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Balmer BR, Sippola J, Beehler S. Processes and outcomes of a communalization of trauma approach: Vets & Friends community-based support groups. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:2764-2780. [PMID: 33506966 PMCID: PMC8316485 DOI: 10.1002/jcop.22516] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/27/2020] [Accepted: 12/25/2020] [Indexed: 06/12/2023]
Abstract
Veterans often experience challenges related to processing traumatic experiences and community reintegration, yet there is a dearth of research on promising community-driven approaches. This paper describes core processes and outcomes of Vets & Friends (V&F), a community-based support program that promotes veteran reintegration by healing trauma and moral injury using a communalization of trauma (CoT) approach. We conducted focus groups with 23 V&F group members. A mix of inductive and deductive codes were generated during thematic analysis. Critical themes identified included processes such as sharing narratives, connecting emotionally with experiences, feeling heard and accepted by group members, and listening as others shared their experiences. Outcomes included restoration of trust, connection with group members, building skills to manage trauma, and community acceptance and engagement. V&F shows promise in meeting veteran-specific needs by employing CoT approaches that offer opportunities to restore community trust and acceptance.
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Affiliation(s)
- B R. Balmer
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth Campus
| | - John Sippola
- Executive Director of Welcome Them Home – Help Them Heal nonprofit, Duluth, Minnesota
| | - Sarah Beehler
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth Campus
- Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC) for Suicide Prevention, Denver, Colorado
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Edmonds AT, Bensley KM, Hawkins EJ, Williams EC. Geographic differences in receipt of addictions treatment in a national sample of patients with alcohol use disorders from the U.S. Veterans Health Administration. Subst Abus 2020; 42:559-568. [DOI: 10.1080/08897077.2020.1803176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Amy T. Edmonds
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA
| | | | - Eric J. Hawkins
- Research and Development Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Services, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
- Center of Excellence in Substance Abuse Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Emily C. Williams
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA
- Research and Development Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Services, Seattle, Washington, USA
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London AS, Wilmoth JM, Oliver WJ, Hausauer JA. The Influence of Military Service Experiences on Current and Daily Drinking. Subst Use Misuse 2020; 55:1288-1299. [PMID: 32167849 DOI: 10.1080/10826084.2020.1735438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background: An extensive public health literature associates military service with increased alcohol consumption and problematic drinking. However, few well-controlled population-based studies compare alcohol use among nonveterans and veterans with diverse military service experiences, and no such study examines everyday drinking. Methods: We use population-representative data from the 2010 and 2011 Behavioral Risk Factor Surveillance System and distinguish four groups of men: nonveterans; non-combat veterans without a psychiatric disorder (PD) or traumatic brain injury (TBI); combat veterans without a PD or TBI; and veterans (non-combat and combat combined) with a PD and/or TBI. We estimate hierarchical multivariate logistic regression models of current drinking (N = 21,947) and daily drinking (among current drinkers; N = 11,491). Results from supplemental analyses are discussed. Results: Relative to nonveterans, non-combat veterans with no PD or TBI and veterans with a PD and/or TBI, respectively, but not combat veterans with no PD or TBI, are more likely to be current drinkers. Among current drinkers, non-combat and combat veterans with no PD or TBI, respectively, are less likely than nonveterans to be daily drinkers. Conversely, among current drinkers, veterans with a PD and/or TBI are more likely to be daily drinkers than nonveterans, non-combat veterans with no PD or TBI, and combat veterans with no PD or TBI. Conclusion: We document heterogeneous and countervailing influences of military service experiences on current and daily drinking. Results indicate that harmful military service experience may be associated with an increased risk of current, moderate daily drinking, which may represent a form of self-medication.
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Affiliation(s)
- Andrew S London
- Aging Studies Institute, Syracuse University, Syracuse, NY, USA
| | - Janet M Wilmoth
- Aging Studies Institute, Syracuse University, Syracuse, NY, USA
| | - William J Oliver
- Department of Sociology, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY, USA
| | - Jessica A Hausauer
- Department of Sociology, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY, USA
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Grittner U, Wilsnack S, Kuntsche S, Greenfield TK, Wilsnack R, Kristjanson A, Bloomfield K. A Multilevel Analysis of Regional and Gender Differences in the Drinking Behavior of 23 Countries. Subst Use Misuse 2019; 55:772-786. [PMID: 31876222 PMCID: PMC7125004 DOI: 10.1080/10826084.2019.1702700] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Drinking behavior differs not only among countries, but also among regions within a country. However, the extent of such variation and the interplay between gender and regional differences in drinking have not been explored and are addressed in this study. Methods: Data stem from 105,061 individuals from 23 countries of the GENACIS data set. The outcomes were heavy drinking (10/20 g or more of pure ethanol per day for women/men), and risky single occasion drinking (RSOD) (5+ drinks per occasion) at least monthly. Analyses used binary logistic mixed models. Variance at specific levels was measured by the intra-class correlation coefficient (ICC). Gender differences in outcomes were measured using gender ratios. Results: Country-level ICC was 0.13 (95% CI: 0.09-0.18) for heavy drinking and 0.16 (95% CI: 0.10-0.26) for RSOD. Within-country regional-level ICC for heavy drinking and RSOD was 0.02 (95% CI: 0.009-0.05; 0.01-0.04, respectively), implying that 2% of variation in heavy drinking and RSOD was explained by regional variation. Variance in drinking indicators was larger for women compared to men across countries. Gender ratios were higher in low- and middle-income countries. Conclusions: Regional variations in risky drinking were more often present in low- to middle-income countries as well as in a few higher-income countries, and could be due to cultural and demographic differences. Variations in gender differences were larger on the country level than on the regional level, with lower-income countries showing larger differences. These results can help to better identify specific high-risk groups for prevention strategies.
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Affiliation(s)
- Ulrike Grittner
- Institute of Biometry and Clinical Epidemiology, Charité – Universitätsmedizin Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Sharon Wilsnack
- School of Medicine and Health Sciences, University of North Dakota, USA
| | - Sandra Kuntsche
- Centre for Alcohol Policy Research, College of Science, Health and Engineering, School of Psychology and Public Health, La Trobe University Melbourne, Australia
| | | | - Richard Wilsnack
- School of Medicine and Health Sciences, University of North Dakota, USA
| | | | - Kim Bloomfield
- Institute of Biometry and Clinical Epidemiology, Charité – Universitätsmedizin Berlin, Germany
- Centre for Alcohol & Drug Research, University of Aarhus, Denmark
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Young LB, Timko C, Tyler KA, Grant KM. Trauma in Veterans With Substance Use Disorder: Similar Treatment Need Among Urban and Rural Residents. J Rural Health 2016; 33:314-322. [DOI: 10.1111/jrh.12199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/17/2016] [Accepted: 06/27/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Lance Brendan Young
- Communication Department; Western Illinois University-Quad Cities; Moline Illinois
| | - Christine Timko
- Center for Innovation to Implementation; VA Palo Alto Health Care System; Menlo Park California
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Palo Alto California
| | - Kimberly A. Tyler
- Department of Sociology; University of Nebraska-Lincoln; Lincoln Nebraska
| | - Kathleen M. Grant
- Substance Use Disorders Program; VA Nebraska-Western Iowa Health Care System; Omaha Nebraska
- Department of Internal Medicine; University of Nebraska Medical Center; Omaha Nebraska
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Bass SB, Muñiz J, Gordon TF, Maurer L, Patterson F. Understanding help-seeking intentions in male military cadets: An application of perceptual mapping. BMC Public Health 2016; 16:413. [PMID: 27184052 PMCID: PMC4869204 DOI: 10.1186/s12889-016-3092-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 05/10/2016] [Indexed: 12/04/2022] Open
Abstract
Background Research suggests that men are less likely to seek help for depression, substance abuse, and stressful life events due to negative perceptions of asking for and receiving help. This may be exacerbated in male military cadets who exhibit higher levels of gender role conflict because of military culture. Methods This exploratory study examined the perceptions of 78 male military cadets toward help-seeking behaviors. Cadets completed the 31-item Barriers to Help Seeking Scale (BHSS) and a component factor analysis was used to generate five composite variables and compare to validated factors. Perceptual mapping and vector modeling, which produce 3-dimensional models of a group’s perceptions, were then used to model how they conceptualize help-seeking. Results Factor analysis showed slightly different groupings than the BHSS, perhaps attributed to different characteristics of respondents, who are situated in a military school compared to general university males. Perceptual maps show that cadets perceive trust of doctors closest to them and help-seeking farthest, supporting the concept that these males have rigid beliefs about having control and its relationship to health seeking. Differences were seen when comparing maps of White and non-White cadets. White cadets positioned themselves far away from all variables, while non-White cadets were closest to “emotional control”. Conclusion To move these cadets toward help-seeking, vector modeling suggests that interventions should focus on their general trust of doctors, accepting lack of control, and decreasing feelings of weakness when asking for help. For non-White cadets a focus on self-reliance may also need to be emphasized. Use of these unique methods resulted in articulation of specific barriers that if addressed early, may have lasting effects on help-seeking behavior as these young men become adults. Future studies are needed to develop and test specific interventions to promote help-seeking among military cadets.
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Affiliation(s)
- Sarah Bauerle Bass
- Department of Social and Behavioral Sciences, Temple University, College of Public Health, 1301 Cecil B. Moore Ave., Room 951, Philadelphia, PA, 19122, USA.
| | - Javier Muñiz
- Department of Social and Behavioral Sciences, Temple University, College of Public Health, 1301 Cecil B. Moore Ave., Room 951, Philadelphia, PA, 19122, USA
| | - Thomas F Gordon
- Department of Psychology, University of Massachusetts-Lowell, 113 Wilder St., Lowell, MA, 01854-3059, USA
| | - Laurie Maurer
- Department of Social and Behavioral Sciences, Temple University, College of Public Health, 1301 Cecil B. Moore Ave., Room 951, Philadelphia, PA, 19122, USA
| | - Freda Patterson
- Department of Behavioral Health and Nutrition, University of Delaware, 026 North College Ave., Carpenter Sports Building, Newark, DE, 19711, USA
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Waller M, McGuire ACL, Dobson AJ. Alcohol use in the military: associations with health and wellbeing. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2015. [PMID: 26216215 PMCID: PMC4518507 DOI: 10.1186/s13011-015-0023-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND This study assessed the extent to which alcohol consumption in a military group differed from the general population, and how alcohol affected the military group's health and social functioning. METHODS A cross sectional survey of military personnel (n = 5311) collected self-reported data on alcohol use (AUDIT scale) and general health, role limitations because of physical health problems (role physical), and social functioning scores (SF36 subscales). Logistic regression was used to compare drinking behaviours between the military sample and a general population sample, using the categories risky drinkers (>2 units per day), low risk drinkers (≤2 standard drinks per day) and abstainers. Groups in the military sample with the highest levels of alcohol misuse (harmful drinking AUDIT ≥ 16, alcohol dependence AUDIT ≥ 20, and binge drinking) were also identified. Linear regression models were then used to assess the association between alcohol misuse and SF36 scores. RESULTS There were fewer risky drinkers in the military sample than in the general population sample. There were also fewer abstainers, but more people who drank at a lower risk level (≤2 standard drinks per day), than in a sample of the general population. Harmful drinking and alcohol dependence were most commonly observed in men, younger age groups, non-commissioned officers and lower ranks as well as reserve and ex-serving groups. Alcohol misuse was clearly associated with poorer general health scores, more role limitations because of physical health problems, and lower social functioning. CONCLUSIONS Although risky drinking was lower in the military group than in the general population, drinking was associated with poorer health, more limitations because of physical health problems, and poorer social functioning in Defence members. These results highlight the potential benefits for Defence forces in reducing alcohol use among members, in both those groups identified at highest risk, and across the military workforce as a whole.
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Affiliation(s)
- Michael Waller
- The University of Queensland, Centre for Australian Military and Veterans Health, School of Public Health, Herston Road, Herston, 4006, Australia. .,The University of Queensland, School of Public Health, Herston Road, Herston, 4006, Australia.
| | - Annabel C L McGuire
- The University of Queensland, Centre for Australian Military and Veterans Health, School of Public Health, Herston Road, Herston, 4006, Australia.
| | - Annette J Dobson
- The University of Queensland, School of Public Health, Herston Road, Herston, 4006, Australia.
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