Narratives of holistic mental health recovery in New Zealand Defence Force personnel.

Research on military mental health recovery has tended to focus on therapy outcomes while backgrounding the role of diverse healing influences. The New Zealand Defence Force (NZDF) is a bicultural military integrated with Maori customs and cultural perspectives on holistic health and wellbeing. This study used narrative analysis to examine the semi-structured interviews of 21 active duty NZDF personnel who had accessed mental healthcare to understand what factors contributed to their return to wellness. Narratives described an orientation toward recovery as a process, where many interrelated wellbeing and social factors together supported the return to health. Culturally available Maori wellbeing metaphors were adopted as heuristics by service members in their storying of growth and healing. Findings are considered in terms of how wellbeing and recovery are conceptualized and promoted within militaries with diverse cultures. Discussion focuses on how narratives within military institutions can promote resilience and support service member recovery from mental distress.

Patterns of post-traumatic stress symptoms in mild traumatic brain injury and their relationship with outcomes: a latent profile analysis.

INTRODUCTION: Post-traumatic stress symptoms (PTSS) are known to contribute to postconcussion symptoms and functional status following mild traumatic brain injury (mTBI). Identifying symptom cluster profiles provide an opportunity to better understand PTSS and their influence on these outcomes. In this study, latent profiles of PTSS following mTBI were identified, and their association with mTBI outcomes was examined. The predictive role of demographic and injury related variables on profile membership was also explored. METHOD: Adults (N = 252) completed self report measures of PTSS and mTBI outcomes (post-concussion symptoms and functional status) within three months of mTBI. These measures were re-administered six months later (N = 187). Latent profile analysis (LPA) was used to ascertain the latent class structure of PTSS, and regression analysis to examine predictors of profiles. ANCOVA, with general psychological distress as a covariate, revealed the relationship between profiles and mTBI outcomes. RESULTS: LPA identified a four-profile model to best describe PTSS at baseline. This included a resilient (49.6%), moderate (30.6%), moderate with high intrusion/avoidance (14.3%) and a highly symptomatic profile (5.6%). A secondary school education or less and/or unemployment before mTBI was significantly more likely in the highly symptomatic profile, as well as sustaining an mTBI due to an assault or motor vehicle accident. PTSS latent class membership was significantly associated with mTBI outcomes even when controlling for general psychological distress. The resilient group had significantly better outcomes at baseline and six-month follow-up. However, no significant differences in mTBI outcomes emerged between the moderate, moderate with high intrusion/avoidance and the highly symptomatic profiles. CONCLUSION: The current study provides novel information on the symptom profiles of PTSS in mTBI, predictors of profile membership and their relationship with mTBI outcomes. Although future research using this approach is needed, the current study offers a more in-depth understanding of PTSS in mTBI to inform clinical care.

A preliminary study investigating the neglected domain of mental health in Australian lifesavers and lifeguards.

BACKGROUND: Surf lifesavers and lifeguards have provided essential education, preventative, and rescue services to the Australian community for over 110 years. In this first responder role, surf lifesavers and lifeguards are inadvertently exposed to high risk and trauma related experiences, which may negatively impact mental well-being. To date however, there has been limited research into the mental health of surf lifesavers and lifeguards, and no studies at all on the mental health of adolescent surf lifesavers. The preliminary study aimed to measure the exposure of potentially traumatic events (PTEs), post-traumatic stress symptoms (PTSS), self-efficacy, social support, and attitudes towards mental health problems in Surf Life Saving (SLS) members. METHODS: An anonymous, online survey was developed (adolescent and adult versions) and created to measure the domain of mental health in surf lifesavers and lifeguards. Pearson's correlations investigated relationships between PTEs, PTSS, self-efficacy, social support, attitudes towards mental health problems, age, years as a SLS member, and years patrolling. Spearman's Rank was used for violations of normality. RESULTS: A total of 57 surf lifesavers/lifeguards aged 13-59 years were included in the final analysis. There was a significant positive relationship between exposure to direct trauma and PTSS, which in turn, were associated with greater negative attitudes towards mental health problems towards the mental health of others, and lower levels of self-efficacy. Male and female adults with PTSS reported lower social support, whereas for adolescent males, a positive relationship between direct trauma and PTSS was observed. CONCLUSION: This research is the first to explore the mental health of Australian surf lifesavers and lifeguards. The results highlight the potential risks to mental health and well-being associated with this first responder role. More research to protect the vulnerability of this population is warranted.

Posttraumatic Growth and Posttraumatic Stress Symptoms in People with HIV.

Receiving a diagnosis of HIV can be challenging. People with HIV (PWH) can experience high levels of distress, as well as some positive psychological changes associated with post-traumatic growth. However, the mechanisms which underlying the association of a highly stressful event (i.e., being diagnosed with HIV) and posttraumatic growth (PTG) and posttraumatic stress symptoms (PTSS) are under-explored, and this is the focus of the study. Cross-sectional survey data were provided by 77 PWH living in New Zealand. An analysis examined the roles of deliberate rumination and coping strategies as serial mediators of the associations between event centrality and PTG and PTSSs. The relationships between event centrality and PTG and PTSSs were found to be sequentially mediated by deliberate rumination and avoidance coping, but not by deliberate rumination and active coping. Further analyses explored active coping and deliberate rumination as parallel mediators, with avoidance coping as a subsequent mediator, between event centrality and PTG and PTSSs. However, these analyses were not supported. The findings indicate that the more participants appraised the HIV diagnosis as central, the greater PTG they perceived; however, the more they deliberately ruminated on it, and the more avoidance coping they adopted, the less PTG and greater PTSSs they perceived. Future studies need to explore the relationships of event centrality and coping and their associations with PTG and PTSSs.

Forgotten first responders: Australian surf lifesavers and lifeguards.

First responders often face traumatic and emotionally-taxing incidents in their role. Understanding their mental health and coping capacity is important for wellbeing and continued service delivery. Surf lifesavers and lifeguards are an under researched yet a vital part of the first responder workforce. The recent Senate Report on first responders explored mental health in the leading emergency services personnel in Australia and found a high incidence of mental health difficulties in those who worked or volunteered as emergency responders. However, a significant literature gap exists regarding mental health of surf lifesavers and lifeguards in both the international and Australian context. Here we propose a strategy to address this gap, at the individual, organisational and community level.

A scoping review of post-disaster social support investigations conducted after disasters that struck the Australia and Oceania continent.

This scoping review provides a summary of research findings on social support dynamics in the wake of disasters that occurred on the continent of Australia and Oceania between 1983 and 2013. Forty-one studies, quantitative and qualitative, were summarised, investigating different facets of post-disaster supportive interactions. All inquiries assessed disasters resulting from natural hazards, with the majority of them conducted following events in Australia and New Zealand. The review revealed similar patterns of post-disaster social support dynamics that routinely unfold after disastrous incidents all over the world. Consistent with the disaster mental health literature, the documentation of social support mobilisation and social support deterioration processes was common. Salutary direct effects of supportive behaviours on post-disaster psychological distress were also highly evident. Most studies, however, posed research questions or hypotheses that lacked empirical or theoretical grounding. In conclusion, the review offers several recommendations on how to advance research on post-disaster social support.

Resilience and attitudes toward help-seeking as correlates of psychological well-being among a sample of New Zealand Defence Force personnel.

Research is needed to examine factors that contribute to psychological well-being among military service members. This study examined associations between various indices of psychological well-being, resilience, and help-seeking stigma among New Zealand Defence Force (NZDF) personnel (N = 2,805). Participants completed self-report measures of psychological well-being, resilience, help-seeking stigma, and past-year help-seeking behaviors. Greater resilience and a lower degree of help-seeking stigma were each significantly associated with better psychological well-being (i.e., greater psychological flourishing, less psychological distress, and better overall mental health). Though effects were relatively small, engagement in help-seeking behaviors moderated the relationship between (1) greater resilience and less psychological distress and (2) greater resilience and better overall mental health, such that these relationships were stronger among those who had sought help for their mental health in the past year. Findings suggest that greater resilience and less mental health help-seeking stigma may independently contribute to better psychological well-being among NZDF personnel; thus, enhancing resilience and reducing help-seeking stigma may serve to promote psychological well-being in this population. Improving resilience among NZDF personnel who seek help, in particular, may contribute to better psychological well-being. However, longitudinal research among service members is needed to establish a temporal relationship between these constructs.

An investigation into discharge, visual perception, and appearance concerns of prosthetic eye wearers.

We investigate prosthetic eye wearers' initial and current concerns about mucoid discharge, visual perception, and appearance, and the reasons for their concerns. A retrospective, cross-sectional study of private practice patients was designed. Participants were 217 experienced prosthetic eye wearers, aged at least 16 years. An anonymous questionnaire was e-mailed or mailed to participants. Descriptive and inferential statistics were used to investigate differences or correlations between variables. Content analysis was used to analyze participants' open responses. Participants were equally concerned about discharge, visual perception, and appearance during the first three months following eye loss and at least 2 years later, even though their concerns decreased. Older participants were less concerned about appearance, while females were more concerned about current discharge and appearance. The greater the frequency and volume of discharge, the greater was the concern. Participants' initial discharge concern was due to a negative interpretation of what it meant, but later, it was due to discomfort from wiping, and how discharge looked to others. Loss of depth perception and reduced visual range were equally concerning. Initial appearance concerns related to disguisability of the prosthesis, but over time, changes to the socket and eyelids became more important. Loss of self-image is commonly considered to be the major concern of anophthalmic patients, but discharge and visual perception concerns are of equal importance. Reasons given for these concerns provide greater insight into patients' personal experience of eye loss.

The development of a three part model of psychological resilience.

Psychological resilience has been defined as the ability of an individual to recover from a traumatic event or to remain psychologically robust when faced with an adverse event. This study investigated a sample of 176 police officers who were surveyed at commencement of their training in 1998/1999 (Time 1), 12 months later (Time 2), and at the end of 2009 (Time 3). A multidimensional model of psychological resilience (including environment, thoughts, feelings, behaviours, and physical activities) was evaluated in terms of the pathogenic outcomes of posttraumatic stress, psychological distress, and physical health at the three time points. A three part model of psychological resilience (environment, physical behaviours, and cognitions) was used to demonstrate that social support, adaptive health practices, adaptive coping, and optimism were effective when police officers were faced with adversity. The model provides initial understandings of the multidimensional nature of psychological resilience which requires further evaluation.