Treatment of military-related post-traumatic stress disorder: challenges, innovations, and the way forward

International Review of Psychiatry, Год журнала: 2019, Номер 31(1), С. 95 - 110

Опубликована: Янв. 2, 2019

Post-traumatic stress disorder (PTSD) is one of the common mental disorders in military and veteran populations. Considerable research clinical opinion has been focused on understanding relationship between PTSD service implications for prevention, treatment, management. This paper examines factors associated with development this population, considers issues relating to engagement discusses empirical support best practice evidence-based treatment. The goes explore challenges those areas, particular reference treatment barriers care, as well non-response. final section addresses innovative solutions these through improvements agreed terminology definitions, strategies increase engagement, early identification approaches, predictors outcome, innovations Treatment include enhancing existing treatments, emerging non-trauma-focused interventions, novel pharmacotherapy, personalized medicine advancing functional outcomes, family intervention support, attention physical health.

Язык: Английский

---

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

The British Journal of Psychiatry, Год журнала: 2020, Номер 216(3), С. 132 - 137

Опубликована: Фев. 28, 2020

Background Veterans 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 complex symptoms of PTSD. ICD-11 PTSD and (CPTSD) previously been explored military sample. Aims This study aimed to validate only measure CPTSD, International Trauma Questionnaire, assess rates sample treatment-seeking UK veterans. Method help-seeking ( N = 177) was recruited from national charity provides clinical services Participants completed measures CPTSD as well childhood adult traumatic life events. Confirmatory factor analysis used latent structure symptoms, disorders were estimated. Results The majority participants (70.7%) reported consistent diagnosis either or CPTSD. indicated presence two separate disorders, being more frequently endorsed (56.7%) (14.0%). strongly associated trauma Conclusions Questionnaire can adequately distinguish between within samples There need explore effectiveness existing new treatments for personnel.

Язык: Английский

---

Moral injury associated with increased odds of past-year mental health disorders: a Canadian Armed Forces examination

European journal of psychotraumatology, Год журнала: 2023, Номер 14(1)

Опубликована: Март 30, 2023

Background: Potentially morally injurious experiences (PMIEs) are common during military service. However, it is unclear to what extent PMIEs related well-established adverse mental health outcomes.Objective: The objective of this study was use a population-based survey determine the associations between moral injury endorsement and presence past-year disorders in Canadian Armed Forces (CAF) personnel Veterans.Methods: Data were obtained from 2018 Members Veterans Mental Health Follow-up Survey (CAFVMHS). With sample 2,941 respondents, weighted represented 18,120 active duty 34,380 released CAF personnel. Multiple logistic regressions used assess sociodemographic characteristics (e.g. sex), factors rank), (using Moral Injury Events Scale [MIES]) specific (major depressive episode, generalized anxiety disorder, panic social PTSD, suicidality).Results: While adjusting for selected factors, odds experiencing any disorder 1.97 times greater (95% CI = 1.94-2.01) each one-unit increase total MIES score. Specifically, PTSD had 1.91 1.87-1.96) being endorsed every unit score, while or 1.86 1.82-1.90) All findings reported statistically significant (p < .001).Conclusion: These emphasize that robustly associated with outcomes among results project further underscore necessity addressing alongside other concerns within CAF.Potentially service, but poorly understood how these members Veterans.Following series multiple regressions, CI: 1.94–2.01) per score.This emphasizes association events deleterious personnel, highlights importance population.

Язык: Английский

---

Primary Care Visit Rates Among Canadian Veterans in Ontario: A Retrospective Cohort Study of Sex- and Length of Service-stratified Comparisons With Nonveterans

Military Medicine, Год журнала: 2025, Номер unknown

Опубликована: Март 12, 2025

ABSTRACT Introduction Research comparing primary care (PC) use among veterans and nonveterans has not widely considered the impact of sex length service on association between veteran status PC use. We calculated relative differences in rate visits Canadian Armed Forces Royal Mounted Police overall by service. Materials Methods conducted a matched, retrospective cohort study residing Ontario, Canada 1990 2019 using routinely collected linked administrative health data held at ICES (formerly known as Institute for Clinical Evaluative Sciences). compared visit rates multivariable Andersen-Gill (AG) recurrent event regression models. Effect measure modification was investigated statistical interaction terms. Results Overall, had higher adjusted (aRR) to (aRR 1.06, 95% CI 1.04-1.07). Male an aRR 1.07 (95% CI, 1.05-1.09), while females 1.31 1.26-1.36). Veterans who served &lt;5 years significantly (RR 1.09, 1.03-1.15), ≥30 comparable 1.00, 0.97-1.02). Conclusions nonveterans, effect appeared stronger with fewer The observed could be result increased need, access PC, or proactive care-seeking behaviors retained from military

Язык: Английский

---

Chronic pain among public safety personnel in Canada

Canadian Journal of Pain, Год журнала: 2017, Номер 1(1), С. 237 - 246

Опубликована: Янв. 1, 2017

Background: Chronic pain is highly prevalent in the general population and may be even higher among public safety personnel (PSP; e.g., correctional officers, dispatchers, firefighters, paramedics, police). Comprehensive data on chronic diverse Canadian PSP are relatively sparse. Aims: The current study was designed to provide initial estimates of frequency severity PSP. Methods: Estimates (i.e., intensity duration) at different bodily locations were derived from self-reported collected through an online survey. Participants included 5093 (32.5% women) grouped into six categories call center operators/dispatchers, municipal/provincial police, Royal Mounted Police [RCMP]). Results: Substantial proportions participants reported pain, with ranging 35.3% 45.4% across categories. Across categories, lower back most prevalent. For some locations, firefighters police prevalence, but paramedics intensity, duration, than other groups. Over 50% RCMP reporting indicated that associated injury related active duty. Conclusions: Discrepancies emerged members respect location, severity. suggest additional resources research necessary mitigate development maintenance distressing or disabling for PSP.Contexte : La prévalence de la douleur chronique est élevée parmi en général et pourrait être encore plus chez le sécurité publique (ex.: agents correctionnels, répartiteurs, pompiers, ambulanciers, policiers). Il y a relativement peu données exhaustives sur canadien.But Cette étude visait à estimer fréquence gravité canadien.Méthodes Des estimations (i.e. intensité durée) différents endroits du corps ont été tirées autodéclarées receuillies par truchement d’un questionnaire ligne. Les 5 093 (32,5 % femmes) regroupés catégories opérateurs répartiteurs centre d’appel, policiers au niveau municipal ou provincial, Gendarmerie royale Canada.)Résultats Une proportion importante déclaré souffrir chronique, avec des allant 35,3 45,4 pour toutes les sécurité. bas dos présentait dans ambulanciers une faible l’intensité durée ressentie certains endroits, comparativement aux autres groupes santé publique. Plus 50 Canada qui affirmé que était associée blessure subie pendant qu’ils étaient service.Conclusions différences relevées entre membres ce concerne prévalence, localisation douleur. actuelles suggèrent ressources études additionnelles sont nécessaires atténuer l’apparition persistance éprouvante invalidante canadien.

---

Prevalence of comorbid chronic pain and mental health conditions in Canadian Armed Forces active personnel: analysis of a cross-sectional survey

CMAJ Open, Год журнала: 2018, Номер 6(4), С. E528 - E536

Опубликована: Окт. 1, 2018

Chronic pain conditions and mental disorders have high prevalence rates in military populations. However, few investigations examined the comorbidity between chronic specific among Canadian active personnel.We conducted a secondary analysis of data from 2013 Forces Mental Health Survey (CFMHS) concerning population regular members. Diagnostic interviews assessed presence disorders, participants self-reported (i.e., arthritis, back problems, musculoskeletal conditions, migraines) indicators severity. We used multiple logistic regressions to assess associations disorders. cross-tabulations severity comorbid relationships compared with condition alone. moderation analyses examine interactions by severity, activity limitation, respectively, on disorders.The CFMHS included 6696 members had response rate 79.8%. About one-quarter (n = 1761) personnel reported having pain. In fully adjusted model, all were significantly associated posttraumatic stress disorder (PTSD) (odds ratio [OR] range 1.86-2.55), several major depressive episode, generalized anxiety panic disorder. Back problems apart alcohol use (OR 1.40-2.17). Cross-tabulations showed higher estimates endorsement for Formal significant relationship migraine limitation PTSD.Chronic are prevalent co-occur force Greater understanding these their impact people's abilities adapt both civilian life is needed.

Язык: Английский

---

Military-to-civilian transition theories and frameworks

Elsevier eBooks, Год журнала: 2019, Номер unknown, С. 21 - 50

Опубликована: Янв. 1, 2019

Язык: Английский

---

Cannabis use among military veterans: A great deal to gain or lose?

Clinical Psychology Review, Год журнала: 2021, Номер 84, С. 101958 - 101958

Опубликована: Янв. 12, 2021

Язык: Английский

---

Feasibility of Virtual Reality Exposure Therapy in the Treatment of Danish Veterans with Post-Traumatic Stress Disorder: A Mixed Method Pilot Study

Cyberpsychology Behavior and Social Networking, Год журнала: 2023, Номер 26(6), С. 425 - 431

Опубликована: Июнь 1, 2023

The BraveMind virtual reality exposure therapy (VRET) has been developed and shown efficacy for U.S. service members veterans. As the first study to date, present examined feasibility of VRET non-U.S. military Moreover, sought explore in-depth participants' experiences with VRET. Nine Danish veterans post-traumatic stress disorder (PTSD) after deployment Afghanistan participated in study. PTSD, depression, quality life were assessed at pretreatment, post-treatment, 3-month followup. treatment consisted 10 sessions. Semistructured interviews completers conducted post-treatment ascertain views about treatment, general, VR system particular. Thematic qualitative analysis was semantic level using an inductive approach. There significant reductions pre- self-reported PTSD improvements life. Treatment gains maintained Pre- Cohen's d effect sizes large (PTSD Checklist-Civilian Version [PCL-C]: = 1.55). Qualitative results indicated that environment does not entirely map soldiers Afghanistan. However, this experienced as a hindering factor therapy. Findings indicate is acceptable, safe, effective PTSD. emphasize importance strong therapeutic alliance, more emotional straining than regular trauma-focused

Язык: Английский

---

Group identity, diffi cult adjustment to civilian life, and suicidal ideation in Canadian Armed Forces Veterans: Life After Service Studies 2016

Journal of Military Veteran and Family Health, Год журнала: 2019, Номер 5(2), С. 100 - 114

Опубликована: Июль 4, 2019

Introduction: Suicide risk is higher in Canadian Armed Forces (CAF) Veterans than the general population (CGP). Suicidality understood to be caused by incompletely clarified, complex interacting combinations of multiple factors. One precipitating factors for suicide thought social identity challenges known occur major life transitions. Methods: The 2016 Life After Service Studies survey representatively sampled Regular Force stratified two release groups: earlier 1998 August 2012 ( n = 1,575) and more recently September 2015 1,180). linked dataset included socioeconomic military characteristics well-being indicators domains. Weak group was indicated weak sense local community belonging and/or not feeling part a with shared attitudes beliefs. Associations were evaluated logistic regression. Results: Suicidal ideation, belonging, perceived difficult adjustment civilian prevalent soon after (September 2015) released (1998 2012). ideation CGP. In Veterans, endorsed majority suicidal (93.3%). adjusted regression models, mental health problems had strongest association (adjusted odds ratio [AOR] 13.4–79.3); however, moderately strongly associated both (AOR 2.4–4.1) particularly 3.8–9.0), independently problems. Discussion: CAF within 3.6 years release. These findings indicate importance prevention attending during transition post-military life.

Язык: Английский

---