Investigating the use of mental health services by combat veterans can help illuminate utilization and unmet needs of this population. The aims of this study were to estimate the use of mental health services and to examine how such use is associated with self-reported symptoms of posttraumatic stress disorder (PTSD) in soldiers before and after deployment to Afghanistan.
Prospectively, 703 Danish soldiers who deployed from January 2009 to August 2009 were followed up with 6 assessments from predeployment to 2.5 years postdeployment in 2012. At assessments, the soldiers responded to a comprehensive questionnaire including a measure of PTSD symptoms (the PTSD Checklist-Civilian version). These self-reported data were combined with individual-level records of receiving psychotherapy from the Military Psychological Division at the Danish Defense and psychiatric treatment from the Danish registers.
The prevalence of PTSD symptoms increased over time, and almost 10% of the sample reported high levels of PTSD symptoms 2.5 years postdeployment. Overall, 37% of the soldiers utilized mental health services; 6% utilized psychiatric services, and 12.4% redeemed a prescription for psychiatric medicine. Approximately one-third received psychotherapy at the Military Psychological Division. In those reporting high PTSD symptomatology, 83% utilized 1 or more types of mental health service. At predeployment and homecoming, high PTSD symptomatology was significantly (P
We examined the relative associations between posttraumatic stress disorder (PTSD) and depression severity with medical and specialist care use in modern peacekeeping veterans with health-related disabilities.
The participants consisted of 1016 male veterans who served in the Canadian Forces from 1990 to 1999, selected from a larger random sample of 1968 veterans who voluntarily completed an anonymous general health survey conducted by Veterans Affairs Canada in 1999. Survey instruments included the PTSD Checklist-Military Version (PCL-M), Center for Epidemiological Studies-Depression Scale, and questionnaires of health problems and service use, sociodemographic characteristics, and military history.
Among peacekeeping veterans with health disabilities, "probable" PTSD (PCL-M score > or = 50) was associated with significantly more medical service use (primary and specialty care combined), with a mean of 16.4 times (SD = 17.4) compared with 6.0 times (SD = 6.6), p
The purpose of this discussion paper is to explore the existing literature from Canada on transitioning from military to civilian life for veterans of recent deployments. A number of topics relating to the transition experience emerged: interpersonal readjustment, emotional including mental health needs, school needs, and social needs. Implications for nursing will be discussed in terms of veterans as a cultural group and culturally competent nursing care. Recommendations for future nursing research include how well current services are meeting the needs of the younger, more recent veterans transitioning to civilian life; conducting longitudinal studies on the impact of transitioning to civilian life for veterans and their families; comparing the transition experience at an international level; developing a transition model that situates the veteran culture as the overarching framework for testing and understanding the experience of transitioning to civilian life.
The purpose of the present study was to examine theoretically motivated predictors for the development of positive changes following potentially traumatic experiences (i.e., posttraumatic growth). Specifically, we wanted to examine the prediction that memories of highly negative and positive deployment events predict subsequent posttraumatic growth.
A total of 251 Danish soldiers (7% female, mean age 26.4) deployed to forward operating bases in Afghanistan filled out questionnaires before, during, and after deployment. This allowed us to perform prospective as well as cross-sectional analyses of the data.
The main findings were that the centrality of highly emotional memories from deployment predicted growth alongside openness to experience, combat exposure, and social support. Importantly, the centrality of both positive and negative memories predicted growth equally well.
The perceived importance of both negative and positive events may play an important part in the development of posttraumatic growth.
The study was carried out to examine participants of current war conflicts and World War II in order to compare the development of the formation of stereotype of old age. It was established that participants of World War II have higher level of the formation of pessimistic stereotype of old age than participants of current war conflicts have.
We tested two empirically validated 4-factor models of posttraumatic stress disorder (PTSD) symptoms using the PTSD Checklist: King, Leskin, King, and Weathers' (1998) model including reexperiencing, avoidance, emotional numbing, and hyperarousal factors, and Simms, Watson, and Doebbeling's (2002) model including reexperiencing, avoidance, dysphoria, and hyperarousal. Our aim was to determine which fit better in two groups of military veterans: peacekeepers previously deployed to a war zone (deployed group) and those trained for peacekeeping operations who were not deployed (nondeployed group). We compared the groups using multigroup confirmatory factor analysis. Adequate model fit was demonstrated among the nondeployed group, with no significant difference between King et al.'s (1998) model (separating avoidance and numbing) and Simms et al.'s (2002) similar model involving a dysphoria factor. A better fitting factor structure consistent with Simms et al.'s (2002) model was found in the deployed group. Comprehensive measurement invariance testing demonstrated significant differences between the deployed and nondeployed groups on all structural parameters, except observed variable intercepts (thus indicating similarities only in PTSD item severity). These findings add to researchers' understanding of PTSD's factor structure, given the revision of PTSD that will appear in the forthcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2010)--namely, that the factor structure may be quite different between groups with and without exposure to major traumatic events.
The article presents some aspects of the health status of the veterans of the Samara region. Intercommunication is marked between the level of social adaptation, quality of life and rate aging combatants. The study shows the effect of chronic posttraumatic stress disorder on the occurrence of psychosomatic pathology and development of senescence combat veterans suffering from arterial hypertension.
Although recent studies suggest that posttraumatic stress disorder (PTSD) symptoms and pain may be related, the possible mediational role of depression in this relationship has not been examined. This study sought to examine this question in a sample of 130 male veterans seeking assessment or treatment for deployment-related PTSD. Results suggest that PTSD and pain are moderately related (r = .29) but that this relationship is fully mediated by depression. Our findings have important clinical implications: Treatment of PTSD and pain in veteran populations should include careful assessment and regular monitoring of depression.
An analysis from the Finnish East and West Cohort of the Seven Countries Study tested the hypothesis that front line service during modern warfare is associated with depression later in life. World War Two-era Finnish combat veterans were compared to Finnish veterans who were non-combatants. Both groups were followed from 1959 to 1984. Dependent variables were the Zung depression scale and other measures of psychosocial adaptation and mental health. Analysis of variance of Zung scores by combat exposure was close to statistical significance (p = 0.0501). Even if statistical significance had been reached, it is felt that the absolute magnitude of the differences between the populations appear quite trivial. A significant association was found for those who had participated in over nine battles and when grouping depression, sleeplessness, paranoia, hallucinations, schizophrenia, and other mental illness into the general category of any mental illness (O.R. = 4.414; 95% C.I. = 1.113, 17.503). This seems to support the residual stress hypothesis pertaining to modern combat exposure.