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Varilek BM, Da Rosa P. Analysis of Palliative Care Knowledge and Symptom Burden Among Female Veterans With Serious Illness: A Cross-Sectional Study. Am J Hosp Palliat Care 2024; 41:641-650. [PMID: 37385594 DOI: 10.1177/10499091231187341] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
Background: The female Veteran population is rapidly growing, as is their use of Veterans Affairs (VA) medical centers (VAMCs). Additionally, 90% of female Veterans are under 65 years old, meaning healthcare providers at VAMCs must be ready to manage the complex serious illnesses that affect female Veterans as they age. These serious illnesses require proper medical management, which can include palliative care. However, little palliative care research includes female Veterans. Aims: The aims of this cross-sectional study were to examine palliative care knowledge and symptom burden among female Veterans' and examine factors associated a symptom burden scale. Methods: Consenting participants completed online questionnaires, including the Palliative Care Knowledge Scale (PaCKS), Condensed Memorial Symptom Assessment Scale (CMSAS), and demographics. Descriptive statistics characterized the sample, bivariate association were carried out with a Chi-square and t test. A generalized linear model explored associations between CMSAS and its subscales with sociodemographic, number of serious illnesses, and facility type (VAMC vs civilian facility). Results: 152 female Veterans completed the survey. PaCKS scores were consistent across our sample. Physical symptoms were rated higher for those receiving care at VAMCs compared to civilian facilities (P = .02) in the bivariate analysis. The factors associated with CMSAS were age, employment status and number of serious illnesses (all P < .05). Conclusions: Palliative care can assist female Veterans with serious illness. More research is needed to further explore variables associated with symptom burden among female Veterans such as age, employment status, and number of serious illnesses.
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Affiliation(s)
- Brandon M Varilek
- College of Nursing, South Dakota State University, Sioux Falls, SD, USA
| | - Patricia Da Rosa
- Office of Nursing Research, College of Nursing, South Dakota State University, Brookings, SD, USA
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Shelef L, Bechor U, Ohayon O, Tatsa-Laur L, Antonovsky A. The Psychological Impact of Exposure to Battle on Medics: A Cross-Sectional Study of Ex-Soldiers Who Sought Help From the IDF Combat Reaction Unit. Mil Med 2024; 189:e781-e788. [PMID: 37721515 DOI: 10.1093/milmed/usad368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/31/2023] [Accepted: 09/11/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION The present study's central aim was to examine two questions: (1) Will there be differences in mental health outcomes between medics and non-medics who sought help at the Israeli Combat Reaction Unit (CRU)? (2) Will there be differences in mental health outcomes between combatants and non-combatants? MATERIALS AND METHODS This cross-sectional study included files of 1,474 Israeli Defense Forces ex-service members (89% combatants, of whom 13% were medics; 11% non-combatants, of whom 6% were medics), who filled out questionnaires on admission for evaluation at the CRU.Dependent variables were mental health measures and included two PTSD measures (Clinician-Administered PTSD Scale and PTSD Checklist for DSM-5), Beck Depression Inventory, Dissociative Experience Scale, and Brief Symptom Inventory. Military profession (medics vs. non-medics) and status (combatant vs. non-combatant) were the independent variables. Background variables were also examined. RESULTS We found no substantial differences between medics and non-medics in the mental health measures. When looking at combat and non-combat separately, the non-combat medics (CMs), in general, were in better mental health conditions than the other three groups- CMs, non-medic combatants, and non-medic non-combatants-all of whom had similar scores in the mental health measures. However, compared to the rest, non-CMs took considerably longer years before approaching the CRU. CONCLUSIONS The elapsed time to seek help for non-MCs was explained by their reluctance to seek help, not being combatants, and being medics who are portrayed as resilient. Recommendations for encouraging this subgroup to seek help were given.
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Affiliation(s)
- Leah Shelef
- The School of Social Work, Sapir Academic College, D. N. Hof Ashkelon 79165, Israel
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Uzi Bechor
- Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Ofir Ohayon
- Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Lucian Tatsa-Laur
- Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Avishai Antonovsky
- Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
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Hitz AC, Hubbling SBD, Hodges A, Campbell EMH, Bangerter A, Polusny MA. Feasibility of a prospective, longitudinal study of resilience among young military recruits with embedded laboratory sub-study: the ARMOR pilot trial. RESEARCH SQUARE 2023:rs.3.rs-3112652. [PMID: 37461702 PMCID: PMC10350231 DOI: 10.21203/rs.3.rs-3112652/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Background Multilevel, longitudinal studies are integral to resilience research; however, they are costly and present unique methodological challenges. The objective of this study was to examine the feasibility of study methods (recruitment, retention, data collection) for a large-scale prospective, longitudinal study of resilience among young National Guard recruits. Methods This feasibility trial used a pre-test/post-test design with embedded laboratory sub-study. Participants were young military recruits who had recently enlisted in the Army National Guard and had not yet shipped to Basic Combat Training (BCT). Recruitment and baseline data collection (Time 1), which included a battery of computerized self-report measures and neurocognitive tests, were conducted at local armories. Participants completed an online follow-up (Time 2) survey outside of drill training after returning from BCT. A subset of participants was recruited to complete extensive laboratory procedures pre-and post-BCT, including clinical interview, additional self-report measures, and performance on a series of neurobehavioral tasks during electroencephalogram recordings and, at pre-BCT only, magnetic resonances imaging. Feasibility outcomes assessed our ability to recruit, retain, and collect data from participants. Analysis of outcomes was based on descriptive statistics and evaluation of the feasibility of the larger study was based on pre-determined go/no go progression criteria. Results All pre-determined progression criteria were met. A total of 102 (97.1%) of eligible military service members consented to participate. Of these, 73 (73.7%) completed the Time 2 survey. Of the 24 participants approached, 14 agreed to participate in the laboratory sub-study, 13 completed follow-up laboratory visits. Overall, completion of online surveys and laboratory tasks was excellent. However, participants had difficulties completing online surveys during BCT and the computerized neurocognitive testing battery at Time 2. Conclusions Study methods were feasible, and all predetermined criteria for progression to the large-scale longitudinal study were met. Some minor protocol adaptations were identified from this feasibility study. Lessons learned and recommendations for future research are discussed.
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Affiliation(s)
- Andrea C Hitz
- University of Minnesota Medical School Twin Cities Campus: University of Minnesota Twin Cities School of Medicine
| | | | - Annika Hodges
- Minneapolis VA Health Care System: Minneapolis VA Medical Center
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Kim D, Kim D, Kim EK. Dissociation mediates association between childhood trauma and distress from trauma research participation: analysis of pooled clinical data. PSYCHOSIS 2023. [DOI: 10.1080/17522439.2023.2176536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
- Dongjoo Kim
- Department of Psychiatry, College of Medicine, Hanyang University, Seoul, South Korea
| | | | - Eun Kyoung Kim
- Department of Premedicine, Hanyang University, Seoul, South Korea
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Cohen-Koren R, Garbi D, Gordon S, Yavnai N, Erlich Shoham Y, Shelef L. Predictors of Emotional Distress in Combat Military Flight Engineers. Mil Med 2023; 188:e301-e310. [PMID: 34050755 DOI: 10.1093/milmed/usab219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/24/2021] [Accepted: 05/20/2021] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Exposure to distressing sights (DSs) during combat missions may cause emotional distress. The present study aimed to investigate the association between exposure to DSs involving severe injuries and fatalities during rescue missions and emotional distress, in Israeli Air Force (IAF) helicopter flight engineers (FEs). METHODS Cross-sectional design using self-report questionnaires. The independent variables included demographics, personal, and military variables-exposure to DSs throughout a whole career service. The dependent variables included Depression (Beck Depression Inventory); State-Trait Anxiety Inventory; Post-traumatic stress disorder (PTSD Checklist-PCL-5); Somatization (Patient Health Questionnaire); Maslach Burnout Inventory; and Coping Strategies (The Brief COPE). The variables PTSD, depression, and anxiety were examined twice: once as dichotomous variables according to the pathology cutoff point and again as a continuous variable to reveal the intensity of symptoms. RESULTS Participants were 106 IAF helicopter FEs (mean age = 39.32, SD = 8.75). Linear regression revealed that initial exposure to distressing battlefield sights (i.e., exposure to severe injuries and fatalities) was a predictor of depression symptoms. Career service FEs aged 31-40 were found to be at the highest risk of emotional distress, with a predictive factor for anxiety symptoms. Use of nonadaptive coping strategies was found to predict depressive symptoms, anxiety symptoms, and post-traumatic stress symptoms. CONCLUSION A significant association was found between exposure to DSs involving severe injuries and fatalities during rescue missions and anxiety, depression, somatization, and burnout. This population is generally perceived as tough and resilient, and this study has a unique contribution in identifying its vulnerabilities. Psychological intervention is crucial after participating in such missions.
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Affiliation(s)
| | - Dror Garbi
- Psychology Branch, Israeli Air Force, Ramat-Gan 5262000, Israel
| | - Shirley Gordon
- Psychology Branch, Israeli Air Force, Ramat-Gan 5262000, Israel
| | - Nirit Yavnai
- Medical Corps, Israel Defense Force, Ramat-Gan 5262000, Israel
| | | | - Leah Shelef
- Psychology Branch, Israeli Air Force, Ramat-Gan 5262000, Israel
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The perception and impact of emotional trauma upon active duty military personnel. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Positive Psychology in Context of Peacekeeping Militaries: A Mediation Model of Work-Family Enrichment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020429. [PMID: 33430401 PMCID: PMC7827820 DOI: 10.3390/ijerph18020429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/29/2020] [Accepted: 01/03/2021] [Indexed: 12/02/2022]
Abstract
Based on the work-family enrichment theory, this study analyzes the contribution of work-family and family-work enrichment to explain the military’s well-being during a peacekeeping mission. The data used were collected in a sample of 306 Brazilian soldiers, who were married and/or had children, during the phase named “employment of troops” (i.e., when peacekeepers had been in the Haitian territory and, as a result, away from their families, for between three to five months). Data analysis was performed using the Structural Equations Model. It was observed that the military’s perception of their spouses’ support for their participation during the mission had a positive relationship with both family-to-work enrichment and work-to-family enrichment, and the work-to-family enrichment mediated the relationship between the perception of the spouses’ support and the military’s health perception and general satisfaction with life. Theoretical and practical implications were discussed and limitations and suggestions for future research were presented.
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Kok BC, Wilk JE, Wickham RE, Bongar B, Riviere LA, Brown LM. Military occupation as a moderator between combat exposure and posttraumatic stress disorder symptoms in US Army personnel. MILITARY PSYCHOLOGY 2020; 32:410-418. [PMID: 38536367 PMCID: PMC10013536 DOI: 10.1080/08995605.2020.1782625] [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: 11/19/2019] [Accepted: 06/03/2020] [Indexed: 10/23/2022]
Abstract
Military occupational designations are standardized classifications that help define and convey a service member's expected duties and responsibilities. The present study examined how occupational designation was related to adverse combat-reactions, specifically posttraumatic stress disorder (PTSD). It was hypothesized that at comparable levels of combat, non-combat units would display greater symptomology than combat units. The study sample consisted of 785 combat-deployed, active-duty enlisted US Army personnel. Participants were administered self-report questionnaires, including the Combat Experiences Scale and PTSD Checklist for DSM-5. Occupation was coded using the three-branch system (i.e., Operations, Support, & Force Sustainment). Hierarchical multiple linear regression (MLR) was run to examine the effect of occupation, combat, and unit cohesion on PTSD symptoms. Operations units reported the highest frequency of combat exposure; however, Force Sustainment units displayed the highest PTSD symptoms. In MLR analysis, there was a significant interaction between Force Sustainment units and combat exposure (β = 0.10, p = .019), that was not observed in Operations or Support units. These findings demonstrate that PTSD symptom intensity is not solely a function of combat exposure, and that non-combat units may react differently when exposed to elevated levels of combat.
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Affiliation(s)
| | - Joshua E. Wilk
- Department of Military Psychology, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | | | | | - Lyndon A. Riviere
- Department of Military Psychology, Walter Reed Army Institute of Research, Silver Spring, Maryland
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Clausen AN, Clarke E, Phillips RD, Haswell C, Morey RA. Combat exposure, posttraumatic stress disorder, and head injuries differentially relate to alterations in cortical thickness in military Veterans. Neuropsychopharmacology 2020; 45:491-498. [PMID: 31600766 PMCID: PMC6969074 DOI: 10.1038/s41386-019-0539-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/23/2019] [Accepted: 10/01/2019] [Indexed: 12/30/2022]
Abstract
Combat-exposed Veterans are at increased risk for developing psychological distress, mood disorders, and trauma and stressor-related disorders. Trauma and mood disorders have been linked to alterations in brain volume, function, and connectivity. However, far less is known about the effects of combat exposure on brain health. The present study examined the relationship between severity of combat exposure and cortical thickness. Post-9/11 Veterans (N = 337; 80% male) were assessed with structural neuroimaging and clinically for combat exposure, depressive symptoms, prior head injury, and posttraumatic stress disorder (PTSD). Vertex-wide cortical thickness was estimated using FreeSurfer autosegmentation. FreeSurfer's Qdec was used to examine relationship between combat exposure, PTSD, and prior head injuries on cortical thickness (Monte Carlo corrected for multiple comparisons, vertex-wise cluster threshold of 1.3, p < 0.01). Covariates included age, sex, education, depressive symptoms, nonmilitary trauma, alcohol use, and prior head injury. Higher combat exposure uniquely related to lower cortical thickness in the left prefrontal lobe and increased cortical thickness in the left middle and inferior temporal lobe; whereas PTSD negatively related to cortical thickness in the right fusiform. Head injuries related to increased cortical thickness in the bilateral medial prefrontal cortex. Combat exposure uniquely contributes to lower cortical thickness in regions implicated in executive functioning, attention, and memory after accounting for the effects of PTSD and prior head injury. Our results highlight the importance of examining effects of stress and trauma exposure on neural health in addition to the circumscribed effects of specific syndromal pathology.
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Affiliation(s)
- Ashley N. Clausen
- VA Mid-Atlantic MIRECC, Durham VAHCS, 508 Fulton St, Durham, NC 27705 USA ,0000 0004 1936 7961grid.26009.3dDuke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC USA
| | - Emily Clarke
- VA Mid-Atlantic MIRECC, Durham VAHCS, 508 Fulton St, Durham, NC 27705 USA ,0000 0004 1936 7961grid.26009.3dDuke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC USA
| | - Rachel D. Phillips
- VA Mid-Atlantic MIRECC, Durham VAHCS, 508 Fulton St, Durham, NC 27705 USA ,0000 0004 1936 7961grid.26009.3dDuke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC USA
| | - Courtney Haswell
- VA Mid-Atlantic MIRECC, Durham VAHCS, 508 Fulton St, Durham, NC 27705 USA ,0000 0004 1936 7961grid.26009.3dDuke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC USA
| | | | - Rajendra A. Morey
- VA Mid-Atlantic MIRECC, Durham VAHCS, 508 Fulton St, Durham, NC 27705 USA ,0000 0004 1936 7961grid.26009.3dDuke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC USA ,0000 0004 1936 7961grid.26009.3dCenter for Cognitive Neuroscience, Duke University, Durham, NC USA ,0000 0004 1936 7961grid.26009.3dDepartment of Psychiatry and Behavioral Sciences, Duke University, Durham, NC USA
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Brown WJ, Dewey D, Bunnell BE, Boyd SJ, Wilkerson AK, Mitchell MA, Bruce SE. A Critical Review of Negative Affect and the Application of CBT for PTSD. TRAUMA, VIOLENCE & ABUSE 2018; 19:176-194. [PMID: 27301345 DOI: 10.1177/1524838016650188] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Forms of cognitive and behavioral therapies (CBTs), including prolonged exposure and cognitive processing therapy, have been empirically validated as efficacious treatments for posttraumatic stress disorder (PTSD). However, the assumption that PTSD develops from dysregulated fear circuitry possesses limitations that detract from the potential efficacy of CBT approaches. An analysis of these limitations may provide insight into improvements to the CBT approach to PTSD, beginning with an examination of negative affect as an essential component to the conceptualization of PTSD and a barrier to the implementation of CBT for PTSD. As such, the literature regarding the impact of negative affect on aspects of cognition (i.e., attention, processing, memory, and emotion regulation) necessary for the successful application of CBT was systematically reviewed. Several literature databases were explored (e.g., PsychINFO and PubMed), resulting in 25 articles that met criteria for inclusion. Results of the review indicated that high negative affect generally disrupts cognitive processes, resulting in a narrowed focus on stimuli of a negative valence, increased rumination of negative autobiographical memories, inflexible preservation of initial information, difficulty considering counterfactuals, reliance on emotional reasoning, and misinterpretation of neutral or ambiguous events as negative, among others. With the aim to improve treatment efficacy of CBT for PTSD, suggestions to incorporate negative affect into research and clinical contexts are discussed.
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Affiliation(s)
- Wilson J Brown
- 1 Center for the Treatment and Study of Traumatic Stress, Summa Health System, Akron, OH, USA
| | - Daniel Dewey
- 2 Medical University of South Carolina, Charleston, SC, USA
- 3 Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | - Brian E Bunnell
- 2 Medical University of South Carolina, Charleston, SC, USA
- 3 Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | - Stephen J Boyd
- 4 Veterans Affairs Portland Health Care System, Portland, OR, USA
| | | | - Melissa A Mitchell
- 1 Center for the Treatment and Study of Traumatic Stress, Summa Health System, Akron, OH, USA
| | - Steven E Bruce
- 5 Center for Trauma Recovery, University of Missouri-St. Louis, St. Louis, MO, USA
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Gandelman E, Petrakis I, Kachadourian L, Ralevski E. Negative Affect Intensity and Hostility in Individuals With Alcohol Use Disorder With or Without Posttraumatic Stress Disorder. J Dual Diagn 2018; 14:96-101. [PMID: 29461925 DOI: 10.1080/15504263.2018.1434264] [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: 10/18/2022]
Abstract
OBJECTIVE Negative affect intensity and hostility have both been implicated in alcohol use disorders (AUD) and posttraumatic stress disorder (PTSD) when they occur separately, but neither have been compared or explored among those with comorbid AUD and PTSD. This study is a secondary analysis designed to compare levels of negative affect intensity and hostility among those with AUD to those with comorbid AUD and PTSD. METHODS Participants (n = 113) were recruited from the placebo-controlled groups of two distinct 12-week clinical trials (NCT00342563 and NCT00744055). The Short Affect Intensity Scale and Buss-Durkee Hostility Inventory were administered at weeks 0, 4, 8, and 12 to all study participants to assess negative affect intensity and hostility levels, respectively. RESULTS Individuals with comorbid AUD and PTSD showed significantly higher levels of negative affect intensity and hostility than individuals with AUD only. These levels remained relatively stable over the course of the study in spite of all study participants showing clinically significant improvements in AUD severity and PTSD symptomatology (for those with dual diagnosis). CONCLUSIONS Our results indicate that individuals with comorbid AUD and PTSD have higher levels of negative affect and higher levels of hostility compared to individuals with AUD alone. In addition, these heightened levels of negative affect intensity and hostility appear to function somewhat independently of diagnosis severity and symptomatology improvement. To our knowledge, this is the first study to compare negative affect intensity and hostility levels between individuals with AUD alone and those with comorbid AUD and PTSD.
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Affiliation(s)
- Erin Gandelman
- a Department of Psychiatry , Yale University School of Medicine , New Haven , Connecticut , USA.,b Department of Veterans Affairs , VA Connecticut Healthcare System , West Haven , Connecticut , USA
| | - Ismene Petrakis
- a Department of Psychiatry , Yale University School of Medicine , New Haven , Connecticut , USA.,b Department of Veterans Affairs , VA Connecticut Healthcare System , West Haven , Connecticut , USA.,c Mental Illness Research Education and Clinical Center, VA Connecticut Healthcare System , West Haven , Connecticut , USA
| | - Lorig Kachadourian
- a Department of Psychiatry , Yale University School of Medicine , New Haven , Connecticut , USA.,b Department of Veterans Affairs , VA Connecticut Healthcare System , West Haven , Connecticut , USA
| | - Elizabeth Ralevski
- a Department of Psychiatry , Yale University School of Medicine , New Haven , Connecticut , USA.,b Department of Veterans Affairs , VA Connecticut Healthcare System , West Haven , Connecticut , USA.,c Mental Illness Research Education and Clinical Center, VA Connecticut Healthcare System , West Haven , Connecticut , USA
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12
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Lubens P, Bruckner TA. A Review of Military Health Research Using a Social–Ecological Framework. Am J Health Promot 2018; 32:1078-1090. [DOI: 10.1177/0890117117744849] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective: We aim to contextualize the growing body of research on the sequelae of military service in the wars in Afghanistan and Iraq. We employ a social–ecological (SE) framework for the taxonomy of military health research and classify risk as arising from the individual, family, community, and the institutional levels. We intend for this review to inform enhanced health promotion efforts in military communities. Data Source: Articles reviewed were extracted from Web of Science, PubMed, and Scopus. Inclusion and Exclusion Criteria: Research focused on somatic and psychological sequelae of combat deployment published from 2001—the year the war in Afghanistan began—through the end of 2014. We excluded studies of non-US military personnel, other systematic reviews, meta-analyses, book chapters, and theoretical papers. Data Extraction: We examined and summarized the aims, participants, methods, study design, SE framework tier, risk factors, and health outcomes. Data Synthesis: Studies were categorized according to SE tier, whether they focused on somatic, behavioral, or psychological outcomes, and by risk factor. Results: Of the 352 peer-reviewed papers, 84% focused on war’s sequelae on the index military personnel, and 75% focused on mental or behavioral health outcomes—mostly on post-traumatic stress disorder. We find comparatively little research focusing on the family, community, or institutional tiers. Conclusions: We know relatively little about how family and community respond to the return of personnel from combat deployment; how family resources affect the health of returning military personnel; and how a war’s persistence presents challenges for federal, state, and local agencies to meet military health-care needs. Such work is especially salient as US troops return home from war—particularly in communities where there are substantial military populations.
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Affiliation(s)
- Pauline Lubens
- Program in Public Health, University of California, Irvine, CA, USA
| | - Tim A. Bruckner
- Program in Public Health, University of California, Irvine, CA, USA
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Wearable bio signal monitoring system applied to aviation safety. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:2349-2352. [PMID: 29060369 DOI: 10.1109/embc.2017.8037327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pilots are required to have the ability to evaluate their own physical and psychological status to operate high performance aircrafts effectively. Existing studies have lacked consideration of applying bio signal of pilots in real time flight situation. The purpose of this study is to develop a wearable bio signal monitoring system that can measure the condition of pilots under an extreme flight environment to ensure flight safety. The wearable bio signal monitoring system consists of an algorithm for evaluating pilots' physiological stability, algorithms for detecting Gravity-induced Loss of Consciousness (G-LOC) prognosis, pilots' interaction module, and pilots' context awareness platform. The algorithm for evaluating pilots' physiological stability uses psychomotor cognitive test (PCT) and heart rate variability (HRV) to measure pilots' mission performance before flight. The algorithms for detecting G-LOC prognosis utilizes electromyogram (EMG) to generate warning signal during flight. The pilots' interaction module was developed for pilots to operate the system efficiently under flight environment. The pilots' context awareness platform was designed for the system to process multiple sensor signals in real time. This wearable bio signal monitoring system is expected to enhance flight safety and mission performance of pilots.
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Meis LA, Erbes CR, Kramer MD, Arbisi PA, Kehle-Forbes SM, DeGarmo DS, Shallcross SL, Polusny MA. Using reinforcement sensitivity to understand longitudinal links between PTSD and relationship adjustment. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2017; 31:71-81. [PMID: 27077237 PMCID: PMC6791525 DOI: 10.1037/fam0000195] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
There is limited research testing longitudinal models of how posttraumatic stress disorder (PTSD) severity leads to impaired relationship adjustment. The present study evaluated 2 potential mechanisms among a longitudinal sample of National Guard soldiers deployed to the Iraq War: (1) sensitivity to cues associated with punishment within intimate relationships and (2) sensitivity to cues associated with incentives in intimate relationships. Participants were surveyed by mail 1 year after an extended 16-month combat deployment and again 2 years later. Using a cross-lagged panel analysis with 2 mediators (relationship-specific threat and incentive sensitivity), findings indicated Time 1 PTSD symptom severity significantly eroded relationship adjustment over time through greater sensitivity to cues of relationship-related punishment, but not through incentive sensitivity. Additionally, findings indicated sensitivity to cues of relationship-related threats maintains symptoms of PTSD while sensitivity to cues of relationship-related incentives maintains relationship adjustment. Finally, PTSD symptoms significantly predicted erosion of relationship adjustment over time; however, associations from relationship adjustment to changes in PTSD severity over time were nonsignificant. Findings are discussed within the context of reinforcement sensitivity theory and emotional processing theory of PTSD. (PsycINFO Database Record
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Affiliation(s)
- Laura A Meis
- Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs (VA) Health Care System
| | - Christopher R Erbes
- Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System
| | | | | | | | | | | | - Melissa A Polusny
- Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System
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Brown WJ, Bruce SE, Buchholz KR, Artime TM, Hu E, Sheline YI. Affective Dispositions and PTSD Symptom Clusters in Female Interpersonal Trauma Survivors. JOURNAL OF INTERPERSONAL VIOLENCE 2016; 31:407-424. [PMID: 25389192 DOI: 10.1177/0886260514555866] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Interpersonal trauma (IPT) against women can have dire psychological consequences including persistent maladaptive changes in the subjective experience of affect. Contemporary literature has firmly established heightened negative affect (NA) as a risk and maintenance factor for posttraumatic stress disorder (PTSD). However, the relationship between NA and PTSD symptoms is not well understood within IPT survivors, the majority of whom are female, as much of this research has focused on combat veterans. In addition, the connection between positive affect (PA) and PTSD symptoms has yet to be examined. With increased emphasis on "negative alterations in cognitions and mood . . ." as an independent symptom cluster of PTSD in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5), understanding the relationship between self-reported affectivity and the classic PTSD symptom clusters may be increasingly useful in differentiating symptom presentations of trauma-related psychopathology. The current study directly compared self-reported trait NA and PA with total severity and frequency cluster scores from the Clinician-Administered PTSD Scale (CAPS) in 54 female survivors of IPT who met criteria for PTSD. Results identify NA (but not PA) as a consistent predictor of total PTSD symptoms and, specifically, re-experiencing symptoms.
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Affiliation(s)
| | - Steven E Bruce
- University of Missouri-St. Louis, MO, USA Washington University, St. Louis, MO, USA
| | | | | | - Emily Hu
- University of Missouri-St. Louis, MO, USA
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Davy CP, Lorimer M, McFarlane A, Hodson S, Crompvoets S, Lawrence-Wood E, Neuhaus SJ. The Well-Being of Australian Service Mothers. Women Health 2015; 55:737-53. [PMID: 25996528 DOI: 10.1080/03630242.2015.1050541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In recent years servicewomen with dependent children have for the first time in history been deployed into conflict zones in support of Australian Defence Force operations. This represents a significant social change, and the implications of deployment on the health of these service mothers are not fully understood. Data from women who participated in the Middle East Area of Operations Census study were analyzed to compare the psychological and physical symptoms reported by service mothers with service women who had no dependent children at the time of deploying to Afghanistan and/or Iraq. Of the 921 women who were included in this analysis, 235 had dependent children and 686 had no dependent children (comparison group). Service mothers were significantly older and were more likely to have served in the Air Force than women in the comparison group. Findings demonstrate that serving mothers were not at any significantly higher risk of psychological distress, post-traumatic stress symptoms, alcohol misuse, or reporting of somatic symptoms, than women who had no dependent children. A number of possible explanations for these findings are discussed, including the healthy soldier/mother effect, support from partners and extended family members, and collegial networks.
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Affiliation(s)
- Carol P Davy
- a South Australian Health and Medical Research Institute , Adelaide , South Australia , Australia.,b Centre for Traumatic Stress Studies , University of Adelaide , Adelaide , South Australia, Australia
| | - Michelle Lorimer
- c Data Management and Analysis Centre , University of Adelaide, Adelaide, South Australia, Australia
| | - Alexander McFarlane
- b Centre for Traumatic Stress Studies , University of Adelaide , Adelaide , South Australia, Australia
| | - Stephanie Hodson
- d Department of Veterans' Affairs, Canberra, Australian Capital Territory , Australia
| | - Samantha Crompvoets
- e College of Medicine, Biology and Environment , Australian National University, Canberra, Australia Capital Territory , Australia
| | - Ellie Lawrence-Wood
- b Centre for Traumatic Stress Studies , University of Adelaide , Adelaide , South Australia, Australia
| | - Susan J Neuhaus
- b Centre for Traumatic Stress Studies , University of Adelaide , Adelaide , South Australia, Australia
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Hines LA, Sundin J, Rona RJ, Wessely S, Fear NT. Posttraumatic stress disorder post Iraq and Afghanistan: prevalence among military subgroups. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2014; 59:468-79. [PMID: 25569079 PMCID: PMC4168809 DOI: 10.1177/070674371405900903] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Accepted: 05/01/2014] [Indexed: 11/16/2022]
Abstract
A large body of research has been produced in recent years investigating posttraumatic stress disorder (PTSD) among military personnel following deployment to Iraq and Afghanistan, resulting in apparent differences in PTSD prevalence. We compare prevalence estimates for current PTSD between military subgroups, providing insight into how groups may be differentially affected by deployment. Systematic literature searches using the terms PTSD, stress disorder, and acute stress, combined with terms relating to military personnel, identified 49 relevant papers. Studies with a sample size of less than 100 and studies based on data for treatment seeking or injured populations were excluded. Studies were categorized according to theatre of deployment (Iraq or Afghanistan), combat and noncombat deployed samples, sex, enlistment type (regular or reserve and [or] National Guard), and service branch (for example, army, navy, and air force). Meta-analysis was used to assess PTSD prevalence across subgroups. There was large variability in PTSD prevalence between studies, but, regardless of heterogeneity, prevalence rates of PTSD were higher among studies of Iraq-deployed personnel (12.9%; 95% CI 11.3% to 14.4%), compared with personnel deployed to Afghanistan (7.1%; 95% CI 4.6% to 9.6%), combat deployed personnel, and personnel serving in the Canadian, US, or UK army or the navy or marines (12.4%; 95% CI 10.9% to 13.4%), compared with the other services (4.9%; 95% CI 1.4% to 8.4%). Contrary to findings from within-study comparisons, we did not find a difference in PTSD prevalence for regular active-duty and reserve or National Guard personnel. Categorizing studies according to deployment location and branch of service identified differences among subgroups that provide further support for factors underlying the development of PTSD.
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Affiliation(s)
- Lindsey A Hines
- Research Assistant, King's Centre for Mental Health Research, King's College London, London, England
| | - Josefin Sundin
- Post-doctoral Researcher, Academic Centre for Defence Mental Health, King's College London, London, England
| | - Roberto J Rona
- Professor, King's Centre for Mental Health Research, King's College London, London, England
| | - Simon Wessely
- Professor, King's Centre for Mental Health Research, King's College London, London, England. Professor, Academic Centre for Defence Mental Health, King's College London, London, England
| | - Nicola T Fear
- Reader, King's Centre for Mental Health Research, King's College London, London, England; Reader, Academic Centre for Defence Mental Health, King's College London, London, England
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Zimmermann P, Höfler M, Schönfeld S, Trautmann S, Hauffa R, Kowalski J, Wittchen HU. Einsatzerlebnisse und einsatzbedingte psychische Erkrankungen deutscher Soldaten–empirische Struktur und prädiktive Wertigkeit traumatischer Stressoren. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2014. [DOI: 10.1026/1616-3443/a000264] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Theoretischer Hintergrund: Noch immer ist wenig über die empirische Struktur von traumatischem Stress und die Assoziationen zwischen Stressoren und psychischen Erkrankungen bekannt, insbesondere nach militärischen Auslandseinsätzen. Methode: 1483 Bundeswehrsoldaten, die 2009/2010 in Afghanistan eingesetzt waren, wurden mittels der militärischen Version eines diagnostischen Interviews (MI-CIDI) untersucht. Zwei Klassifikationsmodelle wurden auf die Items der Liste einsatzbezogener Stressoren des US-MHAT-VI-Reports angewendet und konfirmatorische Faktorenanalysen durchgeführt. Ergebnisse: Aufgrund hoher polychorischer Korrelationen zwischen Items verschiedener Klassen und hoch negativer Korrelationen innerhalb derselben Klasse ergaben die Faktorenanalysen keine zufriedenstellende Modellpassung. Es wurden auch keine unterschiedlichen prädiktiven Wertigkeiten im Hinblick auf einsatzbedingte psychische Erkrankungen gefunden. Schlussfolgerungen: Die Ergebnisse stimmen nicht mit denen vergangener Studien überein und sprechen für den Einfluss von spezifischen Einsatzbedingungen auf die Struktur traumatischer Stressoren.
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Affiliation(s)
| | - Michael Höfler
- Institut für klinische Psychologie und Psychotherapie und Center of Epidemiology and Longitudinal Studies (CELOS)
| | - Sabine Schönfeld
- Institut für klinische Psychologie und Psychotherapie und Center of Epidemiology and Longitudinal Studies (CELOS)
| | - Sebastian Trautmann
- Institut für klinische Psychologie und Psychotherapie und Center of Epidemiology and Longitudinal Studies (CELOS)
| | | | | | - Hans-Ulrich Wittchen
- Institut für klinische Psychologie und Psychotherapie und Center of Epidemiology and Longitudinal Studies (CELOS)
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19
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Neuhaus SJ, Crompvoets SL. Australia's servicewomen and female veterans: do we understand their health needs? Med J Aust 2013; 199:530-2. [DOI: 10.5694/mja13.10370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 08/08/2013] [Indexed: 11/17/2022]
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20
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Lange RT, Brickell TA, Ivins B, Vanderploeg RD, French LM. Variable, Not Always Persistent, Postconcussion Symptoms after Mild TBI in U.S. Military Service Members: A Five-Year Cross-Sectional Outcome Study. J Neurotrauma 2013. [DOI: 10.1089/neu.2012.2743] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Rael T. Lange
- Defense and Veterans Brain Injury Center, Bethesda, Maryland
- Walter Reed National Military Medical Center, Bethesda, Maryland
- University of British Columbia, Vancouver, British Columbia, Canada
- Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland
| | - Tracey A. Brickell
- Defense and Veterans Brain Injury Center, Bethesda, Maryland
- Walter Reed National Military Medical Center, Bethesda, Maryland
- Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland
| | - Brian Ivins
- Defense and Veterans Brain Injury Center, Bethesda, Maryland
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Rodney D. Vanderploeg
- Defense and Veterans Brain Injury Center, Bethesda, Maryland
- James A. Haley Veterans' Hospital, Tampa, Florida
- Departmens of Psychology and Psychiatry and Neurosciences, University of South Florida, Tampa, Florida
| | - Louis M. French
- Defense and Veterans Brain Injury Center, Bethesda, Maryland
- Walter Reed National Military Medical Center, Bethesda, Maryland
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland
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Ragsdale KA, Neer SM, Beidel DC, Frueh BC, Stout JW. Posttraumatic stress disorder in OEF/OIF veterans with and without traumatic brain injury. J Anxiety Disord 2013; 27:420-6. [PMID: 23746495 DOI: 10.1016/j.janxdis.2013.04.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 04/13/2013] [Indexed: 10/26/2022]
Abstract
Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting with high rates of co-occurring posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The purpose of this study was to compare the clinical presentations of combat-veterans with PTSD and TBI (N = 40) to those with PTSD only (N = 56). Results suggest that the groups present two distinct clinical profiles, with the PTSD + TBI group endorsing significantly higher PTSD scores, higher overall anxiety, and more functional limitations. The higher PTSD scores found for the PTSD + TBI group appeared to be due to higher symptom intensity, but not higher frequency, across PTSD clusters and symptoms. Groups did not differ on additional psychopathology or self-report of PTSD symptoms or executive functioning. Further analysis indicated PTSD severity, and not TBI, was responsible for group differences, suggesting that treatments implicated for PTSD would likely be effective for this population.
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Affiliation(s)
- Katie A Ragsdale
- Department of Psychology, University of Central Florida, Orlando, FL 32816-1390, USA.
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22
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Forbes D, Fletcher S, Phelps A, Wade D, Creamer M, O'Donnell M. Impact of combat and non-military trauma exposure on symptom reduction following treatment for veterans with posttraumatic stress disorder. Psychiatry Res 2013; 206:33-6. [PMID: 23068077 DOI: 10.1016/j.psychres.2012.09.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 07/04/2012] [Accepted: 09/20/2012] [Indexed: 11/27/2022]
Abstract
Military veterans with posttraumatic stress disorder (PTSD) frequently report exposure to multiple other traumas in addition to their military experiences. This study aimed to examine the impact of exposure-related factors for military veterans with PTSD on recovery after participation in a group-based treatment program. Subjects included 1548 military veterans with PTSD participating in specialist veterans' PTSD programs across Australia. The study included measures of PTSD, depression, anxiety and alcohol use. Analyses of variance found higher combat exposure was associated with more severe PTSD at intake. No differences in PTSD intake severity were evident in those with additional non-military trauma. Severity of combat exposure did not affect treatment outcomes, although those with low combat exposure and additional non-military trauma (which included high rates of molestation) did report reduced symptom improvement. These findings have implications for considerations of optimal interventions for those with lower levels of combat exposure and additional non-military trauma.
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Affiliation(s)
- David Forbes
- Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Australia.
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23
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Kok BC, Herrell RK, Thomas JL, Hoge CW. Posttraumatic stress disorder associated with combat service in Iraq or Afghanistan: reconciling prevalence differences between studies. J Nerv Ment Dis 2012; 200:444-50. [PMID: 22551799 DOI: 10.1097/nmd.0b013e3182532312] [Citation(s) in RCA: 122] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Studies of posttraumatic stress disorder (PTSD) prevalence associated with deployment to Iraq or Afghanistan report wide variability, making interpretation and projection for research and public health purposes difficult. This article placed this literature within a military context. Studies were categorized according to deployment time-frame, screening case definition, and study group (operational infantry units exposed to direct combat versus population samples with a high proportion of support personnel). Precision weighted averages were calculated using a fixed-effects meta-analysis. Using a specific case definition, the weighted postdeployment PTSD prevalence was 5.5% (95% CI, 5.4-5.6) in population samples and 13.2% (12.8-13.7) in operational infantry units. Both population-level and unit-specific studies provided valuable and unique information for public health purposes; understanding the military context is essential for interpreting prevalence studies.
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Affiliation(s)
- Brian C Kok
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.
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24
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Mota NP, Medved M, Wang J, Asmundson GJG, Whitney D, Sareen J. Stress and mental disorders in female military personnel: comparisons between the sexes in a male dominated profession. J Psychiatr Res 2012; 46:159-67. [PMID: 22024487 DOI: 10.1016/j.jpsychires.2011.09.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 09/09/2011] [Accepted: 09/29/2011] [Indexed: 12/19/2022]
Abstract
The proportion of women in militaries is growing; however, many studies in the area of military mental health have been conducted with majority male samples. The present study examined sex differences in trauma exposure, work stress, and mental disorders in the Canadian Community Health Survey - Canadian Forces Supplement, a representative sample of 5155 regular force personnel and 3286 reservists ages 16-54. Past-year DSM-IV mental disorders (depression, generalized anxiety disorder, panic disorder, social phobia, PTSD, and alcohol dependence), lifetime exposure to 28 traumatic events, and work stress were assessed. Regular and reserve female personnel were less likely than males to experience deployment-related traumas, accidents, and several events involving violence (adjusted odds ratio [AOR] range 0.10-0.62). Women were more likely to endorse sexual trauma, partner abuse, and being stalked (AOR range 3.60-13.63). For work stress, regular force women reported higher levels of job demand and stress around social support than men, whereas regular and reserve force women reported less physical exertion. After adjusting for a range of covariates, regular female personnel were more likely than males to have PTSD (AOR 1.88, 99% CI 1.01-3.50), while reservist women were more likely than men to have depression, panic disorder, and any mood or anxiety disorder (AOR range 1.87-6.98). Both regular and reservist women had lower rates of alcohol dependence (AOR range 0.30-0.34). Clinicians working with female personnel should screen for trauma/stressors and mental disorders that are particularly common in this population.
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Affiliation(s)
- Natalie P Mota
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
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Katz LS, Cojucar G, Davenport C, Clarke S, Williams JC. War Experiences Inventory: Initial Psychometric and Structural Properties. MILITARY PSYCHOLOGY 2012. [DOI: 10.1080/08995605.2012.642291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Lori S. Katz
- a VA Long Beach Healthcare System , Long Beach , California , USA
| | - Geta Cojucar
- a VA Long Beach Healthcare System , Long Beach , California , USA
| | - Cory Davenport
- a VA Long Beach Healthcare System , Long Beach , California , USA
| | - Satish Clarke
- a VA Long Beach Healthcare System , Long Beach , California , USA
| | - John C. Williams
- a VA Long Beach Healthcare System , Long Beach , California , USA
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Mattocks KM, Haskell SG, Krebs EE, Justice AC, Yano EM, Brandt C. Women at war: understanding how women veterans cope with combat and military sexual trauma. Soc Sci Med 2011; 74:537-45. [PMID: 22236641 DOI: 10.1016/j.socscimed.2011.10.039] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Revised: 10/19/2011] [Accepted: 10/24/2011] [Indexed: 11/25/2022]
Abstract
The wars in Iraq (Operation Iraqi Freedom, OIF) and Afghanistan (Operation Enduring Freedom, OEF) have engendered a growing population of US female veterans, with women now comprising 15% of active US duty military personnel. Women serving in the military come under direct fire and experience combat-related injuries and trauma, and are also often subject to in-service sexual assaults and sexual harassment. However, little is known regarding how women veterans cope with these combat and military sexual trauma experiences once they return from deployment. To better understand their experiences, we conducted semi-structured interviews with nineteen OEF/OIF women veterans between January-November 2009. Women veterans identified stressful military experiences and post-deployment reintegration problems as major stressors. Stressful military experiences included combat experiences, military sexual trauma, and separation from family. Women had varying abilities to address and manage stressors, and employed various cognitive and behavioral coping resources and processes to manage their stress.
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Affiliation(s)
- Kristin M Mattocks
- Department of Veterans Affairs, Health Services Research and Development Services 810 Vermont Avenue Northwest, Washington DC 20420-0002, USA.
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Elhai JD, de Francisco Carvalho L, Miguel FK, Palmieri PA, Primi R, Christopher Frueh B. Testing whether posttraumatic stress disorder and major depressive disorder are similar or unique constructs. J Anxiety Disord 2011; 25:404-10. [PMID: 21129914 DOI: 10.1016/j.janxdis.2010.11.003] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Revised: 10/20/2010] [Accepted: 11/08/2010] [Indexed: 11/25/2022]
Abstract
Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) co-occur frequently, are highly correlated, and share three symptoms in common. In the present paper, the authors tested whether PTSD and MDD are similar or unique constructs by examining their symptoms using Rasch modeling. Data were used from the 766 trauma-exposed subjects in the National Comorbidity Survey-Replication (conducted in the early 2000s) with PTSD and MDD symptom ratings. Results demonstrate that MDD symptoms were less frequently endorsed than PTSD symptoms-even for the three symptoms shared between the disorders. PTSD and MDD items represented a single, underlying dimension, although modest support was found for a secondary sub-factor. Removing their shared symptoms, and additional depression-related dysphoria symptoms, continued to result in a single underlying PTSD-MDD symptom dimension. Results raise further questions about PTSD's distinctiveness from MDD, and the causes of their comorbidity.
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Affiliation(s)
- Jon D Elhai
- Department of Psychology, University of Toledo, Toledo, OH 43606-3390, USA
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Gewirtz AH, Polusny MA, DeGarmo DS, Khaylis A, Erbes CR. Posttraumatic stress symptoms among National Guard soldiers deployed to Iraq: associations with parenting behaviors and couple adjustment. J Consult Clin Psychol 2011; 78:599-610. [PMID: 20873896 DOI: 10.1037/a0020571] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE In this article, we report findings from a 1-year longitudinal study examining the impact of change in posttraumatic stress disorder (PTSD) symptoms following combat deployment on National Guard soldiers' perceived parenting and couple adjustment 1 year following return from Iraq. METHOD Participants were 468 Army National Guard fathers from a brigade combat team (mean age = 36 years; median deployment length = 16 months; 89% European American, 5% African American, 6% Hispanic American). Participants completed an in-theater survey 1 month before returning home from Operation Iraqi Freedom deployment (Time 1) and again 1 year postdeployment (Time 2). The PTSD Checklist-Military Version (PCL-M; Weathers, Litz, Herman, Huska, & Keane, 1993) was gathered at both times, and 2 items assessing social support were gathered at baseline only. At Time 2, participants also completed self-report measures of parenting (Alabama Parenting Questionnaire-Short Form; Elgar, Waschbusch, Dadds, & Sigvaldason, 2007), couple adjustment (Dyadic Adjustment Scale-7; Sharpley & Rogers, 1984; Spanier, 1976), parent-child relationship quality (4 items from the Social Adjustment Scale-Self-Report; Weissman & Bothwell, 1976), alcohol use (Alcohol Use Disorders Identification Test; Babor, Higgins-Biddle, Saunders, & Monteiro, 2001), and items assessing injuries sustained while deployed. RESULTS Structural equation modeling analyses showed that increases in PTSD symptoms were associated with poorer couple adjustment and greater perceived parenting challenges at Time 2 (both at p < .001). Furthermore, PTSD symptoms predicted parenting challenges independent of their impact on couple adjustment. CONCLUSIONS Findings highlight the importance of investigating and intervening to support parenting and couple adjustment among combat-affected National Guard families.
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Affiliation(s)
- Abigail H Gewirtz
- Department of Family Social Science, University of Minnesota, 290 McNeal Hall, 1985 Buford Avenue, St. Paul, MN 55108, USA.
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