Preventing psychological trauma in soldiers: The role of operational stress training and psychological debriefing

Abstract

Armed conflict is associated with significant long-term psychiatric morbidity. Interventions to reduce the incidence of psychiatric disorder following psychological trauma may be classified into three categories. Primary prevention includes the selection, preparation and training of individuals likely to be exposed to potentially traumatizing events. Secondary prevention comprises a variety of brief psychological techniques immediately or shortly after traumatizing life events, the best known of which is Psychological Debriefing. Tertiary interventions comprise the treatment of established PTSD and others. Psychiatric morbidity was studied in 106 British soldiers returning from UN peace-keeping duties in the former Republic of Yugoslavia. All 106 soldiers received an Operational Stress Training Package prior to their deployment and a randomly selected group also received a post-operational PD. Very low rates of PTSD and other psychopathology were found overall and the Operational Stress Training Package may have contributed to this. Elevated CAGE scores suggestive of significant alcohol misuse were observed in both groups and chemical avoidance behaviours arising from this may have masked psychopathology. CAGE scores diminished significantly in the debriefed group by the end of the follow-up period suggesting that PD may have been of benefit despite the apparent absence of PTSD. This study also demonstrates that a high incidence of psychiatric morbidity is not an inevitable consequence of military conflict.

Early interventions for the prevention of PTSD in adults: a systematic literature review

“…Results were divided according to the type of intervention (pharmacological or psychological). From the 29 articles reviewed, 16 reported significant effects of interventions for the prevention of PTSD or symptoms related to the disorder [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] . Of these, 22 studies used psychological interventions and 7 used pharmacological interventions (Table 2).…”

“…Four articles described the use of interventions based on a techniques know as debriefing 7,11,25,26 . Debriefing involves different forms of brief counseling and is aimed at allowing victims of psychological trauma to process their experiences cognitively and emotionally.…”

“…Despite these results, in one of the studies participants received training for stress management before the occurrence of the traumatic event (war combat), as well as psychological interventions after the trauma. Therefore, it is still a matter of debate whether the results obtained stem from the primary or the secondary intervention, that is, if they come from the intervention that preceded or the one that followed the trauma 11 .…”

The Air Force Deployment Transition Center: Assessment of Program Structure, Process, and Outcomes

“…In the era of the all-volunteer force, the pace and demands of these conflicts have resulted in longer and more frequent deployments and historically high levels of participation by reserve forces (Hacker Hughes et al, 2008;Deahl et al, 2000). Although most service members have coped well with deployment-related stresses, the high operational tempo of the past 14 years, longer deployments, and frequent redeployments have resulted in significant psychological health problems among service members.…”

“…Results from a nonrandomized trial showed that, relative to a comparison group, alcohol misuse was lower among those who received psychological debriefing one year following the intervention (but not at three or six months post-intervention; Deahl et al, 2000). The authors of a cluster-randomized trial of psychological debriefing reported that peacekeepers who received a debriefing intervention had higher rates of alcohol misuse three to four months after the intervention relative to a comparison group, who received a stress education program (Adler et al, 2008).…”