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Yuan Q, Chen Y, Liu S, Huang Q, Liao M, Zhou J, Li Z, Li Y. UN peacekeeper health and risk factors --- a systematic scoping review. Glob Health Res Policy 2024; 9:13. [PMID: 38600572 PMCID: PMC11005225 DOI: 10.1186/s41256-024-00351-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/31/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Conflicts, natural disasters, and complex emergencies present substantial health challenges to United Nations (UN) peacekeepers deployed in mission areas. This scoping review aims at summarizing previous research on the health of UN peacekeepers and identifies issues for further investigation. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews, we systematically searched Web of Science, PubMed, EMBASE, Scopus and China National Knowledge Infrastructure (CNKI) for English and Chinese literature published from April 1997 to November 2023. A data charting form was developed by two reviewers to extract relevant themes and provided narrative descriptions. RESULTS We screened 1079 de-duplicated records and included 143 studies in this scoping review. There were 112 studies on the health status of UN peacekeepers, with more than half on mental health problems such as stress and anxiety. Many studies explored the health status of UN peacekeepers in African countries deployed from mainly U.S., Canada, U.K., China, Australia and Norway. There were 39 studies on the health risk factors of UN peacekeepers, including natural environmental, social environmental, psychological, behavioral lifestyle, biological factors and health service factors. There were 62 articles on the health protection of UN peacekeepers, mainly based on previous deployment experience, with a lack of theoretical guidance from global health perspectives. This scoping review found that health problems of UN peacekeepers are complicated, and whose impacts are cross-border. Social environmental factors were explored the most among health risk factors. Disease prevention measures, medical and health measures, and psychosocial measures were the main health protection for UN peacekeepers. CONCLUSIONS This scoping review highlighted that health problems of UN peacekeepers were typical global health issues with complicated and cross-border health risk factors. Therefore, comprehensive strategies could be taken from global health perspectives, including multi-phases (before-deployment, during-deployment, and post-deployment), multi-disciplines (public health, medicine, politics, health diplomacy, and others), and multi-levels (the UN, host countries, troop-contributing countries, the UN peacekeeping team, and UN peacekeepers).
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Affiliation(s)
- Quan Yuan
- Department of Social Medicine and Health Service Management, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yong Chen
- Department of Social Medicine and Health Service Management, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shili Liu
- Department of Social Medicine and Health Service Management, Army Medical University (Third Military Medical University), Chongqing, China
| | - Qingning Huang
- Department of Social Medicine and Health Service Management, Army Medical University (Third Military Medical University), Chongqing, China
| | - Miaomiao Liao
- Department of Social Medicine and Health Service Management, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiani Zhou
- Department of Social Medicine and Health Service Management, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhaogang Li
- Department of Social Medicine and Health Service Management, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ying Li
- Department of Social Medicine and Health Service Management, Army Medical University (Third Military Medical University), Chongqing, China.
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de Goede ML, van der Aa N, Mooren TM, Olff M, ter Heide FJJ. Potentially morally injurious experiences and associated factors among Dutch UN peacekeepers: a latent class analysis. Eur J Psychotraumatol 2024; 15:2332105. [PMID: 38577910 PMCID: PMC11000606 DOI: 10.1080/20008066.2024.2332105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/11/2024] [Indexed: 04/06/2024] Open
Abstract
Background: During peacekeeping missions, military personnel may be involved in or exposed to potentially morally injurious experiences (PMIEs), such as an inability to intervene due to a limited mandate. While exposure to such morally transgressive events has been shown to lead to moral injury in combat veterans, research on moral injury in peacekeepers is limited.Objective: We aimed to determine patterns of exposure to PMIEs and associated outcome- and exposure-related factors among Dutch peacekeepers stationed in the former Yugoslavia during the Srebrenica genocide.Method: Self-report data were collected among Dutchbat III veterans (N = 431). We used Latent Class Analysis to identify subgroups of PMIE exposure as assessed by the Moral Injury Scale-Military version. We investigated whether deployment location, posttraumatic stress disorder (PTSD), posttraumatic growth, resilience, and quality of life differentiated between latent classes.Results: The analysis identified a three-class solution: a high exposure class (n = 79), a moderate exposure class (n = 261), and a betrayal and powerlessness-only class (n = 135). More PMIE exposure was associated with deployment location and higher odds of having probable PTSD. PMIE exposure was not associated with posttraumatic growth. Resilience and quality of life were excluded from analyses due to high correlations with PTSD.Conclusions: Peacekeepers may experience varying levels of PMIE exposure, with more exposure being associated with worse outcomes 25 years later. Although no causal relationship may be assumed, the results emphasize the importance of better understanding PMIEs within peacekeeping.
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Affiliation(s)
- Mariëlle L. de Goede
- ARQ Centrum‘45, Diemen, the Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | | | - Trudy M. Mooren
- ARQ Centrum‘45, Diemen, the Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | - Miranda Olff
- ARQ National Psychotrauma Center, Diemen, the Netherlands
- Department of Psychiatry, Amsterdam University Medical Centers location AMC, Amsterdam, the Netherlands
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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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Levi O, Lubin G. Treatment seeking for posttraumatic stress in Israel Defense Forces veterans deployed in the Second Lebanon War (2006) and “Operation Cast Lead” in the Gaza Strip (2009): a comparative study. ANXIETY STRESS AND COPING 2018; 31:328-337. [DOI: 10.1080/10615806.2017.1421179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ofir Levi
- Division of Mental Health, Medical Corps, Israel Defense Forces, Israel
- Social Work Department, Ruppin Academic Center, Emek Hefer, Israel
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Gadi Lubin
- Division of Mental Health, Medical Corps, Israel Defense Forces, Israel
- The Jerusalem Mental Health Center (Eitanim–Kfar Shaul), Jerusalem, Israel
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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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Huang HH, Kashubeck-West S. Exposure, Agency, Perceived Threat, and Guilt as Predictors of Posttraumatic Stress Disorder in Veterans. JOURNAL OF COUNSELING AND DEVELOPMENT 2015. [DOI: 10.1002/j.1556-6676.2015.00176.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
This chapter describes how the impact of psychological trauma and posttraumatic stress disorder (PTSD) differ, depending on individual differences and the social and cultural context and culture-specific teachings and resources available to individuals, families, and communities. A social-ecological framework is used to differentiate the impact of exposure to traumatic stressors and the development of (or resistance to) PTSD, based on the individual’s or group’s (i) personal, unique physical characteristics, including skin color, racial background, gender, and sexual orientation; and (ii) family, ethnocultural, and community membership, including majority or minority group status, religious beliefs and practices, socioeconomic resources, and political and civic affiliations. While personal, familial, social, and cultural factors can be a positive resource contributing to safety and well-being, they also can be a basis for placing the person, group, or entire community or population in harm’s way or at heightened risk of developing PTSD.
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Xu J, Deng Y. Mental health service use one year after China 5.12 earthquake: Relationship with post-traumatic stress disorder among survivors. J Ment Health 2013; 22:509-18. [DOI: 10.3109/09638237.2013.819419] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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BRAMSEN INGE. Psychopathological View of Posttraumatic Stress Reactions is in the Eye of the Beholder. A Commentary on Schok et al. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2012. [DOI: 10.1111/j.1559-1816.2012.00906.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
A meta-analysis was conducted to estimate the prevalence of posttraumatic stress disorder (PTSD) among peacekeepers. A systematic review was carried out using Medline, Institute for Scientific Information/Web of Science and Published International Literature on Traumatic Stress databases, leading to a total of 12 studies reporting PTSD estimates. Pooled current PTSD prevalence was 5.3%, ranging from 0.05% to 25.8%, and a metaregression was used to investigate the variables that could account for the lack of homogeneity. However, none of the extracted information was capable of explaining the heterogeneity of the estimates. Peacekeeping studies presented different methodologies such as several screening instruments and different times from the deployment to the moment of PTSD assessment. The wide difference found among those estimates highlights the importance of the creation of standards for PTSD evaluation among peacekeepers.
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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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Rademaker AR, Kleber RJ, Meijer ME, Vermetten E. Investigating the MMPI-2 trauma profile in treatment-seeking peacekeepers. J Pers Assess 2010; 91:593-600. [PMID: 19838909 DOI: 10.1080/00223890903230899] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Most available research on MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) scores in combat veterans suffering from posttraumatic stress disorder (PTSD) has focused on Vietnam veterans. No data are available from peacekeepers suffering from PTSD. The aim of this study was to investigate the relationship between PTSD and the MMPI-2 in a sample of 120 treatment seeking peacekeeping veterans. Results show that relative to a non-PTSD reference group, veterans who screened positive for PTSD scored higher on Scales F, 2 (D), 4 (Pd), 6 (Pa), 7 (Pt), 8 (Sc), and 0 (Si) of the MMPI-2. Scales 2 (D), 7 (Pt), and 8 (Sc) were highest in the mean PTSD profile but no 2- or 3-point code type could be defined. Moderate correlations were found between a self-report measure for PTSD symptoms and scores on MMPI-2 clinical scales 1 (Hs), 2 (D), 6 (Pa), 7 (Pt), and 8 (Sc). The MMPI-2 proved to be useful in assessing the broad range of symptoms typically present in trauma populations as well as the severity of posttraumatic morbidity.
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Affiliation(s)
- Arthur R Rademaker
- Department of Clinical & Health Psychology, Utrecht University, Utrecht, The Netherlands.
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Nayback AM. Posttraumatic stress: a concept analysis. Arch Psychiatr Nurs 2009; 23:210-9. [PMID: 19446776 DOI: 10.1016/j.apnu.2008.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Revised: 06/02/2008] [Accepted: 06/04/2008] [Indexed: 11/17/2022]
Abstract
The purpose of this article is to examine the phenomenon of "posttraumatic stress" using the process of concept analysis as outlined in L. O. Walker and K. C. Avant's (2005) Strategies for Theory Construction in Nursing. Epidemiological studies estimate that approximately 15% to 24% of adults in America experience posttraumatic stress disorder (PTSD) at some point in their lives. Therefore, it is critical for mental health care professionals to understand its historical evolution, the origins of its name, defining attributes, antecedents and consequences, model cases, and empirical referents. In doing so, a more thorough understanding of the underlying attributes of PTSD will be explicated along with related taxonomies.
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Nayback AM. PTSD in the combat veteran: using Roy's Adaptation Model to examine the combat veteran as a human adaptive system. Issues Ment Health Nurs 2009; 30:304-10. [PMID: 19437249 DOI: 10.1080/01612840902754404] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Posttraumatic stress disorder (PTSD) is the most prevalent mental disorder arising from combat and is poised to be a considerable health risk for our military veterans. To date, there is a paucity of nursing research that examines PTSD in this vulnerable population. The purpose of this article is to demonstrate how Roy's Adaptation Model can be an effective framework for nurses to understand the phenomenon of posttraumatic stress disorder in the combat veteran population. Current research conducted on PTSD across other disciplines is highlighted within the context of Roy's model to elucidate the idea of the combat veteran as a human adaptive system and to identify gaps for future nursing research.
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Richardson JD, Pekevski J, Elhai JD. Post-traumatic stress disorder and health problems among medically ill Canadian peacekeeping veterans. Aust N Z J Psychiatry 2009; 43:366-72. [PMID: 19296293 DOI: 10.1080/00048670902721061] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of the present study was to examine the relationship between post-traumatic stress disorder (PTSD) symptom severity and four significant health conditions (gastrointestinal disorders, musculoskeletal problems, headaches, and cardiovascular problems). METHOD Participants included 707 Canadian peacekeeping veterans with service-related disabilities, from a random, national Canadian survey, who had been deployed overseas. RESULTS PTSD severity was significantly related to gastrointestinal disorders, musculoskeletal problems, and headaches, but not to cardiovascular problems. Controlling for demographic factors did not affect PTSD's relationships with the three significant health conditions. CONCLUSIONS The present study supports previous work in finding consistent relations between PTSD severity and specific types of medical problems.
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Affiliation(s)
- J Don Richardson
- Operational Stress Injury Clinic, Parkwood Hospital, St Joseph's Health Care London, University of Western Ontario, Ontario, Canada.
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Emmerik IJHV, Euwema MC. The international assignments of peacekeepers: What drives them to seek future expatriation? HUMAN RESOURCE MANAGEMENT 2009. [DOI: 10.1002/hrm.20270] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Klaassens ER, van Veen T, Weerts JMP, Zitman FG. Mental health of Dutch peacekeeping veterans 10-25 years after deployment. Eur Psychiatry 2008; 23:486-90. [PMID: 18513928 DOI: 10.1016/j.eurpsy.2008.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Revised: 03/13/2008] [Accepted: 03/16/2008] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This report describes the mental health of Dutch peacekeeping veterans, 10--25 years after deployment, and its association with deployment-related traumatic events. METHOD We randomly selected a group of 1046 peacekeeping veterans, who participated in military missions in Lebanon, former Yugoslavia, and various other missions between 1979 and 1997. We sent a questionnaire assessing current levels of psychological distress (Brief Symptom Inventory--BSI), and a questionnaire assessing trauma related to deployment. RESULTS Psychological data were available for 729 veterans. In 83% of the veterans, no significant psychological distress was found, whereas 17% scored above the BSI cut-off for psychopathology. Interestingly, this percentage was equal to that in a non-patient norm group. CONCLUSION From this finding we concluded that 10--25 years post-deployment, Dutch peacekeeping veterans do not show more psychological distress than the general Dutch population. In addition, we did not find a significant association between trauma exposure 10--25 years ago and current BSI scores. Moreover, trauma-exposure explained only 9% of the variance in psychological distress. Thus, although military peacekeeping operations may have a strong impact on the lives of soldiers, in this group of veterans they do not seem to have caused severe psychological distress10--25 years after deployment.
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Affiliation(s)
- Ellen R Klaassens
- Department of Psychiatry, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
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Ford JD. Trauma, posttraumatic stress disorder, and ethnoracial minorities: Toward diversity and cultural competence in principles and practices. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1468-2850.2008.00110.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Turner JB, Turse NA, Dohrenwend BP. Circumstances of service and gender differences in war-related PTSD: findings from the National Vietnam Veteran Readjustment Study. J Trauma Stress 2007; 20:643-9. [PMID: 17721956 DOI: 10.1002/jts.20245] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Data from the National Vietnam Veteran Readjustment Study (NVVRS) revealed a prevalence of current posttraumatic stress disorder (PTSD) in female Vietnam Theater veterans half the size of the prevalence in their male counterparts. This stands in contrast to the elevated prevalence of PTSD in women obtained in general population surveys. This study undertakes further analyses of gender differences in the NVVRS and how these differences might be specified by the amount and type of exposure to war-zone stress. The findings indicate that male elevations in PTSD are limited to men who served under circumstances of high probable severity of war-zone stress exposure. When prewar demographic differences are controlled, male veterans in low-exposure circumstances display a level of PTSD prevalence substantially lower than female veterans.
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Affiliation(s)
- J Blake Turner
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA.
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Dirkzwager AJE, Bramsen I, Adèr H, van der Ploeg HM. Secondary traumatization in partners and parents of Dutch peacekeeping soldiers. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2005; 19:217-26. [PMID: 15982097 DOI: 10.1037/0893-3200.19.2.217] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This study examines secondary traumatization among 708 partners and 332 parents of Dutch peacekeepers (i.e., personnel who participated in military actions implemented by international organizations such as the United Nations). Partners or parents of peacekeepers with 4 levels of posttraumatic stress symptoms were compared on posttraumatic stress, health problems, the quality of the marital relationship, and social support. In comparison with partners of peacekeepers without posttraumatic stress disorder (PTSD) symptoms, partners of peacekeepers with PTSD symptoms reported more sleeping and somatic problems, reported more negative social support, and judged the marital relationship as less favorable. No significant differences were found for parents. Thus, peacekeepers' stress reactions were related to various problems of their partners. A systemic approach to the treatment of persons with PTSD appears appropriate.
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Affiliation(s)
- Anja J E Dirkzwager
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands.
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