BackgroundVeterans 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 with complex symptoms of PTSD. ICD-11 PTSD and complex PTSD (CPTSD) have not previously been explored in a military sample.AimsThis study aimed to validate the only measure of ICD-11 PTSD and CPTSD, the International Trauma Questionnaire, and assess the rates of the disorder in a sample of treatment-seeking UK veterans.MethodA sample of help-seeking veterans (N = 177) was recruited from a national charity in the UK that provides clinical services to veterans. Participants completed measures of ICD-11 PTSD and CPTSD as well as childhood and adult traumatic life events. Confirmatory factor analysis was used to assess the latent structure of PTSD and CPTSD symptoms, and rates of the disorders were estimated.ResultsThe majority of the participants (70.7%) reported symptoms consistent with a diagnosis of either PTSD or CPTSD. Results indicated the presence of two separate disorders, with CPTSD being more frequently endorsed (56.7%) than PTSD (14.0%). CPTSD was more strongly associated with childhood trauma than PTSD.ConclusionsThe International Trauma Questionnaire can adequately distinguish between PTSD and CPTSD within clinical samples of veterans. There is a need to explore the effectiveness of existing and new treatments for CPTSD in military personnel.

This systematic review examined the literature published from January 2006 to April 2013 related to the effectiveness of occupational therapy interventions for children with autism spectrum disorder (ASD) and their parents to improve parental stress and self-efficacy, coping, and resilience and family participation in daily life and routines. From the 4,457 abstracts, 34 articles were selected that matched the inclusion criteria. The results were mixed and somewhat inconclusive because this body of literature is in its infancy. Studies of children with ASD do not routinely measure parental and family outcomes. Recommendations include an emphasis on family measures other than parental stress and a greater focus on measures of parental and family functioning in all future studies of pediatric interventions to more fully understand the impact of interventions in a wider context.

Pearson et al. / My Invisible PTSD Pg. 2 understanding the barriers or facilitators to accessing treatment (Murphy, Hunt, Luzon & Greenberg, 2013). Research suggests that a common barrier to seeking treatment is stigma (Iversen et al., 2011). Additionally, self-stigmatising beliefs are a common barrier for veterans who report not seeking help, as doing so would cause them to feel weak (Sharpe et al., 2015). The role of stigmatizing beliefs in help-seeking has largely been investigated quantitatively, finding a strong, negative relationship between self-stigma and help-seeking in the veteran population (Coleman, Stevelink, Hatch, Denny, & Greenberg, 2017; Murphy, Palmer & Busuttill, 2016). There is a paucity of research investigating the factors that enable veterans to seek help. However, studies suggest that some factors that compel veterans to seek treatment include: family and friends, psychoeducation, severity of symptoms, and level of distress (Sayer et al., 2009; Pilkington, Msetfi & Watson, 2011; Kim, Britt, Klocko, Riviere, & Adler, 2011). Yet research is sparse into the experiences of these veterans who do access treatment for PTSD and what their lives are like beyond treatment; do they experience recovery and, if so, what supports this process or makes it more challenging? (Iversen et al., 2009). Young and Ensing (1999) defined recovery as an individual's unique journey to overcoming "stuckness," improving their quality of life, and redefining themselves following distress. This research also highlights the importance of spirituality and supportive relationships when seeking help for mental health difficulties, along with a return to basic functioning (e.g., taking care of oneself, eating) as symbolic of being "recovered" (Young & Ensing, 1999). In comparison, some researchers link recovery with post-traumatic growth (PTG), which has been described as the positive changes that some people experience following exposure to traumatic events, such as enhanced personal strength or spiritual change (Tedeschi & Calhoun, 2004). Research suggests that there is a relationship between improvements in symptoms of PTSD and depression with regard to higher levels of PTG (Murphy et al., 2016). Brewin, Garnett, and Andrews (2011) undertook a mixed-methods analysis of veteran's views on their lives post-treatment; they found themes that link with the idea of PTG such as enhanced relationships. However, the study is limited, as the aim was not for thorough exploration of veterans' recovery experiences, thus factors which may have brought about change were not studied. Further research is needed into the actual experiences of veterans who seek treatment and how they define their experience of recovery. The present study aims to qualitatively investigate three main questions: how do veterans make sense of their lives following a diagnosis of PTSD? What factors facilitated their pathway to recovery? And what challenges have they experienced during their process of recovery? Methods The qualitative methodology Interpretive Ph...

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IntroductionResearch has shown that the likelihood of ex-military personnel developing mental health problems following service is around one in five. Little is known about the barriers to accessing mental health in veterans from diverse ethnic backgrounds. This study aims to explore mental health treatment experiences of veterans from commonwealth countries and therefore diverse ethnic backgrounds.MethodsSemi-structured interviews were conducted over the telephone with veterans from commonwealth countries. Veterans were recruited from a mental health charity and were at various stages of treatment.ResultsWe interviewed six veterans who were from a diverse range of commonwealth countries including St Lucia, Gambia, Ghana, Fiji and South Africa. All had served in the UK army in combat roles. Our findings consisted of key themes: (1) feeling that they are treated differently, (2) they felt as though they were unheard when reaching out for help, (3) systemic pressures such as financial difficulties, missed opportunities and lack of insight about mental health and (4) the importance of involving the wider community in care.ConclusionOur findings highlight some distinct barriers to mental health treatment that commonwealth veterans experience. The themes reported by the participants appear to suggest they had experience signs of institutional racism. Suggesting the importance of highlighting these issues, and to help overcome these potential barriers to accessing services. Given that commonwealth veterans involvement in the UK military is significant and increasing, the findings in this study should be used to support this population by implementing service provision and policy.