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Wesemann U, Renner KH, Hofmann H, Hüttermann N, Willmund GD. Cumulative Incidence of Mental Disorders Among German Military Personnel Deployed to Iraq 2015-2018-An Epidemiological Study. Eur J Investig Health Psychol Educ 2025; 15:81. [PMID: 40422310 DOI: 10.3390/ejihpe15050081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2025] [Revised: 04/30/2025] [Accepted: 05/06/2025] [Indexed: 05/28/2025] Open
Abstract
Background: There is currently no study examining the mental health consequences of deployed German service members in Iraq. The aim is, therefore, to determine the cumulative incidence and latency period until the first diagnosis of deployment-related mental disorders. We hypothesized a lower rate than for Afghanistan with 2.4%. Methods: All registered N = 1635 German military personnel who were deployed to the mission "Training support contingent Northern Iraq" between 2015 and 2018 were included. Individuals with mental disorders attributed to this deployment were identified in a central database. Differences in latency between diagnoses were calculated by t-tests for independent samples. Results: By January 2024, n = 55 (3.4%) individuals had been recorded who developed a mental disorder as a result of this deployment. Most of them (54.5%) had a post-traumatic stress disorder (PTSD) as the main or comorbid diagnosis. There were no gender differences in the cumulative incidence (male 3.6%; female 2.9). The latency period between the onset of disease and initial diagnosis was, on average, 1.0 years (standard deviation 1.1 years; Q25 < 1 year, Q50 = 1 year and Q75 = 2 years). With 1.3 vs. 0.6 years, the latency was significantly longer for individuals with PTSD. Conclusions: The cumulative incidence appears to be higher after the Iraq deployment than after most other Bundeswehr deployments. This is attributed to particular threats. The latency period is higher for those affected with PTSD than with other disorders. This could be due to a higher degree of stigmatization. It is, therefore, worthwhile to compare the different deployments in order to be able to derive better preventive and aftercare measures as well as destigmatization programs to prevent chronification.
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Affiliation(s)
- Ulrich Wesemann
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital Berlin, Scharnhorststr. 13, 10115 Berlin, Germany
| | - Karl-Heinz Renner
- Institute of Psychology, Faculty of Human Sciences, Bundeswehr University Munich, 85577 Neubiberg, Germany
| | - Harald Hofmann
- Bundeswehr Operations Command, Henning-von-Tresckow-Kaserne, 14548 Schwielowsee, Germany
| | - Nils Hüttermann
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital Berlin, Scharnhorststr. 13, 10115 Berlin, Germany
| | - Gerd-Dieter Willmund
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital Berlin, Scharnhorststr. 13, 10115 Berlin, Germany
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Wesemann U, Rowlands K, Renner KH, Konhäuser L, Köhler K, Himmerich H. Impact of life-threatening military incidents during deployments abroad on the relationships between military personnel and their families. Front Psychiatry 2024; 15:1419022. [PMID: 39091456 PMCID: PMC11291243 DOI: 10.3389/fpsyt.2024.1419022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/18/2024] [Indexed: 08/04/2024] Open
Abstract
Introduction The influence of deployments on family relationships has hardly been investigated. Following a recently proposed new research strategy, military personnel with and without deployment-related life-threatening military incidents during deployment were compared. The hypothesis was that partner and family relationships of military personnel who experienced such an event would deteriorate more. Methods This study included N = 255 military personnel who had a romantic partner (n = 78 of them had children) when deployed to Afghanistan. Of these, n = 68 military personnel experienced a deployment-related critical event during the deployment, n = 187 did not. Partnership quality was assessed using a semi-structured pre- and post-deployment interview. Results The partner relationships of military personnel who experienced a deployment-related life-threatening military incident during deployment broke up significantly more often. The partner relationships of all military personnel deteriorated significantly, with greater deterioration after deployment in the group who faced such incidents. These results were independent of age, rank or number of previous deployments. In addition, there was a significant deterioration in the relationships between all military personnel and their children with greater deterioration after deployment in the group who faced such incidents. Conclusion Life-threatening military incidents during a deployment abroad appear to have a considerable influence on the quality and stability of the partner and family relationships of military personnel. These findings can be used to inform the development of specific pre- and post-deployment measures and training.
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Affiliation(s)
- Ulrich Wesemann
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Katie Rowlands
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Karl-Heinz Renner
- Institute of Psychology, Faculty of Human Sciences, Bundeswehr University Munich, Neubiberg, Germany
| | - Lucas Konhäuser
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Kai Köhler
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Hubertus Himmerich
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital Berlin, Berlin, Germany
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, United Kingdom
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Lane R, Alves-Costa F, Gribble R, Taylor A, Howard LM, Fear NT, MacManus D. Help-seeking for Intimate Partner Violence and Abuse: Experiences of Serving and Ex-serving UK Military Personnel. JOURNAL OF FAMILY VIOLENCE 2023; 39:1-17. [PMID: 37358979 PMCID: PMC10038774 DOI: 10.1007/s10896-023-00534-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 06/28/2023]
Abstract
Purpose Intimate Partner Violence and Abuse (IPVA) is as a major health concern globally. The prevalence of IPVA perpetration and victimisation has been found to be higher in military compared to civilian populations. Of concern, help-seeking for other psychosocial difficulties among military communities has been shown to be both limited and challenging, and military personnel could face additional or amplified barriers to help-seeking for IPVA than their civilian counterparts. This study aimed to use qualitative methods to explore the experiences of, and barriers to, help-seeking for IPVA victimisation and perpetration among UK military personnel. Methods Thematic analysis was conducted on 40 one-to-one semi-structured interviews with military personnel (29 male, 11 female). Results Four superordinate themes were derived, thematically organised according to different levels of the social ecological model: Military cultural factors; Support service factors; Interpersonal factors; and Individual factors. At a military cultural level, participants described difficulties in help-seeking for IPVA resulting from widespread stigma and hypermasculine attitudes in military communities, minimisation of violence, perceived pressure from chain of command, and fear of consequences of reporting. At a support-service level, participants' negative views or experiences and lack of awareness of services were also significant in deterring help-seeking. At an interpersonal level, participants recounted how relationships with military colleagues, their partner and their family could be both instrumental or a hindrance to help-seeking for IPVA. At an individual level, lack of insight into IPVA and different forms of abuse were suggested through minimisation of violence and described to contribute to delay in help-seeking. Shame, compounded by multi-layered stigma present at each social ecological model level, was a key reason for delaying or avoiding help-seeking. Conclusions The findings indicate the added challenges in help-seeking for IPVA experienced by military personnel and highlight a need for a whole systems approach to improve the provision of support for IPVA in the military serving and ex-serving community to instil meaningful change.
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Affiliation(s)
- Rebecca Lane
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AB UK
| | - Filipa Alves-Costa
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AB UK
- Barnet, Enfield & Haringey Mental Health NHS Trust (North London Forensic Service), London, UK
| | - Rachael Gribble
- King’s Centre for Military Health Research, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
| | - Anna Taylor
- Research Department of Clinical, Educational and Health Psychology, University College London, 1–19 Torrington Place, London, WC1E 7HB UK
| | - Louise M. Howard
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Dr Crespigny Park, London, SE5 8AF UK
| | - Nicola T. Fear
- King’s Centre for Military Health Research, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
| | - Deirdre MacManus
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AB UK
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Lane R, Gribble R, Alves-Costa F, Taylor A, Howard LM, Fear NT, MacManus D. Intimate Partner Violence and Abuse: A Qualitative Exploration of UK Military Personnel and Civilian Partner Experiences. JOURNAL OF FAMILY VIOLENCE 2022; 39:1-17. [PMID: 36373029 PMCID: PMC9638474 DOI: 10.1007/s10896-022-00446-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 05/25/2023]
Abstract
Purpose The prevalence of Intimate Partner Violence and Abuse (IPVA) perpetration and victimisation has been found to be higher in serving and ex-serving military samples compared to civilians. Despite this, there is a lack of qualitative research exploring the IPVA experiences of couples in which one or both partners are serving or have served in the military. This qualitative study aimed to explore IPVA experiences within the UK military community from the perspective of serving and ex-serving military personnel and civilian partners of UK military personnel. Method One-to-one telephone interviews were conducted with 40 serving and ex-serving military personnel (29 male, 11 female) and 25 female civilian partners. Data was analysed using thematic analysis. Results Four superordinate themes were derived: (1) patterns and directions of IPVA, (2) types of IPVA, (3) perceived drivers of IPVA and (4) perceived impact of IPVA. The findings point to frequent bidirectional abuse in part driven by poor communication and emotion regulation, whilst also highlighting the experiences of severe IPVA victimisation of civilian partners by military personnel motivated by power and control. Perceived drivers of both IPVA perpetration and victimisation include military factors borne of military culture or training, alcohol and mental health difficulties. Conclusion These results highlight the role of cultural norms, as well as the role of emotion dysregulation, poor communication skills and mental health difficulties in explaining and perpetuating abuse within ecological theoretical frameworks of violence among couples within which one or both partners are serving or ex-serving military personnel.
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Affiliation(s)
- Rebecca Lane
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, SE5 8AB Camberwell, London, UK
| | - Rachael Gribble
- King’s Centre for Military Health Research, Weston Education Centre, King’s College London, 10 Cutcombe Road, SE5 9RJ London, UK
| | - Filipa Alves-Costa
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, SE5 8AB Camberwell, London, UK
- Barnet, Enfield & Haringey Mental Health NHS Trust (North London Forensic Service), London, UK
| | - Anna Taylor
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, WC1E 7HB London, UK
| | - Louise M Howard
- Section of Women’s Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Dr Crespigny Park, SE5 8AF London, UK
| | - Nicola T Fear
- King’s Centre for Military Health Research, Weston Education Centre, King’s College London, 10 Cutcombe Road, SE5 9RJ London, UK
| | - Deirdre MacManus
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, SE5 8AB Camberwell, London, UK
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Alves-Costa F, Lane R, Gribble R, Taylor A, Fear NT, MacManus D. Help-seeking for Intimate Partner Violence and Abuse: Experiences of Civilian Partners of UK Military Personnel. JOURNAL OF FAMILY VIOLENCE 2022; 38:509-525. [PMID: 35399200 PMCID: PMC8982908 DOI: 10.1007/s10896-022-00382-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 05/10/2023]
Abstract
There is evidence that Intimate Partner Violence and Abuse (IPVA) is more prevalent among military populations compared with civilian populations. However, there has been limited research into the help-seeking experiences of civilian victim-survivors who have experienced IPVA within relationships with military personnel. This qualitative study aimed to explore the experiences of, and barriers to, help-seeking for IPVA victimisation among civilian partners of military personnel in order to identify strategies to improve the management of IPVA both within the military and civilian sectors. The study adopted a descriptive cross-sectional study design and used qualitative research methods. One-to-one telephone interviews were conducted with civilian victim-survivors (n = 25) between January and August 2018. Interview transcripts were analysed using thematic analysis. Three superordinate themes were derived: (1) Drivers to help-seeking; (2) Barriers to help-seeking; and (3) Experiences of services. The findings indicate difficulties in help-seeking for IPVA among civilian partners of military personnel due to stigma, fear, dependency, poor understanding of IPVA, lack of appropriate and timely support, and a perceived lack of victim support. Difficulties in help-seeking were perceived by participants to be amplified by military culture, public perceptions of the military, military protection of personnel and the lack of coordination between civilian and military judicial services. This study reinforces the need for a military specific Domestic Abuse strategy, identifies vulnerable groups and highlights a need for both increased awareness and understanding of IPVA within civilian and military services in order to provide adequate victim protection.
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Affiliation(s)
- Filipa Alves-Costa
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, Camberwell, London, SE5 8AB UK
| | - Rebecca Lane
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, Camberwell, London, SE5 8AB UK
| | - Rachael Gribble
- King‘s Centre for Military Health Research, King‘s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
| | - Anna Taylor
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - Nicola T Fear
- King‘s Centre for Military Health Research, King‘s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
| | - Deirdre MacManus
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, Camberwell, London, SE5 8AB UK
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