Treatment of military-related post-traumatic stress disorder: challenges, innovations, and the way forward

Forbes, David; Pedlar, David; Adler, Amy B.; Bennett, Clare; Bryant, Richard A.; Busuttil, Walter; Cooper, John A.; Creamer, Mark; Fear, Nicola T.; Greenberg, Neil; Heber, Alexandra; Hinton, Mark; Hopwood, Mal; Jetly, Rakesh; Lawrence‐Wood, Ellie; McFarlane, Alexander C.; Metcalf, Olivia; O’Donnell, Meaghan; Phelps, Andrea; Richardson, J. Don; Sadler, Nicole; Schnurr, Paula P.; Sharp, Marie‐Louise; Thompson, James M.; Ursano, Robert J.; Hooff, Miranda Van; Wade, Darryl; Wessely, Simon

doi:10.1080/09540261.2019.1595545

Cited by 58 publications

(50 citation statements)

References 105 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our third central theme related to veteran's cognitive appraisals and emotional responses following morally injurious and non-morally injurious events, which were broadly consistent with previous literature in trauma-exposed and morally injured samples (Bryan et al, 2016(Bryan et al, , 2014Forbes et al, 2019). Following a PMIE, many participating veterans described primary symptoms of guilt, shame and worthlessness as well as secondary maladaptive responses such as poor self-care and risk-taking (Drescher et al, 2011;Frankfurt & Frazier, 2016;Williamson et al, 2019).…”

Section: Discussionsupporting

confidence: 80%

The impact of trauma exposure and moral injury on UK military veterans: a qualitative study

Williamson

Murphy

Stevelink

et al. 2020

European Journal of Psychotraumatology

Self Cite

View full text Add to dashboard Cite

Background: Exposure to a potentially morally injurious event (PMIE) has been found to be associated with a range of adverse mental health outcomes. However, how the psychological consequences following PMIEs compare to those encountered after a traumatic, but not a PMIE, remain poorly understood. Objective: The aim was to qualitatively explore UK military veterans' responses to experiences of trauma and moral injury and the impact of such events on psychological wellbeing. Method: Thirty male veterans who reported exposure to traumatic and/or morally injurious events were recruited. Semi-structured qualitative interviews were conducted, and data were analysed using thematic analysis. Results: Six veterans described exposure to a non-morally injurious traumatic event, 15 reported experiencing a PMIE, and 9 described exposure to a 'mixed' event which was simultaneously morally injurious and traumatic. Veterans who encountered a PMIE described experiencing moral dissonance, or a clash between concurrently held sets of values (e.g. military values versus civilian values), which provoked considerable psychological distress. Veterans' cognitions and responses were found to differ following a PMIE compared to a traumatic, but not PMIE, which could have negative implications for daily functioning. Several risk and protective factors for experiencing distress following a PMIE were described. Conclusions: This study provides some of the first evidence that events experienced by UK veterans can simultaneously be morally injurious and traumatic or life-threatening as well as highlighting the process by which moral injury may occur in UK veterans. These findings illustrate the need to examine effective pathways for prevention and intervention for veterans who have experienced a morally injurious event.

show abstract

Section: Discussionsupporting

confidence: 80%

The impact of trauma exposure and moral injury on UK military veterans: a qualitative study

Williamson

Murphy

Stevelink

et al. 2020

European Journal of Psychotraumatology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Psychotherapy is the initial basis of treatment for PTSD, and various drug therapies adjunctive to psychotherapy are typically added, though there remains a pressing need for development of new therapies (36). Selective serotonin reuptake inhibitors have shown efficacy in symptomatic relief and decreasing rates of relapse, as have norepinephrine reuptake inhibitors (37).…”

Section: Ptsd: Diagnosis and Therapymentioning

confidence: 99%

Long-Term Clinical and Neuronuclear Imaging Sequelae of Cancer Therapy, Trauma, and Brain Injury

et al. 2019

View full text Add to dashboard Cite

Learning Objectives: On successful completion of this activity, participants should be able to (1) describe clinical features and therapeutic approaches in the evaluation and management of cancer-and chemotherapy-related cognitive impairment (CRCI), posttraumatic stress disorder (PTSD), and traumatic brain injury (TBI); (2) discuss the role of neuroimaging in contributing to understanding of relationships between clinical features of CRCI, PTSD, and TBI, with aspects of underlying regional cerebral function; and (3) identify which brain processes are most consistently shown to be affected in CRCI, PTSD, and TBI.

show abstract

“…4 5 While not all mental illness resulting from combat exposure is PTSD, a meta-analysis of risk factors for combat-related PTSD 6 and a comprehensive review of militaryrelated PTSD are valuable summaries of the research evidence. 7 These papers are the basis for the Military Combat Mental Health Framework shown in Figure 1. Exposure to one or more 'potential trauma events' (PTE) is essential for causation.…”

Section: The Military Combat Mental Health Frameworkmentioning

confidence: 99%

MIlitary Combat Mental Health Framework

Bricknell

2020

BMJ Mil Health

View full text Add to dashboard Cite

This paper describes a framework for understanding military combat mental health based on the possible mental ill-health consequences of exposure to ‘potential trauma events’ for members of the armed forces and after their military service as veterans. It uses a life course approach that maps an individual’s mental well-being against four ‘states’: fit, reacting, injured and ill. It then considers five categories of factors that influence the risk of mental illness from this exposure based on research evidence; prejoining vulnerability, resilience, precipitating, treatment and recovery. This framework offers a structure to debate current knowledge, inform policy and therapeutic interventions, provide education and to guide future research into the subject.

show abstract

Treatment of military-related post-traumatic stress disorder: challenges, innovations, and the way forward

Cited by 58 publications

References 105 publications

The impact of trauma exposure and moral injury on UK military veterans: a qualitative study

The impact of trauma exposure and moral injury on UK military veterans: a qualitative study

Long-Term Clinical and Neuronuclear Imaging Sequelae of Cancer Therapy, Trauma, and Brain Injury

MIlitary Combat Mental Health Framework

Contact Info

Product

Resources

About