Posttraumatic growth and posttraumatic stress among military medical personnel.

McLean, Carmen P.; Handa, Sonia; Dickstein, Benjamin D.; Benson, Trisha A.; Baker, Monty T.; Isler, William C.; Peterson, Alan L.; Litz, Brett T.

doi:10.1037/a0022949

Cited by 31 publications

(32 citation statements)

References 45 publications

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“…The direct effect found between exposure and peritraumatic stress symptoms is in line with previous findings of a dose‐response relationship between exposure and PTSS (e.g., McLean et al., ; Wilson, ). Current results demonstrate that this effect begins in the peritraumatic period, while exposure is ongoing.…”

Section: Discussionsupporting

confidence: 91%

Sense of Threat as a Mediator of Peritraumatic Stress Symptom Development During Wartime: An Experience Sampling Study

Pickman

Greene

Gelkopf

2017

Journal of Traumatic Stress

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Exposure and sense of threat have been associated with stress symptoms, yet these relationships have not been clarified during the peritraumatic period. We investigated the mediating role of sense of threat in the link between exposure to rocket warning sirens and stress symptoms during wartime, and the effect of severe mental illness (SMI) status and gender on this mediation. A 30-day twice-daily smartphone-based intensive assessment of exposure to sirens, sense of threat, and peritraumatic stress symptoms was performed during the 2014 Israel-Gaza conflict. Participants included 182 highly exposed individuals with or without SMI. Multilevel structural equation modeling analysis was performed, with SMI status and gender as confounders. Exposure affected the level of peritraumatic stress symptoms both directly, b = 1.07, p < .001, 95% CI [0.32, 1.82], and indirectly, b = 0.78, p < .001, 95% CI [0.24, 1.33], through sense of threat. The effect of sense of threat on stress symptoms was larger in the SMI group, b = 0.86, p < .001, 95% CI [0.31, 1.40]. Gender did not have a significant effect. Sense of threat has a key role in symptom development during the peritraumatic timeframe. Intervention and prevention efforts should start early and focus on promoting a sense of safety, particularly with people with SMI.

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Section: Discussionsupporting

confidence: 91%

Sense of Threat as a Mediator of Peritraumatic Stress Symptom Development During Wartime: An Experience Sampling Study

Pickman

Greene

Gelkopf

2017

Journal of Traumatic Stress

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“…Five (out of a possible 10) studies reported a significant association between combat exposure and PTG, with higher levels of combat exposure being associated with higher levels of growth in four19 37 42 43 studies and a curvilinear relationship being reported in one21 study. However, the other five34 36 38 39 44 studies found a non-significant association.…”

Section: Resultsmentioning

confidence: 94%

“…Studies have sometimes limited their focus to a subsample of the military — for example, infantry,19 chaplains20 or medical personnel21 — or to a specific type of service-related trauma, for example — amputation22 or brain injury 23. Although psychological difficulties are present for a number of returning service personnel,24 there is an increased interest in PTG as a positive consequence of deployment.…”

Section: Introductionmentioning

confidence: 99%

Post-traumatic growth in the military: a systematic review

et al. 2018

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BackgroundPost-traumatic growth is defined as positive psychological, social or spiritual growth after a trauma.ObjectivesThis systematic review aimed to identify studies that quantitatively measured post-traumatic growth among (ex-) military personnel, to determine whether there is evidence of growth in this context and whether such growth is associated with any sociodemographic, military, trauma or mental health factors.Data sourcesThe electronic databases PsycInfo, OVIDmedline and Embase were searched for studies published between 2001 and 2017.Study eligibility criteria and participantsPapers were retained if they involved military or ex-military personnel, where some had been deployed to Iraq or Afghanistan.Study appraisalQuality assessment was conducted on all studies.Results21 studies were retained. The Post-Traumatic Growth Inventory was employed by 14 studies: means ranged from 32.60 (standard deviation = 14.88) to 59.07 (23.48). The Post-Traumatic Growth Inventory Short Form was used by five studies: means ranged from 17.11 (14.88) to 20.40 (11.88). These values suggest moderate growth. Higher levels of social support, spirituality and rumination and minority ethnicity were most frequently associated with more post-traumatic growth.LimitationsThe involved studies may lack generalisability and methodological quality.ConclusionsOverall, this paper confirms that negative reactions to trauma, particularly post-traumatic stress disorder, are not the only possible outcomes for service personnel, as moderate post-traumatic growth can also be observed.Implications of key findingsInterventions aimed at helping current and former armed forces personnel to identify and promote post-traumatic growth post-conflict may be beneficial for their well-being.

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“…Findings concluded that moderate levels of both combat stress and caregiving stress were associated with higher levels of PTSD and PTG. This “underscores the notion that growth and emotional distress are not mutually exclusive” (McLean et al, 2011, p. 4).…”

Section: Introductionmentioning

confidence: 65%

“…Another study examined PTG in U.S. military medics, physicians, and nurses returning from deployment in the Iraq war. This study examined PTG and PTSD in 253 U.S. Air Force personnel (McLean et al, 2011). Although the study’s demographics did not identify the number of nurses included, the investigators reported that nurses were represented.…”

Section: Introductionmentioning

confidence: 99%

A Positive Side of Deployment: Vicarious Posttraumatic Growth in U.S. Military Nurses Who Served in the Iraq and Afghanistan Wars

Doherty

Scannell-Desch

Bready

2020

J of Nursing Scholarship

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Purpose To describe vicarious posttraumatic growth in U.S. military nurses who served in the Iraq and Afghanistan wars. Design A cross‐sectional descriptive design was used. Methods Respondents were asked to complete the Posttraumatic Growth Inventory (PTGI), Core Beliefs Inventory (CBI), and six open‐ended write‐in questions as an electronic survey. Findings Appreciation of life and Personal strength were the strongest dimensions on the PTGI. This was also evident in participant responses to the open‐ended questions. The five dimensions of the PTGI were significantly correlated, indicating as growth increased in one dimension, growth increased in all dimensions. The CBI showed moderate to strong positive correlations with all items. Thus, the relationship between the total PTGI scores and the total CBI scores showed a strong, positive correlation, which indicated higher overall core belief scores associated with more growth in total PTGI scores. Conclusions This study provided initial evidence that some nurses who served in the Iraq and Afghanistan wars experienced posttraumatic growth. While healthcare providers need to be educated about their vulnerability when exposed to trauma, they also need to be aware of potential growth when caring for casualties. Clinical Relevance Nurses preparing to serve in war, as well as those returning, need to pay attention to their physical, psychological, emotional, and spiritual health. Following return from war deployment, the military services need to take deliberate and careful measures to ensure that no returning personnel “fall through the cracks” in getting the help they need.

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Posttraumatic growth and posttraumatic stress among military medical personnel.

Cited by 31 publications

References 45 publications

Sense of Threat as a Mediator of Peritraumatic Stress Symptom Development During Wartime: An Experience Sampling Study

Sense of Threat as a Mediator of Peritraumatic Stress Symptom Development During Wartime: An Experience Sampling Study

Post-traumatic growth in the military: a systematic review

A Positive Side of Deployment: Vicarious Posttraumatic Growth in U.S. Military Nurses Who Served in the Iraq and Afghanistan Wars

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