The effect of military service and trauma exposure on resilience.

Military service members and first responders experience significant trauma exposure in the line of duty. Service members who transition to first-responder positions may be at an increased risk for developing PTSD due to the cumulative effects of trauma exposure. A common criticism of the standard delivery methods for most evidence-based treatments for PTSD is high dropout rates. Massed-prolonged exposure (Massed-PE) has been demonstrated to be efficacious and reduces dropouts by about 50%. This case study is the first of its kind to specifically assess the clinical utility of using Massed-PE to treat PTSD in two firefighters. Results from this case study indicate that both firefighters had significant reductions in their PTSD symptoms. Massed-PE may be an effective approach to treating PTSD in firefighters and may help overcome some of the barriers of conventional treatment delivery. Additional controlled research is needed to further evaluate this promising treatment approach in firefighter populations.

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Trauma, identity and mental health in UK military veterans

Psychological Medicine ◽

10.1017/s003329171000231x ◽

2010 ◽

Vol 41 (8) ◽

pp. 1733-1740 ◽

Cited By ~ 46

Author(s):

C. R. Brewin ◽

R. Garnett ◽

B. Andrews

Keyword(s):

Mental Health ◽

Military Service ◽

Suicide Attempts ◽

Trauma Exposure ◽

Identity Change ◽

Post Traumatic Stress ◽

Civilian Life ◽

Military Trauma ◽

The World ◽

Negative Perceptions

BackgroundMilitary service can lead to profound changes in identity, both in servicemen's perception of themselves and in their relationship to the world, but the significance of these changes for psychopathology is unclear. We investigated whether the extent and valence of identity change was related to the degree of military trauma exposure or to post-traumatic stress disorder (PTSD) and suicide attempts. We further sought to describe the nature of such changes using qualitative analysis.MethodA total of 153 veterans in receipt of a war pension for PTSD or physical disability were identified. Interviews established retrospectively DSM-IV diagnoses of PTSD and reports of suicidal ideation or behaviour since enlistment were examined.ResultsTrauma exposure alone was unrelated to any measure of identity change. By contrast, PTSD was associated with a relationship to the world that had changed in a negative direction. It was also associated with a changed perception of self, which could be either positive or negative. After controlling for trauma exposure and PTSD, suicidal behaviours were associated with more negative perceptions of the world. These perceptions of the world included disillusionment about human nature and a more specific rejection of civilian life.ConclusionsPTSD and suicidal behaviours in veterans seem not to be associated with significantly more negative views of the self but rather with more alienation from civilian life. This has serious consequences for engaging veterans in National Health Service (NHS) mental health services and for the provision of effective treatment.

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The Relationship between Trauma Exposure and Psychiatric Hospitalization for Suicide Ideation or Suicide Attempt among Patients Admitted to a Military Treatment Setting

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17082729 ◽

2020 ◽

Vol 17 (8) ◽

pp. 2729

Author(s):

Arthur T. Ryan ◽

Samantha E. Daruwala ◽

Kanchana U. Perera ◽

Su Yeon Lee-Tauler ◽

Jennifer Tucker ◽

...

Keyword(s):

Suicide Attempt ◽

Military Service ◽

Suicide Ideation ◽

Suicide Attempts ◽

Psychiatric Hospitalization ◽

Psychiatric Inpatient ◽

Trauma Exposure ◽

Inpatient Setting ◽

Childhood Neglect ◽

Lifetime Trauma

Suicide attempts and psychiatric hospitalization represent the final outcomes of a complex dynamical system of interacting factors that influence a particular individual’s likelihood of engaging in suicidal behavior, as well as their ability to seek help prior to acting upon suicidal impulses. This study examined the association between different types of lifetime trauma exposure and the likelihood of psychiatric hospitalization following a suicide attempt (SA) rather than suicidal ideation (SI) alone. Electronic medical records for 1100 U.S. military service members and their dependents admitted to a military psychiatric inpatient setting for SA or SI were reviewed for documented lifetime trauma exposure history. Findings indicated that exposure to at least one childhood trauma of any type, and childhood neglect in particular, increased the likelihood that an individual would be hospitalized for SA rather than SI. Exploratory gender-stratified analyses demonstrated that childhood neglect, childhood sexual abuse, and adulthood traumatic loss may be linked with the likelihood of being hospitalized for SA. These findings demonstrate the importance of developing more detailed and nuanced conception of factors known to be associated with suicide as their effects may depend on details of their timing and nature, as well as their interactions with other systems.

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