Differences in resilience profiles between military veterans and the general population: An exploratory latent profile analysis using the HUNT-4 survey

Using latent profile analyses, the current work investigated levels of adverse childhood experiences, symptoms of anxiety and depression and 3 dimensions of relational promotive factors) to identify resilience profiles in a large general population sample (N = 161,622, mean age = 53.02; SD = 17.80; 56.1% females). We then used the same method to identify the resilience profiles of military veterans (N = 386, mean age = 43.47; SD = 10.08; 9.8% females), all of whom had served in Afghanistan. A four-profile-solution was the best fitting for the general population (High resilient 30%, Moderate resilient 13%, Low resilient 53%, Work/social-based resilience 4%), while a three-profile-solution had the best fit in the veteran cohort (Family-based resilience 28%, Work/social-based resilience 62%, Hardy loners 10%). To ground the identified profiles in occupational function, we also checked how they predicted reports of sleep difficulties, job demand and job control. Despite both samples inhabiting a geographic region known for high socioeconomic similarity among residents, we found marked differences in profile-solutions between the military veterans and the general population. Our findings suggests that resilience profiles are highly influenced by cohort characteristics and the specific resources needed to manage a given stressor load. Accordingly, the generalisability of specific protective factors may be low across distinct cohorts, and reliable findings need to be obtained in specific populations as defined by stressor context, sample characteristics, and relevant outcomes.

From a first person perspective: Soldiers' experiences three decades after an avalanche - A qualitative interview study

STUDY OBJECTIVES

The aim of this study was to explore indirectly exposed soldiers' subjective experiences following an avalanche. Three decades after the trauma, this study describes the perceived impact of the disaster by peers of those who survived or died in the avalanche.

METHOD

A qualitative, cross-sectional, study based on 17 individual interviews with persons indirectly exposed to an avalanche. Data was analysed according to qualitative content analysis.

FINDINGS

The findings revealed 'being a significant first person' as the main theme. Two categories were developed: 1) Experience of closeness to the victims 2) Experience of distance post-disaster. The categories elaborated two subcategories each: 1) Could have been me 2) Sadness, grief, shame and guilt over losing friends and 1) Unorganized military service post-disaster 2) Anger towards the system.

CONCLUSION

The soldiers indirectly exposed to the avalanche need to be seen both as a person and as a group. Both immediately following and decades after the disaster, the informants wanted the military to offer adequate follow-up.

The experiences of dealing with consequences of an avalanche - surviving soldiers' perspectives

Purpose: The aim of the study was to explore and describe experiences of daily life after having experienced an avalanche three decades ago.Method: This paper presents a qualitative study of 12 male survivors of an avalanche during their military service, interviewed 30 years post-disaster.Findings: A comprehensive understanding of the categories led to the latent theme "Finding my own way of managing and dealing with life". Findings revealed three categories describing experiences of daily living: (i) A comfortable life; (ii) A challenging, yet accomplished life; (iii) A demanding life. The first category represents a greater degree of using adaptive coping strategies for managing everyday life compared to the other two categories. The third category represents the group having the most challenging consequences. Among the three, the latter category conveys the most maladaptive coping strategies.Conclusions:The participants had different experiences with regards to their health and how they coped with their everyday life after the avalanche disaster. Insights into coping strategies may provide a guide for appropriate interventions for survivors dealing with traumatic events.

The trajectory of symptom burden in exposed and unexposed survivors of a major avalanche disaster: a 30 year long-term follow-up study

BACKGROUND

Limited research exists concerning the long-term effects of avalanches on survivors' mental health beyond the first years after the accident. The aims of this study were to describe and evaluate possible differences in long-term mental health symptoms after a major avalanche disaster between exposed and unexposed soldiers using a longitudinal design.

METHOD

Present mental health symptoms were examined among avalanche exposed (n = 12) and unexposed (n = 9) soldiers by PTSS-10, IES-15 and STAI-12 in four waves (1986-1987 and 2016).

RESULTS

Binary logistic regression revealed that the odds to score above the cut-off were significantly lower for both groups after one year compared to baseline for PTSS-10 (p = 0.018) and significantly lower after 30 days compared to baseline for IES-15 (p = 0.005). Data did not reveal significant differences between the exposed and unexposed groups regarding adjusted PTSS-10, IES-15 or STAI-12 mean scores compared. Linear mixed model-analyses revealed significant effects of time. The adjusted mean scores declined over time for both groups: PTSS-10 (p = 0.001), IES-15 (p = 0.026) and STAI-12 (p = 0.001), and the time trajectories for PTSS-10 were significantly different between the groups (p = 0.013). Although not significant (all p > 0.05), results indicated that a larger proportion of soldiers in the exposed group experienced posttraumatic stress symptoms (5/12) (PTSS-10 score ≥ 4) and distress symptoms (6/12) (IES-15 score ≥ 26) above cut-off points, 30 years post-disaster.

CONCLUSIONS

The course of mental health symptoms may persist, and even increase, in selected and trained military personnel 30 years after exposure to a natural disaster. These findings may be of great importance for health authorities planning appropriate follow-up.

Sleep quality problems three decades post-disaster

STUDY OBJECTIVES

Sleep quality problems are a core feature of posttraumatic stress disorder (PTSD). The aims of this study were to describe and evaluate possible differences regarding sleep quality problems and hyperarousal symptoms between exposed and unexposed survivors after an avalanche. Further, we wanted to describe any association between avalanche exposure and survivors' self-reported sleep quality problems and posttraumatic stress (disorder) symptoms with and without hyperarousal symptoms.

METHOD

The participants were soldiers who had survived an avalanche (n = 12) and a sample of unexposed soldiers (n = 9). Subjective sleep quality problems and posttraumatic stress (disorder) symptoms were assessed using well-validated measures: Pittsburgh Sleep Quality Index (PSQI), Posttraumatic Symptom Scale-10 (PTSS-10), and Impact of Event Scale-15 (IES-15). Hyperarousal symptoms were assessed using a 3-item hyperarousal-index from PTSS-10 (PTSS-10/Hyp index).

RESULTS

No significant difference in sleep quality problems was revealed between the exposed and unexposed groups. There was a significant association between those with PTSS-10 ≥ 4 combined with hyperarousal symptoms and sleep quality problems (p = .046), 30 years after the avalanche. Likewise, no significant associations was revaled between those with sleep quality problems and IES-15 ≥ 26 with and without hyperarousal. Binary logistic regression showed that those with sleep quality problems (PSQI > 5) 30 years post-disaster, had 2.5 times greater odds (OR = 2.49, 95%CI [0.95-6.55], p = .064) of having hyperarousal symptoms during the whole follow-up period compared to those without sleep quality problems.

CONCLUSION

Our findings may indicate an association between sleep quality problems (PSQI > 5) and hyperarousal symptoms in soldiers with scores above cut-off point for posttraumatic stress (disorder) symptoms.