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Sullivan K, Kintzle S, Barr N, Gilreath TD, Castro CA. Veterans’ social–emotional and physical functioning informs perceptions of family and child functioning. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2018. [DOI: 10.3138/jmvfh.2017-0008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Huffman AH, Dunbar N, Broom TW, Castro CA. Soldiers’ perspectives of the Married Army Couples Program: A review of perceived problems and proposed solutions. MILITARY PSYCHOLOGY 2018. [DOI: 10.1080/08995605.2018.1478537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Keeling ME, Ozuna SM, Kintzle S, Castro CA. Veterans’ Civilian Employment Experiences: Lessons Learnt From Focus Groups. JOURNAL OF CAREER DEVELOPMENT 2018. [DOI: 10.1177/0894845318776785] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Emerging evidence highlights employment as a key factor influencing the success of transition from military to civilian life. Historically, employment programs have focused on improving skills such as resume writing and interview skills. However, it is likely that employment challenges are more than these practical barriers. Four focus groups with employed and unemployed Gulf War Era II veterans were conducted aimed at moving past a practical perspective by gaining experiential understandings of veterans’ employment. Thematic analysis indicated that the veterans’ employment experiences were best understood temporally in two master themes: pretransition and the divergent experiences of veterans who did and did not plan ahead and living the transition and the veterans’ experiences of employment barriers and facilitators. Further to the two master themes, an underlying thread of the need for self-determination was evident. Interpretation of the results led to the development of recommendations for policy, service provision, and future research.
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Porter B, Hoge CW, Tobin LE, Donoho CJ, Castro CA, Luxton DD, Faix D. Measuring Aggregated and Specific Combat Exposures: Associations Between Combat Exposure Measures and Posttraumatic Stress Disorder, Depression, and Alcohol-Related Problems. J Trauma Stress 2018; 31:296-306. [PMID: 29603393 DOI: 10.1002/jts.22273] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 12/27/2017] [Accepted: 01/05/2018] [Indexed: 11/09/2022]
Abstract
Research has shown combat exposure to be associated with negative mental health outcomes. Different combat exposure measures are not composed of the same combat experiences, and few combat exposure measures have been directly compared to another measure. Furthermore, research about the unique associations between specific combat experiences and mental health is lacking. We investigated associations between new-onset posttraumatic stress disorder (PTSD), new-onset depression, and alcohol-related problems and two commonly used measures of combat among a sample of 20,719 recently deployed U.S. military personnel. A 13-item measure assessed both direct and indirect combat exposures, and a 5-item measure assessed only indirect exposures. Both combat measures were associated with all outcomes in the same direction (e.g., PTSD, odds ratio [OR] = 2.97 vs. 4.01; depression, OR = 2.03 vs. 2.42; alcohol-related problems, OR = 1.41 vs. 1.62, respectively, for the 5- and 13-item measures). The 13-item measure had a stronger association with some outcomes, particularly PTSD. Each specific item had significant bivariate associations with all outcomes, ORs = 1.43-4.92. After adjusting for other combat exposures, items assessing witnessing abuse, feeling in danger, and knowing someone injured or killed remained associated with all outcomes, ORs = 1.18-2.72. After this adjustment, several items had unexpected protective associations with some mental health outcomes. Results indicated these two combat exposure measures were approximately equally effective for determining risk for negative mental health outcomes in a deployed population, despite having different content. Additional research is needed to replicate and understand how specific combat exposures affect health.
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Keeling M, Kintzle S, Castro CA. Exploring U.S. Veterans’ post-service employment experiences. MILITARY PSYCHOLOGY 2018. [DOI: 10.1080/08995605.2017.1420976] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Lancaster SL, Kintzle S, Castro CA. Validation of the Warrior Identity Scale in the Chicagoland Veterans Study. IDENTITY 2018. [DOI: 10.1080/15283488.2017.1410157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Wood MD, Adler AB, Bliese PD, McGurk D, Castro CA, Hoge CW, Koffman R. Psychological Adjustment after Combat Deployment: Decompression at Home Versus at Sea. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/21635781.2017.1412842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schuyler AC, Kintzle S, Lucas CL, Moore H, Castro CA. Military sexual assault (MSA) among veterans in Southern California: Associations with physical health, psychological health, and risk behaviors. ACTA ACUST UNITED AC 2017. [DOI: 10.1037/trm0000098] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hoge CW, Lee DJ, Castro CA. Refining Trauma-Focused Treatments for Servicemembers and Veterans With Posttraumatic Stress Disorder: Progress and Ongoing Challenges. JAMA Psychiatry 2017; 74:13-14. [PMID: 27893037 DOI: 10.1001/jamapsychiatry.2016.2740] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Hoge CW, Yehuda R, Castro CA, McFarlane AC, Vermetten E, Jetly R, Koenen KC, Greenberg N, Shalev AY, Rauch SAM, Marmar CR, Rothbaum BO. Unintended Consequences of Changing the Definition of Posttraumatic Stress Disorder in DSM-5: Critique and Call for Action. JAMA Psychiatry 2016; 73:750-2. [PMID: 27224895 DOI: 10.1001/jamapsychiatry.2016.0647] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Timenetsky KT, Castro CA, Eid RC, Carnieli-Cazati D. Prevalence of burnout syndrome among physiotherapist working in intensive care units and step down unit. Intensive Care Med Exp 2015. [PMCID: PMC4797737 DOI: 10.1186/2197-425x-3-s1-a722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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McGurk D, Sinclair RR, Thomas JL, Merrill JC, Bliese PD, Castro CA. Destructive and Supportive Leadership in Extremis: Relationships With Post-Traumatic Stress During Combat Deployments. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/21635781.2014.963765] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Vermetten E, Greenberg N, Boeschoten MA, Delahaije R, Jetly R, Castro CA, McFarlane AC. Deployment-related mental health support: comparative analysis of NATO and allied ISAF partners. Eur J Psychotraumatol 2014; 5:23732. [PMID: 25206953 PMCID: PMC4138710 DOI: 10.3402/ejpt.v5.23732] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 05/26/2014] [Accepted: 06/26/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND For years there has been a tremendous gap in our understanding of the mental health effects of deployment and the efforts by military forces at trying to minimize or mitigate these. Many military forces have recently systematized the mental support that is provided to support operational deployments. However, the rationale for doing so and the consequential allocation of resources are felt to vary considerably across North Atlantic Treaty Organisation (NATO) International Security Assistance (ISAF) partners. This review aims to compare the organization and practice of mental support by five partnering countries in the recent deployment in Afghanistan in order to identify and compare the key methods and structures for delivering mental health support, describe bottlenecks and illustrate new developments. METHOD Information was collected through document analysis and semi-structured interviews with key military mental healthcare stakeholders. The review resulted from close collaboration between key military mental healthcare professionals within the Australian Defense Forces (ADF), Canadian Armed Forces (CAF), United Kingdom Armed Forces (UK), Netherlands Armed Forces (NLD), and the United States Army (US). Key stakeholders were interviewed about the mental health support provided during a serviceperson's military career. The main items discussed were training, prevention, early identification, intervention, and aftercare in the field of mental health. RESULTS All forces reported that much attention was paid to mental health during the individual's military career, including deployment. In doing so there was much overlap between the rationale and applied methods. The main method of providing support was through training and education. The educative focus was to strengthen the mental resilience of individual soldiers while providing a range of mental healthcare services. All forces had abandoned standard psychological debriefing after critical incidents. Instead, by default, mental healthcare professionals acted to support the leader and peer led "after action" reviews. All countries provided professional mental support close to the front line, aimed at early detection and early return to normal activities within the unit. All countries deployed a mental health support team that consisted of a range of mental health staff including psychiatrists, psychologists, social workers, mental health nurses, and chaplains. There was no overall consensus in the allocation of mental health disciplines in theatre. All countries (except the US) provided troops with a third location decompression (TLD) stop after deployment, which aimed to recognize what the deployed units had been through and to prepare them for transition home. The US conducted in-garrison 'decompression', or 'reintegration training' in the US, with a similiar focus to TLD. All had a reasonably comparable infrastructure in the field of mental healthcare. Shared bottlenecks across countries included perceived stigma and barriers to care around mental health problems as well as the need for improving the awareness and recognition of mental health problems among service members. CONCLUSION This analysis demonstrated that in all five partners state-of-the-art preventative mental healthcare was included in the last deployment in Afghanistan, including a positive approach towards strengthening the mental resilience, a focus on self-regulatory skills and self-empowerment, and several initiatives that were well-integrated in a military context. These initiatives were partly/completely implemented by the military/colleagues/supervisors and applicable during several phases of the deployment cycle. Important new developments in operational mental health support are recognition of the role of social leadership and enhancement of operational peer support. This requires awareness of mental problems that will contribute to reduction of the barriers to care in case of problems. Finally, comparing mental health support services across countries can contribute to optimal preparation for the challenges of military deployment.
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Odle-Dusseau HN, Herleman HA, Britt TW, Moore DD, Castro CA, McGurk D. Family-supportive work environments and psychological strain: A longitudinal test of two theories. J Occup Health Psychol 2013; 18:27-36. [DOI: 10.1037/a0030803] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Peterson C, Park N, Castro CA. Assessment for the U.S. Army Comprehensive Soldier Fitness program: the Global Assessment Tool. ACTA ACUST UNITED AC 2011; 66:10-8. [PMID: 21219043 DOI: 10.1037/a0021658] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Psychology and the U.S. military have a long history of collaboration. The U.S. Army Comprehensive Soldier Fitness (CSF) program aims to measure the psychosocial strengths and assets of soldiers as well as their problems, to identify those in need of basic training in a given domain as well as those who would benefit from advanced training, and then to provide that training. The goals of the CSF program include the promotion of well-being as well as the prevention of problems. Assessment is the linchpin of the CSF program, and the Global Assessment Tool (GAT) is a self-report survey that measures psychosocial fitness in emotional, social, family, and spiritual domains. We review the history of psychological assessment in the military and the lessons taught by this history. Then we describe the process by which the GAT was developed and evaluated. We conclude with a discussion of pending next steps in the development and use of the GAT.
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Bliese PD, Thomas JL, McGurk D, McBride S, Castro CA. Mental health advisory teams: a proactive examination of mental health during combat deployments. Int Rev Psychiatry 2011; 23:127-34. [PMID: 21521081 DOI: 10.3109/09540261.2011.558834] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Mental health advisory teams (MHATs) conduct comprehensive mental health surveillance of US service members in combat environments. Since 2003, six teams have deployed to Iraq and four have deployed to Afghanistan, and results have played a key role influencing behavioural health policy. The repeated deployments of the teams have provided opportunities for processes to be refined, and this refinement has led to a scientifically rigorous and replicable approach. In this article we focus on two themes. The first theme is how changes in sampling have influenced the nature of the inferences drawn from the survey-based surveillance data. The second theme is how the ability to utilize different forms of data has served to strengthen the programme. Focusing on these two themes provides a way to discuss key findings, recommendations and limitations while also interspersing practical observations intended to help inform the design of broad-scale, in-theatre mental health surveillance efforts. We believe that future surveillance efforts should build on the lessons of the MHATs and attempt to replicate the more rigorous sampling methods; nonetheless, we also strive to convey that large surveillance efforts are valuable even if they cannot be executed with random sampling.
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Riviere LA, Kendall-Robbins A, McGurk D, Castro CA, Hoge CW. Coming home may hurt: risk factors for mental ill health in US reservists after deployment in Iraq. Br J Psychiatry 2011; 198:136-42. [PMID: 21282784 DOI: 10.1192/bjp.bp.110.084863] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Little research has been conducted on the factors that may explain the higher rates of mental health problems in United States National Guard soldiers who have deployed to the Iraq War. AIMS To examine whether financial hardship, job loss, employer support and the effect of deployment absence on co-workers were associated with depression and post-traumatic stress disorder (PTSD). METHOD Cross-sectional data were obtained from 4034 National Guard soldiers at two time points. All measures were assessed by self-report. RESULTS The four factors were associated with depression and PTSD, with variability based on outcome and time point. For example, job loss increased the odds of meeting criteria for depression at 3 and 12 months and for PTSD at 12 months; the negative effect of deployment absence on co-workers increased the likelihood of meeting criteria for PTSD, but not depression, at both time points. CONCLUSIONS The findings demonstrate that National Guard soldiers have unique post-deployment social and material concerns that impair their mental health.
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Killgore WDS, Castro CA, Hoge CW. Preliminary normative data for the Evaluation of Risks Scale-Bubble Sheet Version (EVAR-B) for large-scale surveys of returning combat veterans. Mil Med 2010; 175:725-31. [PMID: 20968261 DOI: 10.7205/milmed-d-09-00143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The Evaluation of Risks (EVAR) scale has been used to assess risk-taking propensity in military samples. This report provides preliminary reliability, validity, and normative data on a modified version of the instrument designed to facilitate data entry with optical scanners, the Evaluation of Risks-Bubble Sheet version (EVAR-B). METHODS 2,015 U.S. Army soldiers completed the EVAR-B and a survey assessing risk-related behaviors 3 months after returning home from combat deployment in Iraq. RESULTS EVAR-B demonstrated acceptable internal consistency and reliability and correlated significantly with independent measures of self-reported risk-taking behavior, including alcohol use and aggressive behavior, in the weeks preceding the survey. Tentative cut-offs significantly differentiated heavy drinkers, dangerous drivers, and soldiers reporting recent aggressive outbursts. Normative data are provided for comparison with future studies. CONCLUSIONS The EVAR-B is a reliable and valid measure of risk-taking propensity, which provides enhanced flexibility for administration and scoring in large surveys and field environments.
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Carneiro-Júnior MA, Pelúzio MCG, Silva CHO, Amorim PRS, Silva KA, Souza MO, Castro CA, Roman-Campos D, Prímola-Gomes TN, Natali AJ. Exercise training and detraining modify the morphological and mechanical properties of single cardiac myocytes obtained from spontaneously hypertensive rats. Braz J Med Biol Res 2010; 43:1042-6. [PMID: 21049244 DOI: 10.1590/s0100-879x2010007500117] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Accepted: 10/14/2010] [Indexed: 11/22/2022] Open
Abstract
We determined the effects of exercise training and detraining on the morphological and mechanical properties of left ventricular myocytes in 4-month-old spontaneously hypertensive rats (SHR) randomly divided into the following groups: sedentary for 8 weeks (SED-8), sedentary for 12 weeks (SED-12), treadmill-running trained for 8 weeks (TRA, 16 m/min, 60 min/day, 5 days/week), and treadmill-running trained for 8 weeks followed by 4 weeks of detraining (DET). At sacrifice, left ventricular myocytes were isolated enzymatically, and resting cell length, width, and cell shortening after stimulation at a frequency of 1 Hz (~25°C) were measured. Cell length was greater in TRA than in SED-8 (161.30 ± 1.01 vs 156.10 ± 1.02 μm, P < 0.05, 667 vs 618 cells, respectively) and remained larger after detraining. Cell width and volume were unaffected by either exercise training or detraining. Cell length to width ratio was higher in TRA than in SED-8 (8.50 ± 0.08 vs 8.22 ± 0.10, P < 0.05) and was maintained after detraining. Exercise training did not affect cell shortening, which was unchanged with detraining. TRA cells exhibited higher maximum velocity of shortening than SED-8 (102.01 ± 4.50 vs 82.01 ± 5.30 μm/s, P < 0.05, 70 cells per group), with almost complete regression after detraining. The maximum velocity of relengthening was higher in TRA cells than in SED-8 (88.20 ± 4.01 vs70.01 ± 4.80 μm/s, P < 0.05), returning to sedentary values with detraining. Therefore, exercise training affected left ventricle remodeling in SHR towards eccentric hypertrophy, which remained after detraining. It also improved single left ventricular myocyte contractile function, which was reversed by detraining.
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Picchioni D, Cabrera OA, McGurk D, Thomas JL, Castro CA, Balkin TJ, Bliese PD, Hoge CW. Sleep Symptoms as a Partial Mediator Between Combat Stressors and Other Mental Health Symptoms in Iraq War Veterans. MILITARY PSYCHOLOGY 2010. [DOI: 10.1080/08995605.2010.491844] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Thomas JL, Wilk JE, Riviere LA, McGurk D, Castro CA, Hoge CW. Prevalence of mental health problems and functional impairment among active component and National Guard soldiers 3 and 12 months following combat in Iraq. ACTA ACUST UNITED AC 2010; 67:614-23. [PMID: 20530011 DOI: 10.1001/archgenpsychiatry.2010.54] [Citation(s) in RCA: 558] [Impact Index Per Article: 39.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT A growing body of literature has demonstrated the association of combat in Iraq and Afghanistan with postdeployment mental health problems, particularly posttraumatic stress disorder (PTSD) and depression. However, studies have shown varying prevalence rates of these disorders based on different case definitions and have not assessed functional impairment, alcohol misuse, or aggressive behavior as comorbid factors occurring with PTSD and depression. OBJECTIVES To (1) examine the prevalence rates of depression and PTSD using several case definitions including functional impairment, (2) determine the comorbidity of alcohol misuse or aggressive behaviors with depression or PTSD, and (3) compare rates between Active Component and National Guard soldiers at the 3- and 12-month time points following their deployment to Iraq. DESIGN Population-based, cross-sectional study. SETTING United States Army posts and National Guard armories. PARTICIPANTS A total of 18 305 US Army soldiers from 4 Active Component and 2 National Guard infantry brigade combat teams. INTERVENTIONS Between 2004 and 2007, anonymous mental health surveys were collected at 3 and 12 months following deployment. MAIN OUTCOME MEASURES Current PTSD, depression, functional impairment, alcohol misuse, and aggressive behavior. RESULTS Prevalence rates for PTSD or depression with serious functional impairment ranged between 8.5% and 14.0%, with some impairment between 23.2% and 31.1%. Alcohol misuse or aggressive behavior comorbidity was present in approximately half of the cases. Rates remained stable for the Active Component soldiers but increased across all case definitions from the 3- to 12-month time point for National Guard soldiers. CONCLUSIONS The prevalence rates of PTSD and depression after returning from combat ranged from 9% to 31% depending on the level of functional impairment reported. The high comorbidity with alcohol misuse and aggression highlights the need for comprehensive postdeployment screening. Persistent or increased prevalence rates at 12 months compared with 3 months postdeployment illustrate the persistent effects of war zone service and provide important data to guide postdeployment care.
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