PTSD in an era of uncertainty and challenge (original) (raw)
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BMC Psychiatry, 2009
The mental health of the Armed Forces is an important issue of both academic and public interest. The aims of this study are to: a) assess the prevalence and risk factors for common mental disorders and post traumatic stress disorder (PTSD) symptoms, during the main fighting period of the Iraq War (TELIC 1) and later deployments to Iraq or elsewhere and enlistment status (regular or reserve), and b) compare the prevalence of depression, PTSD symptoms and suicidal ideation in regular and reserve UK Army personnel who deployed to Iraq with their US counterparts.
The Prevalence and Longitudinal Course of PTSD
Annals of the New York Academy of Sciences, 1997
Posttraumatic stress disorder (PTSD) cannot just be looked at from a cross-sectional perspective. It progresses and changes with the passage of time.'.2 This suggests that the neurobiology should be viewed as being in a progressive state of modification in the different stages of the disorder. This issue needs to be considered against the background of a series of observations that have emerged which were not anticipated two decades ago.3 First, PSTD is the exception rather than the rule following exposure to trauma. The disorder is not a normal response to an abnormal experience, because many studies have shown the existence of risk factors other than trauma as predictors of PTSD. The biological data suggest the atypical rather than normative nature of
Time-course of PTSD symptoms in the Australian Defence Force: a retrospective cohort study
Epidemiology and Psychiatric Sciences, 2015
Aims.Understanding the time-course of post-traumatic stress disorder (PTSD), and the underlying events, may help to identify those most at risk, and anticipate the number of individuals likely to be diagnosed after exposure to traumatic events.Method.Data from two health surveys were combined to create a cohort of 1119 Australian military personnel who deployed to the Middle East between 2000 and 2009. Changes in PTSD Checklist Civilian Version (PCL-C) scores and the reporting of stressful events between the two self-reported surveys were assessed. Logistic regression was used to examine the association between the number of stressful events reported and PTSD symptoms, and assess whether those who reported new stressful events between the two surveys, were also more likely to report older events. We also assessed, using linear regression, whether higher scores on the Kessler Psychological Distress Scale or the Alcohol Use Disorder Identification Test were associated with subsequent ...
PTSD: A Case Study in Retrospect
PTSD has long been associated with combat trauma. More recently, PTSD has been recognized as related to other traumatic experiences. The effects of PTDS profoundly affect a person's behavior, often out of character for the person experiencing PTSD. Even if it does not bring on suicidal effects, PTSD can be impacting on family members, especially the patient's children into their adult lives. Families themselves often will not recognize or deny the need for treatment as the intensity can be variable and easy to pass off as personality traits, especially when the parent's partner tries to be a peacekeeper during familial conflict. Whether or not the patient ever receives treatment for PTSD may be important. But sometimes for their own mental health, the patient's children as adults should make a concerted effort to pursue their own counselling path so as to keep the PTSD effects from being passed along generationally to their children.
Prevalence Estimates of Combat-Related Post-Traumatic Stress Disorder: Critical Review
Australian & New Zealand Journal of Psychiatry, 2010
The aim of the present study was to provide a critical review of prevalence estimates of combat-related post-traumatic stress disorder (PTSD) among military personnel and veterans, and of the relevant factors that may account for the variability of estimates within and across cohorts, including methodological and conceptual factors accounting for differences in prevalence rates across nations, conflicts/wars, and studies. MEDLINE and PsycINFO databases were examined for literature on combat-related PTSD. The following terms were used independently and in combinations in this search: PTSD, combat, veterans, military, epidemiology, prevalence. The point prevalence of combat-related PTSD in US military veterans since the Vietnam War ranged from approximately 2% to 17%. Studies of recent conflicts suggest that combat-related PTSD afflicts between 4% and 17% of US Iraq War veterans, but only 3–6% of returning UK Iraq War veterans. Thus, the prevalence range is narrower and tends to have ...
Journal of Traumatic Stress, 2010
The authors reviewed 29 studies that provide prevalence estimates of posttraumatic stress disorder (PTSD) among service members previously deployed to Operations Enduring and Iraqi Freedom and their non-U.S. military counterparts. Studies vary widely, particularly in their representativeness and the way PTSD is defined. Among previously deployed personnel not seeking treatment, most prevalence estimates range from 5 to 20%. Prevalence estimates are generally higher among those seeking treatment: As many as 50% of veterans seeking treatment screen positive for PTSD, though much fewer receive a PTSD diagnosis. Combat exposure is the only correlate consistently associated with PTSD. When evaluating PTSD prevalence estimates among this population, researchers and policymakers should carefully consider the method used to define PTSD and the population the study sample represents.
European Journal of Psychotraumatology, 2014
Given the unique context of warzone engagement, which may include chronic threat, multiple and lengthy deployments, and loss, there is a need to understand whether and to what extent knowledge about PTSD derived from studies of civilian trauma exposure is generalizeable to the military. This special issue on PTSD in the military addresses a range of issues and debates related to mental health in military personnel and combat veterans. This article provides an overview of the issues covered in selected contributions that have been assembled for a special volume to consider issues unique to the military. Several leading scholars and military experts have contributed papers regarding: 1) prevalence rates of PTSD and other post-deployment mental health problems in different NATO countries, 2) the search for biomarkers of PTSD and the potential applications of such findings, and 3) prevention and intervention approaches for service members and veterans. The volume includes studies that highlight the divergence in prevalence rates of PTSD and other post-deployment mental health problems across nations and that discuss potential causes and implications. Included studies also provide an overview of research conducted in military or Veteran's Affairs settings, and overarching reviews of military-wide approaches to research, promotion of resilience, and mental health interventions in the Unites States and across NATO and allied ISAF partners.
Research Square (Research Square), 2023
Posttraumatic stress disorder (PTSD) is one of the most serious and incapacitating mental diseases that can result from trauma exposure. However, despite its relevance, there is still considerable confusion and debate surrounding its diagnosis. The aim of this umbrella review is to clarify the overall prevalence of PTSD. Furthermore, the study examined whether the diagnostic methodology applied (self-reported vs structured interviews) and the nature of the traumatic event (interpersonal vs not interpersonal) impact on PTSD prevalence. A systematic search of major databases and additional sources was conducted. Fiftynine reviews met the criteria of this umbrella review. Overall PTSD prevalence was 23.95% (95% CI 20.74-27.15), with no publication bias or signi cant smallstudy effects, but a high level of heterogeneity between meta-analyses. Findings suggest that using structured clinical interviews results in a lower PTSD prevalence than using of self-report instruments, while no difference was found in the disorder prevalence when confronting interpersonal and noninterpersonal events. This analysis gives a solid foundation for future research and PTSD assessment. * No sample size provided.
Risk factors for post-traumatic stress disorder among UK Armed Forces personnel
Psychological Medicine, 2008
Background-Understanding the factors which increase the risk of PTSD for military personnel is important. This study aims to investigate the relative contribution of pre-deployment, perideployment, and post deployment variables to the prevalence of post traumatic stress symptoms in UK Armed Forces personnel who have been deployed in Iraq since 2003. Method-Data are drawn from stage 1 of a retrospective cohort study comparing a random sample of UK military personnel deployed to the 2003 Iraq War with a control group who were not deployed to the initial phase of war fighting (response rate 61%). The analyses are limited to 4762 regular service individuals who responded and who deployed to Iraq since 2003. Results-Post traumatic stress symptoms were associated with lower rank, being unmarried, low educational attainment and a history of childhood adversity. Exposure to potentially traumatising events was associated with post traumatic stress symptoms. Appraisals of the experience as involving threat to life or that work in theatre was above an individual's trade and experience were strongly associated with post traumatic stress symptoms Low morale, poor social support within the unit and non-receipt of a homecoming brief were associated with greater risk of post traumatic stress symptoms. Conclusions-These results support that there are modifiable occupational factors which may influence an individual's risk of PTSD. Personal appraisal of threat to life during the trauma emerged as the strongest predictor of symptoms, and therefore interventions focused on reinstating a sense of control are an important focus for treatment.