Deployment trauma and seeking treatment for PTSD in US soldiers

Differences in military personnel's hardiness depending on their leadership levels and combat experience: An exploratory pilot study

Constant challenges and permanently stressful conditions at military workplaces demand high levels of hardiness for military personnel. We aimed to determine possible differences in Ukrainian military personnel's hardiness depending on their leadership levels and existing combat experience. The study involved 543 Ukrainian service members (85.8% male and 14.2% female, aged 18 to 61 years). We used the Professional Hardiness Questionnaire and the Brief Resilience Scale. The obtained data showed that the higher leadership levels the military personnel had, the higher their hardiness was (up to the company commander level in our study). We revealed a significant predominance of professional challenge acceptance in the structure of military personnel's hardiness, followed by professional control and professional commitment. This proportion of professional hardiness components did not differ depending on service members' leadership levels. Additionally, we showed significantly higher hardiness stability after participating in combat operations in military leaders compared to service members without subordinates. Our findings necessitate hardiness examination during military personnel selection and its development during military training, in particular for deployment.

Virtual Reality Exposure Therapy for Armed Forces Veterans with Post-Traumatic Stress Disorder: A Systematic Review and Focus Group

Virtual reality exposure therapy (VRET) is an emerging treatment for people diagnosed with Post-Traumatic Stress Disorder (PTSD) due to the limited accessibility of psychotherapies. This research aims to determine the guidelines for developing a Virtual Reality–War Scenario program for Armed Forces veterans with PTSD and encompasses two studies: Study 1, a systematic electronic database review; Study 2, a focus group of twenty-two Portuguese Armed Forces veterans. Results showed a positive impact of VRET on PTSD; however, there were no group differences in most of the studies. Further, according to veterans, new VRET programs should be combined with the traditional therapy and must consider as requirements the sense of presence, dynamic scenarios, realistic feeling, and multisensorial experience. Regardless, these findings suggest VRET as a co-creation process, which requires more controlled, personalized, and in-depth research on its clinical applicability.

Moral injury, mental health and behavioural health outcomes: A systematic review of the literature

Despite a burgeoning of research on moral injury in the past decade, existing reviews have not explored the breadth of consequences and the multitude of pathways through which moral injury and potentially morally injurious experiences (PMIEs) influence mental and behavioural health outcomes. This study aimed to identify associations between moral injury on mental and behavioural health. Literature searches of psychological and medical databases were conducted through April 2020. Eligible studies measured moral injury or PMIEs, and health outcomes (e.g., depression, substance use and suicidality). Fifty-seven publications representing 49 separate samples were included. Studies examined the impact of moral injury on post-traumatic stress disorder (PTSD) (n = 43); depression (n = 32); anxiety (n = 15); suicide (n = 15); substance use (n = 14); and 'other' health outcomes, including pain, burnout, sleep disturbance and treatment-seeking behaviours (n = 11). The majority of studies found significant positive associations between moral injury-related constructs, mental health and behavioural health outcomes; however, the majority were also cross-sectional and focused on military samples. Proposed mediators included lack of social support, negative cognitions and meaning-making. Moderators included self-compassion, pre-deployment mental health education and mindfulness. Moral injury is associated with a variety of negative health outcomes. Research is needed to determine the mechanisms by which moral injury may influence these outcomes over time.