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Kibris A, Goodwin R. The long-term effects of war exposure on psychological health: An experimental study with Turkish conscript veterans. Soc Sci Med 2024; 340:116453. [PMID: 38061221 DOI: 10.1016/j.socscimed.2023.116453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/26/2023] [Accepted: 11/21/2023] [Indexed: 01/23/2024]
Abstract
The study of the effects of war exposure on the psychological health of combatants has so far been constrained by possible selection biases which limits the establishment of causality, the clear identification of dynamics, and the generalizability of findings. In this study, we make use of a population-level natural experiment enabled by the strict military conscription system in Turkey which uses a draft lottery to randomly allocate conscripts to bases across the country, including those south-eastern areas experiencing a long running civil conflict. We build on this setting with a representative field survey of 5024 adult males. Our results indicate that those exposed to high intensity armed conflict environments during their service are more likely to experience depressive symptoms even long after their discharge. Further detailing conflict exposure, we find war traumas to be the primary drivers of the effects we observe.
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Bricknell MCM. Observations from the Korean War for Modern Military Medicine. UI SAHAK 2023; 32:787-828. [PMID: 38273721 PMCID: PMC10822696 DOI: 10.13081/kjmh.2023.32.787] [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: 07/15/2023] [Revised: 07/15/2023] [Accepted: 12/12/2023] [Indexed: 01/27/2024]
Abstract
This paper reviews developments in military medicine during the Korean War and places them in the evolution of military medical lessons from the Second World War and the subsequent development of military medicine through the Vietnam War to the present day. The analysis is structured according to the '10 Instruments of Military Healthcare.' Whilst there were incremental developments in military medicine in all these areas, several innovations are specifically attributed to the Korean War. The introduction of helicopters to the battlefield led to the establishment of dedicated medical evacuation helicopters crewed with medical personnel and the evolution into the DUSTOFF system during the Vietnam War. Helicopter evacuation was the primary medical evacuation system in the wars in Iraq and Afghanistan. The establishment of the Mobile Army Surgical Hospital during the Korean War were founded upon the US Auxiliary Surgical Groups or the UK Casualty Clearing Stations of World War II. The requirement for resuscitation and surgical teams close to the battlefield has endured through the development of mobile hospitals of varying sizes from Field Surgical Teams to the current 'modular' Hospital Centre and other international equivalents. There were many innovations in the clinical care of battle casualties covering wound shock, surgical techniques, preventive medicine, and acute psychiatric care that refreshed or advanced knowledge from the Second World War. These were enabled through the establishment of medical research programs that were managed within the theatre of operations. Further advances in all these clinical topics can be observed through the Vietnam War to the wars in Iraq and Afghanistan - all of which were underpinned by institutional directed research programs. Finally, collaboration between international military medical services and the development of Korean military medical services is a major theme of this review. This 'military-tomilitary' and 'civil-military' medical engagement was also a major activity during the Vietnam War and more recently in Iraq and Afghanistan. Overall, the topics and themes in military medicine that were important during the Korean War can be considered to be part of trajectory of innovation in military medicine have been replicated in many subsequent wars. The paper also highlights some 'lessons' from World War II that had to be relearned in the Korean War, and some observations from the Korean War that had to be relearned in subsequent wars.
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Rabinowitz EP, Sayer MA, Richeson AL, Samii MR, Kutash LA, Delahanty DL. 50 Years After Political Protest Violence, Posttraumatic Growth is Associated with PTSD and Anxiety but not Depression or Sleep Difficulties. INTERNATIONAL JOURNAL OF APPLIED POSITIVE PSYCHOLOGY 2023; 8:195-210. [PMID: 36718256 PMCID: PMC9879249 DOI: 10.1007/s41042-023-00085-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/12/2023] [Indexed: 01/27/2023]
Abstract
Rates of, and relationships between, posttraumatic stress disorder (PTSD), depression, anxiety, and posttraumatic growth (PTG) decades after a single-incident trauma remain unclear. During a two-month period surrounding the 50th anniversary of the political protest violence at Kent State University on May 4, 1970, 132 individuals completed measures of PTG, PTSD, depression, anxiety, and sleep difficulties. Participants were, on average, 19 years old (SD = 3.01) on May 4, 1970, and 44% were present at the protests. 17% met cutoff scores consistent with PTG, 6% for PTSD, 8% for anxiety, 11% for depression and 20% for sleep difficulties. PTG was significantly and positively correlated with PTSD (r = .32, 95% CI: 0.17-0.44) and anxiety (r = .23, 95% CI: 0.08-0.38) but not depression or sleep difficulties after controlling for additional trauma exposure since May 4, 1970. All relationships were best explained by linear rather than curvilinear relationships and were not moderated by proximity to the events of May 4, 1970. Results indicate that clinicians working with survivors of trauma decades later may be able to capitalize on the adaptive functions of PTG to foster positive treatment outcomes.
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Affiliation(s)
- Emily P. Rabinowitz
- grid.258518.30000 0001 0656 9343Department of Psychological Sciences, Kent State University, 317 Kent Hall, 44240 Kent, OH USA
| | - MacKenzie A. Sayer
- grid.258518.30000 0001 0656 9343Department of Psychological Sciences, Kent State University, 317 Kent Hall, 44240 Kent, OH USA
| | - Alexis L. Richeson
- grid.258518.30000 0001 0656 9343Department of Psychological Sciences, Kent State University, 317 Kent Hall, 44240 Kent, OH USA
| | - Marielle R. Samii
- grid.258518.30000 0001 0656 9343Department of Psychological Sciences, Kent State University, 317 Kent Hall, 44240 Kent, OH USA
| | - Lindsay A. Kutash
- grid.258518.30000 0001 0656 9343Department of Psychological Sciences, Kent State University, 317 Kent Hall, 44240 Kent, OH USA
| | - Douglas L. Delahanty
- grid.258518.30000 0001 0656 9343Department of Psychological Sciences, Kent State University, 317 Kent Hall, 44240 Kent, OH USA ,grid.261103.70000 0004 0459 7529Northeast Ohio Medical University, Rootstown, OH USA
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Aloni R, Ginzburg K, Solomon Z. Trajectories analysis of comorbid depression and anxiety among Israeli veterans: The implications on cognitive performance. J Psychiatr Res 2022; 156:55-61. [PMID: 36242944 DOI: 10.1016/j.jpsychires.2022.10.013] [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: 03/07/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Among war veterans, research has indicated high rates of depression, anxiety, and comorbidity of these disorders, with even higher rates among prisoners-of-war. However, little is known about the longitudinal effects of comorbidity profiles on cognitive performance, particularly in the case of aging war veterans. METHOD This longitudinal study focuses on Israeli veterans from the 1973 Yom Kippur War, with assessments at four time-points: 1991 (T1), 2003 (T2), 2008 (T3), and 2015 (T4). Two groups were included: veterans who were held captive (ex-POWs; n = 196), and veterans who were not (war veterans; n = 159). Participants completed validated self-report measures, and their cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). RESULTS Three distinct profiles of comorbidity were identified: resiliency (57.5%, n = 204); delayed-onset (29.6%, n = 105), and chronic (13.00%, n = 46). The chronic profile identified mostly among ex-POW (91.3%, n = 42), veterans with lower education at T1, and with more cognitively impaired compared to the other profiles (p < .0001). No differences were found between the profiles in age and family status at T1. CONCLUSIONS The findings highlight the importance of viewing aging veterans as a high-risk population for cognitive impairments, particularly those suffering from chronic comorbidity of depression and anxiety. Therefore, the appropriate diagnosis and cognitive treatment are required to preserve cognitive abilities and prevent decline.
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Affiliation(s)
- Roy Aloni
- Department of Psychology, Ariel University, Kiryat HaMada 3, Ariel, Israel.
| | - Karni Ginzburg
- Bob Shapell School of Social Work, Tel Aviv University, Chaim Levanon 30, Tel Aviv, Israel.
| | - Zahava Solomon
- Bob Shapell School of Social Work, Tel Aviv University, Chaim Levanon 30, Tel Aviv, Israel.
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5
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Rahnejat AM, Ebrahimi M, Khoshdel A, Noorbala AA, Shahmiri Barzoki H, Avarzamani L, Avakh F, Taghva A. The prevalence of depression among iran-iraq war veterans, combatants and former prisoners of war: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2022; 57:295-305. [PMID: 34608645 DOI: 10.1002/ijop.12813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 09/10/2021] [Indexed: 02/05/2023]
Abstract
By exposing individuals to trauma, wars can cause a host of psychiatric disorders. This study aimed to collect and compare the studies conducted to estimate the prevalence of depression among veterans, former prisoners of war (POWs) and military personnel in the Iran-Iraq war (1980-1988). In this systematic review, a search was conducted using relevant keywords in major national and international databases, personal archives and national academic libraries. We screened 135 records using their abstracts and selected a total of 56 studies for full-text review. Eventually, 19 studies were included in our systematic review and meta-analysis. The estimated pooled prevalence of depression among Iranian veterans and POWs was 22.4% (95% confidence interval = 15.0-32.0). Although the results indicated disparities in the prevalence of depression among veterans and POWs, the aggregate estimated prevalence was much higher than what has been reported for military personnel. Effective policies and strategies are required for prevention and treatment of depression and related psychiatric complications among veterans and former POWs.
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Affiliation(s)
- Amir Mohsen Rahnejat
- Department of Clinical Psychology, Aja University of Medical Sciences, Tehran, Iran
| | | | - Alireza Khoshdel
- Department of Epidemiology, School of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Ahmad Ali Noorbala
- Psychosomatic Medicine Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Farhad Avakh
- School of Aerospace and Subaquatic Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Arsia Taghva
- Department of Clinical Psychology, Aja University of Medical Sciences, Tehran, Iran
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6
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Yang MS, Quach L, Lee LO, Spiro A, Burr JA. Subjective well-being among male veterans in later life: the enduring effects of early life adversity. Aging Ment Health 2022; 26:107-115. [PMID: 33170037 PMCID: PMC9239431 DOI: 10.1080/13607863.2020.1842999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 10/17/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVES This study investigated the association between childhood and young adult adversities and later-life subjective well-being among older male veterans. We also explored whether early-life parent-child relationships and later-life social engagement served as moderators and mediators, respectively. METHODS Data were from the 2008 to 2012 waves of the Health and Retirement Study for male veterans (N = 2026). Subjective well-being measures included depressive symptoms, self-rated health, and life satisfaction. Linear regression with the Process macro was employed to estimate the relationships. RESULTS Adverse childhood experiences (ACEs) were positively associated with number of depressive symptoms and negatively related to life satisfaction. Combat exposure, a young adulthood adversity experience, was positively associated with depressive symptoms, but not with self-rated health or life satisfaction. Later-life social engagement mediated the relationship between ACEs and subjective well-being indices. Parent-child relationship quality did not moderate the association between the measures of adversity and any measure of subjective well-being. DISCUSSION Childhood adversity and combat exposure were related to worse later life subjective well-being. Also, later-life social engagement mediated the association of two early life adversity measures and subjective well-being. Future research should examine subjective well-being and early life adversity for female veterans and should employ more detailed information about combat exposure.
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Affiliation(s)
- Mai See Yang
- Center on Demography and Economics of Aging, University of Chicago, Chicago, IL, USA
| | - Lien Quach
- Department of Veterans Affairs, Boston Healthcare System and University of Massachusetts Boston, Boston, MA, USA
| | - Lewina O Lee
- Department of Veterans Affairs, Boston Healthcare System and Boston University, Boston, MA, USA
| | - Avron Spiro
- Department of Veterans Affairs, Boston Healthcare System and Boston University, Boston, MA, USA
| | - Jeffrey A Burr
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
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7
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Bachem R, Zhou X, Levin Y, Solomon Z. Trajectories of depression in aging veterans and former prisoners-of-war: The role of social support and hardiness. J Clin Psychol 2021; 77:2203-2215. [PMID: 34000063 DOI: 10.1002/jclp.23168] [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: 12/27/2019] [Revised: 01/14/2021] [Accepted: 03/30/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Depression is a prevalent outcome of traumatic experiences, such as combat and war captivity. This study explores the heterogeneity of changes over time and assesses the contribution of trauma exposure (combat vs. war captivity), hardiness, and social support for depression trajectories. METHODS Two groups of Israeli veterans were assessed in 1991, 2003, 2008, and 2015: 149 former prisoners-of-war (ex-POWs) and 107 combat veterans. Protective factors were evaluated in 1991. Group-based trajectory modeling was conducted to identify latent trajectories of change. RESULTS Four trajectories of "resiliency" (62.8%), "delayed onset" (25.1%), "exacerbation" (6.2%), and "chronicity" (5.9%) were found. The majority of the resilient group were combat veterans whereas the clinical groups consisted primarily of ex-POWs. Lower hardiness and social support were related to more deleterious trajectories. CONCLUSIONS Spirals of loss involving hardiness and social support, normative experiences, and contextual factors may present explanations for the various depression trajectories.
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Affiliation(s)
- Rahel Bachem
- I-Core Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel.,Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.,Department of Psychology, University of Zurich, Zürich, Switzerland
| | - Xiao Zhou
- I-Core Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel.,Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.,Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yafit Levin
- I-Core Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel.,Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.,Department of Psychology, University of Zurich, Zürich, Switzerland
| | - Zahava Solomon
- I-Core Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel.,Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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8
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Zhao X, Lan M, Li H, Yang J. Perceived stress and sleep quality among the non-diseased general public in China during the 2019 coronavirus disease: a moderated mediation model. Sleep Med 2021; 77:339-345. [PMID: 32482485 PMCID: PMC7240276 DOI: 10.1016/j.sleep.2020.05.021] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The 2019 coronavirus disease (COVID-19) has spread worldwide, and its associated stressors have resulted in decreased sleep quality among front-line workers. However, in China, the general public displayed more psychological problems than the front-line workers during the pandemic. Therefore, we investigated the influence of perceived stress on the sleep quality of the non-diseased general public and developed a moderated mediation model to explain said relationship. METHODS Questionnaire-based surveys were conducted online from February 18-25, 2020 with 1630 Chinese participants (aged 18-68 years). RESULTS Around one-third (36.38%) of participants were poor sleepers during the COVID-19 pandemic. Moreover, higher perceived stress was significantly associated with higher anxiety levels, which, in turn, was associated with lower sleep quality. Self-esteem moderated the indirect effect of perceived stress on sleep quality through its moderation of the effect of perceived stress on anxiety. This indicated that the mediation effect of anxiety was stronger in those with low levels of self-esteem than in those with high levels of self-esteem. CONCLUSIONS These findings suggest that both the sleep quality and perceived stress levels of the non-diseased general public required attention during the COVID-19 pandemic. Our findings also identify personality characteristics related to better sleep quality, demonstrating the important role of self-esteem in environmental adaptation.
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Affiliation(s)
- Xiaolin Zhao
- Faculty of Psychology, Southwest University, Chongqing, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Mengxue Lan
- Faculty of Psychology, Southwest University, Chongqing, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Huixiang Li
- Faculty of Psychology, Southwest University, Chongqing, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Juan Yang
- Faculty of Psychology, Southwest University, Chongqing, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China.
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9
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Levy BR, Chung PH, Slade MD, Van Ness PH, Pietrzak RH. Active coping shields against negative aging self-stereotypes contributing to psychiatric conditions. Soc Sci Med 2019; 228:25-29. [PMID: 30870669 DOI: 10.1016/j.socscimed.2019.02.035] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 01/23/2019] [Accepted: 02/22/2019] [Indexed: 11/25/2022]
Abstract
RATIONALE Psychiatric conditions are often falsely considered inherent to aging. We examined whether negative age stereotypes, which older individuals tend to assimilate from the environment across their lifespan, contributed to an increased risk of developing four psychiatric conditions, and, if so, whether this risk was reduced through active coping. METHOD The sample consisted of participants aged 55 years and older, free of the psychiatric conditions at baseline, drawn from the National Health and Resilience in Veterans Study, a nationally representative sample. New cases of posttraumatic stress disorder, suicidal ideation, generalized anxiety disorder, and major depressive disorder were assessed during three waves spanning a four-year period. RESULTS As predicted, participants holding more-negative age stereotypes were more likely to develop the psychiatric conditions, and their engagement in active coping reduced the risk of their developing these conditions. CONCLUSION Our findings suggest that prevention and treatment efforts designed to reduce psychiatric conditions in later life may benefit from bolstering active coping as well as positive age stereotypes.
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Affiliation(s)
| | | | - Martin D Slade
- Yale School of Public Health, USA; Yale School of Medicine, USA
| | | | - Robert H Pietrzak
- Yale School of Medicine, USA; National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, USA
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10
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Baez S, Santamaría-García H, Ibáñez A. Disarming Ex-Combatants' Minds: Toward Situated Reintegration Process in Post-conflict Colombia. Front Psychol 2019; 10:73. [PMID: 30761041 PMCID: PMC6361777 DOI: 10.3389/fpsyg.2019.00073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/10/2019] [Indexed: 01/23/2023] Open
Abstract
Collective violence in the context of armed conflict impacts the economy, health systems, and social stability of affected countries. This is considered a complex phenomenon with interwoven biological, psychological, social, cultural, and political factors. However, most of the research on this topic still lacks suitable established integrative approaches to assess multilevel perspectives. Social, cognitive and affective mental processes (SCAMP) are critical factors that should be considered in multilevel approaches. In this article, we critically discuss some of the classically isolated approaches used in violence research, the absence of successful interventions for ex-combatants reintegration, and the specific neglect of SCAMP in these interventions. We present the case of post-conflict Colombia as a unique opportunity to study the different roots of collective violence, and we call for a more robust and situated approach to understanding of and intervention in this multifaceted phenomenon. In addition, we suggest a two-stage approach for addressing ex-combatants’ reintegration programs, which considers the situated nature of post-conflict scenarios and the urgent need for evidence-based interventions. This approach focuses on the comprehensive scientific assessment of specific factors involved in violence exposure and the subsequent design of successful interventions. The implementation of this approach will contribute to the effective reintegration of individuals who have been exposed to extreme violence for more than 50 years.
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Affiliation(s)
- Sandra Baez
- Departamento de Psicología, Universidad de los Andes, Bogotá, Colombia
| | - Hernando Santamaría-García
- Centro de Memoria y Cognición, Intellectus-Hospital Universitario San Ignacio, Bogotá, Colombia.,Physiology and Psychiatry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Agustín Ibáñez
- Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive and Translational Neuroscience, INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council, Buenos Aires, Argentina.,Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile.,Universidad Autónoma del Caribe, Barranquilla, Colombia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
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11
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González-Salinas S, Cruz-Sánchez R, Ferrer-Juárez L, Reyes-Garduño M, Gil-Trejo M, Sánchez-Moguel S. Short-term changes in the mental health of recently enrolled university students. JOURNAL OF MENTAL HEALTH AND HUMAN BEHAVIOUR 2019. [DOI: 10.4103/jmhhb.jmhhb_42_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Dai W, Kaminga AC, Tan H, Wang J, Lai Z, Wu X, Xiong Y, Deng J, Liu A. Comorbidity of post-traumatic stress disorder and anxiety in flood survivors: Prevalence and shared risk factors. Medicine (Baltimore) 2017; 96:e7994. [PMID: 28885358 PMCID: PMC6393105 DOI: 10.1097/md.0000000000007994] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) and anxiety are both prevalent in trauma-related populations. However, comorbidity of these 2 psychiatric disorders has not been investigated in flood survivors. This study aimed to estimate the extent to which PTSD and anxiety co-occur in flood survivors, and identify shared risk factors for PTSD only and comorbidity of PTSD and anxiety.Individuals who experienced Dongting Lake flood in 1998 were enrolled in this study using stratified and systematic random sampling method. Information on social support, personality traits, PTSD, and anxiety was collected using self-report questionnaires. The intensity of exposure to the flood was measured by some questions. Logistic regression analyses were used to identify factors associated with PTSD only and comorbidity of PTSD and anxiety.In all, 325 participants were enrolled in this study. The prevalence of PTSD, anxiety, and comorbidity of PTSD and anxiety among survivors of the 1998 Dongting Lake flood at 17-year follow-up was 9.54%, 9.23%, and 6.15%, respectively. Furthermore, 64.52% of those with PTSD had anxiety and 66.67% of those with anxiety had PTSD. Loss of relative, injury of body, damage of house, and emotional instability were shared risk factors for PTSD only and comorbidity of PTSD and anxiety, in comparison with neither PTSD nor anxiety.Post-traumatic stress disorder only and comorbidity of PTSD and anxiety are prevalent in flood survivors, and are both related to the intensity of exposure to the flood and personality traits, indicating that integrated intervention strategies of PTSD and anxiety for flood survivors are needed.
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Affiliation(s)
- Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Atipatsa C. Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
- Department of Mathematics, Mzuzu University, Mzuzu, Malawi
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Jieru Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Zhiwei Lai
- Hunan Provincial Center for Disease Control and Prevention, Hunan, China
| | - Xin Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Yuan Xiong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
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13
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Gal S, Shelef L, Oz I, Yavnai N, Carmon E, Gordon S. The contribution of personal and seniority variables to the presence of stress symptoms among Israeli UAV operators. DISASTER AND MILITARY MEDICINE 2017; 2:18. [PMID: 28265452 PMCID: PMC5330134 DOI: 10.1186/s40696-016-0028-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 11/25/2016] [Indexed: 12/03/2022]
Abstract
Background The exposure to war scenes via screens, despite offering a degree of detachment, can be stressful for the operator. The aim of the current study is to examine the existence of anxiety, depression, and post traumatic stress disorder (PTSD) symptoms among unmanned aerial vehicle (UAV) Israeli operators. Methods Participants comprised 41 UAV operators (87.2% male), aged 22–38 (Mage = 26.05, SD = 3.54). Most (78.0%) reported having viewed battlefield scenes. All participants completed a total of five questionnaires: Beck Depression Inventory, State-Trait Anxiety Inventory, and three questionnaires of PTSD: Post Trauma Questionnaire (CAPS), the Post-Traumatic Cognition Inventory (CTPI), and the Post-Traumatic Symptom Scale (PSS). Results Mean scores of depression and anxiety were found significantly lower than diagnosis cut-off points (p < .001). Senior operators showed higher means for depression (5.69 vs. 2.58, p = .040), of stress level (PSS; 3.17 vs. 0.25, p = .020) and for distress intensity (3.79 vs. 0.57, p = 0.041) than less-experienced operators. Conclusions Investigating and monitoring the impact of battlefield exposure in UAV operators are highly beneficial for preventing psychopathology.
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Affiliation(s)
- Shiri Gal
- Psychology Branch, Israeli Air Force, Ramat Gan, Israel.,Mental Health Unit, Medical Corps, Israel Defense Forces, Ramat Gan, Israel
| | - Leah Shelef
- Psychology Branch, Israeli Air Force, Ramat Gan, Israel.,Mental Health Unit, Medical Corps, Israel Defense Forces, Ramat Gan, Israel
| | - Idit Oz
- Psychology Branch, Israeli Air Force, Ramat Gan, Israel.,Mental Health Unit, Medical Corps, Israel Defense Forces, Ramat Gan, Israel
| | - Nirit Yavnai
- IDF Medical Corps, Israel Defense Forces, Ramat Gan, Israel
| | | | - Shirley Gordon
- Psychology Branch, Israeli Air Force, Ramat Gan, Israel.,Mental Health Unit, Medical Corps, Israel Defense Forces, Ramat Gan, Israel
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14
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Yang MS, Burr JA. Combat exposure, social relationships, and subjective well-being among middle-aged and older Veterans. Aging Ment Health 2017; 20:637-46. [PMID: 25928024 DOI: 10.1080/13607863.2015.1033679] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study described the association of subjective well-being with combat exposure and social relationships among middle-aged and older Veteran men in the USA. The stress-buffering hypothesis, which predicts social relationships may moderate the association between combat exposure and subjective well-being, was also examined. METHOD Data from the 2008 Health and Retirement Study (N = 2961) were used to estimate logistic regression models, focusing on three measures of subjective well-being: depression, life satisfaction, and self-reported health. RESULTS In the fully adjusted models, there were no statistically significant relationships between combat exposure and the three indicators of subjective well-being. However, compared to Veterans who had lower scores on the social relationship index, Veterans who had higher scores were less likely to be depressed and less likely to report poor or fair health. Veterans who had higher scores on the social relationships index reported higher levels of life satisfaction than those Veterans who had lower scores. There was no evidence for a social relationships buffering effect. CONCLUSION The results of this study demonstrated that combat exposure did not have a long-term relationship with subjective well-being. Longitudinal research designs with more comprehensive indicators of combat exposure may help researchers better understand some of the underlying complexity of this relationship. Complementary research with samples of women Veterans, as well as samples of Hispanic, and non-Black, non-White Veterans, is also needed.
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Affiliation(s)
- Mai See Yang
- a Department of Gerontology , McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston , Boston , MA , USA
| | - Jeffrey A Burr
- a Department of Gerontology , McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston , Boston , MA , USA
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Stanton MV, Matsuura J, Fairchild JK, Lohnberg JA, Bayley PJ. Mindfulness as a Weight Loss Treatment for Veterans. Front Nutr 2016; 3:30. [PMID: 27574603 PMCID: PMC4983552 DOI: 10.3389/fnut.2016.00030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 07/29/2016] [Indexed: 01/23/2023] Open
Abstract
Despite substantial evidence for their effectiveness in treating disordered eating and obesity, mindfulness-based treatments have not been broadly implemented among Veterans. A number of reviews have reported mindfulness to be beneficial in promoting healthy eating behaviors and weight loss among non-Veteran samples. We discuss this approach in the context of the Veterans Affairs system, the largest integrated healthcare provider in the U.S. and in the context of Veterans, among whom obesity is at epidemic proportions. In this article, we discuss what is known about treating obesity using a mindfulness approach, mindfulness interventions for Veterans, a new pilot mindfulness-based weight loss program designed for Veterans, and future directions for this type of obesity treatment in Veterans. We conclude that this population may be uniquely poised to benefit from mindfulness-based treatments.
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Affiliation(s)
- Michael V Stanton
- Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Justin Matsuura
- US Army Health Clinic Schofield Barracks Brain Injury Clinic , Schofield Barracks, HI , USA
| | | | | | - Peter J Bayley
- Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
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16
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Bonde JP, Utzon-Frank N, Bertelsen M, Borritz M, Eller NH, Nordentoft M, Olesen K, Rod NH, Rugulies R. Risk of depressive disorder following disasters and military deployment: systematic review with meta-analysis. Br J Psychiatry 2016; 208:330-6. [PMID: 26892850 DOI: 10.1192/bjp.bp.114.157859] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 05/28/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Numerous studies describe the occurrence of post-traumatic stress disorder following disasters, but less is known about the risk of major depression. AIMS To review the risk of depressive disorder in people surviving disasters and in soldiers returning from military deployment. METHOD A systematic literature search combined with reference screening identified 23 controlled epidemiological studies. We used random effects models to compute pooled odds ratios (ORs). RESULTS The average OR was significantly elevated following all types of exposures: natural disaster OR = 2.28 (95% CI 1.30-3.98), technological disaster OR = 1.44 (95% CI 1.21-1.70), terrorist acts OR = 1.80 (95% CI 1.38-2.34) and military combat OR = 1.60 (95% CI 1.09-2.35). In a subset of ten high-quality studies OR was 1.41 (95% CI 1.06-1.87). CONCLUSIONS Disasters and combat experience substantially increase the risk of depression. Whether psychological trauma per se or bereavement is on the causal path is unresolved.
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Affiliation(s)
- J P Bonde
- J. P. Bonde, DMSc, N. Utzon-Frank, MD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Bertelsen, PhD, Danish Veteran Centre, Copenhagen; M. Borritz, PhD, N. H. Eller, DMSc, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Nordentoft, DMSc, Psychiatric Centre Bispebjerg, Bispebjerg University Hospital; K. Olesen, PhD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, and Department of Public Health, University of Copenhagen; N. H. Rod, DMSc, Department of Public Health, University of Copenhagen; R. Rugulies, PhD, Department of Public Health, University of Copenhagen, National Research Centre for the Working Environment, and Department of Psychology, University of Copenhagen, Denmark
| | - N Utzon-Frank
- J. P. Bonde, DMSc, N. Utzon-Frank, MD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Bertelsen, PhD, Danish Veteran Centre, Copenhagen; M. Borritz, PhD, N. H. Eller, DMSc, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Nordentoft, DMSc, Psychiatric Centre Bispebjerg, Bispebjerg University Hospital; K. Olesen, PhD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, and Department of Public Health, University of Copenhagen; N. H. Rod, DMSc, Department of Public Health, University of Copenhagen; R. Rugulies, PhD, Department of Public Health, University of Copenhagen, National Research Centre for the Working Environment, and Department of Psychology, University of Copenhagen, Denmark
| | - M Bertelsen
- J. P. Bonde, DMSc, N. Utzon-Frank, MD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Bertelsen, PhD, Danish Veteran Centre, Copenhagen; M. Borritz, PhD, N. H. Eller, DMSc, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Nordentoft, DMSc, Psychiatric Centre Bispebjerg, Bispebjerg University Hospital; K. Olesen, PhD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, and Department of Public Health, University of Copenhagen; N. H. Rod, DMSc, Department of Public Health, University of Copenhagen; R. Rugulies, PhD, Department of Public Health, University of Copenhagen, National Research Centre for the Working Environment, and Department of Psychology, University of Copenhagen, Denmark
| | - M Borritz
- J. P. Bonde, DMSc, N. Utzon-Frank, MD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Bertelsen, PhD, Danish Veteran Centre, Copenhagen; M. Borritz, PhD, N. H. Eller, DMSc, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Nordentoft, DMSc, Psychiatric Centre Bispebjerg, Bispebjerg University Hospital; K. Olesen, PhD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, and Department of Public Health, University of Copenhagen; N. H. Rod, DMSc, Department of Public Health, University of Copenhagen; R. Rugulies, PhD, Department of Public Health, University of Copenhagen, National Research Centre for the Working Environment, and Department of Psychology, University of Copenhagen, Denmark
| | - N H Eller
- J. P. Bonde, DMSc, N. Utzon-Frank, MD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Bertelsen, PhD, Danish Veteran Centre, Copenhagen; M. Borritz, PhD, N. H. Eller, DMSc, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Nordentoft, DMSc, Psychiatric Centre Bispebjerg, Bispebjerg University Hospital; K. Olesen, PhD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, and Department of Public Health, University of Copenhagen; N. H. Rod, DMSc, Department of Public Health, University of Copenhagen; R. Rugulies, PhD, Department of Public Health, University of Copenhagen, National Research Centre for the Working Environment, and Department of Psychology, University of Copenhagen, Denmark
| | - M Nordentoft
- J. P. Bonde, DMSc, N. Utzon-Frank, MD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Bertelsen, PhD, Danish Veteran Centre, Copenhagen; M. Borritz, PhD, N. H. Eller, DMSc, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Nordentoft, DMSc, Psychiatric Centre Bispebjerg, Bispebjerg University Hospital; K. Olesen, PhD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, and Department of Public Health, University of Copenhagen; N. H. Rod, DMSc, Department of Public Health, University of Copenhagen; R. Rugulies, PhD, Department of Public Health, University of Copenhagen, National Research Centre for the Working Environment, and Department of Psychology, University of Copenhagen, Denmark
| | - K Olesen
- J. P. Bonde, DMSc, N. Utzon-Frank, MD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Bertelsen, PhD, Danish Veteran Centre, Copenhagen; M. Borritz, PhD, N. H. Eller, DMSc, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Nordentoft, DMSc, Psychiatric Centre Bispebjerg, Bispebjerg University Hospital; K. Olesen, PhD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, and Department of Public Health, University of Copenhagen; N. H. Rod, DMSc, Department of Public Health, University of Copenhagen; R. Rugulies, PhD, Department of Public Health, University of Copenhagen, National Research Centre for the Working Environment, and Department of Psychology, University of Copenhagen, Denmark
| | - N H Rod
- J. P. Bonde, DMSc, N. Utzon-Frank, MD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Bertelsen, PhD, Danish Veteran Centre, Copenhagen; M. Borritz, PhD, N. H. Eller, DMSc, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Nordentoft, DMSc, Psychiatric Centre Bispebjerg, Bispebjerg University Hospital; K. Olesen, PhD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, and Department of Public Health, University of Copenhagen; N. H. Rod, DMSc, Department of Public Health, University of Copenhagen; R. Rugulies, PhD, Department of Public Health, University of Copenhagen, National Research Centre for the Working Environment, and Department of Psychology, University of Copenhagen, Denmark
| | - R Rugulies
- J. P. Bonde, DMSc, N. Utzon-Frank, MD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Bertelsen, PhD, Danish Veteran Centre, Copenhagen; M. Borritz, PhD, N. H. Eller, DMSc, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital; M. Nordentoft, DMSc, Psychiatric Centre Bispebjerg, Bispebjerg University Hospital; K. Olesen, PhD, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, and Department of Public Health, University of Copenhagen; N. H. Rod, DMSc, Department of Public Health, University of Copenhagen; R. Rugulies, PhD, Department of Public Health, University of Copenhagen, National Research Centre for the Working Environment, and Department of Psychology, University of Copenhagen, Denmark
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Thompson JM, VanTil LD, Zamorski MA, Garber B, Dursun S, Fikretoglu D, Ross D, Richardson JD, Sareen J, Sudom K, Courchesne C, Pedlar DJ. Mental health of Canadian Armed Forces Veterans: review of population studies. JOURNAL OF MILITARY VETERAN AND FAMILY HEALTH 2016. [DOI: 10.3138/jmvfh.3258] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction. The mental health of Canadian Armed Forces (CAF) populations emerged as an important concern in the wake of difficult CAF deployments in the 1990s. This article is the first comprehensive summary of findings from subsequent surveys of mental health and well-being in CAF Veterans, undertaken to inform mental health service renewals by CAF Health Services and Veterans Affairs Canada (VAC). Methods. Epidemiological findings in journal publications and government reports were summarized from four cross-sectional national surveys: a survey of Veterans participating in VAC programs in 1999 and three surveys of health and well-being representative of whole populations of Veterans in 2003, 2010, and 2013. Results. Although most Veterans had good mental health, many had mental health problems that affected functioning, well-being, and service utilization. Recent Veterans had a higher prevalence of mental health problems than the general Canadian population, earlier-era Veterans, and possibly the serving population. There were associations between mental health conditions and difficult adjustment to civilian life, physical health, and multiple socio-demographic factors. Mental health problems were key drivers of disability. Comparisons with other studies were complicated by methodological, era, and cultural differences. Discussion. The survey findings support ongoing multifactorial approaches to optimizing mental health and well-being in CAF Veterans, including strong military-to-civilian transition support and access to effective mental and physical health services. Studies underway of transitioning members and families in the peri-release period of the military-to-civilian transition and longitudinal studies of mental health in Veterans will address important knowledge gaps.
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Affiliation(s)
- James M. Thompson
- Research Directorate, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - Linda D. VanTil
- Research Directorate, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - Mark A. Zamorski
- Directorate of Mental Health, Canadian Forces Health Services Group, Ottawa, Ontario, Canada
| | - Bryan Garber
- Directorate of Mental Health, Canadian Forces Health Services Group, Ottawa, Ontario, Canada
| | - Sanela Dursun
- Director General Military Personnel Research and Analysis (DGMPRA), Ottawa, Ontario, Canada
| | - Deniz Fikretoglu
- Defense Research and Development Canada, Toronto, Ontario, Canada
| | - David Ross
- National Centre for Operational Stress Injuries, Veterans Affairs Canada, Sainte-Anne-de-Bellevue, QC
| | | | - Jitender Sareen
- Departments of Psychiatry, Psychology and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kerry Sudom
- Director General Military Personnel Research and Analysis (DGMPRA), Ottawa, Ontario, Canada
| | - Cyd Courchesne
- Health Professionals, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - David J. Pedlar
- Research Directorate, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
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Forbes D, O’Donnell M, Brand RM, Korn S, Creamer M, McFarlane AC, Sim MR, Forbes AB, Hawthorne G. The long-term mental health impact of peacekeeping: prevalence and predictors of psychiatric disorder. BJPsych Open 2016; 2:32-37. [PMID: 27703751 PMCID: PMC4995565 DOI: 10.1192/bjpo.bp.115.001321] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 10/25/2015] [Accepted: 10/26/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The mental health outcomes of military personnel deployed on peacekeeping missions have been relatively neglected in the military mental health literature. AIMS To assess the mental health impacts of peacekeeping deployments. METHOD In total, 1025 Australian peacekeepers were assessed for current and lifetime psychiatric diagnoses, service history and exposure to potentially traumatic events (PTEs). A matched Australian community sample was used as a comparator. Univariate and regression analyses were conducted to explore predictors of psychiatric diagnosis. RESULTS Peacekeepers had significantly higher 12-month prevalence of post-traumatic stress disorder (16.8%), major depressive episode (7%), generalised anxiety disorder (4.7%), alcohol misuse (12%), alcohol dependence (11.3%) and suicidal ideation (10.7%) when compared with the civilian comparator. The presence of these psychiatric disorders was most strongly and consistently associated with exposure to PTEs. CONCLUSIONS Veteran peacekeepers had significant levels of psychiatric morbidity. Their needs, alongside those of combat veterans, should be recognised within military mental health initiatives. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.
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Affiliation(s)
| | | | - Rachel M. Brand
- Rachel M. Brand, DClinPsy, Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Sam Korn
- Sam Korn, PhD, Mental Health Evaluation Unit, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Mark Creamer
- Mark Creamer, PhD, Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Alexander C. McFarlane
- Alexander C. McFarlane, AO, MD, FRANZCP, Centre for Traumatic Stress Studies, University of Adelaide, South Australia, Australia
| | | | - Andrew B. Forbes
- Andrew B. Forbes, PhD, Monash Centre for Occupational & Environmental Health, Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Graeme Hawthorne
- Graeme Hawthorne (deceased), PhD, Mental Health Evaluation Unit, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
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Gwini SM, Forbes AB, Kelsall HL, Ikin JF, Sim MR. Increased symptom reporting persists in 1990-1991 Gulf War veterans 20 years post deployment. Am J Ind Med 2015; 58:1246-54. [PMID: 26497120 DOI: 10.1002/ajim.22490] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Following the 1990-1991 Gulf War, Gulf War veterans (veterans) reported health symptoms more commonly than non-deployed groups. This article examines symptom persistence, incidence and prevalence 20 years on. METHODS In 2000-2003 and 2011-2012, a 63-item symptom checklist was administered to 697 veterans and 659 comparison group. Symptomatology was compared using log-binomial regression. RESULTS Both veterans and comparison group reported significantly increased prevalence (3-52%) over time in more than half the symptoms, with a similar overall rate of increase. Half the symptoms had higher incidence (risk-ratios ranged 1.43-1.50) and a quarter were more persistent (risk-ratios ranged 1.12-1.20) in veterans than the comparison group. CONCLUSIONS Symptomatology increased in both groups over time, but persisted to a similar extent and had higher incidence among veterans than the comparison group. The gap in symptom prevalence between the two groups remained unchanged. These findings suggest enduring health consequences of Gulf War service.
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Affiliation(s)
- Stella M. Gwini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - Andrew B Forbes
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - Helen L. Kelsall
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - Jillian F. Ikin
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - Malcolm R. Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
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Abstract
OBJECTIVES In many countries veterans from World War II are growing old. Research has shown that war experiences continue to impact those who have been involved in war for a long time. The present study targets old injured war veterans from World War II in Finland. The aim of this study was to produce knowledge of the impact of war experiences and injuries on the lifespan of Finnish war veterans. METHOD The method used was grounded theory. Data were collected by interviewing 20 aged war veterans in their homes. RESULTS The analysis resulted in four categories, with also subcategories: (1) lost childhood and youth; (2) war traumas impacting life; (3) starting life from scratch; and (4) finding one's own place. A substantive theory of war veterans' lifelong struggle for freedom throughout the lifespan was outlined. CONCLUSION The war overshadowed the whole lifespan of the veterans, but in old age they finally felt free. Since war experiences vary depending on historical context, a formal theory would require additional research.
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Affiliation(s)
- Sirkka Nivala
- a Department of Health Sciences , University of Jyväskylä , Jyväskylä , Finland
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21
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Huang HH, Kashubeck-West S. Exposure, Agency, Perceived Threat, and Guilt as Predictors of Posttraumatic Stress Disorder in Veterans. JOURNAL OF COUNSELING AND DEVELOPMENT 2015. [DOI: 10.1002/j.1556-6676.2015.00176.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Levy BR, Pilver CE, Pietrzak RH. Lower prevalence of psychiatric conditions when negative age stereotypes are resisted. Soc Sci Med 2014; 119:170-4. [PMID: 25189737 DOI: 10.1016/j.socscimed.2014.06.046] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 06/09/2014] [Accepted: 06/25/2014] [Indexed: 01/17/2023]
Abstract
Older military veterans are at greater risk for psychiatric disorders than same-aged non-veterans. However, little is known about factors that may protect older veterans from developing these disorders. We considered whether an association exists between the potentially stress-reducing factor of resistance to negative age stereotypes and lower prevalence of the following outcomes among older veterans: suicidal ideation, anxiety, and posttraumatic stress disorder (PTSD). Participants consisted of 2031 veterans, aged 55 or older, who were drawn from the National Health and Resilience in Veterans Study, a nationally representative survey of American veterans. The prevalence of all three outcomes was found to be significantly lower among participants who fully resisted negative age stereotypes, compared to those who fully accepted them: suicidal ideation, 5.0% vs. 30.1%; anxiety, 3.6% vs. 34.9%; and PTSD, 2.0% vs. 18.5%, respectively. The associations followed a graded linear pattern and persisted after adjustment for relevant covariates, including age, combat experience, personality, and physical health. These findings suggest that developing resistance to negative age stereotypes could provide older individuals with a path to greater mental health.
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Affiliation(s)
- Becca R Levy
- Social and Behavioral Sciences Division, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA.
| | - Corey E Pilver
- Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA
| | - Robert H Pietrzak
- United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, and Department of Psychiatry, Yale School of Medicine, 950 Campbell Avenue, West Haven, CT 06516, USA
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Woodhead C, Rona RJ, Iversen AC, MacManus D, Hotopf M, Dean K, McManus S, Meltzer H, Brugha T, Jenkins R, Wessely S, Fear NT. Health of national service veterans: an analysis of a community-based sample using data from the 2007 Adult Psychiatric Morbidity Survey of England. Soc Psychiatry Psychiatr Epidemiol 2011; 46:559-66. [PMID: 20490456 DOI: 10.1007/s00127-010-0232-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Accepted: 04/26/2010] [Indexed: 11/28/2022]
Abstract
PURPOSE In the context of increasing concerns for the health of UK armed forces veterans, this study aims to compare the prevalence of current mental, physical and behavioural difficulties in conscripted national service veterans with population controls, and to assess the impact of length of service in the military. The compulsory nature of national service sets these veterans apart from younger veterans. METHOD Data are drawn from a nationally representative community-dwelling sample of England. We compared 484 male national service veterans to 301 male non-veterans aged 65+ years. RESULTS There were no differences in mental, behavioural or physical outcomes, except that veterans were less likely to have "any mental disorder" than non-veterans (age adjusted OR = 0.56, 95% CI 0.31, 0.99). Longer serving veterans were older but were not different in terms of mental, behavioural or physical outcomes. CONCLUSIONS Community-dwelling national service veterans are at no greater risk of current adverse mental, physical or behavioural health than population controls.
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Affiliation(s)
- Charlotte Woodhead
- Academic Centre for Defence Mental Health, Weston Education Centre, King's College London, Cutcombe Rd, London SE5 9RJ, UK
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Wu LF. Group integrative reminiscence therapy on self-esteem, life satisfaction and depressive symptoms in institutionalised older veterans. J Clin Nurs 2011; 20:2195-203. [DOI: 10.1111/j.1365-2702.2011.03699.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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The relationships between quality of life, psychiatric illness, and suicidal ideation in geriatric veterans living in a veterans' home: a structural equation modeling approach. Am J Geriatr Psychiatry 2011; 19:597-601. [PMID: 21606903 DOI: 10.1097/jgp.0b013e3181faec0e] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This study tested a structural model and examined the relationships between age, suicidal ideation, and scores on the 5-item Brief Symptom Rating Scale (BSRS-5), the 15-item Geriatric Depression Scale (GDS-15), and the Medical Outcome Study Short Form-12 (MOS SF-12) in a sample of veterans' home residents. METHODS Of the 266 individuals recruited, 226 completed the questionnaires, resulting in a response rate of 84.9%. Participants completed the BSRS-5, GDS-15, MOS SF-12, and a demographic survey. Analysis of Moment Structures, Version 7.0, was used to test the structural relationships of the model with a structural equation modeling analysis and a maximum likelihood ratio estimation. Patient subitem scores, which ranked their feelings of depression, hostility, and inferiority, were summed to determine their 3-BSRS-subitem sum scores. RESULTS The measures of model fitness were as follows: goodness-of-fit (χ = 12.03, df = 7, p = 0.1), goodness-of-fit index (0.98), adjusted goodness-of-fit index (0.95), comparative fit index (0.99), parsimony ratio (0.47), and root mean square error of approximation (0.06). All indices suggested that the final model fit the data well. Age was inversely related to physical component summary, which was inversely related to the 3-BSRS-subitem sum score. Mental component summary was inversely related to the 3-BSRS-subitem sum score and the GDS-15. Physical component summary was inversely related to the GDS-15. The 3-BSRS-subitem sum score correlated with suicidal ideation. CONCLUSIONS The data reveal a significant relationship between quality of life and suicidal ideation, which may be affected more by the 3-BSRS-subitem sum score than by the GDS-15. The proposed model has the potential to help healthcare professionals effectively design and implement their suicide prevention programs.
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Range and specificity of war-related trauma to posttraumatic stress; depression and general health perception: displaced former World War II children in late life. J Affect Disord 2011; 128:267-76. [PMID: 20692706 DOI: 10.1016/j.jad.2010.07.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Revised: 07/09/2010] [Accepted: 07/09/2010] [Indexed: 11/23/2022]
Abstract
BACKGROUND Dose-response relation of war experiences and posttraumatic stress, depression and poor health functioning in late life is well documented in war-affected populations. The influence of differing trauma types experienced by war-affected population in the study of dose-response relation of war trauma and psychological maladaptation in late life has not been investigated. We examined a subgroup of displaced elders and investigated whether specific trauma types were associated with differential health outcomes. METHODS From representative practitioner lists, matched groups of former displaced and non-displaced World War II children were assigned, yielding a total sample of 417 participants (response rate 50%). Measurement encompassed a self-report survey including the Impact of Event Scale-Revised, the Patient Health Questionnaire and the Harvard Trauma Questionnaire. RESULTS Consistent dose-relation between war-related experiences and posttraumatic stress or depressive symptoms in late life was found for both, displaced and non-displaced elders, whereas a gradient for poor health perception was only found in displaced people. Trauma types derived from principal component analysis showed differential associations with health outcomes. Human Right Violations emerged as risk factor for posttraumatic stress symptoms and Deprivation & Threat to Life as risk factor for depressive symptoms. Poor self-rated health was associated with multiple trauma types. LIMITATIONS Non-random recruitment, retrospective design and use of self-report. CONCLUSIONS Posttraumatic stress and depression are associated with war-related experiences more than 60 years after World War II. Results suggest that different trauma types lead to unique variants of syndrome configurations, which may result from different etiological factors.
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Woodhead C, Rona RJ, Iversen A, MacManus D, Hotopf M, Dean K, McManus S, Meltzer H, Brugha T, Jenkins R, Wessely S, Fear NT. Mental health and health service use among post-national service veterans: results from the 2007 Adult Psychiatric Morbidity Survey of England. Psychol Med 2011; 41:363-372. [PMID: 20406527 DOI: 10.1017/s0033291710000759] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is concern surrounding the psychological health and uptake of treatment services among veterans of the UK Armed Forces. METHOD Data from a cross-sectional, nationally representative sample were used to compare health outcomes and treatment seeking among 257 post-national service veterans aged 16-64 years and 504 age and sex frequency-matched non-veterans living in the community in England. Early leavers (<4 years service) were compared with longer serving veterans. RESULTS Male veterans reported more childhood adversity and were more likely to have experienced a major trauma in adulthood than non-veterans. There was no association between any measure of mental health and veteran status in males, except reporting more violent behaviours [adjusted odds ratio (aOR) 1.44, 95% confidence interval (CI) 1.01-2.06]. In females, a significant association was found between veteran status and ever having suicidal thoughts (aOR 2.82, 95% CI 1.13-7.03). No differences in treatment-seeking behaviour were identified between veterans and non-veterans with any mental disorder. Early service leavers were more likely to be heavy drinkers (aOR 4.16, 95% CI 1.08-16.00), to have had suicidal thoughts (aOR 2.37, 95% CI 1.21-4.66) and to have self-harmed (aOR 12.36, 95% CI 1.61-94.68) than longer serving veterans. CONCLUSIONS The findings of this study do not suggest that being a veteran is associated with adversity in terms of mental health, social disadvantage or reluctance to seek treatment compared with the general population. Some evidence implies that early service leavers may experience more mental health problems than longer-serving veterans.
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Affiliation(s)
- C Woodhead
- Academic Centre for Defence Mental Health, King's College London, UK
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Ikin JF, Creamer MC, Sim MR, McKenzie DP. Comorbidity of PTSD and depression in Korean War veterans: prevalence, predictors, and impairment. J Affect Disord 2010; 125:279-86. [PMID: 20071032 DOI: 10.1016/j.jad.2009.12.005] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Revised: 12/07/2009] [Accepted: 12/07/2009] [Indexed: 11/17/2022]
Abstract
BACKGROUND Rates of PTSD and depression are high in Korean War veterans. The prevalence and impact of the two disorders occurring comorbidly, however, has not been investigated. This paper aims to investigate the extent to which PTSD and depression co-occur in Australian veterans of the Korean War, the symptom severity characteristics of comorbidity, the impact on life satisfaction and quality, and the association with war-related predictors. METHODS Veterans (N=5352) completed self-report questionnaires including the Posttraumatic Stress Disorder Checklist, the Hospital Anxiety and Depression Scale, the Life Satisfaction Scale, the brief World Health Organisation Quality of Life questionnaire and the Combat Exposure Scale. RESULTS Seventeen percent of veterans met criteria for comorbid PTSD and depression, 15% had PTSD without depression, and a further 6% had depression without PTSD. Compared with either disorder alone, comorbidity was associated with impaired life satisfaction, reduced quality of life, and greater symptom severity. Several war-related factors were associated with comorbidity and with PTSD alone, but not with depression alone. LIMITATIONS The reliance on self-reported measures and the necessity for retrospective assessment of some deployment-related factors renders some study data vulnerable to recall bias. CONCLUSIONS Comorbid PTSD and depression, and PTSD alone, are prevalent among Korean War veterans, are both associated with war-related factors 50 years after the Korean War, and may represent a single traumatic stress construct. The results have important implications for understanding complex psychopathology following trauma.
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Affiliation(s)
- Jillian F Ikin
- Monash Centre for Occupational and Environmental Health, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
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Williams JE, Johnson AM, Rose KM, Heiss G. Association between exposure to combat-related stress and psychological health in aging men: the Atherosclerosis Risk in Communities (ARIC) Study. J Trauma Stress 2010; 23:358-66. [PMID: 20564369 PMCID: PMC5441384 DOI: 10.1002/jts.20533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Exposure to military combat has been associated with myriad adverse health effects. Mechanisms are not well understood, but may include negative emotional states. The authors investigated the relationship between combat and trait anger and vital exhaustion among 5,347 middle-aged male participants in the Atherosclerosis Risk in Communities Study. Combat was significantly associated with trait anger, although results were limited to men of the Korean and Vietnam War eras. Among men of the Korean War era, combat- and noncombat veterans, compared to their nonveteran counterparts, reported more trait anger. Compared to their noncombat and nonveteran counterparts, Vietnam War era combat veterans reported more trait anger. Noncombat veterans from the World War II and Vietnam War eras reported lower vital exhaustion compared to nonveterans. Anger proneness may be a mechanism through which combat stress is associated with adverse health outcomes.
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Affiliation(s)
| | - Anna M. Johnson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina School– Chapel Hill, Chapel Hill, North Carolina
| | - Kathryn M. Rose
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina School– Chapel Hill, Chapel Hill, North Carolina
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina School– Chapel Hill, Chapel Hill, North Carolina
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Alici Y, Smith D, Lu HL, Bailey A, Shreve S, Rosenfeld K, Ritchie C, Casarett DJ. Families' perceptions of veterans' distress due to post-traumatic stress disorder-related symptoms at the end of life. J Pain Symptom Manage 2010; 39:507-14. [PMID: 20083372 DOI: 10.1016/j.jpainsymman.2009.07.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2009] [Revised: 07/28/2009] [Accepted: 07/30/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To define the frequency of post-traumatic stress disorder (PTSD)-related symptoms among veterans who are near the end of life and to describe the impact that these symptoms have on patients and their families. METHODS Patients had received inpatient or outpatient care from a participating VA facility in the last month of life, and one family member per patient was selected using predefined eligibility criteria. Family members then completed a telephone survey, The Family Assessment of Treatment at End-of-Life, which assessed their perceptions of the quality of the care that the patients and they themselves received during the patients' last month of life. RESULTS Seventeen percent of patients (89 of 524) were reported to have had PTSD-related symptoms in the last month of life. PTSD-related symptoms caused discomfort less often than pain did (mean frequency score 1.79 vs. 1.93; Wilcoxon sign rank test, P<0.001) but more often than dyspnea did (mean severity score 1.79 vs. 1.73; Wilcoxon sign rank test, P<0.001). Family members of patients with PTSD-related symptoms reported less satisfaction overall with the care the patient received (mean score 48 vs. 62; rank sum test, P<0.001). Patients who received a palliative care consult (n=49) had lower ratings of discomfort attributed to PTSD-related symptoms (mean 1.55 vs. 2.07; rank sum test, P=0.007). CONCLUSION PTSD-related symptoms may be common and severe among veterans near the end of life and may have a negative effect on families' perceptions of the quality of care that the veteran received.
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Affiliation(s)
- Yesne Alici
- Geriatric Services Unit, Central Regional Hospital, Butner, North Carolina 27509, USA.
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Abstract
The aim of the present study was to provide a critical review of prevalence estimates of combat-related post-traumatic stress disorder (PTSD) among military personnel and veterans, and of the relevant factors that may account for the variability of estimates within and across cohorts, including methodological and conceptual factors accounting for differences in prevalence rates across nations, conflicts/wars, and studies. MEDLINE and PsycINFO databases were examined for literature on combat-related PTSD. The following terms were used independently and in combinations in this search: PTSD, combat, veterans, military, epidemiology, prevalence. The point prevalence of combat-related PTSD in US military veterans since the Vietnam War ranged from approximately 2% to 17%. Studies of recent conflicts suggest that combat-related PTSD afflicts between 4% and 17% of US Iraq War veterans, but only 3-6% of returning UK Iraq War veterans. Thus, the prevalence range is narrower and tends to have a lower ceiling among combat veterans of non-US Western nations. Variability in prevalence is likely due to differences in sampling strategies; measurement strategies; inclusion and measurement of the DSM-IV clinically significant impairment criterion; timing and latency of assessment and potential for recall bias; and combat experiences. Prevalence rates are also likely affected by issues related to PTSD course, chronicity, and comorbidity; symptom overlap with other psychiatric disorders; and sociopolitical and cultural factors that may vary over time and by nation. The disorder represents a significant and costly illness to veterans, their families, and society as a whole. Further carefully conceptualized research, however, is needed to advance our understanding of disorder prevalence, as well as associated information on course, phenomenology, protective factors, treatment, and economic costs.
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Affiliation(s)
| | - B. Christopher Frueh
- The Menninger Clinic and Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Ronald Acierno
- Veterans Affairs Medical Center and Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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Selby EA, Anestis MD, Bender TW, Ribeiro JD, Nock MK, Rudd MD, Bryan CJ, Lim IC, Baker MT, Gutierrez PM, Joiner TE. Overcoming the fear of lethal injury: evaluating suicidal behavior in the military through the lens of the Interpersonal-Psychological Theory of Suicide. Clin Psychol Rev 2009; 30:298-307. [PMID: 20051309 DOI: 10.1016/j.cpr.2009.12.004] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Revised: 12/02/2009] [Accepted: 12/03/2009] [Indexed: 12/25/2022]
Abstract
Suicide rates have been increasing in military personnel since the start of Operation Enduring Freedom and Operation Iraqi Freedom, and it is vital that efforts be made to advance suicide risk assessment techniques and treatment for members of the military who may be experiencing suicidal symptoms. One potential way to advance the understanding of suicide in the military is through the use of the Interpersonal-Psychological Theory of Suicide. This theory proposes that three necessary factors are needed to complete suicide: feelings that one does not belong with other people, feelings that one is a burden on others or society, and an acquired capability to overcome the fear and pain associated with suicide. This review analyzes the various ways that military service may influence suicidal behavior and integrates these findings into an overall framework with relevant practical implications. Findings suggest that although there are many important factors in military suicide, the acquired capability may be the most impacted by military experience because combat exposure and training may cause habituation to fear of painful experiences, including suicide. Future research directions, ways to enhance risk assessment, and treatment implications are also discussed.
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Affiliation(s)
- Edward A Selby
- Florida State University, Tallahassee, Florida 32306-1270, United States
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O'Toole BI, Catts SV, Outram S, Pierse KR, Cockburn J. The physical and mental health of Australian Vietnam veterans 3 decades after the war and its relation to military service, combat, and post-traumatic stress disorder. Am J Epidemiol 2009; 170:318-30. [PMID: 19564170 DOI: 10.1093/aje/kwp146] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The long-term health consequences of war service remain unclear, despite burgeoning scientific interest. A longitudinal cohort study of a random sample of Australian Vietnam veterans was designed to assess veterans' postwar physical and mental health 36 years after the war (2005-2006) and to examine its relation to Army service, combat, and post-traumatic stress disorder (PTSD) assessed 14 years previously (1990-1993). Prevalences in veterans (n = 450) were compared with those in the Australian general population. Veterans' Army service and data from the first assessments were evaluated using multivariate logistic regression prediction modeling. Veterans' general health and some health risk factors were poorer and medical consultation rates were higher than Australian population expectations. Of 67 long-term conditions, the prevalences of 47 were higher and the prevalences of 4 were lower when compared with population expectations. Half of all veterans took some form of medication for mental well-being. The prevalence of psychiatric diagnoses exceeded Australian population expectations. Military and war service characteristics and age were the most frequent predictors of physical health endpoints, while PTSD was most strongly associated with psychiatric diagnoses. Draftees had better physical health than regular enlistees but no better mental health. Army service and war-related PTSD are associated with risk of illness in later life among Australian Vietnam veterans.
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Affiliation(s)
- Brian I O'Toole
- ANZAC Research Institute, Repatriation General Hospital Concord, New South Wales, Australia.
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Barton CA, Dobson A, Treloar SA, McClintock C, McFarlane AC. The Deployment Health Surveillance Program: vision and challenges of health surveillance for Australian military cohorts. Aust N Z J Public Health 2008; 32:529-34. [PMID: 19076743 DOI: 10.1111/j.1753-6405.2008.00304.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The Australian Government has supported the establishment of a Deployment Health Surveillance Program for the Australian Defence Force. Although some health screening mechanisms already exist for Australian Defence Force personnel, until now health data have been used largely for clinical management at an individual level and have not been aggregated to identify trends in health and risk factors in the shorter or longer term. We identify challenges for and potential benefits of health surveillance in the military context, describe features of the Program and progress to date. Retrospective and cross-sectional projects based on deployments to the Near North Area of Influence since 1997 are under way. A planned prospective model of health surveillance for those deploying to the Middle East promises more timely attention to any emerging health problems for military personnel and veterans.
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Affiliation(s)
- Christopher A Barton
- Centre for Military and Veterans' Health, School of Population Health and Clinical Practice, The University of Adelaide, South Australia, Australia 5005.
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McKenzie D. Commentary on "coping with life-threatening events was associated with better self-perceived health in a naval cross-sectional study," by Nils Magerøy, Trond Riise, Bjørn H. Johnsen, and Bente E. Moen. J Psychosom Res 2008; 65:619-21. [PMID: 19027453 DOI: 10.1016/j.jpsychores.2008.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Revised: 07/15/2008] [Accepted: 07/24/2008] [Indexed: 11/30/2022]
Affiliation(s)
- Dean McKenzie
- Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Australia.
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36
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Watson PB, Daniels B. Post-traumatic stress disorder symptoms in the files of Australian servicemen hospitalized in 1942-1952. Australas Psychiatry 2008; 16:13-7. [PMID: 17957524 DOI: 10.1080/10398560701616213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate post-traumatic stress disorder (PTSD) symptomatology in servicemen hospitalized 1942-1952. METHOD Hospital files of servicemen (n = 590) were studied and PTSD symptoms in groups, based on service experience, were compared. RESULTS Based on their hospital files, 19% of servicemen were classified as having partial PTSD. No full cases of PTSD were identified, due primarily to the small number of recorded avoidance symptoms and the limited information in relation to the stressor criterion. Prisoners of war had the highest reported avoidance and lowest intrusive symptoms compared with other combatants. CONCLUSIONS PTSD symptoms may have been common during and after World War II. At that time avoidance was not considered a symptom of disorder. Intrusive and arousal symptoms may be the core symptoms of PTSD and avoidance symptoms need to be reconsidered.
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