Impact of exposure to combat during deployment to Iraq and Afghanistan on mental health by gender

BackgroundInterest in the mental health of women deployed to modern military campaigns is increasing, although research examining gender differences is limited. Little is known about experiences women have had on these deployments, or whether men and women respond differently to combat exposure.MethodThe current study used data from a representative sample of UK Armed Forces personnel to examine gender differences among those deployed to Iraq and Afghanistan (n=432 women,n=4554 men) in three measures of experience: ‘risk to self’, ‘trauma to others’ and ‘appraisal of deployment’. We examined the impact of such experiences on post-deployment symptoms of post-traumatic stress disorder (PTSD), symptoms of common mental disorder (CMD) and hazardous alcohol use.ResultsAfter adjustment, men reported more exposure to ‘risk to self’ and ‘trauma to others’ events and more negative appraisals of their deployment. Among both genders, all measures of combat experience were associated with symptoms of PTSD and CMD (except ‘risk to self’ events on symptoms of CMD among women) but not with alcohol misuse. Women reported higher scores on the PTSD Checklist – Civilian Version (PCL-C) among those exposed to lower levels of each experience type but this did not hold in the higher levels. Women reported greater symptoms of CMD and men reported greater hazardous alcohol use across both levels of each experience type. Examining men and women separately suggested similar responses to exposure to adverse combat experiences.ConclusionsThe current findings suggest that, although gender differences in mental health exist, the impact of deployment on mental health is similar among men and women.

Download Full-text

UK veterans’ mental health and well-being before and during the COVID-19 pandemic: a longitudinal cohort study

BMJ Open ◽

10.1136/bmjopen-2021-049815 ◽

2021 ◽

Vol 11 (8) ◽

pp. e049815

Author(s):

Marie-Louise Sharp ◽

Danai Serfioti ◽

Margaret Jones ◽

Howard Burdett ◽

David Pernet ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Alcohol Use ◽

Armed Forces ◽

Well Being ◽

Hazardous Drinking ◽

Hazardous Alcohol Use ◽

Hazardous Alcohol ◽

The Uk ◽

Health And Well Being

ObjectiveTo investigate the impact of the COVID-19 pandemic on the health and well-being of UK ex-service personnel (veterans) before and during the pandemic, and to assess associations of COVID-19 experiences and stressors with mental health, alcohol use and loneliness.DesignAn additional wave of data was collected from a longitudinal cohort study of the UK Armed Forces.SettingOnline survey June–September 2020.ParticipantsCohort members were included if they had completed a questionnaire at phase 3 of the King’s Centre for Military Health Research health and well-being study (2014–2016), had left the Armed Forces after regular service, were living in the UK, had consented to follow-up and provided a valid email address. Invitation emails were sent to N=3547 with a 44% response rate (n=1562).Primary outcome measuresCommon mental health disorders (CMDs) (measured using the General Health Questionnaire, 12 items—cut-off ≥4), hazardous alcohol use (measured using the Alcohol Use Disorder Identification Test, 10 items—cut off ≥8) and loneliness (University of California, Los Angeles, Loneliness Scale— 3 items-cut-off ≥6).ResultsVeterans reported a statistically significant decrease in hazardous drinking of 48.5% to 27.6%, while CMD remained stable (non-statistically significant increase of 24.5% to 26.1%). 27.4% of veterans reported feelings of loneliness. The COVID-19 stressors of reporting difficulties with family/social relationships, boredom and difficulties with health were statistically significantly associated with CMD, hazardous drinking and loneliness, even after adjustment for previous mental health/hazardous alcohol use.ConclusionsOur study suggests a COVID-19 impact on veterans’ mental health, alcohol use and loneliness, particularly for those experiencing difficulties with family relationships. Veterans experienced the pandemic in similar ways to the general population and in some cases may have responded in resilient ways. While stable levels of CMD and reduction in alcohol use are positive, there remains a group of veterans who may need mental health and alcohol treatment services.

Download Full-text

Mental health and resilience among Eritrean refugees at arrival and one-year post-registration in Switzerland: a cohort study

BMC Research Notes ◽

10.1186/s13104-021-05695-5 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Afona Chernet ◽

Nicole Probst-Hensch ◽

Véronique Sydow ◽

Daniel H. Paris ◽

Niklaus D. Labhardt

Keyword(s):

Mental Health ◽

Asylum Seekers ◽

Assessment Tools ◽

Migration Route ◽

Post Traumatic Stress ◽

Hazardous Alcohol Use ◽

Hazardous Alcohol ◽

One Year ◽

The One

Abstract Objective Eritrea is the most frequent country of origin among asylum seekers in Switzerland. On their journey through the desert and across the Mediterranean Sea, Eritrea refugees are often exposed to traumatizing experiences. The aim of this study is to assess the mental health status and resilience of Eritrean migrants in Switzerland upon arrival and one-year post-arrival, using standardized mental health screening and resilience assessment tools. Results At baseline, 107 refugees (11.2% female, median age 25) were interviewed: 52 (48.6%) screened positive for Post-Traumatic Stress Disorder (score ≥ 30), 10.3% for anxiety (≥ 10) and 15.0% for depression (≥ 10); 17.8% scored as risk/hazardous drinkers (≥ 8). The majority (94.4%) had a high resilience score (≥ 65). For one-year follow-up, 48 asylum seekers could be reached. In interviews 18 (38%) of these reported imprisonment in a transit country and 28 (58%) that they had witnessed the death of a close person along the migration route. At the one year assessment, rates of risky/hazardous alcohol use remained unchanged, rates of positive PTSD screening tended to be lower (50.0% (24/48) at baseline vs 25.0% (12/48) at follow-up), as were rates of positive screening for anxiety (8.3% vs 4.2%) and depression (14.6 vs 6.3%).

Download Full-text

Killing in Combat; the Diverging Mental Health Impact on Distinct Veteran Populations – A Two-Sample Study

10.31234/osf.io/4g9fb ◽

2020 ◽

Author(s):

Andreas Espetvedt Nordstrand ◽

Christer Lunde Gjerstad ◽

Odin Hjemdal ◽

Are Holen ◽

Tore Tveitstul ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Psychological Distress ◽

Alcohol Use ◽

Posttraumatic Stress ◽

Armed Forces ◽

Mental States ◽

Two Samples ◽

The Impact

This study examined the warzone stressors: killing in combat, experiencing personal threats, or traumatic witnessing during deployment in relation to psychological distress, alcohol consumption and quality of life at long-term follow-up. The study was conducted in two samples of Norwegian veterans who had served in Afghanistan (Study 1, N = 4,053) or in Lebanon (Study 2, N = 10,605), respectively. Data were collected through two postdeployment mental health surveys conducted by the Norwegian Armed Forces Joint Medical Services. Using linear regressions, we investigated the impact of warzone stressors on posttraumatic stress symptoms, depression, anxiety, insomnia, alcohol use, and quality of life. In study 1 (Afghanistan veterans), killing was not a significant predictor of psychological distress, alcohol use, or quality of life, when controlling for Personal Threats and Witnessing exposure. In study 2 (Lebanon veterans) killing remained a significant predictor (p < .001) of symptoms of posttraumatic stress, depression, and anxiety, after controlling for other warzone stressors. However, killing was not a significant predictor of alcohol use or quality of life in Study 2. In summary, killing in combat may be associated with increased reports of psychological distress, but there were distinct results in the two studies. Differences in mission statements, rules of engagement, and mental states during combat could explain the diverging outcomes. The results indicate that it may be erroneous to ubiquitously regard killing in combat as a moral stressor, and highlight the importance of clear rules of engagements that accounts for the “on the ground” reality of soldiers.

Download Full-text

Contribution of mental ill health during military service to postservice benefit claims in the UK

Occupational and Environmental Medicine ◽

10.1136/oemed-2020-107050 ◽

2021 ◽

pp. oemed-2020-107050

Author(s):

Howard Burdett ◽

Nicola T Fear ◽

Simon Wessely ◽

Neil Greenberg ◽

Roberto J Rona

Keyword(s):

Mental Health ◽

Military Service ◽

Mental Health Problems ◽

Common Mental Disorder ◽

Population Attributable Fraction ◽

Armed Forces ◽

Post Traumatic Stress ◽

Civilian Life ◽

Carry Over ◽

The Uk

ObjectivesWhile most UK military personnel transition successfully into civilian life, some experience unemployment and disability, which may be partly attributable to in-service factors. This study aims to determine the degree to which in-service mental health problems impact on postservice benefit claims.MethodsUsing data from a cohort of 5598 recent leavers from regular service in the UK Armed Forces linked with data from the Department for Work and Pensions, we assessed associations between in-service mental health and postservice benefit claims, and the population attributable fraction (PAF) of benefit claims related to in-service mental health. An analysis with postservice mental ill health as mediator was performed to determine the degree to which the observed effects were a consequence of persistent illness, as opposed to remitted.ResultsMental illness occurring in-service predicted both unemployment and disability claims, partly mediated by postservice health (23%–52% total effects mediated), but alcohol misuse did not. Common mental disorder (CMD) (PAF 0.07, 95% CI: 0.02 to 0.11) and probable post-traumatic stress disorder (PTSD) (PAF 0.05, 95% CI 0.01 to 0.09) contributed to unemployment claims. Probable PTSD was the largest contributor to disability claims (PAF 0.25, 95% CI 0.13 to 0.36), with a smaller contribution from CMD (PAF 0.16, 95% CI 0.03 to 0.27).ConclusionsIn-service mental ill health gives rise to benefit claims. These effects are only partly mediated by postservice mental health, implying that in-service (or pre-service) mental issues have carry-over effects into civilian life even if remitted. Better prevention and treatment of in-service PTSD symptoms may well reduce postservice disability claims.

Download Full-text

Gender Differences in the Association of Hazardous Alcohol Use with Hypertension in an Urban Cohort of People Living with HIV in South Florida

PLoS ONE ◽

10.1371/journal.pone.0113122 ◽

2014 ◽

Vol 9 (12) ◽

pp. e113122 ◽

Cited By ~ 5

Author(s):

María José Míguez-Burbano ◽

Clery Quiros ◽

John E. Lewis ◽

Luis Espinoza ◽

Robert Cook ◽

...

Keyword(s):

Gender Differences ◽

Alcohol Use ◽

South Florida ◽

People Living With Hiv ◽

Hazardous Alcohol Use ◽

Hazardous Alcohol ◽

Living With Hiv

Download Full-text

Subjective executive function deficits in hazardous alcohol drinkers

Journal of Psychopharmacology ◽

10.1177/02698811211032605 ◽

2021 ◽

pp. 026988112110326

Author(s):

Anna Powell ◽

Harry Sumnall ◽

Cecil Kullu ◽

Lynn Owens ◽

Catharine Montgomery

Keyword(s):

Alcohol Use ◽

Recovery Of Function ◽

Brain Regions ◽

Future Research ◽

Hazardous Alcohol Use ◽

Cross Sectional ◽

Hazardous Alcohol ◽

The Impact ◽

The Relationship ◽

Alcohol Related Problems

Background: Dependent alcohol drinkers exhibit differences in the structure and function of the brain, and impairments in cognitive function, including executive functions (EFs). Less is known about the impact of non-dependent but hazardous use (that which raises the risk of harm), and it is also unclear to what extent executive impairments in this cohort affect real-world function. The current study examines the relationship between alcohol use, EF and alcohol-related problems, in the general population. Methods: A between-groups cross-sectional design assessed EF across two levels of drinking; hazardous (Alcohol Use Disorders Identification Test (AUDIT) score of ⩾8) and non-hazardous. Alcohol drinkers ( n = 666; 136 male; 524 female; six not disclosed; aged 28.02 ± 10.40 years) completed validated questionnaires online assessing subjective EF, alcohol use and alcohol-related problems. Results: Organisation, Strategic Planning, Impulse Control and overall function were significantly impaired in hazardous drinkers. Furthermore, the effect of alcohol on EF, partially mediated the relationship between alcohol use and alcohol-related problems. Conclusion: Hazardous drinking was associated with lower subjective EF, and this mediated the effect of alcohol on alcohol-related problems. This may be due to changes in prefrontal brain regions, which could indicate greater risk for the development of alcohol dependence (AD). Future research should use additional means to assess EF in hazardous drinkers, including recovery of function, development of AD and the relationship between cognition and alcohol-related daily problems.

Download Full-text

The Impact of Hazardous Alcohol Use on Behavioral Healthcare Utilization Among National Guard Service Members

Substance Use & Misuse ◽

10.3109/10826084.2015.1133644 ◽

2016 ◽

Vol 51 (5) ◽

pp. 625-636 ◽

Cited By ~ 2

Author(s):

Carissa van den Berk-Clark ◽

Sundari Balan ◽

Manan V. Shroff ◽

Greg Widner ◽

Rumi Kato Price

Keyword(s):

Alcohol Use ◽

Healthcare Utilization ◽

National Guard ◽

Service Members ◽

Hazardous Alcohol Use ◽

Behavioral Healthcare ◽

Hazardous Alcohol ◽

The Impact

Download Full-text

Impact of co-occurring drug use, hazardous alcohol use and mental health disorders on drug use patterns in people living with HIV and hepatitis C virus infection

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab520 ◽

2021 ◽

Author(s):

Sean McCormick ◽

Kathleen M Ward ◽

Catherine G Sutcliffe ◽

Risha Irvin ◽

Geetanjali Chander ◽

...

Keyword(s):

Mental Health ◽

Alcohol Use ◽

Drug Use ◽

Mental Health Disorders ◽

People Living With Hiv ◽

Hazardous Alcohol Use ◽

Use Patterns ◽

Hazardous Alcohol ◽

Health Disorders ◽

Living With Hiv

Abstract Drug use, hazardous alcohol use, and mental health disorders are prevalent among people with HIV and HCV infection. Co-occurrence of alcohol use and depression negatively impacts substance use patterns. Nevertheless, HCV treatment provides a promising opportunity to identify and address co-occurring drug use, hazardous alcohol use, and mental health disorders.

Download Full-text