increased odds of new-onset depression in police officers.
Collapse
Affiliation(s)
- Emily N Jenkins
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, 1095 Willowdale Road, Mailstop L-4050, Morgantown, WV 26505, USA
| | - Penelope Allison
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, 1095 Willowdale Road, Mailstop L-4050, Morgantown, WV 26505, USA
| | - Kim Innes
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - John M Violanti
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Michael E Andrew
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, 1095 Willowdale Road, Mailstop L-4050, Morgantown, WV 26505, USA
| |
Collapse
|
12
|
Pflieger JC, LeardMann CA, McMaster HS, Donoho CJ, Riviere LA. The Impact of Military and Nonmilitary Experiences on Marriage: Examining the Military Spouse's Perspective. J Trauma Stress 2018; 31:719-729. [PMID: 30338551 DOI: 10.1002/jts.22321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 05/15/2018] [Accepted: 06/02/2018] [Indexed: 11/08/2022]
Abstract
There has been conflicting research regarding direct association between deployments and marital quality, particularly from the military spouse's perspective. In the current study, we sought to extend past research by examining the direct association between both military and nonmilitary experiences and military spouse marital quality using 2011-2013 baseline data from the Millennium Cohort Family Study, a large sample of military couples representing all U.S. service branches and components. Military experiences were assessed using electronic deployment records to capture the number and length of deployments since 2001, and service members reported combat experience and symptoms indicative of posttraumatic stress disorder (PTSD). Military spouses reported on service members' recent time away from home, nonmilitary family stressors, and marital quality. Results of the logistic regression model adjusted for demographic, relationship, and military covariates indicated that most military experiences did not have a direct statistical association with low marital quality except service member PTSD, odds ratio (OR) = 1.54, 95% CI [1.17, 2.04]. Rather, nonmilitary experiences of the military spouse, including lack of social support, OR = 2.68, 95% CI [2.07, 3.47]; caregiver burden, OR = 1.56, 95% CI [1.22, 1.99]; work-family conflict, OR = 1.42, 95% CI [1.18, 1.69]; and financial strain, OR = 1.27, 95% CI [1.03, 1.55], increased odds of low marital quality. Implications of these findings include providing additional supports to address nonmilitary family stressors that are particularly salient to military spouses with an aim to promote marital quality.
Collapse
Affiliation(s)
- Jacqueline C Pflieger
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA.,Military Population Health, Naval Health Research Center, San Diego, California, USA
| | - Cynthia A LeardMann
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA.,Military Population Health, Naval Health Research Center, San Diego, California, USA
| | - Hope S McMaster
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA.,Military Population Health, Naval Health Research Center, San Diego, California, USA
| | - Carrie J Donoho
- Military Population Health, Naval Health Research Center, San Diego, California, USA.,Center for Military Psychiatry and Neuroscience Research, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Lyndon A Riviere
- Center for Military Psychiatry and Neuroscience Research, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | | |
Collapse
|
13
|
Kautzmann CL, Lancaster RJ. Teaching Culturally Competent Veteran Nursing Care in Prelicensure Programs. Nurs Educ Perspect 2018; 39:119-120. [PMID: 28906415 DOI: 10.1097/01.nep.0000000000000213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
With the publication of Healthy People 2020, health disparities have been redefined to expand concepts beyond traditional racial and ethnic minorities and include a broader range of populations. Veterans, with their unique experiences and values, comprise a distinct culture with health risks and potential disparities. Although accrediting agencies require programs of nursing to teach culturally competent care, it is unknown whether nurse faculty recognize veterans as having a culture distinct from the rest of the population. Recognizing veterans as possessing a distinct culture is a first step in the provision of culturally competent care.
Collapse
Affiliation(s)
- Cynthia L Kautzmann
- About the Authors Cynthia L. Kautzmann, MSN, RN, CCRN, is a nurse educator, Clement J. Zablocki VA Medical Center, Milwaukee, Wisconsin. Rachelle J. Lancaster, PhD, RN, is an associate professor of nursing, University of Wisconsin Oshkosh College of Nursing, Oshkosh, Wisconsin. For more information, contact Ms. Kautzmann at
| | | |
Collapse
|
14
|
Cordova JV, Cigrang JA, Gray TD, Najera E, Havrilenko M, Pinkley C, Nielsen M, Tatum J, Redd K. Addressing Relationship Health Needs in Primary Care: Adapting the Marriage Checkup for Use in Medical Settings with Military Couples. J Clin Psychol Med Settings 2017; 24:259-269. [PMID: 29170878 DOI: 10.1007/s10880-017-9517-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The overall objective of this study was to pilot the Marriage Checkup (MC), a brief intervention for enhancing marital resiliency tailored to a military population, for use by internal behavioral health consultants (IBHCs) working in an integrated primary care clinic. The MC was revised to fit into the fast-paced environment of primary care (e.g., streamlined to fit within three 30-min appointments), and military-relevant material was added to the content. IBHCs working in primary care were then trained to offer the intervention. Thirty participants were enrolled in the study and completed a relationship checkup and one-month follow-up questionnaires. Analysis of post-test and one-month follow-up data showed statistically significant improvements in participants' marital health compared to pre-treatment. The MC intervention appeared to be well received by both couples and IBHCs.
Collapse
Affiliation(s)
- James V Cordova
- Psychology Department, Clark University, 950 Main St., Worcester, MA, 01610, USA.
| | - Jeffrey A Cigrang
- School of Professional Psychology, Wright State University, Dayton, OH, USA
| | - Tatiana D Gray
- Psychology Department, Clark University, 950 Main St., Worcester, MA, 01610, USA
| | - Elizabeth Najera
- Wilford Hall, Ambulatory Services Center, Lackland Air Force Base, San Antonio, TX, USA
| | - Matt Havrilenko
- Psychology Department, Clark University, 950 Main St., Worcester, MA, 01610, USA
| | - Crystal Pinkley
- United States Air Force School of Aerospace Medicine, Dayton, OH, USA
| | - Matthew Nielsen
- Air Force Medical Operations Agency, Lackland Air Force Base, San Antonio, TX, USA
| | - JoLyn Tatum
- Wright-Patterson Medical Center, Dayton, OH, USA
| | - Kristen Redd
- Wright-Patterson Medical Center, Dayton, OH, USA
| |
Collapse
|
15
|
Kertes DA, Kamin HS, Hughes DA, Rodney NC, Bhatt S, Mulligan CJ. Prenatal Maternal Stress Predicts Methylation of Genes Regulating the Hypothalamic-Pituitary-Adrenocortical System in Mothers and Newborns in the Democratic Republic of Congo. Child Dev 2016; 87:61-72. [PMID: 26822443 DOI: 10.1111/cdev.12487] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Exposure to stress early in life permanently shapes activity of the hypothalamic-pituitary-adrenocortical (HPA) axis and the brain. Prenatally, glucocorticoids pass through the placenta to the fetus with postnatal impacts on brain development, birth weight (BW), and HPA axis functioning. Little is known about the biological mechanisms by which prenatal stress affects postnatal functioning. This study addresses this gap by examining the effect of chronic stress and traumatic war-related stress on epigenetic changes in four key genes regulating the HPA axis in neonatal cord blood, placenta, and maternal blood: CRH, CRHBP, NR3C1, and FKBP5. Participants were 24 mother-newborn dyads in the conflict-ridden region of the eastern Democratic Republic of Congo. BW data were collected at delivery and maternal interviews were conducted to assess culturally relevant chronic and war-related stressors. Chronic stress and war trauma had widespread effects on HPA axis gene methylation, with significant effects observed at transcription factor binding (TFB) sites in all target genes tested. Some changes in methylation were unique to chronic or war stress, whereas others were observed across both stressor types. Moreover, stress exposures impacted maternal and fetal tissues differently, supporting theoretical models that stress impacts vary according to life phase. Methylation in several NR3C1 and CRH CpG sites, all located at TFB sites, was associated with BW. These findings suggest that prenatal stress exposure impacts development via epigenetic changes in HPA axis genes.
Collapse
Affiliation(s)
| | | | - David A Hughes
- Institute of Evolutionary Biology (CSIC-Universitat Pompeu Fabra)
| | | | | | | |
Collapse
|
16
|
Marshall EM, Kuijer RG. Weathering the storm? The impact of trauma on romantic relationships. Curr Opin Psychol 2016; 13:54-59. [PMID: 28813294 DOI: 10.1016/j.copsyc.2016.04.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/18/2016] [Accepted: 04/20/2016] [Indexed: 11/30/2022]
Abstract
The current paper reviews the recent literature examining the impact of trauma on romantic relationships. We introduce the Dyadic Responses to Trauma (DRT) Model as a framework for organizing existing research and guiding future research. A traumatic event affects romantic relationships for the better or for the worse depending on the diverse trauma-related experiences people can have, influencing the way partners interact with each other and ultimately the quality of the relationship. In addition, recent research demonstrates how romantic partners can demonstrate resiliency in spite of a negative trauma experience depending on how they interpret and cope with the experience individually and as a couple.
Collapse
|
17
|
Lee JEC, Phinney B, Watkins K, Zamorski MA. Psychosocial Pathways Linking Adverse Childhood Experiences to Mental Health in Recently Deployed Canadian Military Service Members. J Trauma Stress 2016; 29:124-31. [PMID: 26954537 DOI: 10.1002/jts.22085] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 11/15/2015] [Accepted: 01/11/2016] [Indexed: 11/12/2022]
Abstract
Multiple pathways have been suggested to account for the relationship of adverse childhood experiences (ACEs) and well-being in adulthood, including interpersonal difficulties, the underestimation of one's sense of mastery, and a greater propensity to experience stressors later in life. This study was conducted to examine the association between ACEs and mental health in Canadian Armed Forces (CAF) personnel, and the possible mediating roles of social support, mastery, and combat stressors in that relationship. The study consisted of a prospective analysis involving 3,319 CAF members upon their return from an overseas deployment. Results were that ACEs were associated with poorer mental health (β = -.14, p < .001) and that approximately 42.6% of this relationship could be explained by the mediating effects of low social support, low mastery, and a greater number of combat stressors. The full model, including the covariates, ACEs, social support, mastery, and combat stressors as correlates of postdeployment mental health, was statistically significant with adjusted R(2) = .28, F(9, 3309) = 141.96, p < .001. On the whole, results suggested that social support, mastery, and life stressors may be possible targets for interventions to minimize the impact of ACEs on later mental health in military personnel.
Collapse
Affiliation(s)
- Jennifer E C Lee
- Department of National Defence, Ottawa, Ontario, Canada.,Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Brigitte Phinney
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | | | | |
Collapse
|
18
|
Kent M, Rivers CT, Wrenn G. Goal-Directed Resilience in Training (GRIT): A Biopsychosocial Model of Self-Regulation, Executive Functions, and Personal Growth (Eudaimonia) in Evocative Contexts of PTSD, Obesity, and Chronic Pain. Behav Sci (Basel) 2015; 5:264-304. [PMID: 26039013 PMCID: PMC4493448 DOI: 10.3390/bs5020264] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 05/18/2015] [Indexed: 02/05/2023] Open
Abstract
This paper presents a biopsychosocial model of self-regulation, executive functions, and personal growth that we have applied to Goal-Directed Resilience in Training (GRIT) interventions for posttraumatic stress disorder (PTSD), obesity, and chronic pain. Implications of the training for the prevention of maladaptation, including psychological distress and health declines, and for promoting healthy development are addressed. Existing models of attention, cognition, and physiology were sourced in combination with qualitative study findings in developing this resilience skills intervention. We used qualitative methods to uncover life skills that are most salient in cases of extreme adversity, finding that goal-directed actions that reflected an individual's values and common humanity with others created a context-independent domain that could compensate for the effects of adversity. The efficacy of the resilience skills intervention for promoting positive emotion, enhancing neurocognitive capacities, and reducing symptoms was investigated in a randomized controlled trial with a veteran population diagnosed with PTSD. The intervention had low attrition (8%) and demonstrated improvement on symptom and wellbeing outcomes, indicating that the intervention may be efficacious for PTSD and that it taps into those mechanisms which the intervention was designed to address. Feasibility studies for groups with comorbid diagnoses, such as chronic pain and PTSD, also showed positive results, leading to the application of the GRIT intervention to other evocative contexts such as obesity and chronic pain.
Collapse
Affiliation(s)
- Martha Kent
- Research Department R151, Phoenix VA Health Care System, 650 E. Indian School Rd., Phoenix, AZ 85012, USA.
- Department of Psychology, Arizona State University, 651 E. University Drive, Tempe, AZ 85287-1104, USA.
| | - Crystal T Rivers
- Department of Psychology, Arizona State University, 651 E. University Drive, Tempe, AZ 85287-1104, USA.
| | - Glenda Wrenn
- Department of Psychiatry and Behavioral Science, Morehouse School of Medicine, 720 Westview Dr. SW, Atlanta, GA 30310, USA.
| |
Collapse
|
19
|
Cigrang JA, Balderrama-Durbin C, Snyder DK, Talcott GW, Tatum J, Baker M, Cassidy D, Sonnek S, Smith Slep AM, Heyman RE. Predictors of Suicidal Ideation Across Deployment: A Prospective Study. J Clin Psychol 2015; 71:828-42. [PMID: 26010392 DOI: 10.1002/jclp.22192] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Concurrent and prospective predictors of suicidal ideation were examined in a sample of 318 United States Air Force Security Forces across a 1-year deployment in Iraq and 6- to 9-month follow-up. METHOD Participants included 294 male and 24 female Airmen ranging in age from 18 to 46 years, predominantly (67%) Caucasian. Measures included self-reports of postdeployment suicidal ideation, posttraumatic stress and depressive symptoms, alcohol use, combat experiences, relationship distress, social support, and postdeployment readjustment. RESULTS Problem drinking before deployment prospectively predicted postdeployment suicidal ideation in univariate analyses. Depressive symptoms and problem drinking were significant independent predictors of postdeployment suicidal ideation. Findings demonstrated a ninefold increase in suicidal ideation among service members with even mild depressive symptoms if moderate problem drinking was also present. CONCLUSIONS Predeployment problem drinking may serve as a modifiable target for early intervention of suicidal ideation. Findings illuminate the compound risk of comorbid depressive symptoms and moderate problem drinking in predicting suicidal ideation.
Collapse
|
20
|
Highland KB, Costanzo ME, Jovanovic T, Norrholm SD, Ndiongue RB, Reinhardt BJ, Rothbaum B, Rizzo AA, Roy MJ. Catecholamine responses to virtual combat: implications for post-traumatic stress and dimensions of functioning. Front Psychol 2015; 6:256. [PMID: 25852586 PMCID: PMC4362077 DOI: 10.3389/fpsyg.2015.00256] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 02/20/2015] [Indexed: 01/10/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) symptoms can result in functional impairment among service members (SMs), even in those without a clinical diagnosis. The variability in outcomes may be related to underlying catecholamine mechanisms. Individuals with PTSD tend to have elevated basal catecholamine levels, though less is known regarding catecholamine responses to trauma-related stimuli. We assessed whether catecholamine responses to a virtual combat environment impact the relationship between PTSD symptom clusters and elements of functioning. Eighty-seven clinically healthy SMs, within 2 months after deployment to Iraq or Afghanistan, completed self-report measures, viewed virtual-reality (VR) combat sequences, and had sequential blood draws. Norepinephrine responses to VR combat exposure moderated the relationship between avoidance symptoms and scales of functioning including physical functioning, physical-role functioning, and vitality. Among those with high levels of avoidance, norepinephrine change was inversely associated with functional status, whereas a positive correlation was observed for those with low levels of avoidance. Our findings represent a novel use of a virtual environment to display combat-related stimuli to returning SMs to elucidate mind-body connections inherent in their responses. The insight gained improves our understanding of post-deployment symptoms and quality of life in SMs and may facilitate enhancements in treatment. Further research is needed to validate these findings in other populations and to define the implications for treatment effectiveness.
Collapse
Affiliation(s)
- Krista B Highland
- Center for Neuroscience and Regenerative Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD USA ; Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD USA ; Henry Jackson Foundation, Bethesda, MD USA
| | - Michelle E Costanzo
- Center for Neuroscience and Regenerative Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD USA ; Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD USA ; Henry Jackson Foundation, Bethesda, MD USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
| | - Seth D Norrholm
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA ; Atlanta Veterans' Affairs Medical Center, Decatur, GA USA
| | - Rochelle B Ndiongue
- Walter Reed National Military Medical Center, National Intrepid Center of Excellence, Bethesda, MD USA
| | - Brian J Reinhardt
- Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, MD USA
| | - Barbara Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
| | - Albert A Rizzo
- Exploratory Center for the Interdisciplinary Study of Neuroplasticity and Stroke Rehabilitation, University of Southern California, Los Angeles, CA, USA
| | - Michael J Roy
- Center for Neuroscience and Regenerative Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD USA ; Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD USA
| |
Collapse
|