Holding and rupture: Describing post-traumatic stress among former UK Army and Royal Marine personnel deployed to Iraq and Afghanistan DOI Creative Commons
Laura Palmer,

Walter Busuttil,

Amos Simms

et al.

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(8), P. e0308101 - e0308101

Published: Aug. 9, 2024

Former UK military personnel who were previously deployed to Iraq and Afghanistan in combat roles have exhibited elevated levels of Post-Traumatic Stress Disorder (PTSD) compared other groups. The present qualitative analyses used semi-structured interviews a framework analysis compare the experiences symptomatic (N=10) asymptomatic (N=7) former Army Royal Marine exposed combat. Participants drawn from large health wellbeing cohort study sampled based upon probable PTSD status using scores Checklist-Civilian Version (PCL-C). All participants attributed development post-traumatic stress deployment events, with one additionally ascribing symptoms childhood events. Among participants, was temporarily buffered, held at bay, by holding function various structures, including collective; cultural ethical frameworks that helped organise traumatic experiences; an operational necessity for psychological compartmentalisation even distraction itself. Leaving appeared elicit global rupture these supports. As result, military-to-civilian transition led intensification stress, deployment-related memories, among participants. In contrast, tended report continuity their structures across lifespan, especially transition. onset maintenance may thus be explained interplay between capacity magnitude lifetime rupture. Overall, findings might provide explanation widening discrepancies those enduring without further research is required determine fit our groups contexts. This approach illustrates need situate individual wider structural, ecological,

Language: Английский

COVID-19 and experiences of moral injury in front-line key workers DOI Creative Commons
Victoria Williamson, Dominic Murphy, Neil Greenberg

et al.

Occupational Medicine, Journal Year: 2020, Volume and Issue: 70(5), P. 317 - 319

Published: March 26, 2020

Language: Английский

Citations

329
Moral injury: the effect on mental health and implications for treatment DOI Open Access
Victoria Williamson, Dominic Murphy, Andrea Phelps

et al.

The Lancet Psychiatry, Journal Year: 2021, Volume and Issue: 8(6), P. 453 - 455

Published: March 18, 2021

Language: Английский

Citations

106
ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in treatment seeking veterans: risk factors and comorbidity DOI
Dominic Murphy, Thanos Karatzias,

Walter Busuttil

et al.

Social Psychiatry and Psychiatric Epidemiology, Journal Year: 2021, Volume and Issue: 56(7), P. 1289 - 1298

Published: Jan. 19, 2021

Language: Английский

Citations

64
‘It hurts your heart’: frontline healthcare worker experiences of moral injury during the COVID-19 pandemic DOI Creative Commons
Siobhan Hegarty, Danielle Lamb, Sharon A. M. Stevelink

et al.

European journal of psychotraumatology, Journal Year: 2022, Volume and Issue: 13(2)

Published: Oct. 18, 2022

Background: Moral injury is defined as the strong emotional and cognitive reactions following events which clash with someone's moral code, values or expectations. During COVID-19 pandemic, increased exposure to Potentially Morally Injurious Events (PMIEs) has placed healthcare workers (HCWs) at risk of injury. Yet little known about lived experience cumulative PMIE how NHS staff respond this.Objective: We sought rectify this knowledge gap by qualitatively exploring experiences perspectives clinical frontline who responded COVID-19.Methods: recruited a diverse sample 30 HCWs from CHECK study cohort, for single time point qualitative interviews. All participants endorsed least one item on 9-item Injury Scale (MIES) [Nash et al., 2013. Psychometric evaluation scale. Military Medicine, 178(6), 646–652] six month follow up. Interviews followed semi-structured guide were analysed using reflexive thematic analysis.Results: described being routinely exposed ethical conflicts, created exacerbations pre-existing systemic issues including inadequate staffing resourcing. found that experienced range mental health symptoms primarily related perceptions institutional betrayal well feeling unable fulfil their duty care towards patients.Conclusion: These results suggest multi-facetted organisational strategy warranted prepare exposure, promote opportunities resolution associated prevent disengagement.HIGHLIGHTS Clinical have been an accumulation potentially morally injurious throughout betrayed both government leaders provide patients.HCWs significant adverse impact health, anxiety depression sleep disturbance.Most interviewed believed change within was necessary excess distress.

Language: Английский

Citations

50
Moral injury and psychological wellbeing in UK healthcare staff DOI Creative Commons
Victoria Williamson, Danielle Lamb, Matthew Hotopf

et al.

Journal of Mental Health, Journal Year: 2023, Volume and Issue: 32(5), P. 890 - 898

Published: March 8, 2023

Potentially morally injurious events (PMIEs) can negatively impact mental health. The COVID-19 pandemic may have placed healthcare staff at risk of moral injury.To examine the PMIE on wellbeing.Twelve thousand nine hundred and sixty-five (clinical non-clinical) were recruited from 18 NHS-England trusts into a survey exposure wellbeing.PMIEs significantly associated with adverse health symptoms across staff. Specific work factors experiences injury, including being redeployed, lack PPE, having colleague die COVID-19. Nurses who reported disorders more likely to report all forms PMIEs than those without (AOR 2.7; 95% CI 2.2, 3.3). Doctors only betrayal events, such as breach trust by colleagues 2.7, 1.5, 4.9).A considerable proportion NHS in both clinical non-clinical roles during pandemic. Prospective research is needed identify direction causation between injury disorder well continuing monitor longer term outcomes PMIEs.

Language: Английский

Citations

28
The impact of moral injury on the wellbeing of UK military veterans DOI Creative Commons
Victoria Williamson, Dominic Murphy, Sharon A. M. Stevelink

et al.

BMC Psychology, Journal Year: 2021, Volume and Issue: 9(1)

Published: May 5, 2021

Abstract Background Experiences of potentially morally injurious events (PMIEs) have been found to negatively impact the mental health US personnel/veterans, yet little is known about effect PMIEs on UK Armed Forces (AF). This cross-sectional study aimed examine association between and outcomes AF veterans. Method Assessments PMIE exposure self-report measures common disorders were administered using an online questionnaire 204 Subjects classified as having experienced a event (n = 66), non-morally traumatic 57), ‘mixed’ 31), or no 50). Results Potentially experiences associated with adverse outcomes, including likely anxiety suicidal ideation, compared those who reported exposure. The likelihood meeting criteria for probable PTSD was greatest in had trauma. No statistically significant alcohol misuse experiencing observed. Conclusions results provide preliminary evidence that are Further work needed better understand interplay threat-based trauma order design effective pathways prevention intervention people exposed highly challenging events.

Language: Английский

Citations

33
Addressing moral injury in the military DOI
Andrea Phelps, Amy B. Adler, Stéphanie A.H. Bélanger

et al.

BMJ Military Health, Journal Year: 2022, Volume and Issue: 170(1), P. 51 - 55

Published: June 15, 2022

Moral injury is a relatively new, but increasingly studied, construct in the field of mental health, particularly relation to current and ex-serving military personnel. refers enduring psychosocial, spiritual or ethical harms that can result from exposure high-stakes events strongly clash with one’s moral beliefs. There pressing need for further research advance understanding nature injury; its relationship disorders such as posttraumatic stress disorder depression; triggering underpinning mechanisms; prevalence, prevention treatment. In meantime, leaders have an immediate guidance on how should be addressed and, where possible, prevented. Such theoretically sound, evidence-informed ethically responsible. Further, implementation any practice change based contribute advancement science through robust evaluation. This paper draws together injury, best-practice approaches adjacent psychological resilience, principles effective combined veteran health expertise authors provide design, evaluation interventions military. The discusses relevant training practice, well key roles creating cohesive teams having frank discussions about challenges personnel face.

Language: Английский

Citations

23
Conceptualization of moral injury: A socio-cognitive perspective DOI
Amanda Bonson, Dominic Murphy, Vicky Aldridge

et al.

Journal of Military Veteran and Family Health, Journal Year: 2023, Volume and Issue: 9(2), P. 75 - 81

Published: Feb. 17, 2023

LAY SUMMARY This article looks at how moral injury (MI) may develop by considering what event features be especially salient and cause MI experiences an individual have after that might lead to the occurrence of a MI. It proposes beliefs someone has about themselves, others, world can shaped in childhood early life. Once experienced potentially morally injurious (PMIE) — for example, witnessing something violates deeply held or ethical codes but being unable stop it, doing these codes, experiencing significant betrayal they try make sense it changing way see world, others. problems individual’s relationship with themselves leading feelings shame guilt withdrawal from other people. Finally, PMIE, must significantly challenge strongly right wrong.

Language: Английский

Citations

14
Experiences of nurses caring for respiratory patients during the first wave of the COVID-19 pandemic: an online survey study DOI Creative Commons
Nicola Roberts, Carol Kelly, Kate Lippiett

et al.

BMJ Open Respiratory Research, Journal Year: 2021, Volume and Issue: 8(1), P. e000987 - e000987

Published: July 1, 2021

Background Nurses have been at the forefront of pandemic response, involved in extensive coordination services, screening, vaccination and front-line work respiratory, emergency intensive care environments. The nature this is often intense stress-provoking with an inevitable psychological impact on nurses all healthcare workers. This study focused working respiratory areas aim identifying characterising self-reported issues that exacerbated or alleviated their concerns during first wave COVID-19 pandemic. Methods An online survey was developed consisting 90 questions using a mixture open-ended closed questions. Participant demographic data were also collected (age, gender, ethnicity, number years qualified, details long-term health conditions, geographical location, nursing background/role home life). disseminated via social media professional societies (British Thoracic Society, Primary Care Respiratory Association Nurse Specialists) over 3-week period May 2020 1 June 2020. Results highlights experiences caring for patients early Concerns expressed environment, supply availability adequate protective personal equipment, quality individuals able to deliver, mental families. A high provided free-text comments around worries about household; these included bringing virus home, effect family members worrying them, changing patterns, managing children. Although both formal informal support available, there inconsistencies provision, highlighting importance leadership management ensuring equity access services. Conclusions Support staff essential throughout afterwards, it important preparation regarding building resilience recognised. It clear services wider team need be available quickly convened event similar major incidents, either global local.

Language: Английский

Citations

30
Exploring the health and well-being of a national sample of U.K. treatment-seeking veterans. DOI
Charlotte Williamson, Julia Baumann, Dominic Murphy

et al.

Psychological Trauma Theory Research Practice and Policy, Journal Year: 2022, Volume and Issue: 15(4), P. 672 - 680

Published: Oct. 11, 2022

Objective: Military veterans experience a higher prevalence of mental health difficulties compared to the general population.Research has highlighted who have poorer treatment outcomes.Understanding veteran needs may help improve services and outcomes.The aim this study was explore complexity wellbeing among national clinical sample veterans. Method:In total 989 from UK charity were invited complete questionnaire about their sociodemographic characteristics, military experiences, physical health, wellbeing.Results: 428 (43.3%) completed questionnaire.Common difficulties, such as anxiety depression, most frequently reported difficulty (80.7%), followed by loneliness (79.1%) perceived low social support (72.2%).Rates post-traumatic stress disorder (PTSD) also high (68.7%any PTSD), with majority participants experiencing Complex PTSD (CPTSD; 62.5%) (6.2%).Veterans co-occurring CPTSD symptoms due number comorbidities, for instance between moral injury.Conclusions: Co-morbidity appeared be norm rather than exception within treatmentseeking veterans.As such, it seems important take holistic approach when supporting

Language: Английский

Citations

20