scholarly journals Mental Health Outcomes Among Military Service Members After Severe Injury in Combat and TBI

2019 ◽  
Vol 185 (5-6) ◽  
pp. e711-e718 ◽  
Author(s):  
David L Chin ◽  
John E Zeber
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Traumatic Stress ◽  
Military Service ◽  
Mental Health Outcomes ◽  
Service Members ◽  
Post Traumatic Stress ◽  
Military Service Members ◽  
Severe Tbi ◽  
Post Traumatic

Abstract Introduction Studies examining the mental health outcomes of military personnel deployed into combat zones have focused on the risk of developing post-traumatic stress disorder conferred by mild or moderate traumatic brain injury (TBI). However, other mental health outcomes among veterans who sustained critical combat injuries have not been described. Materials and Method We examined the associations of moderate and severe TBI and combat injury with the risk for anxiety and mood disorders, adjustment reactions, schizophrenia and other psychotic disorders, cognitive disorders, and post-traumatic stress disorder. We conducted a retrospective cohort study of U.S. military service members critically injured in combat during military operations in Iraq and Afghanistan from February 1, 2002, to February 1, 2011. Health care encounters from (1) the Department of Defense (DoD) Trauma Registry (TR), (2) acute and ambulatory care in military facilities, and (3) civilian facilities are reimbursed by Tricare. Service members who sustained severe combat injury require critical care. We estimated the risk of mental health outcomes using risk-adjusted logit models for demographic and clinical factors. We explored the relationship between TBI and the total number of mental health diagnoses. Results Of the 4,980 subjects who met inclusion criteria, most injuries occurred among members of the Army (72%) or Marines (25%), with mean (SD) age of 25.5(6.1) years. The prevalence of moderate or severe TBI was 31.6% with explosion as the most common mechanism of injury (78%). We found 71% of the cohort was diagnosed with at least one poor mental health condition, and the adjusted risk conferred by TBI ranged from a modest increase for anxiety disorder (odds ratio, 1.27; 95% confidence interval [CI], 1.11–1.45) to a large increase for cognitive disorder (odds ratio, 3.24; 95% CI, 2.78–3.77). We found TBI was associated with an increased number of mental health diagnoses (incidence rate ratio, 1.52; 95% CI, 1.42–1.63). Conclusions Combat-associated TBI may have a broad effect on several mental health conditions among critically injured combat casualties. Early recognition and treatment for trauma-associated mental health are crucial to improving outcomes among service personnel as they transition to post-deployment care in the DoD, Department of Veterans Affairs, or community health systems.

Prospective study of anxiety, post-traumatic stress and depression on postural control, gait, otolith and visuospatial function in military service members with persistent post-concussive symptoms

2019 ◽  
pp. 271-287
Author(s):  
◽  
Andrew Lewandowski ◽  
Lindell K. Weaver ◽  
◽  
◽  
...  
Keyword(s):  
Brain Injury ◽  
Postural Control ◽  
Traumatic Stress ◽  
Military Service ◽  
Service Members ◽  
Post Traumatic Stress ◽  
High Anxiety ◽  
Affective Symptoms ◽  
Military Service Members ◽  
Post Traumatic

Purpose: Military service members often report both affective and vestibular complaints after mild traumatic brain injury (mTBI), but associations between symptoms and vestibular deficits can be subtle and inconsistent. Methods: From two complementary studies, one of military service members with persistent post-concussive symptoms after mTBI (NCT01611194) and the other of adult volunteers with no history of brain injury (NCT01925963), affective symptoms were compared to postural control, gait, otolith and visuospatial function. Results: The studies enrolled 71 participants with mTBI and 75 normative controls. Participants with mTBI had significantly reduced postural equilibrium on the sensory organization test (SOT), and more so in those with high anxiety or post-traumatic stress. Cervical and ocular vestibular evoked myogenic potentials (cVEMP; oVEMP) showed prolonged latencies in mTBI participants compared to controls; oVEMPs were significantly delayed in mTBI participants with high anxiety, post-traumatic stress or depression. A subset of the mTBI group had abnormal tandem gait and high anxiety. Anxiety, posttraumatic stress, and depression did not correlate with performance on the 6-Minute Walk Test, visuospatial neuropsychological measures, and the Satisfaction with Life Scale in the mTBI group. Conclusions: In this study military service members with mTBI reported affective symptoms, concurrently with vestibular-balance concerns. Worse scores on affective measures were associated with abnormal findings on measures of postural control, gait and otolith function.

scholarly journals A Nosological Exploration of PTSD and Trauma in Disaster Mental Health and Implications for the COVID-19 Pandemic

2021 ◽  
Vol 11 (1) ◽  
pp. 7
Author(s):  
Carol S. North ◽  
Alina M. Surís ◽  
David E. Pollio
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Diagnostic Criteria ◽  
Traumatic Stress ◽  
Essential Elements ◽  
Mental Health Outcomes ◽  
Medical Illness ◽  
Health Consequences ◽  
Post Traumatic Stress ◽  
Post Traumatic

The coronavirus disease of 2019 (COVID-19) pandemic rapidly spread around the world, resulting in massive medical morbidity and mortality and substantial mental health consequences. Post-traumatic stress disorder (PTSD) is an important psychiatric disorder associated with disasters, and many published scientific articles have reported post-traumatic stress syndromes in populations studied for COVID-19 mental health outcomes. American diagnostic criteria for PTSD have evolved across editions of the manual, and the current definition excludes naturally occurring medical illness (such as viral illness) as a qualifying trauma, ruling out this viral pandemic as the basis for a diagnosis of PTSD. This article provides an in-depth nosological consideration of the diagnosis of PTSD and critically examines three essential elements (trauma, exposure, and symptomatic response) of this diagnosis, specifically applying these concepts to the mental health outcomes of the COVID-19 pandemic. The current criteria for PTSD are unsatisfying for guiding the response to mental health consequences associated with this pandemic, and suggestions are made for addressing the conceptual diagnostic problems and designing research to resolve diagnostic uncertainties empirically. Options might be to revise the diagnostic criteria or consider categorization of COVID-19-related psychiatric syndromes as non-traumatic stressor-related syndromes or other psychiatric disorders.

scholarly journals ‘Master My Demons’: art therapy montage paintings by active-duty military service members with traumatic brain injury and post-traumatic stress

2018 ◽  
Vol 45 (4) ◽  
pp. 353-360 ◽  
Author(s):  
Marygrace Berberian ◽  
Melissa S Walker ◽  
Girija Kaimal
Keyword(s):  
Traumatic Brain Injury ◽  
Art Therapy ◽  
Traumatic Stress ◽  
Military Service ◽  
Active Duty ◽  
Service Members ◽  
Post Traumatic Stress ◽  
Active Duty Military ◽  
Military Service Members ◽  
Post Traumatic

This study involved a thematic analysis of montage paintings and of related clinical records of 240 active-duty military service members collected during their art therapy treatment for traumatic brain injury and underlying psychological health concerns, including post-traumatic stress, at the National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA. Congruent with other research findings, the qualitative analyses of this study suggest that the group art therapy experiences fostered improvement in interpersonal relatedness, hopefulness and gratification for the service members in treatment, aiding in externalisation, progressive exposure and construction of a trauma narrative imperative for recovery. The mixed media nature of the montage painting supported the expression of a range of postcombat symptoms. Results from this study highlighted the complexity of military culture, necessitating a broader scope of analyses for how art therapy helps service members express and communicate their challenges to care providers, peers and family as well as regulate emotion in the short and long term.

scholarly journals Mechanisms underlying the mental health impact of family separation on resettled refugees

2020 ◽  
pp. 000486742096742
Author(s):  
Belinda J Liddell ◽  
Yulisha Byrow ◽  
Meaghan O’Donnell ◽  
Vicki Mau ◽  
Nicole Batch ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Traumatic Stress ◽  
Indirect Effects ◽  
Mental Health Outcomes ◽  
Depression Symptoms ◽  
Post Traumatic Stress ◽  
Family Separation ◽  
Self Identity ◽  
Post Traumatic

Objective: Many refugees experience prolonged separation from family members, which research suggests has adverse effects on mental health and post-displacement outcomes in refugee populations. We examine mental health differences in refugees separated and not separated from their families, and key post-migration factors and cultural mechanisms that may underlie this impact. Methods: A sample of 1085 refugees resettled in Australia, of which 23.3% were separated from all of their immediate family, took part in an online battery of survey measures indexing pre- and post-migration refugee experiences, mental health symptoms, disability and individualistic/collectivistic self-identity. Family separation was used as a predictor of mental health outcomes in a series of linear regressions, and the separated and non-separated groups were compared in multigroup path analysis models to examine group-specific indirect effects. Results: The separated group reported greater exposure to pre-migration potentially traumatic events and higher levels of post-migration living difficulties compared to the non-separated group. Family separation predicted higher post-traumatic stress and depression symptoms, but not disability, after controlling for potentially traumatic event exposure, age and sex. Path analyses revealed distinct indirect effects for separated and non-separated groups. Principally, higher collectivistic self-identity was associated with elevated post-traumatic stress, depression and disability symptoms via social-related post-migration living difficulties such as isolation and loneliness in the separated group; whereas collectivism was linked with increased depression symptoms via economic-related post-migration living difficulties in the non-separated group. Conclusion: These findings indicate that family separation powerfully influences mental health outcomes, but that its effect may be mediated by the type of post-migration stress experienced in the settlement environment and culturally bound differences in how the sense of self is interconnected with family.

scholarly journals Mental health outcomes at the end of the British involvement in the Iraq and Afghanistan conflicts: a cohort study

2018 ◽  
Vol 213 (6) ◽  
pp. 690-697 ◽  
Author(s):  
Sharon A. M. Stevelink ◽  
Margaret Jones ◽  
Lisa Hull ◽  
David Pernet ◽  
Shirlee MacCrimmon ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Traumatic Stress ◽  
Alcohol Misuse ◽  
Armed Forces ◽  
Mental Health Outcomes ◽  
Post Traumatic Stress ◽  
King's College ◽  
Post Traumatic ◽  
The Uk

BackgroundLittle is known about the prevalence of mental health outcomes in UK personnel at the end of the British involvement in the Iraq and Afghanistan conflicts.AimsWe examined the prevalence of mental disorders and alcohol misuse, whether this differed between serving and ex-serving regular personnel and by deployment status.MethodThis is the third phase of a military cohort study (2014–2016; n = 8093). The sample was based on participants from previous phases (2004–2006 and 2007–2009) and a new randomly selected sample of those who had joined the UK armed forces since 2009.ResultsThe prevalence was 6.2% for probable post-traumatic stress disorder, 21.9% for common mental disorders and 10.0% for alcohol misuse. Deployment to Iraq or Afghanistan and a combat role during deployment were associated with significantly worse mental health outcomes and alcohol misuse in ex-serving regular personnel but not in currently serving regular personnel.ConclusionsThe findings highlight an increasing prevalence of post-traumatic stress disorder and a lowering prevalence of alcohol misuse compared with our previous findings and stresses the importance of continued surveillance during service and beyond.Declaration of interest:All authors are based at King's College London which, for the purpose of this study and other military-related studies, receives funding from the UK Ministry of Defence (MoD). S.A.M.S., M.J., L.H., D.P., S.M. and R.J.R. salaries were totally or partially paid by the UK MoD. The UK MoD provides support to the Academic Department of Military Mental Health, and the salaries of N.J., N.G. and N.T.F. are covered totally or partly by this contribution. D.Mu. is employed by Combat Stress, a national UK charity that provides clinical mental health services to veterans. D.MacM. is the lead consultant for an NHS Veteran Mental Health Service. N.G. is the Royal College of Psychiatrists’ Lead for Military and Veterans’ Health, a trustee of Walking with the Wounded, and an independent director at the Forces in Mind Trust; however, he was not directed by these organisations in any way in relation to his contribution to this paper. N.J. is a full-time member of the armed forces seconded to King's College London. N.T.F. reports grants from the US Department of Defense and the UK MoD, is a trustee (unpaid) of The Warrior Programme and an independent advisor to the Independent Group Advising on the Release of Data (IGARD). S.W. is a trustee (unpaid) of Combat Stress and Honorary Civilian Consultant Advisor in Psychiatry for the British Army (unpaid). S.W. is affiliated to the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King's College London in partnership with Public Health England, in collaboration with the University of East Anglia and Newcastle University. The views expressed are those of the author(s) and not necessarily those of the National Health Service, the NIHR, the Department of Health, Public Health England or the UK MoD.

scholarly journals Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers

2021 ◽  
Vol 18 (4) ◽  
pp. 1435 ◽  
Author(s):  
Andreas Chatzittofis ◽  
Maria Karanikola ◽  
Kyriaki Michailidou ◽  
Anastasia Constantinidou
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Health Outcomes ◽  
Traumatic Stress ◽  
Healthcare Workers ◽  
Prevalence Ratio ◽  
Mental Health Outcomes ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Traumatic

The coronavirus disease 2019 (COVID-19) has a great impact on healthcare workers (HCWs) that includes negative mental health outcomes, such as post-traumatic stress, anxiety and depressive symptoms. In this cross-sectional study, we report on mental health outcomes among HCWs in Cyprus. Data were collected between 3 May and 27 May 2020, with the use of an online questionnaire that included demographics (sex, age, occupation, education, work sector, years of work experience), the 9-item Patient Health Questionnaire (PHQ-9) which assesses depressive symptoms, the Impact of Events Scale Revised (IES-R), which measures post-traumatic stress disorder (PTSD) symptoms, and the-10 item Perceived Stress Scale (PSS-10) which quantifies stress responses. Participants (42% physicians, 24% nurses, 18% physiotherapists, 16% classified as “other”) were 58% of female gender and aged 21–76. A total of 79 (18.6%) and 62 HCWs (14.6%) reported clinically significant depressive (PHQ-9 ≥ 10) and post-traumatic stress (IES-R > 33) symptoms respectively. Nurses were more likely than physicians to suffer from depression (adjusted prevalence ratio 1.7 (1.06–2.73); p = 0.035) and PTSD (adjusted prevalence ratio 2.51 (1.49–4.23); p = 0.001). Even in a country with a rather low spread of the COVID-19, such as Cyprus, HCWs reported a substantial mental health burden, with nurses reporting increased depressive and PTSD symptoms compared to other HCWs.

scholarly journals Trajectories of trauma symptoms and resilience in deployed US military service members: Prospective cohort study

2012 ◽  
Vol 200 (4) ◽  
pp. 317-323 ◽  
Author(s):  
George A. Bonanno ◽  
Anthony D. Mancini ◽  
Jaime L. Horton ◽  
Teresa M. Powell ◽  
Cynthia A. LeardMann ◽  
...  
Keyword(s):  
Traumatic Stress ◽  
Prospective Cohort ◽  
Military Service ◽  
National Guard ◽  
Service Members ◽  
Post Traumatic Stress ◽  
Us Military ◽  
Growth Mixture Modelling ◽  
Military Service Members ◽  
Post Traumatic

BackgroundMost previous attempts to determine the psychological cost of military deployment have been limited by reliance on convenience samples, lack of pre-deployment data or confidentiality and cross-sectional designs.AimsThis study addressed these limitations using a population-based, prospective cohort of US military personnel deployed in support of the operations in Iraq and Afghanistan.MethodThe sample consisted of US military service members in all branches including active duty, reserve and national guard who deployed once (n= 3393) or multiple times (n= 4394). Self-reported symptoms of post-traumatic stress were obtained prior to deployment and at two follow-ups spaced 3 years apart. Data were examined for longitudinal trajectories using latent growth mixture modelling.ResultsEach analysis revealed remarkably similar post-traumatic stress trajectories across time. The most common pattern was low–stable post-traumatic stress or resilience (83.1% single deployers, 84.9% multiple deployers), moderate–improving (8.0%, 8.5%), then worsening–chronic posttraumatic stress (6.7%, 4.5%), high–stable (2.2% single deployers only) and high–improving (2.2% multiple deployers only). Covariates associated with each trajectory were identified.ConclusionsThe final models exhibited similar types of trajectories for single and multiple deployers; most notably, the stable trajectory of low post-traumatic stress pre- to post-deployment, or resilience, was exceptionally high. Several factors predicting trajectories were identified, which we hope will assist in future research aimed at decreasing the risk of post-traumatic stress disorder among deployers.

Relationships Between Childhood Interpersonal Trauma, Religious Coping, Post-traumatic Stress Symptoms, and Resilience

2021 ◽  
pp. 088626052199188
Author(s):  
Hannah E. Walker ◽  
Rachel Wamser-Nanney ◽  
Kathryn H. Howell
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Religious Coping ◽  
Traumatic Stress ◽  
Interpersonal Trauma ◽  
Mental Health Outcomes ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Post Traumatic ◽  
Negative Religious Coping

Positive and negative religious coping strategies have been linked to symptom trajectories following adult interpersonal trauma. However, the interactions between childhood interpersonal trauma, religious coping, and psychological outcomes are less clear. This study examined whether aspects of religious coping moderated the associations between cumulative childhood interpersonal trauma and mental health outcomes, such as post-traumatic stress symptoms (PTSS) and resilience. Participants included 525 undergraduates from two universities ( Mage = 20.04, SD = 1.71; range = 18–24; 57.7% White; 82.1% female). In both the positive and negative religious coping models, cumulative childhood interpersonal trauma was related to PTSS ( b = 6.66; b = 6.10, respectively). While positive religious coping was not associated with PTSS ( b = .01), it was linked to resilience ( b = .69). Negative religious coping was significantly related to PTSS ( b = .75) but not resilience ( b = –.20). No significant interactions were identified between aspects of religious coping and cumulative childhood interpersonal trauma. While religious coping was directly related to both positive and negative mental health outcomes, it may not be associated with the relationships between childhood interpersonal trauma exposure and clinical outcomes. Such findings offer valuable information on malleable factors that may contribute to adaptive and maladaptive functioning following childhood adversity.

Sign in / Sign up

Export Citation Format

Share Document