Mental Health During Naval Deployment: The Protective Role of Family Support

Long-term risk for mental health symptoms in Dutch ISAF veterans: the role of perceived social support

BACKGROUND

Military personnel deployed to combat and peacekeeping missions are exposed to high rates of traumatic events. Accumulating evidence suggests an important association between deployment and the development of other mental health symptoms beyond post-traumatic stress disorder.

METHODS

This study examined the prevalence of agoraphobia, anxiety, depression, and hostility symptoms in a cohort of Dutch ISAF veterans (N = 978) from pre-deployment up to 10 years after homecoming. The interaction of potential moderating factors with the change in mental health symptoms relative to pre-deployment was investigated at each time point.

RESULTS

The probable prevalence of agoraphobia, anxiety, depression, and hostility symptoms significantly increased over time to respectively 6.5, 2.7, 3.5, and 6.2% at 10 years after deployment. Except for hostility symptoms, the probable prevalence at 10 years after deployment was the highest compared to all previous follow-up assessments. Importantly, less perceived social support after returning from deployment was found as a risk factor for all different mental health symptoms. Unit support was not associated with the development of mental health problems.

CONCLUSIONS

This study suggests a probable broad and long-term impact of deployment on the mental health of military service members. Due to the lack of a non-deployed control group, causal effects of deployment could not be demonstrated. Continued effort should nevertheless be made in the diagnosis and treatment of a wide range of mental health symptoms, even a decade after deployment. The findings also underscore the importance of social support after homecoming and its potential for the prevention of long-term mental health problems.

Prevalence and predictors of anxiety disorder courses in the Canadian Armed Forces

Few studies have examined the longitudinal courses of anxiety disorders in military members. This study examined the prevalence and predictors of courses of any anxiety disorder in members and veterans of the Canadian Armed Forces, including no lifetime, remitted, new onset, and persistent/recurrent anxiety disorder. The 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey is a 16-year follow-up of n = 2941 participants from the Canadian Community Health Survey: Canadian Forces Supplement in 2002. Diagnoses of any DSM-IV anxiety disorder (i.e., generalized anxiety, social anxiety, and/or panic disorder) in 2002 and 2018 were used to create four anxiety course groups. A large proportion of the sample (36.3 %; new onset = 24.6 %, remitting = 6.9 %, and persistent/recurrent = 4.8 %) met criteria for an anxiety disorder during one or both time points. Factors at baseline and/or between 2002 and 2018, including income, education, military rank, comorbidity of PTSD or depression, deployment history, and traumatic events, were positively associated with most anxiety courses relative to no anxiety in analyses. Targeted interventions are needed to help mitigate anxiety disorders among this population. Social support and active coping were protective factors for most anxiety courses and may need to be incorporated into targeted interventions.

Risk factors for mental health symptoms during the COVID-19 pandemic in ophthalmic personnel and students in USA (& Canada): a cross-sectional survey study

BACKGROUND

The COVID-19 pandemic poses mental health challenges to frontline healthcare workers. Eye care professionals may be especially susceptible to mental health problems due to high-risk exposures to patients. Yet, no prior research has studied mental health issues among eye care professionals during the COVID-19 pandemic.

OBJECTIVE

The purpose of this study was to identify risk factors for mental health problems during the COVID-19 pandemic among eye care professionals.

METHODS

We conducted a cross-sectional survey study among eye care professionals and students in the United States and Canada from June 23 to July 8, 2020 during the COVID-19 pandemic. A total of 8505 eye care professionals and students received email invitations to the survey and 2134 participated. We measured mental health outcomes including symptoms of depression, anxiety, and stress using validated scales, as well as potential risk factors including demographic characteristics, state-level COVID-19 case counts, participants' patient interactions, childcare responsibilities, and pre-pandemic stress levels. Linear multiple regression and logistic regression analyses were used to determine relationships between risk factors and mental health outcomes.

RESULTS

We found that 38.4% of eyecare professional participants in the survey met screening threshold as probable cases of anxiety, depression, or both during the COVID-19 pandemic. Controlling for self-reported pre-pandemic stress level and state COVID-19 case daily cases, significant risk factors for depression, anxiety, and psychological stress during the COVID-19 pandemic included: being female, younger age, and being Black or Asian. Interestingly, we found two somewhat surprising protective factors against depression symptoms: more frequent interactions with patients and having a greater proportion of childcare responsibilities at home.

CONCLUSIONS

This study showed a high prevalence of mental health problems and revealed disparities in mental health among eye care personnel and students: Female, younger, Black, and Asian populations are particularly vulnerable to mental health issues. These results indicate that it is critical to identify mental health issues more effectively and develop interventions among this population to address this significant and growing public health issue. The strategies and policies should be reflective of the demographic disparities in this vulnerable population.

The Dimensionality of the 12-Item General Health Questionnaire (GHQ-12): Comparisons of Factor Structures and Invariance Across Samples and Time

Because of its brevity, the 12-item General Health Questionnaire (GHQ-12) has become one of the most popular and used measure for detecting psychological distress. Originally intended as a unidimensional measure, the majority of subsequent factor-analytic studies have failed to support GHQ-12 as a unitary construct and have instead proposed a plethora of multidimensional structures. In this study, we further examined the factor structure in two different military samples, one consisting of crewmembers from four different frigates deployed in anti-piracy operations and Standing NATO Maritime Group deployments (N = 591) and one consisting of crewmember from three different minehunters/sweepers serving in Standing NATO Mine Counter-Measures Group deployments (N = 196). Results from confirmatory factor analyses (CFA) performed in the first sample supported a bifactor model, consisting of a general factor representing communality among all items and two specific factors reflecting common variance due to wording effects (negatively and positively phrased items). A multi-group CFA further confirmed this structure to be invariant across our second sample. Structural equation modeling also showed that the general factor was strongly associated with symptoms of insomnia and mental health, whereas the specific factors were either non-significantly or considerably weaker associated with the criterion variables. Overall, our results are congruent with the notion that the multidimensionality demonstrated in many previous investigations is most likely an expression of method-specific variance caused by item wording. The explained unique variance associated with these specific factors was further relatively small. Ignoring the multidimensionality and treating GHQ-12 as a unitary construct will therefore most likely introduce minimal bias to most practical applications.