Falklands War veterans' perceptions of social support and the reconciliation of traumatic memories

Quality of life among residents of Gaza, Palestine: the predictive role of mental distress, fear of COVID-19, and social support

BACKGROUND

Living under siege and deteriorated health, social, educational, and economic conditions and isolation with scarce opportunities to fulfil basic needs and aspirations affect the civil population's mental health and perceived quality of life. In this cross-sectional investigation, we explored the consequences of mental distress, fear of COVID-19, and social support for QoL in the Gaza strip.

METHODS

Nine hundred seventy nine (32.9% males; 67.1% females; mean age was 35.2 years; s.d. = 11.4) adults were recruited in the Gaza strip. We used the Fear for COVID-19 scale (FCS-19), The WHOQOL-BREF Scale, Berlin Social Support Scale (BSSS), Depression Anxiety and Stress Scale (DASS). Pearson correlation coefficient was computed to assess relationships between quality of life, fear of COVID19, mental distress, and social support; a hierarchical regression analysis was used to assess the association between QoL as the dependent variable and demographic variables and fear of COVID19, mental health, and social support as the independent variables.

RESULTS

QoL was positively associated with perceived emotion, instrumental, and support seeking. Depression, anxiety, stress, and fear of COVID19 were negatively associated with quality of life. Gender was significantly associated with lower QoL. The study highlighted that the level of fear of COVID-19 was negatively influencing individuals' quality of life (QoL). This fear was negatively associated to psychological distress, gender, place of residence, and family type. Lower-educated and poorer participants had lower QoL scores. Conversely, female gender was notably linked to a lower QOL. The hierarchical regression confirmed that COVID-19 was an added burden for the Palestinian population. The fear of COVID-19 term added a 6.2% variance in QoL. In the final analysis, all predictors were statistically significant, with the fear of COVID-19 term recording a higher contribution of 22.5%, followed by depression term with 21.5%, perceived emotional 18.5%, income at 15.4%, and perceived instruments at 14.8% towards QoL.

CONCLUSIONS

Practitioners and policymakers must consider the severe violation of human rights when developing psychosocial programs to intervene in the COVID-19 crisis.

The social prescribing of psychosocial interventions in the treatment of addictions and substance use disorders with military veterans: a reclamation of identity and belonging

Social prescribing is a way of connecting individuals to a source of support within the community to help improve their health and well-being. Social prescribing programmes are being widely promoted within the United Kingdom (UK) and United States as non-pharmaceutical interventions for those living with addiction and substance misuse needs. These needs have been exasperated by the recent COVID-19 pandemic and global economic crisis, with emerging research indicating short-term and long-term detrimental effects on physical and mental health due to substance misuse and addictions. Psychosocial interventions utilize psychological or social factors rather than an overreliance on biological interventions to treat the health impacts of mental illnesses such as addictions and substance use disorder. In this paper, I will discuss the associated determinants of addictions and substance for the military veteran population, as well as how the social prescribing of psychosocial interventions could be used to reaffirm participant's identity and enhance their sense of belonging for military veterans, using a real-world example in Wales, UK.

A narrative inquiry into the resettlement of armed forces personnel in the Arabian Gulf: a model for successful transition and positive mental well-being

Background: The study sought to explore the lived experiences of individuals having served in the Armed Forces of Saudi Arabia, as they made the transition to civilian life and sought new employment opportunities.    

Methods: Researchers carried out qualitative research in the form of narrative inquiry. Narratives were collected from eleven in-depth interviews conducted in Saudi Arabia in 2021, allowed for insight into participant experiences. Existing literature on military retirement was also investigated.

Results: Interviews were transcribed verbatim and analyzed concurrently using thematic analysis to identify patterns or themes. The researchers adopted thematic synthesis as an analytical framework though which descriptive themes from the literature on military retirement were generated. Overall, this approach allowed for the comparison of themes in literature with those of narrative interviews.

Conclusion: The study identified challenges encountered by veterans during the resettlement and transitional phase from military to civilian life. There was a general consensus, however, that military life equips individuals with valuable skills that are transferrable to successful post-military employment, known as Positive Transferable Adaptability for Employability (PTAE), ( Mottershead, 2019), which can greatly empower those making the transition. These findings led the researchers to develop a new model for veteran career paths that meet the contemporary employment needs of the Kingdom of Saudi Arabia: the REVERE Transition Model, which identifies six career paths.

Psychological Adjustment of Aging Vietnam Veterans: The Role of Social Network Ties in Reengaging with Wartime Memories

It is projected that by 2020 there will be 8.7 million veterans over the age of 65 years, more than half (64%) of whom served during the Vietnam War. The effects of military service on mental health and well-being may be more pronounced later in life among those who served in Vietnam than prior cohorts of veterans. Many veterans confront and rework their wartime memories later in life in an attempt to find meaning and coherence, engaging in a process referred to as Later-Adulthood Trauma Reengagement (LATR). LATR often occurs in the context of other stressors that are a normative part of aging, such as role transitions (e.g., retirement), declines in physical health, and the death of close others (e.g., spouses), perhaps because these events trigger reminiscence. Importantly, LATR may result in either positive (e.g., acceptance) or negative (e.g., distress) psychological outcomes. It has been suggested that the presence of social/environmental resources, including socioemotional support, may aid veterans in successfully navigating LATR. We, therefore, review relevant areas of research to delineate the role that various layers of social context may play in -helping - or hindering - aging Vietnam veterans as they navigate LATR in the context of normative late-life stressors. We conclude by offering fruitful directions for future research and applied implications for intervention efforts.

Exploring the suitability and acceptability of peer support for older veterans

Purpose

Informal social support is often sought by veterans to support reminiscence or cope with traumatic memories. However, it can also encourage unhelpful ways of coping, such as avoidance, or may be absent altogether. This project is borrowed from the growing peer support literature. The purpose of this paper is to explore the suitability of peer support services to enhance the wellbeing for older veterans, when naturally occurring support is absent or unhelpful.

Design/methodology/approach

This was a sequentially staged research programme involving a scoping review of current practice and evidence, and a consultation with veterans. In total, ten veterans (nine male, one female) took part in the consultation (M=66 years).

Findings

Peer support was considered suitable, particularly in addressing loneliness and social isolation. There was an understandable concern regarding its use with more complex issues such as trauma. An added issue was the implicit assumption that this consultation concerned transition; supporting younger veteran as they move from military to civilian life. This mirrored the focus of current UK policy and affected the focus of the consultation. Issues were also raised around the sustainability of services more broadly.

Social implications

Peer support is appropriate in supporting older veterans, but must be implemented in a sustainable way. Raising awareness of the needs of older veterans in older adult services is an important implication for service development and delivery.

Originality/value

There is a considerable lack of research concerning older veterans, particularly concerning their formal and informal social support needs. This paper addresses the current gap in the literature.

Transitioning from military to civilian life: the role of mastery and social support

Introduction: The Survey on Transition to Civilian Life (STCL) was created to measure the adjustment outcomes of recently released Canadian Armed Forces (CAF) members. The survey was administered to a sample of CAF regular force members released from 1998 to 2007. The aim of the current study was to examine resources that promote the successful adjustment to civilian life. Specifically, the goal was to conduct a secondary analysis of the STCL that examined the roles of mastery and social environment (that is, community belonging and satisfaction with support) in the transition to civilian life, as well as how these variables correlate with health and life stress. Methods: The sample data were used to conduct Kendall's tau correlations. Prevalence estimates, 95 per cent confidence intervals, and ordinal logistic regressions were conducted using weighted data that accounted for the complex survey design to ensure findings were representative of the sampled veteran population. Results: Ordinal logistic regression results revealed that mastery, satisfaction with types of social support (friends and family), and a sense of community belonging acted as potential protective factors that were associated with easier adjustment to civilian life for Veterans with physical health conditions, mental health conditions, and higher levels of life stress. The first model showed that the odds of an easier adjustment were lower for those who were more stressed (adjusted odds ratio [AOR]=0.13), self-reported a physical health condition (AOR=0.53), and self-reported a mental health condition (AOR=0.23). The second model revealed that the odds of an easier adjustment were lower for those Veterans dissatisfied with their family relationships (AOR=0.42) and their relationships with friends (AOR=0.47) and those with a very weak sense of community belonging (AOR=0.39), and they were higher among those with high levels of mastery (AOR=3.93). Discussion: The results of this study point to the importance of personal characteristics and aspects of the social environment in the adjustment to civilian life among military veterans. As well, ensuring a successful adjustment to civilian life may lead to better outcomes, such as enhanced mastery, following transition.

Hard is Normal: Military Families' Transitions Within the Process of Deployment

US military deployments have become more frequent and lengthier in duration since 2003. Over half of US military members are married, and many also have children. The authors sought to understand the process of deployment from the perspective of the military family. After a thorough search of the literature, 21 primary research reports of 19 studies with an aggregate sample of 874 were analyzed using qualitative metasynthesis. The deployment process was experienced in four temporal domains. The military family as a whole shared the pre-deployment transition: all family members felt uncertain about the future, needed to complete tasks to "get ready" for deployment, and experienced a sense of distancing in preparation for the upcoming separation. The AD member went through the deployment transition independently, needing to "stay engaged" with the military mission, building a surrogate family and simultaneously trying to maintain connection with the family at home. In parallel, the home front family was going through a transposement transition, moving forward as an altered family unit, taking on new roles and responsibilities, and trying to simultaneously connect with the deployed member and find support from other military families. In post-deployment, the family went through the "reintegration" transition together, managing expectations, and readjusting family roles, all needing understanding and appreciation for their sacrifices during the recent separation. Effective family communication was important for military family well-being after deployment but unexpectedly challenging for many. Clinical, research, and policy recommendations are discussed.

War leaves an enduring legacy in combatants' lives

The memory of combat experience endures in World War II veterans. As veterans age, traumatic memory that previously may have been suppressed in the busyness of family and everyday life can re-emerge. Combat stress may affect not only the veterans, but also those people closely associated with them. Interviews were conducted with World War II veteran aircrew, wives, children, grandchildren, siblings, and friends to examine the impact of combat experience on the veterans and the family across the life course from the perspectives of the various participants. The combat experience significantly affected the life course of most.

The front line of social capital creation--a natural experiment in symbolic interaction

This paper offers theoretical and empirical contributions to understanding the micro-sociological processes behind the creation of social capital. Theoretically, we argue that the emotional and shared experience of participating in symbolic interaction rituals may affect social capital in four different ways, via: (i) a 'citizenship' effect, connecting participants symbolically to the broader, civic society; (ii) a 'supportive' effect, bonding participants with each other; (iii) an exclusive 'tribal' effect, which crowds-out connections with other groups and the wider society; and (iv) an 'atomising' effect, whereby intense experiences create mental health problems that damage social capital. We illustrate this with a case study of Australian veterans of the Vietnam War. The randomness of the National Service conscription lotteries of that era translates into a high-quality natural experiment. We formulate several hypotheses about which of the four effects dominates for veterans who participated in the 'symbolic interaction' of training and deployment. We test these hypotheses using data from the 2006 Australian Census of Population and Housing, and the NSW 45 & Up Study. We found that war service reduced 'bonding' social capital, but increased 'bridging' social capital, and this is not explained completely by mental health problems. This suggests that while the combined 'tribal' and 'atomizing' effects of service outweigh the 'supportive' effects, the 'citizenship' effect is surprisingly robust. Although they feel unsupported and isolated, veterans are committed to their community and country. These paradoxical findings suggest that social capital is formed through symbolic interaction. The emotional and symbolic qualities of interaction rituals may formulate non-strategic (perhaps irrational) connections with society regardless of the status of one's personal support networks.

Psychological Growth in Aging Vietnam Veterans

This study offers alternative interpretations of war-related distress embedded within the social and political context of the Vietnam War. Subjective interpretations from aging Vietnam veterans were analyzed using interpretative phenomenological analysis. A central theme— Moral authenticity: Overcoming the betrayal and shame of war—overarched five subordinate themes. Four subordinate themes encapsulated layers of war-related betrayal associated with shame. Shame was likely to be described as either (a) internal/sense of personal failure, with no acts of rage; or (b) external/reckless or threatening acts of others, engendering rage. A fifth theme, reparation with self, reflected humility, gratitude, and empathy, currently undefined domains of the growth construct.

Wartime experiences and their implications for the everyday lives of older people

Past research has documented the influences that ‘traumatic’ memories of war have on older people's mental health (e.g. Post-Traumatic Stress Disorder). However, fewer studies have explored the longer-term implications of wartime experiences for older men and women's everyday lives. This article explores the impact of Second World War experiences on older men and women living in the United Kingdom (UK), to provide an insight into how such experiences influence how they construct their daily lives. Forty UK-based participants born between 1914 and 1923 were interviewed as part of the ENABLE-AGE project that was undertaken in five European countries. The key concepts underpinning the interview schedule were: home, independence, participation, health and wellbeing, and societal supports. The data were analysed using a grounded theory approach. Participants emphasised how wartime experiences continue to hold significance within their lives and settings some 60 years later. Seven themes emerged from the analysis. Four of these reflect the way wartime experiences remain important influences on participants' present-day social worlds: comradeship, storytelling about the war, community and alienation, and long-term physical effects. A further three themes reflect how skills and personal characteristics defined by wartime experiences are embedded in the way many older people continue to negotiate and structure their practical lives: managing, resilience and adaptability, and independence.

A Good War? Exploring British veterans' moral evaluation of deployment

Historically, war trauma research has concentrated on the relationship between level of exposure and development of post-traumatic symptoms. More recently, it has been recognized that intra- and interpersonal differences can mediate how service personnel are affected by their experiences. This paper is a qualitative study exploring moral evaluations of 30 British male veterans towards their deployment in conflicts from WWII to the most recent Iraq War (2003-2009). Retrospective thematic analysis is used to explore moral evaluation and societal support. Four categories emerged based on veterans' moral evaluation of deployment: justifiable, implicitly justifiable, unclear, and unjustifiable. Analysis revealed broad differences between these groups. Veterans able to justify their experiences reported more positive aspects of both deployment and societal support than those unable to justify their deployment. These findings make clear the importance of future research exploring the interactions between civilians and service personnel, and the impact this has on mental health.

Coping with traumatic memories: Second World War veterans' experiences of social support in relation to the narrative coherence of war memories

This paper reports a qualitative study that used narrative analysis to explore how social support helps many armed-services veterans cope with traumatic memories. The analysis was carried out on two levels, that of narrative form (level of narrative coherence), argued to be indicative of reconciliation, and narrative content (themes of social support), which allowed exploration of the types of social support experienced by veterans with coherent, reconciled and incoherent narratives. Ten British male Second World War veterans were interviewed regarding their war experiences, presence of traumatic memories, and experiences of social support from comrades, family and society. Different patterns of support were qualitatively related to coherent, reconciled and incoherent narratives. Veterans with coherent narratives were no less likely to have experienced traumatic events than those with reconciled or incoherent narratives, but they reported more positive perceptions of their war experience and of the war's outcomes, more positive experiences of communication with family in later life, and more positive perceptions of societal opinion. The results are discussed in relation to how veterans can be supported by family and friends to reconcile their traumatic memories, thus to lessen the burden in later life when vital support resources may be unavailable.