War Zone stress, personal and environmental resources, and PTSD symptoms in Gulf War Veterans: A longitudinal perspective.

Abstract

Cross-sectional research has demonstrated a link between personal and environmental resources and development of emotional distress after war zone service. Less is known about the longitudinal relationship between resources and distress. The authors addressed this issue in a study of 348 Gulf War returnees tested at 2 time points. Resources decreased and posttraumatic stress disorder (PTSD) symptoms increased over time. Time 1 avoidance and family cohesion predicted PTSD symptoms at Time 2. Regression analyses revealed a bidirectional relationship over time between resources and PTSD symptoms. Time 1 resources predicted Time 2 psychopathology after accounting for Time 1 emotional distress. PTSD symptoms at Time 1 also predicted changes in coping and family relationships, even after accounting for Time 1 resources. Findings are consistent with the concept of a loss spiral (Hobfoll, 1989), in which resource factors and emotional sequelae to war stress exert reciprocal effects.

Coping Strategies and Posttraumatic Stress Symptoms in Post-ICU Family Decision Makers

“…Some authors have presumed the presence of PTSD symptoms causes the use of avoidant coping (36,50). However, other authors have reported avoidant coping as a predictor of later PTSD symptoms in populations of Gulf War victims, domestic violence victims, and traumatic injury victims (51)(52)(53). A recent study measured coping strategy in 56 mothers of premature infants in the neonatal ICU (31).…”

“…The presumably high stress of the ICU experience, influenced in part by the outcome of the patient, mobilizes coping strategies. The use of avoidant coping in response to ongoing ICU and post-ICU stressors may play a role in sustaining and accelerating PTSD symptom severity as has been shown in other traumatic stress populations (27,51,53). Problem-focused coping has been associated with negative psychological health outcomes from acute stress-ors but positive health outcomes with chronic stressors, suggesting psychological difficulty in the short term but improved psychological adjustment in the long term (22,26,36).…”

The occupational role of women in military service: Validation of occupation and prevalence of exposures in the Millennium Cohort Study

“…Studies from the Vietnam War and the 1991 Gulf War have documented specific exposures of concern among deployed military women, including witnessing of death and morbidity due to war, disaster, or tragic event (Hobfoll et al 1991;Orsillo et al 1998;Carson et al 2000;Carney et al 2003); exposure to prisoners of war (Benotsch et al 2000;Carney et al 2003); chemical or biological warfare or countermeasures for these agents (Gray et al 1999;Smith et al 2002;Boyd et al 2003;Carney et al 2003;Smith et al 2003Smith et al , 2004a; depleted uranium (Carney et al 2003;Macfarlane et al 2005); and pesticides (Gambel et al 1998;Carney et al 2003;Macfarlane et al 2005). These and other studies investigating exposures associated with morbidity and reproductive health outcomes (Hourani & Hilton 2000;Kang et al 2000Kang et al , 2001Reutman et al 2002;Araneta et al 2003) highlight the growing occupational challenges faced by increasing numbers of women as they serve in an evolving military work force.…”

Feasibility, Acceptability, and Clinical Trends of a Mindfulness-Informed Child Welfare Intervention: Implications for Trauma-Focused Practice

“…Teaching mindfulness to families aligns with traumainformed child welfare practice such that strategies can be used to help target stress and coping with the potential to improve long-term parent-child interactions and family functioning. For example, individuals exposed to adversity may struggle to adaptively cope, thereby affecting self-regulation skills (Cloitre et al, 2009) and engaging in more avoidant-related coping (Benotsch et al, 2000) in the presence of distressing thoughts and feelings. Exposure to stress and impaired coping may in turn increase the likelihood of unhealthy behaviors such as substance use or hostile parenting practices.…”