The relationship between number of trauma types, resilience, and psychological symptoms in ex-military personnel from India.

Abstract

Objective: Traumatic event (TE) types have been shown to relate to adverse psychological outcomes. However, research in this area has relied almost exclusively on linear analysis and has been limited to Western countries with similar cultural values. Addressing these limitations, this study examined (a) presence and nature of relations between number of TE types and psychological outcomes and (b) minimum number of TE types predicting psychological symptoms in a culturally distinct sample of ex-military members from India. Method: The sample of 144 trauma-exposed Indian ex-military members (M age = 43.49; 90.90% males) completed a web-based survey. Results: Curvilinear regression analyses indicated quadratic relationships between number of TE types and psychological symptoms (posttraumatic stress disorder [PTSD], depression, and anxiety severity) and resilience. Exploratory analyses showed (a) linear relationships between number of directly experienced TE types and psychological outcomes, (b) quadratic relationships between number of Predominant Death Threat TEs and psychological symptoms, (c) linear relationship between number of Predominant Death Threat TEs and resilience, and (d) linear relationships between other TE categories and psychological outcomes. Nonparametric receiver operating characteristic curve analyses indicated that a threshold of at least 10.5 TE types provided the optimal balance between sensitivity and specificity in classifying participants with (vs. without) probable PTSD, depression, and generalized anxiety disorder. For those reporting directly experienced TE types, this threshold was 2.5-3.5 TE types. Conclusion: Study results enhance an understanding of psychological difficulties faced by Indian ex-military members who have experienced multiple TE types, which can inform psychotherapeutic treatments for this population. Clinical Impact StatementClinicians would benefit from assessing posttrauma psychopathology beyond posttraumatic stress disorder (PTSD) symptoms in trauma-exposed, ex-military personnel from India. In this sample, clinicians may benefit from focusing on patients reporting (a) more than 10 traumatic event (TE) types and (b) more than 2 directly experienced TEs; these patients may be at risk for clinically significant posttrauma psychopathology such as PTSD, depression, and anxiety. Broadly, study findings are an initial step in assisting researchers, clinicians, and policymakers who seek to improve mental health treatment for Indian military personnel.

Asian Indians in the United States and Posttraumatic Stress Disorder Interventions: A Narrative Literature Review

“…Asian Indians report traumatic experiences before, during, or after immigration to the U.S., such as natural disasters, witnessing violent death of family members, war/conflict, torture as political prisoners, medical-related traumas, interpersonal traumas (e.g., domestic violence), and racial traumas (Dar & Deb, 2021; Dolan et al, in press; A. R. Gilmoor et al, 2019; Kaduvettoor-Davidson & Inman, 2013; Lee & Lu, 1989; Maji et al, 2021; Pillaia et al, 2015; Rechsteiner et al, 2019).…”

Posttraumatic Stress Disorder Symptoms and Sleep Disturbances Among Asian Indians: A Systematic Review

“…Further, India is one of the nine countries projected to account for more than half of the increase in the global population between 2020 and 2050 (United Nations Department of Economic and Social Affairs Population Division, 2021). Critically, Asian Indians living in India report mental health concerns and stressors (Dolan et al, 2022; Gilmoor et al, 2019). For instance, studies indicate that South Asians (including Asian Indians) report depression and interpersonal violence (Masood et al, 2009), and that the lifetime prevalence of mental health conditions among Asian Indians living in India is ~14% (Murthy, 2017), which is comparable to the worldwide pooled prevalence estimate of common mental health disorders (~13%; Polanczyk et al, 2015).…”

“…In a systematic review of Asian Indians living in India, Gilmoor et al (2019) found the average prevalence rates of PTSD to be as high as ~31% among individuals who experienced natural disasters and ~28% among individuals experiencing abuse. Further, studies have indicated that PTSD is linked to depression (Contractor et al, 2020), distress (Contractor et al, 2014), somatic symptoms (Mushtaq et al, 2006), increased risk of further trauma exposure (Dolan et al, 2022), and increased risk of suicide (A. R. Patel et al, 2021) among Asian Indians living in India.…”

Victims of armed conflict in India: psychosocial impact and available support

“…Limited literature focuses on mental health in the Indian Armed Forces, correlating the type of traumatic event and psychological symptomatology. Still, the prevalence of psychiatric diagnoses in the Indian military is difficult to track (Contractor et al, 2020 ; Dolan et al, 2022 ).…”