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Ovsyannikova Y, Pokhilko D, Krasnokutskyi M, Kerdyvar V, Kreshchuk K. The Nature of Combat Stress Development During Military Operations and Psychotherapy in Extreme Situations. J Nerv Ment Dis 2024; 212:270-277. [PMID: 38536039 DOI: 10.1097/nmd.0000000000001768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
ABSTRACT The purpose of the research work is the theoretical and empirical analysis of the study of the nature of combat stress in military personnel and the assessment of psychotherapeutic methods of providing psychological assistance in extreme situations. The authors used the following methods to achieve this goal: method of analysis and synthesis, hermeneutic method, testing method, comparative method, and generalization method. The results of the research work have revealed the meaning of traumatic stress, psychological trauma, and combat mental trauma, and explained the concept of combat stress and the dynamics of its growth. The findings identified the factors of posttraumatic stress syndrome and its prevalence, tracked down the dynamics of psychoemotional disorders, and revealed the importance of military psychological selection and determination of combat readiness. The authors established the main tasks of a staff psychologist in working with military personnel, conducted an empirical study of the nature of combat stress in the military, observed main psychotherapeutic tools for the prevention of negative mental states in combat conditions, and investigated self-regulation techniques of emotional, physical, and mental health. The practical significance of the scientific work lies in the modern coverage of the phenomenon of combat stress and the classification of effective psychotherapeutic methods that will ensure the sustainable psychological preparation of the soldiers for extreme situations.
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Affiliation(s)
- Yanina Ovsyannikova
- From the Educational and Scientific Laboratory of Extreme and Crisis Psychology, National University of Civil Defence of Ukraine, Kharkiv, Ukraine
| | - Diana Pokhilko
- From the Educational and Scientific Laboratory of Extreme and Crisis Psychology, National University of Civil Defence of Ukraine, Kharkiv, Ukraine
| | - Mykola Krasnokutskyi
- From the Educational and Scientific Laboratory of Extreme and Crisis Psychology, National University of Civil Defence of Ukraine, Kharkiv, Ukraine
| | - Valentyn Kerdyvar
- From the Educational and Scientific Laboratory of Extreme and Crisis Psychology, National University of Civil Defence of Ukraine, Kharkiv, Ukraine
| | - Kateryna Kreshchuk
- Social and Psychological Faculty, National University of Civil Defence of Ukraine, Kharkiv, Ukraine
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Wilson N, Clement C, Summers JA, Thomson G, Harper G. Impact of war on veteran life span: natural experiment involving combat versus non-combat exposed military personnel. BMJ Mil Health 2023; 169:505-509. [PMID: 34937743 DOI: 10.1136/bmjmilitary-2021-001991] [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: 09/04/2021] [Accepted: 11/18/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION There is still uncertainty around the impact of combat exposure on the life span of war veterans. Therefore we made use of a natural experiment to study the impact on veteran life span of combat versus non-combat exposure in World War II (WW2). METHODS The combat-exposed military personnel were derived from a random (10%) sample of the military roll of the 28th (Māori) Battalion from New Zealand. One non-combat cohort was the 15th Reinforcements of this same Battalion, since the war ended before they reached the front line. The other non-combat cohort were Māori personnel who were only involved in Jayforce, which occupied Japan at the end of the WW2. Data on life span were mainly derived from an official repository of birth and death records, but supplemented with other sources, including military files. RESULTS When comparing life spans of service veterans, there was no statistically significant reduction for the average life span of the 234 combat-exposed veterans in our sample from the 28th (Māori) Battalion (66.7 years), relative to the Māori veterans from two non-combat cohorts: the 132 personnel in the 15th Reinforcements (67.2 years) and the 147 personnel in Jayforce (66.9 years). CONCLUSIONS Despite a very high level of wounding in the combat-exposed group (48%), there were no statistically significant reductions in life span between this group and comparable non-combat exposed veterans. This finding contrasts to life span reductions found in a similar study of New Zealand veterans of WW1.
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Affiliation(s)
- Nick Wilson
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - C Clement
- Independent researcher, Te Puke, New Zealand
| | - J A Summers
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - G Thomson
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - G Harper
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
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Mitchell NA, McCauley M, O’Brien D, Wilson CE. Mental health and resilience in the Irish defense forces during the COVID-19 global pandemic. MILITARY PSYCHOLOGY 2023; 35:383-393. [PMID: 37615557 PMCID: PMC10453996 DOI: 10.1080/08995605.2021.2007728] [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: 05/26/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
The Irish Defense Forces (DF) responded to the COVID-19 pandemic and national public health crisis by deploying personnel to aid domestic civil authorities in medical and care settings, contact tracing, logistics, and operations. Current research on COVID-19 reveals increased psychological distress among frontline workers and the general public. Resilience has previously been associated with lower levels of psychological distress. This study sets out to test these associations, and to examine mental health differences between DF personnel deployed in Ireland on pandemic-related duties (DIPD) and non-DIPD. Participants were 231 DF members who completed the: Connor-Davidson Resilience Scale-10, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Perceived Coronavirus Threat Questionnaire, Brief Trauma Questionnaire, Post-traumatic Stress Disorder Checklist-5, and Alcohol Use Disorder Identification Test. Independent t-tests revealed no differences between DIPD and non-DIPD on measures of psychological distress or on self-rated mental health prior to COVID-19 (PC19) and during COVID-19 (DC19). Results of multiple hierarchical regression analyses revealed that depression predicted lower levels of resilience, while multiple traumatic events predicted higher levels of resilience. The total adjusted variance explained by the model was 25%. Clinical and policy implications for improving access to psychological support within the DF and military populations are discussed.
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Affiliation(s)
- Nicola A. Mitchell
- School of Psychology, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - Mathew McCauley
- School of Psychology, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
- Military Clinical Psychology, Office of the DMB, Defence Forces Ireland, Dublin, Ireland
| | - Dorota O’Brien
- Military Clinical Psychology, Office of the DMB, Defence Forces Ireland, Dublin, Ireland
| | - Charlotte E. Wilson
- School of Psychology, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
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Hall AL, Batchelor T, Bogaert L, Buckland R, Cowieson AB, Drew M, Harrison K, McBride DI, Schneiderman A, Taylor K. International perspective on military exposure data sources, applications, and opportunities for collaboration. Front Public Health 2023; 11:1154595. [PMID: 37213639 PMCID: PMC10198376 DOI: 10.3389/fpubh.2023.1154595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/07/2023] [Indexed: 05/23/2023] Open
Abstract
Military personnel may be exposed to a range of hazards. The assessment, documentation and reporting of military exposure information are important steps to guide health protection, services, and research to support actively serving members and veterans. In 2021, a Working Group of researchers from veteran and defense administrations across the Five Eyes countries (Australia, Canada, New Zealand, the United Kingdom, and the United States) was established to examine large military exposure data sources available in each country, their applications, and opportunities to leverage information across administrations and internationally. We provide a brief summary of this work here to highlight some successful examples of data applications and to elicit interest in this evolving area of exposure science.
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Affiliation(s)
- Amy L. Hall
- Research Directorate, Veterans Affairs Canada, Charlottetown, PE, Canada
- *Correspondence: Amy L. Hall,
| | - Trish Batchelor
- Department of Veterans’ Affairs, Canberra City, ACT, Australia
| | - Laura Bogaert
- Directorate of Force Health Protection, Department of National Defence, Ottawa, ON, Canada
| | - Robert Buckland
- Defence Health Directorate, New Zealand Defence Force, Wellington, New Zealand
| | - Ali B. Cowieson
- Research Directorate, Veterans Affairs Canada, Charlottetown, PE, Canada
| | - Michael Drew
- Department of Defence, Canberra City, ACT, Australia
| | | | - David I. McBride
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Aaron Schneiderman
- Epidemiology Program, US Department of Veterans Affairs, Washington, DC, United States
| | - Kathryn Taylor
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, MA, United States
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Jones C, Smith-MacDonald L, Brown MRG, VanDehy J, Grunnet-Jepsen R, Ordek VP, Kruger S, Ayres Gerhart A, van Veelen N, Nijdam MJ, Burback L, Cao B, Roy MJ, Sessoms P, Vermetten E, Brémault-Phillips S. The Redesign and Validation of Multimodal Motion-Assisted Memory Desensitization and Reconsolidation Hardware and Software: Mixed Methods, Modified Delphi-Based Validation Study. JMIR Hum Factors 2022; 9:e33682. [PMID: 35819834 PMCID: PMC9328788 DOI: 10.2196/33682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 05/06/2022] [Accepted: 05/14/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In recent years, the delivery of evidence-based therapies targeting posttraumatic stress disorder (PTSD) has been the focus of the Departments of Defense in countries such as Canada, the Netherlands, and the United States. More than 66% of military members continue to experience symptoms of PTSD that significantly impact their daily functioning and quality of life after completing evidence-based treatments. Innovative, engaging, and effective treatments for PTSD are needed. Multimodal motion-assisted memory desensitization and reconsolidation (3MDR) is an exposure-based, virtual reality-supported therapy used to treat military members and veterans with treatment-resistant PTSD. Given the demonstrated efficacy of 3MDR in recently published randomized control trials, there is both an interest in and a need to adapt the intervention to other populations affected by trauma and to improve accessibility to the treatment. OBJECTIVE We aimed to further innovate, develop, and validate new and existing hardware and software components of 3MDR to enhance its mobility, accessibility, feasibility, and applicability to other populations affected by trauma, including public safety personnel (PSP), via international collaboration. METHODS This study used a modified Delphi expert consultation method and mixed methods quasi-experimental validation with the purpose of software validation among PSP (first responders, health care providers) participants (N=35). A team of international experts from the Netherlands, the United States, and Canada met on the web on a weekly basis since September 2020 to discuss the adoption of 3MDR in real-world contexts, hardware and software development, and software validation. The evolution of 3MDR hardware and software was undertaken followed by a mixed methods software validation study with triangulation of results to inform the further development of 3MDR. RESULTS This study resulted in the identification, description, and evolution of hardware and software components and the development of new 3MDR software. Within the software validation, PSP participants widely acknowledged that the newly developed 3MDR software would be applicable and feasible for PSP affected by trauma within their professions. The key themes that emerged from the thematic analysis among the PSP included the desire for occupationally tailored environments, individually tailored immersion, and the applicability of 3MDR beyond military populations. CONCLUSIONS Within the modified Delphi consultation and software validation study, support for 3MDR as an intervention was communicated. PSP participants perceived that 3MDR was relevant for populations affected by trauma beyond military members and veterans. The resulting hardware and software evolution addressed the recommendations and themes that arose from PSP participants. 3MDR is a novel, structured, exposure-based, virtual reality-supported therapy that is currently used to treat military members and veterans with PTSD. Going forward, it is necessary to innovate and adapt 3MDR, as well as other trauma interventions, to increase effectiveness, accessibility, cost-effectiveness, and efficacy among other populations affected by trauma.
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Affiliation(s)
- Chelsea Jones
- Leiden University Medical Center, Leiden University, Leiden, Netherlands.,Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Alberta Health Services, Edmonton, AB, Canada
| | - Lorraine Smith-MacDonald
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Matthew R G Brown
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jacob VanDehy
- Department of Warfighter Performance, Naval Health Research Center, San Diego, CA, United States.,Leidos Inc, San Diego, CA, United States
| | - Rasmus Grunnet-Jepsen
- Department of Warfighter Performance, Naval Health Research Center, San Diego, CA, United States.,Leidos Inc, San Diego, CA, United States
| | - Vrajeshri P Ordek
- Department of Warfighter Performance, Naval Health Research Center, San Diego, CA, United States.,Leidos Inc, San Diego, CA, United States
| | - Sarah Kruger
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Anne Ayres Gerhart
- Department of Warfighter Performance, Naval Health Research Center, San Diego, CA, United States
| | - Nancy van Veelen
- Leiden University Medical Center, Leiden University, Leiden, Netherlands
| | - Mirjam J Nijdam
- ARQ National Psychotrauma Center, Diemen, Netherlands.,Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Lisa Burback
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Alberta Health Services, Edmonton, AB, Canada.,Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Bo Cao
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Michael J Roy
- Department of Medicine and Center for Neuroscience and Regenerative Medicine, Uniformed Services University, Bethesda, MD, United States
| | - Pinata Sessoms
- Department of Warfighter Performance, Naval Health Research Center, San Diego, CA, United States
| | - Eric Vermetten
- Leiden University Medical Center, Leiden University, Leiden, Netherlands
| | - Suzette Brémault-Phillips
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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McBride D, Samaranayaka A, Richardson A, Gardner D, Shepherd D, Wyeth E, de Graaf B, Derrett S. Factors associated with self-reported health among New Zealand military veterans: a cross-sectional study. BMJ Open 2022; 12:e056916. [PMID: 35613796 PMCID: PMC9134175 DOI: 10.1136/bmjopen-2021-056916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To identify factors associated with better or poorer self-reported health status in New Zealand military Veterans. DESIGN A cross-sectional survey. PARTICIPANTS The participants of interest were the 3874 currently serving Veterans who had been deployed to a conflict zone, but all Veterans were eligible to participate. STUDY VARIABLES The EQ-5D-5L, asking about problems across five dimensions (mobility, self-care, usual activities, pain or discomfort and anxiety or depression), with five levels of severity (eg, no, slight, moderate, severe or extreme problems), also containing a Visual Analogue Scale (EQ-VAS) to self-assess health state, scaled from 0 (worst) to 100 (best) imagined health.Hypothetical relationships with better health were positive social support, sleep and psychological flexibility; with poorer health, post-traumatic stress, exposure to psychological trauma, distress and hazardous drinking. RESULTS The EQ5-D-5L was completed by 1767 Veterans, 1009 serving, a response rate of 26% from that group, 1767 completing the EQ5-D, 1458 who had deployed, 288 who had not and the 21 who did not provide deployment data. Of these, 247 were not used in the analysis due to missing values in one or more variables, leaving 1520 for analysis.A significantly higher proportion of Veterans reported 'any problems' rather than 'no problems' with four EQ-5D dimensions: mobility, self-care, usual activities and pain or discomfort, but no difference in anxiety or depression. Age, length of service, deployment, psychological flexibility and better sleep quality were associated with higher EQ-VAS scores; distress with lower EQ-VAS scores. CONCLUSION In this sample of New Zealand Veterans, psychological flexibility and good sleep are associated with better self-rated health, and distress and poor sleep with diminished health. These factors might be used as sentinel health indicators in assessing Veteran health status, and cognitive-behavioural therapy encompassing these domains may be useful in improving the health of New Zealand Veterans.
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Affiliation(s)
- David McBride
- Department of Preventive and Social Medicine, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
| | - Ariyapala Samaranayaka
- Biostatistics Centre, University of Otago Division of Health Sciences, Dunedin, New Zealand
| | - Amy Richardson
- Preventive and Social Medicine, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
| | - Dianne Gardner
- Department of Psychology, Massey University, Palmerston North, New Zealand
| | - Daniel Shepherd
- Health Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Emma Wyeth
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, New Zealand
| | - Brandon de Graaf
- Injury Prevention Research Unit, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
| | - Sarah Derrett
- Preventive and Social Medicine, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
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Fikretoglu D, Sharp ML, Adler AB, Bélanger S, Benassi H, Bennett C, Bryant R, Busuttil W, Cramm H, Fear N, Greenberg N, Heber A, Hosseiny F, Hoge CW, Jetly R, McFarlane A, Morganstein J, Murphy D, O'Donnell M, Phelps A, Richardson DJ, Sadler N, Schnurr PP, Smith P, Ursano R, Hooff MV, Wessely S, Forbes D, Pedlar D. Pathways to mental health care in active military populations across the Five-Eyes nations: An integrated perspective. Clin Psychol Rev 2021; 91:102100. [PMID: 34871868 DOI: 10.1016/j.cpr.2021.102100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/29/2021] [Accepted: 11/05/2021] [Indexed: 12/19/2022]
Abstract
Military service is associated with increased risk of mental health problems. Previous reviews have pointed to under-utilization of mental health services in military populations. Building on the most recent systematic review, our narrative, critical review takes a complementary approach and considers research across the Five-Eyes nations from the past six years to update and broaden the discussion on pathways to mental healthcare in military populations. We find that at a broad population level, there is improvement in several indicators of mental health care access, with greater gains in initial engagement, time to first treatment contact, and subjective satisfaction with care, and smaller gains in objective indicators of adequacy of care. Among individual-level barriers to care-seeking, there is progress in improving recognition of need for care and reducing stigma concerns. Among organizational-level barriers, there are advances in availability of services and cultural acceptance of care-seeking. Other barriers, such as concerns around confidentiality, career impact, and deployability persist, however, and may account for some remaining unmet need. To address these barriers, new initiatives that are more evidence-based, theoretically-driven, and culturally-sensitive, are therefore needed, and must be rigorously evaluated to ensure they bring about additional improvements in pathways to care.
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Affiliation(s)
- Deniz Fikretoglu
- Defence Research and Development Canada, 1133 Sheppard Ave. West, Toronto, ON, Canada.
| | | | - Amy B Adler
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | | | | | | | | | - Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | | | | | | | - Fardous Hosseiny
- Centre of Excellence on Post-Traumatic Stress Disorder (PTSD), Ottawa, ON, Canada
| | - Charles W Hoge
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Rakesh Jetly
- Department of National Defence, Ottawa, ON, Canada
| | | | | | - Dominic Murphy
- Combat Stress, Leatherhead, Surrey, UK; King's College London, London, UK
| | - Meaghan O'Donnell
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Carlton, Australia
| | - Andrea Phelps
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Carlton, Australia
| | - Don J Richardson
- Parkwood Institute- St. Joseph's Health Care London, London, ON, Canada
| | - Nicole Sadler
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Carlton, Australia
| | | | - Patrick Smith
- Centre of Excellence on Post-Traumatic Stress Disorder (PTSD), Ottawa, ON, Canada
| | | | - Miranda Van Hooff
- Military and Emergency Services Health Australia (MESHA), Woodville, SA, Australia
| | | | - David Forbes
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Carlton, Australia
| | - David Pedlar
- Canadian Institute for Military and Veteran Health Research, Queen's University, Kingston, ON, Canada
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