Association Between Responsibility for the Death of Others and Postdeployment Mental Health and Functioning in US Soldiers

Khan, Amanda J.; Campbell‐Sills, Laura; Sun, Xiaoying; Kessler, Ronald C.; Adler, Amy B.; Jain, Sonia; Ursano, Robert J.; Stein, Murray B.

doi:10.1001/jamanetworkopen.2021.30810

Cited by 5 publications

(4 citation statements)

References 67 publications

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“…The themes of Haunted by Combat and Life-altering Moments highlight the traumatic experiences that veterans endure, including those that are unique to service and often inaccessible to most civilians ( 22 ). Our study's findings demonstrate that veterans want their providers to know about the trauma they’ve suffered.…”

Section: Discussionmentioning

confidence: 99%

What Do You Want Us to Know?: Learning From Life Stories to Improve Veterans’ Healthcare Experiences

Nguyen

Khetarpal

et al. 2022

Journal of Patient Experience

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My Life My Story (MLMS) is a national Veterans Health Administration (VA) life story interview program that aims to provide more humanistic care for veterans by focusing on the patient as a person. Our project took place at the Pittsburgh VA Healthcare System and had 3 main goals: (1) describe themes that emerge in MLMS interviews from the prompting question, what do you want your healthcare provider to know about you?; (2) identify topics of importance to veterans and suggest ways for healthcare providers to explore them; and (3) foster a culture at the Pittsburgh VA that places not only the health but also the personal triumphs, hardships, and aspirations of veterans at the center. Veterans provided verbal consent to have their previously recorded stories used in this study. Stories were coded and then analyzed for patterns and themes. A total of 17 veterans participated in our study. Themes that emerged from the stories include (1) Early Hardships; (2) Economic Disadvantage; (3) Polaroid Snapshots; (4) Around the World; (5) Haunted by Combat; (6) Life-altering Moments; (7) Homecoming; (8) Romantic Beginnings & Obstacles; (9) Inequity across Gender & Race; and (10) Facing Mortality. This study's findings underscore the need to address the traumas associated with military service, as well as the challenges faced with re-integration into civilian life, when working with veterans. The MLMS interviews explored in this study can help clinicians identify topics of importance to veterans, strengthen their relationships with their patients, and improve the care that veterans receive.

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Section: Discussionmentioning

confidence: 99%

What Do You Want Us to Know?: Learning From Life Stories to Improve Veterans’ Healthcare Experiences

Nguyen

Khetarpal

et al. 2022

Journal of Patient Experience

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“…The adaptation of military personnel and veterans to civilian life following military service has been extensively studied, and the link between violence during military operations and the psychosocial effects on those exposed is also well-documented and focused on the negative consequences ( Solomon et al, 1992 ; Shay, 2003 ; Zerach et al, 2013 ; Griffin et al, 2019 ). Direct involvement in killing ( Khan et al, 2021 ), moral injury ( Levi-Belz et al, 2022 ), and physical injury ( Xue et al, 2015 ) have been linked with post-traumatic stress disorder (PTSD) symptoms, a trauma-influenced outlook on life, mental illness, poor physical health, and generally poor adaptation to post-service life.…”

Section: Introductionmentioning

confidence: 99%

The adaptation of soldiers to post-service life – the mediating impact of political views on the relationship between violence and adaptation

et al. 2023

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IntroductionThe current research explores the association between political views, combat experiences, and the adaptation of soldiers to post-service life. Violent experiences in military service were explored as contributors to both positive and negative dimensions of adaptation, while political views served as possible mediators.MethodsThree hundred and twenty Israeli veterans participated in the study.ResultsPolitical views were correlated with adaptation, especially left-to-right voting and anti-militarism. The results support the mediating role of political beliefs (left–right voting and militarism) in the relationship between combat experience and adaptation to post-service life.DiscussionWe contend that political perceptions affect adaptation through sense-making of the combat experiences and the individual processing of these experiences, and the willingness to continue in reserve service, which allows social support and recognition. In addition, they are linked to a sense of bitterness following the reduction of public participation in military and reserve service.

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“…The effects of combat on veterans' mental health have long been known; however, a study of suicide in the US Army over the last 100 years showed that the rate during the Afghanistan and Iraq wars was 4-to 6-fold greater than it was during the last year of World War II, 7 and the mental health consequences were associated with the types of combat experienced. [8][9][10] Additionally, reports of randomized clinical trials have compared therapies for veterans with military-related posttraumatic stress disorder. 11,12 Gender-based violence during war, whether from sexual assault, enslavement, or partner violence, has long-term effects on the mental health of its survivors, which can persist for years.…”

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confidence: 99%

“…Studies have included the long-term outcomes associated with sulfur mustard in survivors of the Iran-Iraq war and studies on traumatic brain injury, which many call the signature injury of the wars in Iraq and Afghanistan after September 11, 2001. The effects of combat on veterans’ mental health have long been known; however, a study of suicide in the US Army over the last 100 years showed that the rate during the Afghanistan and Iraq wars was 4- to 6-fold greater than it was during the last year of World War II, and the mental health consequences were associated with the types of combat experienced . Additionally, reports of randomized clinical trials have compared therapies for veterans with military-related posttraumatic stress disorder …”

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confidence: 99%

Call for Papers on the Effects of War on Health and Health Care Delivery, Access, and Equity

et al. 2022

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The mission of JAMA Network Open is to improve health, health care, and health equity worldwide. 1 War is the antithesis of health. It affects combatants and civilians, families, communities, institutions, and the environment. All of these become less healthy, each are wounded, and each can die. By definition, war is inequitable.While the attention of the world is currently on the brutal war in Ukraine, 2 there have been constant and escalating conflicts around the world since the end of World War II. An estimated 80 100 people died in 2020 alone from organized violence-and state-based conflicts. 3 There are ongoing conflicts in Syria, Yemen, and Ethiopia and many other parts of the world; the Uppsala Conflict Data Program 4 lists 21 555 fatalities from organized violence in March 2022, with 2717 in Africa, 482 in Asia, 322 in the Middle East, 569 in the Americas, and 17 465 in Europe. Contemporary wars and civil conflicts have disproportionately affected civilians, some directly, but far more indirectly through the breakdown in public health, spread of infectious diseases, starvation owing to related famines and population malnutrition, disruption of infrastructures (including health systems), forced migration and internal displacement, and assaults and trafficking of women and children.As we have done for other important issues, JAMA Network Open is issuing a call for papers on the health effects of war and interventions that address the health consequences of war. This topic is not new for the journal. We have published studies on both direct and indirect effects of war, those occurring in the short term as well as those occurring over longer time horizons. Studies have included the long-term outcomes associated with sulfur mustard in survivors of the Iran-Iraq war 5 and studies on traumatic brain injury, 6 which many call the signature injury of the wars in Iraq and Afghanistan after September 11, 2001. The effects of combat on veterans' mental health have long been known; however, a study of suicide in the US Army over the last 100 years showed that the rate during the Afghanistan and Iraq wars was 4-to 6-fold greater than it was during the last year of World War II, 7 and the mental health consequences were associated with the types of combat experienced. [8][9][10] Additionally, reports of randomized clinical trials have compared therapies for veterans with military-related posttraumatic stress disorder. 11,12 Gender-based violence during war, whether from sexual assault, enslavement, or partner violence, has long-term effects on the mental health of its survivors, which can persist for years. 13,14 The high prevalence of self-reported severe posttraumatic stress symptoms in Rohingya refugees suggests that the trauma of displacement and consequences of violent military persecution will also persist. 15 Children are exposed to the violence of war in their families, neighborhoods, and communities. A study from Western Chitwan in Nepal found that children younger than 11 years who witnessed beatings related t...

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Association Between Responsibility for the Death of Others and Postdeployment Mental Health and Functioning in US Soldiers

Cited by 5 publications

References 67 publications

What Do You Want Us to Know?: Learning From Life Stories to Improve Veterans’ Healthcare Experiences

What Do You Want Us to Know?: Learning From Life Stories to Improve Veterans’ Healthcare Experiences

The adaptation of soldiers to post-service life – the mediating impact of political views on the relationship between violence and adaptation

Call for Papers on the Effects of War on Health and Health Care Delivery, Access, and Equity

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