Cohort profile: the Prospective Research In Stress-Related Military Operations (PRISMO) study in the Dutch Armed Forces

PurposeThe Prospective Research in Stress-Related Military Operations (PRISMO) study was initiated to gain a better understanding of the long-term impact of military deployment on mental health, and to map the different biological and psychological factors that contribute to the development of stress-related mental health symptoms.ParticipantsThe PRISMO cohort consists of a convenience sample of Dutch military personnel deployed to Afghanistan between 2005 and 2008. Baseline data collection resulted in the recruitment of 1032 military men and women. Combat troops as well as non-combat support troops were recruited to increase the representativeness of the sample to the population as a whole.Findings to dateThe prevalence of various mental health symptoms increases after deployment in PRISMO cohort members, but symptom progression over time appears to be specific for various mental health symptoms. For post-traumatic stress disorder, we found a short-term symptom increase within 6 months after deployment (8.2%), and a long-term symptom increase at 5 years after deployment (12.9%). Several biological vulnerability factors associated with the development of stress-related conditions after deployment were identified, including predeployment glucocorticoid receptor sensitivity and predeployment testosterone level. Thus far, 34 publications have resulted from the cohort.Future plansVarious analyses are planned that will include the prevalence of mental health symptoms at 10 years postdeployment, as well as trajectory analyses that capture the longitudinal development of symptoms. Furthermore, we will use a machine learning approach to develop predictive and network models for several mental health symptoms, incorporating biological, psychological and social factors.

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COVID-19 and the Mental Health of Canadian Armed Forces Veterans: A Cross-Sectional Survey

Military Medicine ◽

10.1093/milmed/usab157 ◽

2021 ◽

Author(s):

Alyson L Mahar ◽

Christina R Rindlisbacher ◽

Megan Edgelow ◽

Shailee Siddhpuria ◽

Julie Hallet ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Military Training ◽

Armed Forces ◽

Mental Health Symptoms ◽

Cross Sectional ◽

Convenience Sample ◽

Health Symptoms ◽

Canadian Armed Forces ◽

The Impact

ABSTRACT Background There are no data on the impact of COVID-19 and associated public health measures, including sheltering at home, travel restrictions, and changes in health care provision, on the mental health of older veterans. This information is necessary for government and philanthropic agencies to tailor mental health supports, services, and resources for veterans in the peri- and post-pandemic periods. The objective of this study was to compare mental health symptoms between Canadian Armed Forces (CAFs) veterans and the general Canadian older adult population in the early months of the COVID-19 pandemic. Materials and Methods This was a secondary analysis of a cross-sectional study of older adults in the national Canadian COVID-19 Coping Study. Individuals aged 55 years and older were eligible. A convenience sample of older adults was recruited through a web-based survey administered between May 01, 2020 and June 30, 2020. Canadian Armed Force military service history status (yes/no) was ascertained. The eight-item Center for Epidemiological Studies Depression Scale, the five-item Beck Anxiety Inventory, and the three-item Loneliness Scale were used to measure mental health symptoms. Multivariable logistic regression compared the odds of screening positive for depression, anxiety, and loneliness between veterans and non-veterans. Results Of 1,541 respondents who answered the final question (87% survey completeness rate), 210 were veterans. Forty percent of veterans met criteria for at least one of the mental health diagnoses compared to 46% of non-veterans (P = .12). The odds of reporting elevated symptoms of depression, anxiety, and loneliness were similar for veteran and non-veteran respondents after adjusting for confounders. Conclusion Veterans’ report of mental health symptoms was similar to the general population Spring 2020 of the COVID-19 pandemic. Although veterans’ military training may better prepare them to adapt in the face of a pandemic, additional research is needed to understand the longitudinal impacts on physical and mental health.

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Cognitive therapy as an early treatment for children with PTSD: the outcomes for parents’ own PTSD, depression, anxiety and general mental health.

10.31234/osf.io/e657k ◽

2021 ◽

Author(s):

Laura Hammond ◽

Richard Meiser-Stedman ◽

Anna McKinnon ◽

Tim Dalgleish ◽

Patrick Smith ◽

...

Keyword(s):

Mental Health ◽

Cognitive Therapy ◽

Traumatic Stress ◽

Self Report ◽

Health Questionnaire ◽

Post Traumatic Stress ◽

Mental Health Symptoms ◽

Health Symptoms ◽

General Mental Health ◽

Post Traumatic

Post-traumatic stress disorder (PTSD) experienced by children can have a large impact on the wider family. The National Institute for Health and Care Excellence (NICE, 2018) recommend that parents are involved in their child’s PTSD treatment. Studies have found that parents themselves also report high levels of PTSD and other mental health symptoms but few have explored whether these symptoms reduce following their child receiving trauma-focused CBT. In this study, parents (N=29) whose children (ages 8-17 years) were randomly assigned to either 10 sessions of Cognitive Therapy for PTSD (CT-PTSD) or a wait-list control condition (WL) completed the Post Traumatic Stress Diagnostic Scale (PDS), the Patient Health Questionnaire (PHQ-9; to measure depression), the Generalised Anxiety Disorder Questionnaire (GAD-7), and the General Health Questionnaire (GHQ-28; to measure general mental health) for pre-post comparison. Parents whose children were allocated to CT-PTSD reported greater improvements on self-report PTSD, depression, anxiety and general mental health, relative to the WL condition. This trial provides preliminary support for the efficacy of CT-PTSD delivered to children for reducing parent PTSD, depression, anxiety and general mental health symptoms. Replication is needed as well as further exploration of parent factors and frequency of parental involvement required to predict improvements.

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The Relation between Self-Concealment and Self-Reported Mental Health Symptoms in a Sample of Canadian Armed Forces Personnel

Military Behavioral Health ◽

10.1080/21635781.2020.1838365 ◽

2020 ◽

pp. 1-8

Author(s):

Madeleine T. D’Agata ◽

Joshua A. Granek ◽

Ronald R. Holden ◽

Anthony Nazarov

Keyword(s):

Mental Health ◽

Armed Forces ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Canadian Armed Forces

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The relationship between post-traumatic stress and positive mental health symptoms among health workers during COVID-19 pandemic in Lombardy, Italy

Journal of Affective Disorders ◽

10.1016/j.jad.2020.11.065 ◽

2021 ◽

Vol 280 ◽

pp. 1-6

Author(s):

Marta Bassi ◽

Luca Negri ◽

Antonella Delle Fave ◽

Roberto Accardi

Keyword(s):

Mental Health ◽

Traumatic Stress ◽

Health Workers ◽

Positive Mental Health ◽

Post Traumatic Stress ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Post Traumatic ◽

The Relationship

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Longitudinal determinants of mental health treatment-seeking by US soldiers

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.146506 ◽

2015 ◽

Vol 207 (4) ◽

pp. 346-350 ◽

Cited By ~ 34

Author(s):

Amy B. Adler ◽

Thomas W. Britt ◽

Lyndon A. Riviere ◽

Paul Y. Kim ◽

Jeffrey L. Thomas

Keyword(s):

Mental Health ◽

Mental Health Treatment ◽

Mental Healthcare ◽

Armed Forces ◽

Self Management ◽

Treatment Seeking ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Positive Attitudes ◽

The Impact

BackgroundStudies with members of the armed forces have found a gap between reports of mental health symptoms and treatment-seeking.AimsTo assess the impact of attitudes on treatment-seeking behaviours in soldiers returning from a combat deployment.MethodA sample of 529 US soldiers were surveyed 4 months (time 1) and 12 months (time 2) post-deployment. Mental health symptoms and treatment-seeking attitudes were assessed at time 1; reported mental healthcare visits were assessed at time 2.ResultsFactor analysis of the total time 1 sample revealed four attitude factors: professional concerns, practical barriers, preference for self-management and positive attitudes about treatment. For the subset of 160 soldiers reporting a mental health problem at time 1, and controlling for mental health symptom severity, self-management inversely predicted treatment-seeking; positive attitudes were positively related.ConclusionsResults demonstrate the importance of broadening the conceptualisation of barriers and facilitators of mental healthcare beyond stigma. Techniques and delivery models emphasising self-care may help increase soldiers' interest in using mental health services.

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Moral Injury as a Mediator of the Associations Between Sexual Harassment and Mental Health Symptoms and Substance Use Among Women Veterans

Journal of Interpersonal Violence ◽

10.1177/0886260520985485 ◽

2021 ◽

pp. 088626052098548

Author(s):

Hannah C. Hamrick ◽

Sarah J. Ehlke ◽

Rachel L. Davies ◽

Jennise M. Higgins ◽

Jennifer Naylor ◽

...

Keyword(s):

Mental Health ◽

Sexual Harassment ◽

Military Service ◽

Women Veterans ◽

Moral Injury ◽

Health Providers ◽

Mental Health Symptoms ◽

Convenience Sample ◽

Health Symptoms ◽

Military Members

Moral injury is an array of symptoms theorized to develop in response to morally injurious events, defined as events that challenge one’s core moral beliefs and expectations about the self, others, and world. Recent measures of moral injury have distinguished self-directed moral injury (e.g., moral injury symptoms that emerge following the perpetration of morally injurious events) from other-directed moral injury, the symptoms of which are believed to stem from one’s response to actions that others have committed (e.g., within-rank violence, failures of leadership, and acts of betrayal committed by trusted others or institutions). Using a convenience sample of 154 primarily former military women, the present study examined if other-directed moral injury symptoms (e.g., anger, betrayal, and mistrust) associated with military experience would mediate the association between military sexual harassment and mental health and substance abuse symptoms. Results demonstrated that 85.8% ( n = 127) of the of this sample of women veterans reported experiencing sexual harassment during their military service. Using a single mediation model, we further demonstrated that other-directed moral injury mediated the association between sexual harassment experience and mental health symptoms. Given the percentage of women veterans who reported sexual harassment, these results suggest that additional training for military members, and particularly, military leaders, is necessary to begin to reduce sexual harassment. In addition, mental health providers who work with current and former military members should consider how other-directed moral injury may be associated with mental health symptoms among women veterans who have experienced sexual harassment while in the military.

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Mental health screening amongst police officers: factors associated with under-reporting of symptoms

BMC Psychiatry ◽

10.1186/s12888-021-03125-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ruth E. Marshall ◽

Josie Milligan-Saville ◽

Katherine Petrie ◽

Richard A. Bryant ◽

Philip B. Mitchell ◽

...

Keyword(s):

Mental Health ◽

Police Officers ◽

Common Mental Disorder ◽

Health Screening ◽

Mental Health Screening ◽

Self Report ◽

Post Traumatic Stress ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Factors Associated

Abstract Background Mental health screening in the workplace aims to identify employees who are becoming symptomatic, in order to provide timely support and evidence-based interventions to those affected. Given the stigma associated with mental illness, accurate disclosure of mental health symptoms cannot be assumed. The present study sought to investigate factors associated with the accurate reporting of mental health symptoms amongst police officers. Methods A total of 90 serving police officers completed identical mental health screening surveys, one administered by the employer and the other anonymously by an independent organisation. Responses were then linked to compare differences in the number and severity of mental health symptoms reported on each questionnaire. Results Comparisons of matched self-report scores indicated that employees under-reported symptoms of mental health disorders when completing screening administered by their employer, with only 76.3% of symptoms declared. Under-reporting occurred regardless of gender and symptom type. Less senior staff (p = 0.05) and those with the most severe post-traumatic stress disorder and common mental disorder symptoms (p = 0.008) were significantly more likely to under-report symptoms. Conclusions Employer-administered mental health screening is not able to accurately capture all mental health symptoms amongst first responders. The fact that the severity of symptoms predicted the level of under-reporting means that simple changes to cut-off values cannot correct this problem.

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Long-Term Impact of COVID-19 on Mental Health among the General Public: A Nationwide Longitudinal Study in China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168790 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8790

Author(s):

Le Shi ◽

Zheng-An Lu ◽

Jian-Yu Que ◽

Xiao-Lin Huang ◽

Qing-Dong Lu ◽

...

Keyword(s):

Mental Health ◽

General Public ◽

Severity Index ◽

Mental Health Symptoms ◽

Related Factors ◽

Protection Measures ◽

Health Symptoms ◽

Work Related ◽

Mental Problems

COVID-19 might have long-term mental health impacts. We aim to investigate the longitudinal changes in mental problems from initial COVID-19 peak to its aftermath among general public in China. Depression, anxiety and insomnia were assessed among a large-sample nationwide cohort of 10,492 adults during the initial COVID-19 peak (28 February 2020 to 11 March 2020) and its aftermath (8 July 2020 to 8 August 2020) using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Insomnia Severity Index. We used generalized estimating equations and linear mixed models to explore factors associated with long-term mental health symptoms during COVID-19. During the five months, mental health symptoms remained consistently elevated (baseline 46.4%; follow-up 45.1%). Long-term depression, anxiety and insomnia were associated with several personal and work-related factors including quarantine (adjusted OR for any mental health symptoms 1.31, 95%CI 1.22–1.41, p < 0.001), increases in work burden after resuming work (1.77, 1.65–1.90, p < 0.001), occupational exposure risk to COVID-19 (1.26, 1.14–1.40, p < 0.001) and living in places severely affected by initial COVID-19 peak (1.21, 1.04–1.41, p = 0.01) or by a COVID-19 resurgence (1.38, 1.26–1.50, p < 0.001). Compliance with self-protection measures, such as wearing face masks (0.74, 0.61–0.90, p = 0.003), was associated with lower long-term risk of mental problems. The findings reveal a pronounced and prolonged mental health burden from the initial COVID-19 peak through to its aftermath in China. We should regularly monitor the mental health status of vulnerable populations throughout COVID-19.

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