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Gjerstad CL, Bøe HJ, Falkum E, Martinsen EW, Nordstrand AE, Tønnesen A, Reichelt JG, Lystad JU. Prevalence and Correlates of Mental Health Problems in Norwegian Peacekeepers 18-38 Years Postdeployment. J Trauma Stress 2020; 33:762-772. [PMID: 32810318 DOI: 10.1002/jts.22578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 05/26/2020] [Accepted: 06/02/2020] [Indexed: 11/09/2022]
Abstract
Peacekeeping missions involve experiences that may impact the mental health of participating soldiers. However, research on the long-term mental health consequences of peacekeeping is sparse. The present study aimed to find the prevalence of mental health problems (MHPs), possible MHP predictors, and associations between predictors and MHPs in Norwegian peacekeepers 18-38 years after deployment to a United Nations peacekeeping mission. We used data from a cross-sectional, postdeployment survey of Norwegian peacekeepers who served in Lebanon between 1978 and 1998 (N = 10,605). Participants were assessed for posttraumatic stress disorder (PTSD); anxiety; depression; insomnia; alcohol misuse; drug misuse; and exposure to pre-, peri-, and postdeployment stressors. Logistic regressions were executed to explore key variables associated with MHPs. Total MHP prevalence was 15.1%, 95% CI [14.4, 15.8]. The estimates for specific disorders were 0.1% for drug misuse, 3.4% for alcohol misuse, 4.0% for depression, 6.2% for PTSD, 6.4% for anxiety, and 9.3% for insomnia. Postdeployment stressors, OR = 1.91, 95% CI [1.79, 2.04]; employment status, OR = 1.41, 95% CI [1.33, 1.48]; and traumatic exposure during deployment, OR = 1.11, 95% CI [1.09, 1.12], were positively related to PTSD, χ2(17, N = 8,568) = 1,791.299, p < .001. Similar patterns were found for the other MHPs. Considering that most participants (84.9%) reported low symptom levels, our findings challenge the widespread public perception that most peacekeepers have MHPs. Moreover, our results indicate that future peacekeepers should be prepared for challenges they may face not only during deployment but also in the years following their homecoming.
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Affiliation(s)
- Christer Lunde Gjerstad
- Institute of Military Psychiatry, Norwegian Armed Forces Joint Medical Services, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hans Jakob Bøe
- Institute of Military Psychiatry, Norwegian Armed Forces Joint Medical Services, Oslo, Norway.,Division of Mental Health and Addiction, Kongsberg DPS, Vestre Viken Hospital Trust, Kongsberg, Norway
| | - Erik Falkum
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Egil Wilhelm Martinsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Andreas Espetvedt Nordstrand
- Institute of Military Psychiatry, Norwegian Armed Forces Joint Medical Services, Oslo, Norway.,Department of Psychology, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Arnfinn Tønnesen
- Institute of Military Psychiatry, Norwegian Armed Forces Joint Medical Services, Oslo, Norway
| | | | - June Ullevoldsaeter Lystad
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Section of Early Psychosis Treatment, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Loscalzo Y, Giannini M, Gori A, Fabio AD. The Wellbeing of Italian Peacekeeper Military: Psychological Resources, Quality of Life and Internalizing Symptoms. Front Psychol 2018; 9:103. [PMID: 29487552 PMCID: PMC5816820 DOI: 10.3389/fpsyg.2018.00103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/22/2018] [Indexed: 11/30/2022] Open
Abstract
Working as a peacekeeper is associated with the exposure to acute and/or catastrophic events and chronic stressors. Hence, the meager literature about peacekeepers' wellbeing has mainly analyzed Post-Traumatic Stress Disorder (PTSD). This study aims to deep the analysis of the wellbeing of peacekeepers military. Based on the few studies on this population, we hypothesized that Italian peacekeeper military officers and enlisted men (n = 167; 103 males, 6 females, 58 missing) exhibit lower levels of internalizing symptoms (i.e., PTSD, depression, general anxiety, obsessions, and somatization) as compared to a control group (n = 60; 32 males, 28 females). Moreover, we hypothesized that peacekeepers have higher levels of psychological resources (i.e., self-efficacy, self-esteem, social support) and quality of life (i.e., higher life satisfaction and lower general stress). We compared the groups by means of MANOVAs on the subscales of the Psychological Treatment Inventory (PTI; Gori et al., 2015). We found that Italian peacekeepers have lower internalizing symptoms and higher levels of self-efficacy and self-esteem than the control group; however, no statistically significant differences were observed on perceived social support. Finally, peacekeepers have a higher quality of life: scores reflect higher life satisfaction and lower distress than the control group. This study is in line with previous literature supporting the claim that Italian peacekeeper military officers have sufficient psychological resources for coping with the stressful situations implied in peacekeeping missions. Future studies should deepen the analysis of the military's psychological characteristics by comparing war veterans and peacekeeper military.
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Affiliation(s)
- Yura Loscalzo
- Department of Health Sciences, School of Psychology, University of Florence, Florence, Italy
| | - Marco Giannini
- Department of Health Sciences, School of Psychology, University of Florence, Florence, Italy
| | - Alessio Gori
- Department of Human Sciences, LUMSA University, Rome, Italy
| | - Annamaria Di Fabio
- Psychology Section, Department of Education and Psychology, University of Florence, Florence, Italy
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Trautmann S, Goodwin L, Höfler M, Jacobi F, Strehle J, Zimmermann P, Wittchen HU. Prevalence and severity of mental disorders in military personnel: a standardised comparison with civilians. Epidemiol Psychiatr Sci 2017; 26:199-208. [PMID: 27086743 PMCID: PMC6998688 DOI: 10.1017/s204579601600024x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/22/2016] [Indexed: 11/06/2022] Open
Abstract
AIMS Provision and need for mental health services among military personnel are a major concern across nations. Two recent comparisons suggest higher rates of mental disorders in US and UK military personnel compared with civilians. However, these findings may not apply to other nations. Previous studies have focused on the overall effects of military service rather than the separate effects of military service and deployment. This study compared German military personnel with and without a history of deployment to sociodemographically matched civilians regarding prevalence and severity of 12-month DSM-IV mental disorders. METHOD 1439 deployed soldiers (DS), 779 never deployed soldiers (NS) and 1023 civilians were assessed with an adapted version of the Munich Composite International Diagnostic interview across the same timeframe. Data were weighted using propensity score methodology to assure comparability of the three samples. RESULTS Compared with adjusted civilians, the prevalence of any 12-month disorder was lower in NS (OR: 0.7, 95% CI: 0.5-0.99) and did not differ in DS. Significant differences between military personnel and civilians regarding prevalence and severity of individual diagnoses were only apparent for alcohol (DS: OR: 0.3, 95% CI: 0.1-0.6; NS: OR: 0.2, 95% CI: 0.1-0.6) and nicotine dependence (DS: OR: 0.5, 95% CI: 0.3-0.6; NS: OR: 0.5, 95% CI: 0.3-0.7) with lower values in both military samples. Elevated rates of panic/agoraphobia (OR: 2.7, 95% CI: 1.4-5.3) and posttraumatic stress disorder (OR: 3.2, 95% CI: 1.3-8.0) were observed in DS with high combat exposure compared with civilians. CONCLUSIONS Rates and severity of mental disorders in the German military are comparable with civilians for internalising and lower for substance use disorders. A higher risk of some disorders is reduced to DS with high combat exposure. This finding has implications for mental health service provision and the need for targeted interventions. Differences to previous US and UK studies that suggest an overall higher prevalence in military personnel might result from divergent study methods, deployment characteristics, military structures and occupational factors. Some of these factors might yield valuable targets to improve military mental health.
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Affiliation(s)
- S. Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - L. Goodwin
- Department of Psychological Medicine, King's Centre for Military Health Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M. Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - F. Jacobi
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - J. Strehle
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - P. Zimmermann
- Centre for Psychiatry and Posttraumatic Stress, Federal Armed Forces Hospital Berlin, Berlin, Germany
| | - H.-U. Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Occupational stress and UN peacekeepers. Ir J Psychol Med 2015; 32:205-208. [PMID: 30185242 DOI: 10.1017/ipm.2014.56] [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] [Indexed: 11/06/2022]
Abstract
BACKGROUND Ireland has been actively involved in peacekeeping operations since the 1950s. The unique psychological stressors associated with this form of military activity have been under-recognised and under-researched. Aim The aim of this paper is to bring to the attention of mental health professionals, who have been caring for military and retired military peacekeeping personnel, the unique difficulties associated with peacekeeping and how they can impact upon the mental health of the peacekeeper. METHODS The nature of peacekeeping is outlined. There is a short review of the limited literature on the mental health effects of this kind of military deployment. There is also an outline of the positive outcomes for the majority of those who have served as peacekeepers. RESULTS Both the negative and the positive mental health outcomes depend on the particular mission. Each mission is different and the nature of a mission also changes over time. Post-traumatic stress disorder rates can vary from 3% to 15% of a peacekeeping cohort, depending upon the nature of the violence associated with the mission. The vast majority of peacekeepers have found their peacekeeping deployments as an enriching experience. CONCLUSION Peacekeepers are often witnesses as well as the victims of traumatic events. The restrictions placed upon their military role by the mission mandate can be a source of stress for them. Their mental health needs to be supported during the mission and after they have returned home.
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Sareen J, Stein MB, Thoresen S, Belik SL, Zamorski M, Asmundson GJ. Is peacekeeping peaceful? A systematic review. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2010; 55:464-72. [PMID: 20704774 DOI: 10.1177/070674371005500710] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To systematically review the literature on the association between deployment to a peacekeeping mission and distress, mental disorders, and suicide. METHODS Peer-reviewed English publications were found through key word searches in MEDLINE, PsycINFO, Scopus, and Embase, and by contacting authors in the field. Sixty-eight articles were included in this review. RESULTS Some studies have found higher levels of postdeployment distress and posttraumatic stress disorder (PTSD) symptoms. Most studies have not shown an increased risk of suicide in former peacekeepers. Correlates of distress and PTSD symptoms included level of exposure to traumatic events during deployment, number of deployments, predeployment personality traits or disorder, and postdeployment stressors. Perceived meaningfulness of the mission, postdeployment social supports, and positive perception of homecoming were associated with lower likelihood of distress. CONCLUSIONS Most peacekeepers do not develop high levels of distress or symptoms of PTSD. As postdeployment distress is consistently shown to be associated with high levels of exposure to combat during deployment, targeted interventions for peacekeepers who have been exposed to high levels of combat should be considered.
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Affiliation(s)
- Jitender Sareen
- Psychology, and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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