Traumatic events, other operational stressors and physical and mental health reported by Australian Defence Force personnel following peacekeeping and war-like deployments

Michael Waller,Alexander C Mcfarlane,Annette J Dobson,Susan A Treloar,Annabel C L Mcguire,Malcolm R Sim,Jonathan Bleier

doi:10.1186/1471-244x-12-88

Abstract

BackgroundThe association between stressful events on warlike deployments and subsequent mental health problems has been established. Less is known about the effects of stressful events on peacekeeping deployments.MethodsTwo cross sectional studies of the Australian Defence Force were used to contrast the prevalence of exposures reported by a group deployed on a peacekeeping operation (Bougainville, n = 1704) and those reported by a group deployed on operations which included warlike and non-warlike exposures (East Timor, n = 1333). A principal components analysis was used to identify groupings of non-traumatic exposures on deployment. Multiple regression models were used to assess the association between self-reported objective and subjective exposures, stressors on deployment and subsequent physical and mental health outcomes.ResultsThe principal components analysis produced four groups of non-traumatic stressors which were consistent between the peacekeeping and more warlike deployments. These were labelled ‘separation’, ‘different culture’, ‘other people’ and ‘work frustration’. Higher levels of traumatic and non-traumatic exposures were reported by veterans of East Timor compared to Bougainville. Higher levels of subjective traumatic exposures were associated with increased rates of PTSD in East Timor veterans and more physical and psychological health symptoms in both deployed groups. In Bougainville and East Timor veterans some non-traumatic deployment stressors were also associated with worse health outcomes.ConclusionStrategies to best prepare, identify and treat those exposed to traumatic events and other stressors on deployment should be considered for Defence personnel deployed on both warlike and peacekeeping operations.

Highlights

The association between stressful events on warlike deployments and subsequent mental health problems has been established
A 12% absolute increase in psychiatric morbidity was found in a small study of Australian troops who deployed to Somalia [6], and higher levels of anxiety, depression and psychological distress were found in a study of New Zealand peacekeepers [7] deployed predominantly to Cambodia, Somalia and Sinai
A study of UK personnel showed a twofold increase in heavy drinking in those who had deployed to Bosnia [8], but this study and others of deployments to this region have not shown an increase in psychiatric morbidity or Post Traumatic Stress Disorder (PTSD) in deployed troops [9,10]

Summary

Introduction

The association between stressful events on warlike deployments and subsequent mental health problems has been established. People exposed to stressful events on deployment are more likely to report subsequent mental health problems, in particular symptoms of Post Traumatic Stress Disorder (PTSD) or alcohol misuse [1,2,3,4]. This finding has been well documented in studies focused on combat exposures during deployments to Vietnam, Iraq and Afghanistan. The differing locations and exposures associated with the operations studied make it difficult to generalise these results to other peacekeeping deployments [5]

Methods

Results

Discussion

Conclusion