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Combat and peacekeeping operations in relation to prevalence of mental disorders and perceived need for mental health care: findings from a large representative sample of military personnel.

https://arctichealth.org/en/permalink/ahliterature162700
Source
Arch Gen Psychiatry. 2007 Jul;64(7):843-52
Publication Type
Article
Date
Jul-2007
Author
Jitender Sareen
Brian J Cox
Tracie O Afifi
Murray B Stein
Shay-Lee Belik
Graham Meadows
Gordon J G Asmundson
Author Affiliation
Department of Psychiatry, University of Manitoba, 771 Bannatyne Ave, Winnipeg, MB PZ430, Canada R3E 3N4. sareen@cc.umanitoba.ca
Source
Arch Gen Psychiatry. 2007 Jul;64(7):843-52
Date
Jul-2007
Language
English
Publication Type
Article
Keywords
Attitude to Health
Canada - epidemiology
Combat Disorders - diagnosis - epidemiology - psychology
Diagnostic and Statistical Manual of Mental Disorders
Health Services Accessibility
Health services needs and demand
Health Surveys
Humans
Life Change Events
Male
Mental Disorders - diagnosis - epidemiology - therapy
Mental Health Services - supply & distribution - utilization
Military Personnel - psychology - statistics & numerical data
Patient Acceptance of Health Care
Prevalence
Psychiatric Status Rating Scales
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology
Suicide - psychology
Violence - psychology
War
Abstract
Although military personnel are trained for combat and peacekeeping operations, accumulating evidence indicates that deployment-related exposure to traumatic events is associated with mental health problems and mental health service use.
To examine the relationships between combat and peacekeeping operations and the prevalence of mental disorders, self-perceived need for mental health care, mental health service use, and suicidality.
Cross-sectional, population-based survey.
Canadian military.
A total of 8441 currently active military personnel (aged 16-54 years).
The DSM-IV mental disorders (major depressive disorder, posttraumatic stress disorder, generalized anxiety disorder, panic disorder, social phobia, and alcohol dependence) were assessed using the World Mental Health version of the World Health Organization Composite International Diagnostic Interview, a fully structured lay-administered psychiatric interview. The survey included validated measures of self-perceived need for mental health treatment, mental health service use, and suicidal ideation. Lifetime exposure to peacekeeping and combat operations and witnessing atrocities or massacres (ie, mutilated bodies or mass killings) were assessed.
The prevalences of any past-year mental disorder assessed in the survey and self-perceived need for care were 14.9% and 23.2%, respectively. Most individuals meeting the criteria for a mental disorder diagnosis did not use any mental health services. Deployment to combat operations and witnessing atrocities were associated with increased prevalence of mental disorders and perceived need for care. After adjusting for the effects of exposure to combat and witnessing atrocities, deployment to peacekeeping operations was not associated with increased prevalence of mental disorders.
This is the first study to use a representative sample of active military personnel to examine the relationship between deployment-related experiences and mental health problems. It provides evidence of a positive association between combat exposure and witnessing atrocities and mental disorders and self-perceived need for treatment.
PubMed ID
17606818 View in PubMed
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Exposure to traumatic events and experiences: aetiological relationships with personality function.

https://arctichealth.org/en/permalink/ahliterature183613
Source
Psychiatry Res. 2003 Aug 30;120(1):61-9
Publication Type
Article
Date
Aug-30-2003
Author
Kerry L Jang
Murray B Stein
Steven Taylor
Gordon J G Asmundson
W John Livesley
Author Affiliation
Division of Behavioural Science, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, Canada V6T 2A1. kjang@unixg.ubc.ca
Source
Psychiatry Res. 2003 Aug 30;120(1):61-9
Date
Aug-30-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Antisocial Personality Disorder - diagnosis - genetics - psychology
British Columbia
Diseases in Twins - genetics
Female
Genetic Predisposition to Disease - genetics
Humans
Life Change Events
Likelihood Functions
Male
Middle Aged
Personality Inventory - statistics & numerical data
Psychometrics
Risk
Statistics as Topic
Stress Disorders, Post-Traumatic - diagnosis - genetics - psychology
Substance-Related Disorders - diagnosis - genetics - psychology
Twins, Dizygotic
Twins, Monozygotic
Violence - psychology
Abstract
Empirical research has shown that the odds of experiencing traumatic events are influenced by genetic factors and the heritability of trauma exposure varies with the type of trauma. Traumatic events per se are unlikely to be heritable; more likely to be inherited are factors such as personality that influence the person's risk for entering into, or creating, potentially hazardous situations. With data from 406 twin pairs (222 monozygotic and 184 dizygotic twin pairs) from the urban general population, the present study used multiple regression analysis to identify personality variables associated with exposure to trauma, and estimated the degree to which these relationships were mediated by genetic factors. The experience of violent assaultive traumatic events was predicted by antisocial personality traits, specifically juvenile antisocial behavior, self-harming behavior, Psychoticism (e.g. adult antisocial behavior and substance misuse), and being open to new ideas and experiences. Genetic factors were found to partially mediate these relationships as indexed by the genetic correlation coefficient. The values of the genetic correlations were statistically significant and ranged from 0.14 to 0.36, accounting for 5-11% of the observed correlation between personality and trauma exposure. These findings suggest that heritable personality characteristics explain part of the variance in the likelihood of exposure to some classes of traumatic events.
PubMed ID
14500115 View in PubMed
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Prevalence and correlates of sleep paralysis in adults reporting childhood sexual abuse.

https://arctichealth.org/en/permalink/ahliterature157535
Source
J Anxiety Disord. 2008 Dec;22(8):1535-41
Publication Type
Article
Date
Dec-2008
Author
Murray P Abrams
Ashlee D Mulligan
R Nicholas Carleton
Gordon J G Asmundson
Author Affiliation
University of Regina, Regina, Saskatchewan, Canada.
Source
J Anxiety Disord. 2008 Dec;22(8):1535-41
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Adult
Canada - epidemiology
Chi-Square Distribution
Child
Child Abuse, Sexual - psychology - statistics & numerical data
Control Groups
Emotions
Female
Hallucinations - epidemiology - psychology
Humans
Life Change Events
Male
Middle Aged
Models, Psychological
Personality Inventory - statistics & numerical data
Prevalence
Psychometrics
Questionnaires
Sleep Paralysis - diagnosis - epidemiology - psychology
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology
Survivors - psychology - statistics & numerical data
Abstract
Sleep paralysis (SP) occurs when rapid eye movement (REM) activity and concomitant paralysis of the skeletal muscles persist as an individual awakens and becomes conscious of his/her surroundings. SP is often accompanied by frightening hallucinations that some researchers suggest may be confounded with memories of childhood sexual abuse (CSA; [McNally, R. J., & Clancy, S. A. (2005). Sleep paralysis in adults reporting repressed, recovered, or continuous memories of childhood sexual abuse. Journal of Anxiety Disorders, 19, 595-602]). The purpose of this study was to evaluate relationships between CSA and SP. Based on self-report, participants (n=263) were categorized into three CSA groups: confirmed, unconfirmed, or no history of CSA. Relative to participants reporting no CSA history, those reporting CSA reported more frequent and more distressing episodes of SP. Post hoc analyses revealed that participants with clinically significant post-traumatic symptoms (irrespective of CSA history) also reported more frequent and more distressing episodes of SP. Significant correlations were found among SP indices and measures of post-traumatic symptoms, depression, dissociation, and absorption. Implications and future research directions are discussed.
PubMed ID
18436428 View in PubMed
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Relation between traumatic events and suicide attempts in Canadian military personnel.

https://arctichealth.org/en/permalink/ahliterature152318
Source
Can J Psychiatry. 2009 Feb;54(2):93-104
Publication Type
Article
Date
Feb-2009
Author
Shay-Lee Belik
Murray B Stein
Gordon J G Asmundson
Jitender Sareen
Author Affiliation
Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba. sbelik@hsc.mb.ca
Source
Can J Psychiatry. 2009 Feb;54(2):93-104
Date
Feb-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alcoholism - epidemiology - psychology
Canada
Child Abuse - psychology - statistics & numerical data
Cross-Sectional Studies
Female
Health Surveys
Humans
Life Change Events
Male
Mental Disorders - epidemiology - psychology
Middle Aged
Military Personnel - psychology - statistics & numerical data
Odds Ratio
Rape - psychology - statistics & numerical data
Sex Factors
Sex Offenses - psychology - statistics & numerical data
Spouse Abuse - psychology - statistics & numerical data
Statistics as Topic
Suicide, Attempted - psychology - statistics & numerical data
Violence - psychology - statistics & numerical data
Young Adult
Abstract
To determine whether exposure to particular types of traumatic events was differentially associated with suicide attempts in a representative sample of active military personnel.
Data came from the Canadian Community Health Survey: Mental Health and Well-Being Canadian Forces Supplement (CCHS-CFS), a cross-sectional survey that provided a comprehensive examination of mental disorders, health, and the well-being of currently active Canadian military personnel (n = 8441; aged 16 to 54 years; response rate 81.1%). Respondents were asked about exposure to 28 traumatic events that occurred during their lifetime. Suicide attempts were measured using a question about whether the person ever "attempted suicide or tried to take [his or her] own life."
The prevalence of lifetime suicide attempts for currently active Canadian military men and women was 2.2% and 5.6%, respectively. Sexual and other interpersonal traumas (for example, rape, sexual assault, spousal abuse, child abuse) were significantly associated with suicide attempts in both men (adjusted odds ratios [AORs] ranging from 2.31 to 4.43) and women (AORs ranging from 1.73 to 3.71), even after adjusting for sociodemographics and mental disorders. Additionally, the number of traumatic events experienced was positively associated with increased risk of suicide attempts, indicating a dose-response effect of exposure to trauma.
The current study is the first to demonstrate that sexual and other interpersonal traumatic events are associated with suicide attempts in a representative sample of active Canadian military men and women.
PubMed ID
19254440 View in PubMed
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