scholarly journals Stability of recall of military hazards over time

2003 ◽  
Vol 183 (4) ◽  
pp. 314-322 ◽  
Author(s):  
S. Wessely ◽  
C. Unwin ◽  
M. Hotopf ◽  
L. Hull ◽  
K. Ismail ◽  
...  
Keyword(s):  
Physical Health ◽  
Armed Forces ◽  
Significant Rise ◽  
Self Report ◽  
Psychological Status ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Uk ◽  
Changes Over Time ◽  
Over Time

BackgroundWartime traumatic events are related to subsequent psychological and physical health, but quantifying the association is problematic. Memory changes over time and is influenced by psychological status.AimsTo use a large, two-stage cohort study of members of the UK armed forces to study changes in recall of both traumatic and ‘toxic’ hazards.MethodA questionnaire-based follow-up study assessed 2370 UK military personnel, repeating earlier questions about exposure to military hazards.ResultsThe κ statistics for reporting of hazards were good for some exposures, but very low for others. Gulf veterans reported more exposures over time (no significant rise in the Bosnia cohort). In the Gulf cohort only, reporting new exposures was associated with worsening health perception, and forgetting previously reported exposures with improved perception. We found no association between physical health, psychological morbidity or post-traumatic stress disorder symptoms and endorsement or non-endorsement of exposures.ConclusionsReporting of military hazards after a conflict is not static, and is associated with current self-rated perception of health. Self-report of exposures associated with media publicity needs to be treated with caution.

scholarly journals Self-reported auditory problems are associated with adverse mental health outcomes and alcohol misuse in the UK Armed Forces

2021 ◽  
Author(s):  
Fred N. H. Parker ◽  
Nicola T. Fear ◽  
S. A. M. Stevelink ◽  
L. Rafferty
Keyword(s):  
Mental Health ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Alcohol Misuse ◽  
Mental Health Problems ◽  
Armed Forces ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Uk ◽  
Hearing Problems

Abstract Purpose Auditory problems, such as hearing loss and tinnitus, have been associated with mental health problems and alcohol misuse in the UK general population and in the US Armed Forces; however, few studies have examined these associations within the UK Armed Forces. The present study examined the association between auditory problems and probable common mental disorders, post-traumatic stress disorder and alcohol misuse. Methods 5474 serving and ex-service personnel from the UK Armed Forces were examined, selected from those who responded to phase two (data collection 2007–09) and phase three (2014–16) of a military cohort study. Multivariable logistic regression was used to examine the association between auditory problems at phase two and mental health problems at phase three. Results 9.7% of participants reported ever experiencing hearing problems alone, 7.9% reported tinnitus within the last month alone, and 7.8% reported hearing problems with tinnitus. After adjustment, hearing problems with tinnitus at phase two was associated with increased odds of probable common mental disorders (AOR = 1.50, 95% CI 1.09–2.08), post-traumatic stress disorder (AOR = 2.30, 95% CI 1.41–3.76), and alcohol misuse (AOR = 1.94, 95% CI 1.28–2.96) at phase three. Tinnitus alone was associated with probable post-traumatic stress disorder (AOR = 1.80, 95% CI 1.03–3.15); however, hearing problems alone were not associated with any outcomes of interest. Conclusions The association between auditory problems and mental health problems emphasises the importance of the prevention of auditory problems in the Armed Forces: through enhanced audiometric screening, improved hearing protection equipment, and greater levels of utilisation of such equipment.

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 A validation study of the International Trauma Questionnaire to assess post-traumatic stress disorder in treatment-seeking veterans

2020 ◽  
Vol 216 (3) ◽  
pp. 132-137 ◽  
Author(s):  
Dominic Murphy ◽  
Mark Shevlin ◽  
Emily Pearson ◽  
Neil Greenberg ◽  
Simon Wessely ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Help Seeking ◽  
Stress Disorder ◽  
Armed Forces ◽  
Treatment Seeking ◽  
Clinical Samples ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Uk

BackgroundVeterans with post-traumatic stress disorder (PTSD) typically report a poorer treatment response than those who have not served in the Armed Forces. A possible explanation is that veterans often present with complex symptoms of PTSD. ICD-11 PTSD and complex PTSD (CPTSD) have not previously been explored in a military sample.AimsThis study aimed to validate the only measure of ICD-11 PTSD and CPTSD, the International Trauma Questionnaire, and assess the rates of the disorder in a sample of treatment-seeking UK veterans.MethodA sample of help-seeking veterans (N = 177) was recruited from a national charity in the UK that provides clinical services to veterans. Participants completed measures of ICD-11 PTSD and CPTSD as well as childhood and adult traumatic life events. Confirmatory factor analysis was used to assess the latent structure of PTSD and CPTSD symptoms, and rates of the disorders were estimated.ResultsThe majority of the participants (70.7%) reported symptoms consistent with a diagnosis of either PTSD or CPTSD. Results indicated the presence of two separate disorders, with CPTSD being more frequently endorsed (56.7%) than PTSD (14.0%). CPTSD was more strongly associated with childhood trauma than PTSD.ConclusionsThe International Trauma Questionnaire can adequately distinguish between PTSD and CPTSD within clinical samples of veterans. There is a need to explore the effectiveness of existing and new treatments for CPTSD in military personnel.

scholarly journals Quantitative and Qualitative Outcomes of Transactional Analysis Psychotherapy with Male Armed Forces Veterans in the UK presenting with Post-Traumatic Stress Disorder

2014 ◽  
Vol 5 (2) ◽  
Author(s):  
David Harford ◽  
Mark Widdowson
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Armed Forces ◽  
Transactional Analysis ◽  
Post Traumatic Stress ◽  
Short Term ◽  
Post Traumatic ◽  
The Uk

This paper presents findings from a two-year research project conducted within a live-in residential charity setting in the UK, examining clinical outcomes of TA psychotherapy among 15 male armed forces veterans presenting with severe PTSD (post-traumatic stress disorder) and other comorbid disorders. Outcomes were measured for short-term (24 sessions) and long-term (52 sessions) transactional analysis (TA) treatment using the quantitative CORE-OM (Evans, Mellor-Clark, Margison, Barkham, McGrath, Connell & Audin, 2000), PHQ-9 (Kroenke, Spitzer & Williams, 2001) and GAD-7 (Spitzer, Kroenke, Williams & Löwe, 2006) questionnaires and the qualitative Change Interview (Elliott, Slatick, & Urman, 2001, as cited in Frommer & Rennie, 2001). Quantitative findings show that positive Reliable Change on global distress, depression and anxiety has taken place within both the short-term and long-term treatment groups with some clients achieving Clinically Significant Change on these measures. Qualitative findings arising from thematic analysis (Braun & Clarke, 2006) indicate that a broad spectrum of therapist factors and psychotherapy process factors within the TA therapy delivered were beneficial for this particular client group. The negative influence of a number of psychosocial factors on the veterans' well-being is also discussed based on numerical data and interview responses. Overall, these results suggest that TA psychotherapy can be effective in the treatment of PTSD among combat veterans.

Frequency and impact of patient suicide on psychiatric trainees

2003 ◽  
Vol 18 (7) ◽  
pp. 345-349 ◽  
Author(s):  
Guido Pieters ◽  
Véronique De Gucht ◽  
Gustaaf Joos ◽  
Elke De Heyn
Keyword(s):  
Traumatic Stress ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Dutch Version ◽  
Patient Suicide ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Post Traumatic ◽  
The Uk ◽  
The Impact

AbstractThe objective of the present study was to conduct a systematic inquiry into the frequency and impact of patients’ suicide on psychiatric trainees, and the availability and usefulness of training courses. Data were collected from 114 psychiatric trainees of the Dutch-speaking part of Belgium, representing a 70% response rate. A self-report questionnaire developed in the UK was adapted to the Flemish situation. A Dutch version of the Impact of Event Scale (IES) inquiring about post-traumatic stress symptoms was also used. The frequency of suicide experience was considerably higher in the present study than in similar studies in the USA and the UK. Thirty percent of first year trainees had been confronted with patient suicide. Personal and professional impact of patient suicide, as well as post-traumatic stress scores were considerably lower in Flemish psychiatric trainees. They considered informal support to be of more value than formal support to come to terms with the event. Finally, postgraduate training in post-suicide management was found to be largely insufficient. The results of the present study show that psychiatric trainees in the Dutch-speaking part of Belgium are at a high risk of experiencing patient suicide, whereas the impact of this experience appears to be relatively low. Only a small minority of trainees has received adequate training on procedures to follow after patient suicide.

scholarly journals Mental health of Kosovan Albanian refugees in the UK

2003 ◽  
Vol 182 (5) ◽  
pp. 444-448 ◽  
Author(s):  
Stuart W. Turner ◽  
Cameron Bowie ◽  
Graham Dunn ◽  
Laidon Shapo ◽  
William Yule
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Significant Proportion ◽  
Psychosocial Interventions ◽  
Good Health ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Health And Social Care ◽  
Post Traumatic ◽  
The Uk

BackgroundIn 1999 the UK received 4346 refugees from Kosovo.AimsTo determine the prevalence of mental health problems in this group.MethodA sample of 842 adults was surveyed. All were asked to complete self-report questionnaires (translated into Kosovan Albanian). A subset of 120 participants were later interviewed in Albanian using the Clinician Administered PTSD (post-traumatic stress disorder) Scale and a depression interview.ResultsThe study yielded estimates of prevalence of PTSD and depression. Self-report measures appear to overestimate the prevalence of these disorders. Just under half of the group surveyed had a diagnosis of PTSD and less than one-fifth had a major depressive disorder.ConclusionsThese results may be taken as a sign of the resilience of many who survived this conflict but they also imply that there is still a substantial need for good health and social care in a significant proportion. Psychosocial interventions are likely to be an important part of the treatment programme.

UK Fiscal Squeezes over a Century

2017 ◽  
Author(s):  
Christopher Hood ◽  
Rozana Himaz
Keyword(s):  
Data Sources ◽  
Fiscal Consolidation ◽  
Financial Outcomes ◽  
Financial Conditions ◽  
Deficit Reduction ◽  
Before And After ◽  
The Uk ◽  
Changes Over Time ◽  
Spending Cuts ◽  
Over Time

This chapter draws on historical statistics reporting financial outcomes for spending, taxation, debt, and deficit for the UK over a century to (a) identify quantitatively and compare the main fiscal squeeze episodes (i.e. major revenue increases, spending cuts, or both) in terms of type (soft squeezes and hard squeezes, spending squeezes, and revenue squeezes), depth, and length; (b) compare these periods of austerity against measures of fiscal consolidation in terms of deficit reduction; and (c) identify economic and financial conditions before and after the various squeezes. It explores the extent to which the identification of squeeze episodes and their classification is sensitive to which thresholds are set and what data sources are used. The chapter identifies major changes over time that emerge from this analysis over the changing depth and types of squeeze.

scholarly journals Military and demographic predictors of mental ill-health and socioeconomic hardship among UK veterans

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
H. Burdett ◽  
N. T. Fear ◽  
S. Wessely ◽  
R. J. Rona
Keyword(s):  
Socioeconomic Status ◽  
Common Mental Disorders ◽  
Economic Status ◽  
Childhood Adversity ◽  
Armed Forces ◽  
Sociodemographic Factors ◽  
Post Traumatic Stress ◽  
Length Of Service ◽  
Socioeconomic Outcomes ◽  
The Uk

Abstract Background Around 8% of the UK Armed Forces leave in any given year, and must navigate unfamiliar civilian systems to acquire employment, healthcare, and other necessities. This paper determines longer-term prevalences of mental ill health and socioeconomic outcomes in UK Service leavers, and how they are related to demographic factors, military history, and pre-enlistment adversity. Methods This study utilised data from a longitudinal sample of a cohort study UK Armed Forces personnel since 2003. A range of self-reported military and sociodemographic factors were analysed as predictors of probable Post-Traumatic Stress Disorder, common mental disorders, alcohol misuse, unemployment and financial hardship. Prevalences and odds ratios of associations between predictors and outcomes were estimated for regular veterans in this cohort. Results Veteran hardship was mostly associated with factors linked to socio-economic status: age, education, and childhood adversity. Few military-specific factors predicted mental health or socio-economic hardship, except method of leaving (where those leaving due to medical or unplanned discharge were more likely to encounter most forms of hardship as veterans), and rank which is itself related to socioeconomic status. Conclusion Transition and resettlement provisions become increasingly generous with longer service, yet this paper shows the need for those services becomes progressively less necessary as personnel acquire seniority and skills, and instead could be best targeted at unplanned leavers, taking socioeconomic status into consideration. Many will agree that longer service should be more rewarded, but the opposite is true if provision instead reflects need rather than length of service. This is a social, political and ethical dilemma.

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