Mental health in the military Flashcards

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1
Q

How is the military service perceived by the media?

A

Media often focuses on negative effects of military service

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2
Q

When did the research by King’s Centre for Military Health Research start?

A

2003, at beginning of Irak conflict, then Afghanistan

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3
Q

Who funds the research done by King’s Centre for Military Health Research?

A

UK Ministry of Defense

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4
Q

What does King’s Centre for Military Health Research cohort study consist of?

A

> Random selection of

  • Irak and Afghanistan deployed personnel
  • non-deployed serving personnel

> Sample:

  • Royal Navy, Royal Marines, RAF, Army
  • regulars and reservists
  • men and women
  • service leavers
  • exclusion of special forces

> 2 phases of data collection (via postal questionnaires)

> N = approx. 10,000

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5
Q

What are the three key outcomes measures in the King’s Centre for Military Health Research cohort study?

A
  1. Probable PTSD (measured with PCL-C)
  2. Common mental disorders (measured with GHQ)
  3. Alcohol misuse (measured with AUDIT)
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6
Q

What do the prevalence of key outcome measures show in the King’s Centre for Military Health Research cohort study?

A

Common mental disorders and alcohol misuse are more prevalent than PTSD

  • PTSD: 4% (n = 376)
  • Common mental disorders: 19.7%
    (n = 1908)
  • Alcohol misuse: 13% (n = 1323)
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7
Q

What is observed with the rates of PTSD in the armed forces compared to the general population?

A

PTSD is not more common in the armed forces

- it’s equal to the rates in gen. pop.

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8
Q

What is observed with the rates of alcohol misuse in the armed forces compared to the general population?

A

> Alcohol misuse is higher in armed forces than in gen. pop.

> Within armed forces:
- higher in regular personnel than in reserves

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9
Q

Which factors could account for the differences of alcohol misuse in the armed forces compared to the general population?

A

Age and gender

  • there are more young men in armed forces
  • young men drink more than other people
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10
Q

How do male military personnel compare with males in the general population, regarding alcohol misuse?

A

Males in armed forces drink more across all age groups compared to their equivalent in gen. pop.

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11
Q

How do female military personnel compare with females in the general population, regarding alcohol misuse?

A
  • Females in armed forces drink more across all age groups compared to their equivalent in gen. pop.
  • The differences are stronger than what is observed for male military, particularly at young age
  • These differences with the gen. pop. decrease with age
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12
Q

Which types of deaths are more common within the military overall than expected?

A
  • Non-recreational drowning
  • Off road motor vehicle accidents
  • Air transport accidents
  • Heat injury
  • Injury by firearms
  • Alcohol-related conditions
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13
Q

What is the impact of the significant rates of alcohol misuse in the military personnel?

A

Long-term impact on personnel’s mortality

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14
Q

What are the differences of alcohol misuse within the military personnel between those who have been deployed and those who haven’t?

A

Increase of alcohol misuse in deployed personnel vs. those who haven’t been, when they return in the UK from deployment

  • service personnel do not drink when deployed
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15
Q

What is observed on the rates of probable PTSD by deployment status?

A

Rates of PTSD remain at around 4%

  • whether military personnel had or hadn’t been deployed
  • and whether they were deployed in Irak or Afghanistan or somewhere else

-> serving in Iraq/Afghanistan is not the main risk factor for PTSD

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16
Q

What is the role of combat on the rates of PTSD, common mental disorders and alcohol misuse?

A

Military personnel who has been in combat have higher rates of PTSD, common mental disorders and alcohol misuse
- compared to those who haven’t been in combat

-> role army personnel has when they’re deployed has an impact on their mental health (and disorders)

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17
Q

What is the role of the number of deployments on the levels of PTSD symptoms among currently serving UK Army regulars?

A

Positive correlation between number of deployments and PTSD symptoms reduction

18
Q

What could explain why the symptoms of PTSD in currently serving UK Army regulars decreases with the number of deployments?

A

Those who haven’t been deployed more than once may be more resilient than those who’ve been deployed once and came home

19
Q

Which factors are associated with probable PTSD King’s Centre for Military Health Research cohort study?

A
  • Childhood adversity
  • Low rank
  • Discharged from service
  • Serious accident
  • Combat role
20
Q

Which factors are not associated with probable PTSD in King’s Centre for Military Health Research cohort study

A
  • Deployment to Irak or Afghanistan

- Deployed somewhere else

21
Q

What could explain the deployment effect observed in reservists (similar rates of outcome than regulars)?

A

> Reservists are

  • more likely females
  • more likely to hold higher ranks
  • > makes them less likely to report PTSD

> Reservists reported:

  • fewer previous deployments
  • > less preparation (resilience)
  • lower levels of comradeship and unit cohesion
  • more self-reported traumatic exposures
  • more problems adjusting to homecoming
  • more likely to consider divorce
22
Q

Why is the higher self-reported traumatic exposures reported by army reservists compared to army regulars important?

A

It means reservists are more likely to perceive that they were exposed to trauma then their regular counterparts

  • evidence suggests perception of the trauma is more important than the trauma itself
23
Q

What are the possible definitions of a veteran?

A
  • Left service to retire
  • Deployed on operations (not necessarily overseas)
  • Deployed overseas in combat mission
  • Left service after four years
  • Completed basic training
  • Deployed overseas
  • Completed a minimum of one day’s service
24
Q

What are the statistics on veteran outflow from the UK Armed Forces?

A

18,750

  • 49.5% service leavers with 4 years or more
  • 50.5% early service leavers (less than 4 years)
25
Q

What do the public think on how common it is for former members of the Armed forces to have some kind of physical, emotional or mental health problem as a result of their time in the Forces?

A
  • 34%: very common
  • 57%: quite common
  • 8%: quite rare
26
Q

What is the employment rate of veterans?

A

85%

27
Q

What is the rate of veterans in a temporary housing situation?

A

8%

28
Q

What is the difference of violent behaviours in veterans compared to the general population?

A

Less likely to be in prison than gen. pop.

BUT more likely to be for violent or sexual offences

29
Q

What is the prevalence of common mental disorders in service leavers compared to currently serving personnel?

A
  • Service leavers: 22%

- Serving: 19%

30
Q

What is the prevalence of PTSD symptoms in service leavers compared to currently serving personnel?

A
  • Service leavers: 6%

- Serving: 3%

31
Q

What is the prevalence of alcohol misuse in service leavers compared to currently serving personnel?

A
  • Service leavers: 13%

- Serving: 13%

32
Q

What are early service leavers?

A

Those who leave before completing their basic term of service (always unplanned)
- approx. 50% of those leaving service yearly

  • More likely to be females, single, lower rank, with experience of childhood adversity
33
Q

What is the difference of mental health problems and adverse outcomes between early service leavers compared with other leavers?

A

Compared to other leavers, early service leavers are more likely to report

  • range of mental health problems
  • adverse outcomes
34
Q

What is a military family nowadays?

A

> Spouses and partners (current or former)

> With step-children or children living at different addresses (previous marriages)

> Parents, grandparents, and sibling of personnel

35
Q

What is unique about military families?

A

> Frequent separation and relocation

  • deployment
  • training exercises
  • postings (UK and overseas)

> Risk of injury or death

  • > Impact on
  • relationships
  • housing
  • children
  • employment
  • mental health
35
Q

What is unique about military families?

A

> Frequent separation and relocation

  • deployment
  • training exercises
  • postings (UK and overseas)

> Risk of injury or death

  • > Impact on
  • relationships
  • housing
  • children
  • employment
  • mental health
35
Q

What is observed on the marital status statistics of UK military compared with the general population?

A
  • Military personnel are more likely to be married than their equivalent counterparts in gen. pop.
  • They’re less likely to co-habit and be unmarried
  • No difference with gen. pop. for unpartnered, widowed or divorced
36
Q

What is the self-reported impact of the military career on the marriage or relationship?

A
  • 49% negative impact
  • 22% positive impact
  • 29% no impact
37
Q

What is the perceived impact of the military career on children?

A
  • 51% report a negative impact
  • 20% positive impact
  • 29% no impact
38
Q

What do children report as the worst things about having a father in the UK Armed Forces?

A
  • 61% lack of contact
  • 18% nothing
  • 16% relocating
39
Q

What do children report as the best things about having a father in the UK Armed Forces?

A
  • 25% financial benefits (e.g. good schools)
  • 25% sense of pride that father fights for ‘Queen and country’
  • 21% relocating