ABSTRACT
BACKGROUND: Posttraumatic stress disorder (PTSD) and physical health conditions commonly co-occur and are both prevalent among military personnel. This study examined how courses of PTSD (no PTSD, remitted, new onset, persistent/recurrent) are associated with physical health conditions, among a population-based sample of Canadian military personnel. METHOD: We analyzed data from the 2002 Canadian Community Health Survey-Mental Health and Well-being-Canadian Forces supplement (CCHS-CF) and the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-Up Survey (CAFVMHS; N = 2941). Multivariable logistic regressions examined associations between PTSD courses (reference = no PTSD) and physical health conditions. RESULTS: In general, physical health conditions were more prevalent among symptomatic PTSD courses compared to no PTSD. After adjustment, new onset PTSD was associated with increased odds of all physical health conditions with the exception of ulcers and cancer (AOR range: 1.41-2.31) and remitted PTSD was associated with increased odds of diabetes (AOR = 2.31). CONCLUSION: Results suggest that new onset PTSD may be most strongly associated with physical health conditions. Findings may inform targeted screening and intervention methods among military personnel with PTSD and physical health conditions.
Subject(s)
Military Personnel , Stress Disorders, Post-Traumatic , Veterans , Canada/epidemiology , Humans , Military Personnel/psychology , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Surveys and Questionnaires , Veterans/psychologyABSTRACT
SUMMARY The fear-avoidance model of chronic pain has stimulated extensive research and the development of a variety of interventions focused on reducing pain-related fear, avoidance behavior and functional disability in individuals with chronic pain. Although there is considerable evidence supporting the model, oversight of potentially important factors and inconsistent findings regarding postulated pathways have led to proposed model revisions. The purpose of this brief narrative review is to provide an overview of the original model, highlight key model revisions and review existing research that directly analyzed the pathways proposed in the original and revised models. The growing body of evidence emerging from analysis of proposed fear-avoidance pathways using structural equation modeling is generally supportive of the original model, as well as various proposed revisions. Additional evaluation using structural equation modeling may lead to a formulation of the fear-avoidance model that balances parsimony with heuristic value. Clinical implications and areas for future research are discussed.
ABSTRACT
OBJECTIVE: To systematically review the literature on the association between deployment to a peacekeeping mission and distress, mental disorders, and suicide. METHODS: Peer-reviewed English publications were found through key word searches in MEDLINE, PsycINFO, Scopus, and Embase, and by contacting authors in the field. Sixty-eight articles were included in this review. RESULTS: Some studies have found higher levels of postdeployment distress and posttraumatic stress disorder (PTSD) symptoms. Most studies have not shown an increased risk of suicide in former peacekeepers. Correlates of distress and PTSD symptoms included level of exposure to traumatic events during deployment, number of deployments, predeployment personality traits or disorder, and postdeployment stressors. Perceived meaningfulness of the mission, postdeployment social supports, and positive perception of homecoming were associated with lower likelihood of distress. CONCLUSIONS: Most peacekeepers do not develop high levels of distress or symptoms of PTSD. As postdeployment distress is consistently shown to be associated with high levels of exposure to combat during deployment, targeted interventions for peacekeepers who have been exposed to high levels of combat should be considered.
