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Clary KL, Campbell C, Chiu C. Qualitatively Exploring Mental Health Attitude Changes among Emerging Adult Motivational Interviewing after One Motivational Enhanced Interview. CLINICAL SOCIAL WORK JOURNAL 2022; 50:445-457. [PMID: 35493776 PMCID: PMC9028893 DOI: 10.1007/s10615-022-00837-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/25/2022] [Indexed: 05/30/2023]
Abstract
UNLABELLED Emerging adult military members and veterans (MMV) are experiencing many transitions (e.g., adulthood, military). The sum of these changes can cause stress, anxiety, and mental health challenges. Stigma of mental health and treatment exists, and military populations are often not seeking or engaging in appropriate care. Recent research emphasizes the need to uncover mental health attitudes and self-stigma barriers regarding help seeking. We evaluated the impact of a single motivational-interviewing enhanced interview with 26 MMV, all who reported high risk substance use. In 75-minute interviews with the primary focus of discussing their experiences regarding mental health, substance use, and identity development, the interviewer incorporated motivational interviewing strategies (e.g., affirmations, complex reflections). Participants shared their developmental experiences, stressors transitioning, and barriers and stigma around mental health treatment. Participants completed a survey which included a variety of standardized measures and open-ended questions two weeks before and after the interview. Qualitative follow-up data via open ended questions shows the session was well received by participants as they could share their stories, think critically about their military experiences, and brainstorm solutions for mental health care. We conclude that using individual, confidential interviews to discuss sensitive topics for data collection with MMV is an area to continue developing. Conducting qualitative research with motivational interviewing strategies has the potential to be twofold: advance scholarship and inform practitioners, but also serve as a therapeutic platform for some participants. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10615-022-00837-z.
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Affiliation(s)
- Kelly Lynn Clary
- School of Social Work, Texas State University, 601 University Drive; Encino Hall, 78666 San Marcos, TX United States
| | - Corey Campbell
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, United States
| | - Chungyi Chiu
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, United States
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Larsen SE, Larson ER, Hunt JC, Lorber WG, deRoon-Cassini TA. Interaction Between Psychiatric Symptoms and History of Mild TBI When Evaluating Postconcussion Syndrome in Veterans. Mil Med 2020; 185:161-167. [PMID: 31498405 DOI: 10.1093/milmed/usz193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Symptoms of postconcussive syndrome (PCS) after mild TBI (mTBI) have been shown to resolve quickly, yet new research raises questions about possible long-term effects of this condition. It is not clear how best to address assessment and treatment when someone reports lingering symptoms of PCS. One self-report measure used by the VA and the DoD is the Neurobehavioral Symptom Inventory (NSI), but this measure may be affected by underlying psychiatric symptoms. We investigated whether the NSI is sensitive to mTBI after considering a number of psychiatric and demographic factors. METHODS This study examined which factors are associated with NSI scores in a Veteran sample (n = 741) that had recently returned from deployment. RESULTS Post-traumatic stress disorder (PTSD) and depression accounted for most of the variance on the NSI. Although history of mTBI was initially related to NSI, this association was no longer significant after other covariates were considered. CONCLUSIONS The NSI score was primarily explained by symptoms of PTSD and depression, suggesting that the NSI is not specific to the experience of a brain injury. We recommend cautious interpretation when this measure is used in the chronic phase after mTBI, especially among patients with comorbid depression or PTSD.
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Affiliation(s)
- Sadie E Larsen
- Division of Mental Health, Milwaukee VA Medical Center, 5000 W, National Avenue, Milwaukee, WI 53295.,Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 1155 N, Mayfair Road, Wauwatosa, WI 53226
| | - Eric R Larson
- Division of Mental Health, Milwaukee VA Medical Center, 5000 W, National Avenue, Milwaukee, WI 53295.,Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 1155 N, Mayfair Road, Wauwatosa, WI 53226
| | - Joshua C Hunt
- Department of Surgery, Division of Trauma & Critical Care, Medical College of Wisconsin, 9200 W, Wisconsin Avenue, Milwaukee, WI 53226 Larsen SE, Lorber W, and deRoon-Cassini TA, Are TBI symptoms specific to TBI?, Poster presented at the International Society for Traumatic Stress Studies Thirty-first Annual Meeting in New Orleans, LA, 11/2015. Hunt JC, Larsen SE, Larson ER, Lorber WG, and deRoon-Cassini TA. Interaction between psychiatric symptoms and history of mild TBI when evaluating postconcussion syndrome in Veterans, Poster presented at the annual Military Health Research Symposium in Kissimmee, FL, 08/2018. Abstract number MHSRS-18-0593-TBI
| | - William G Lorber
- Division of Mental Health, Milwaukee VA Medical Center, 5000 W, National Avenue, Milwaukee, WI 53295.,Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 1155 N, Mayfair Road, Wauwatosa, WI 53226
| | - Terri A deRoon-Cassini
- Department of Surgery, Division of Trauma & Critical Care, Medical College of Wisconsin, 9200 W, Wisconsin Avenue, Milwaukee, WI 53226 Larsen SE, Lorber W, and deRoon-Cassini TA, Are TBI symptoms specific to TBI?, Poster presented at the International Society for Traumatic Stress Studies Thirty-first Annual Meeting in New Orleans, LA, 11/2015. Hunt JC, Larsen SE, Larson ER, Lorber WG, and deRoon-Cassini TA. Interaction between psychiatric symptoms and history of mild TBI when evaluating postconcussion syndrome in Veterans, Poster presented at the annual Military Health Research Symposium in Kissimmee, FL, 08/2018. Abstract number MHSRS-18-0593-TBI
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Duncan JM, Reed-Fitzke K, Ferraro AJ, Wojciak AS, Smith KM, Sánchez J. Identifying Risk and Resilience Factors Associated With the Likelihood of Seeking Mental Health Care Among U.S. Army Soldiers-in-Training. Mil Med 2020; 185:e1247-e1254. [PMID: 32077952 DOI: 10.1093/milmed/usz483] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/08/2019] [Accepted: 09/10/2019] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The Department of Defense aims to maintain mission readiness of its service members. Therefore, it is important to understand factors associated with treatment seeking in order to identify areas of prevention and intervention early in a soldier's career that can promote positive functioning and increase their likelihood of seeking mental health care when necessary. METHOD Using a theory of planned behavior lens, this study identified potential barriers (risk) and facilitators (resilience) to treatment seeking among 24,717 soldiers-in-training who participated in the New Soldiers Study component of the "Army Study to Assess Risk and Resilience in Servicemembers" (Army STARRS). Approval for this study was granted by the University of Iowa IRB # 201706739. Hierarchal linear regression modeling and independent samples t-tests were used to examine associations between demographics and study variables, intersections of risk and resilience, and to explore differences in the likelihood of seeking help based on mental health diagnoses. RESULTS A four-stage hierarchical linear regression was conducted, using likelihood of help-seeking as the dependent variable, to identify the most salient factors related to help-seeking. "Step one" of the analysis revealed soldiers-in-training who identified as female, Hispanic or Other ethnicity, and married, divorced, or separated reported a greater likelihood of seeking help. "Step two" of the analysis indicated soldiers-in-training with a history of sexual trauma, experience of impaired parenting, and clinical levels of mental health symptomatology (anxiety, depression, PTSD) reported a greater likelihood of seeking help. Inversely, soldiers-in-training with a history of emotional trauma and parental absence/separation reported a lower likelihood of seeking help. "Step three" of the analysis demonstrated soldiers-in-training with a prior history of seeking help and larger social networks had a greater likelihood of seeking help. "Step four" of the analysis revealed several interactive effects between risk and resilience factors. Specifically, soldiers-in-training who reported greater depressive symptomatology in combination with prior history of treatment seeking reported a greater likelihood of help seeking, whereas soldiers-in-training who reported prior sexual trauma and PTSD in combination with large social networks reported a lower likelihood of seeking help. Finally, a greater percentage of soldiers-in-training with clinical levels of anxiety, depression, and PTSD indicated they would likely seek help in comparison to soldiers-in-training without clinical symptoms. CONCLUSION Findings suggest few soldiers-in-training are likely to seek help when experiencing a problem. General efforts to encourage help-seeking when needed are warranted with particular focus on subsets of soldiers-in-training (eg, men, those with a history of some adverse childhood experiences). Strengths of this study include the examination of a large sample of soldiers-in-training to identify possible leverage points for early intervention or prevention prior to entering stressful military operating environments. Limitations of this study include the examination of only one military branch and exclusion of soldiers not "in-training." Future studies could consider replicating the current study using a sample of military personnel longitudinally to track behavioral trends as well as looking at military populations outside of basic combat training.
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Affiliation(s)
- James M Duncan
- Dale Bumpers College of Agricultural, Food and Life Sciences, The University of Arkansas, 118 Human Environmental Sciences Building, 987 W. Maple St., Fayetteville, AR 72701
| | - Kayla Reed-Fitzke
- College of Education, The University of Iowa, 361 Lindquist Center, 240 South Madison Street, Iowa City, IA 52242
| | - Anthony J Ferraro
- College of Health & Human Sciences, The Kansas State University, 312 Justin Hall, 1324 Lovers Lane Manhattan, KS 66506
| | - Armeda S Wojciak
- College of Education, The University of Iowa, 361 Lindquist Center, 240 South Madison Street, Iowa City, IA 52242
| | - Kevin M Smith
- College of Education, The University of Iowa, 361 Lindquist Center, 240 South Madison Street, Iowa City, IA 52242
| | - Jennifer Sánchez
- College of Education, The University of Iowa, 361 Lindquist Center, 240 South Madison Street, Iowa City, IA 52242
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