Canadian Armed Forces Members Research Articles

Awareness and use of Canadian Armed Forces mental wellbeing programs and resources among Regular Force personnel

To support broader efforts to empower military personnel to improve their health and wellbeing, the Canadian Armed Forces (CAF) have implemented numerous mental wellbeing programs and resources. The aim of the present study was to better understand factors that may drive awareness and use of these programs/resources. Data from the Your Say Survey, which is routinely administered to CAF members to assess their perceptions of policies and programs, were analyzed to identify key predictors of awareness and use of programs and resources promoting positive mental health at the individual, unit leader, and organizational levels. The survey was completed in 2021 by a stratified random sample of 1,743 Regular Force members, which was weighted to be representative of the CAF Regular Force population. Awareness of most programs/resources that were considered was found to be quite high, whereas use was comparatively low. Results of logistic regression analyses revealed that program/resource awareness was generally lower among younger CAF members, those who were single and had no dependent children, and those who indicated their supervisors infrequently demonstrated positive behaviours around mental health. Awareness also varied depending on the organizational command in which CAF members worked. It was found that CAF members were generally more likely to have used the program/resource if they reported poorer self-rated mental health and were older. Similar to program/resource awareness, use varied significantly depending on CAF members’ organizational command. The potential implications of these findings for enhancing awareness of mental wellbeing programs and resources in the CAF, and in occupational settings as a whole, are discussed.

Coping style as a risk factor for future alcohol use disorder: A 16-year longitudinal study in a Canadian military sample

BackgroundCoping strategies used in response to stress have the potential to influence the development of mental health disorders, including alcohol use disorders. The current study investigated whether coping strategies placed an individual at greater likelihood for developing a future alcohol use disorder. MethodsThis study used data from the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey; a nationally representative 16-year follow-up survey, with initial data collected in the 2002 Canadian Community Health Survey – Canadian Forces Supplement. The total sample from the two datasets included 2941 individuals who were Regular Force members in 2002. Coping styles included problem-focused, avoidant, and self-medication. Adjusted logistic regression analyses examined relationships between coping style (in 2002) and alcohol use disorders (developed between 2002 and 2018). ResultsSelf-medication coping in 2002 was associated with any alcohol disorder since last interview (i.e., 2002–2018) (AOR 1.26; 95 % CI, 1.02–1.57) and during the past year (adjusted odds ratios [AOR 1.26; 95 % CI, 1.08–1.47]), as well as past-year binge drinking (AOR 1.19; 95 % CI, 1.09–1.29). Problem-focused coping was protective against past-year alcohol abuse (AOR 0.84; 95 % CI, 0.71–1.00) and any alcohol use disorder (AOR 0.87; 95 % CI 0.76–1.00). ConclusionCoping styles were strongly associated with future alcohol use disorders. Notably, results show the risk extended over a 16-year period. Findings suggest the use of self-medicating coping strategies places an individual at increased risk of developing alcohol use disorders, while problem-focused coping may decrease future risk of alcohol use disorders.

Are physical fitness, a history of childbirth and injury history related to knee valgus in female Canadian Armed Forces members during a bodyweight overhead squat movement?

ObjectivesA history of childbirth is associated with musculoskeletal injury (MSKi) in female members of the Canadian Armed Forces (CAF). While previous injury and pregnancy impact knee kinematics, it is unclear...

Employment equity groups' experience of inclusion and commitment to the CAF.

The Canadian Armed Forces (CAF) are subject to the Employment Equity Act, which requires federally regulated employers to identify and eliminate barriers to the employment of designated groups (women, Indigenous peoples, persons with disabilities (PwD), and racialized members), and establish short-term, numerical goals to address underrepresentation. Addressing employment barriers experienced by these equity seeking groups is one of the CAF's key priorities. The objective of this study is to examine group differences in feelings of inclusion (i.e., relatedness, organizational inclusion, and microaggressions) and retention-related measures (i.e., job satisfaction, affective commitment, and intentions to leave), the contribution of feelings of inclusion to retention measures, and the effect of numerical representation and number of marginalized identities on these concepts. We analyzed data from the 2022 Your Say Matters survey, which was administered to a representative sample of CAF members, with oversampling of under-represented groups. Respondents included 4,483 Regular Force members (30.9% response rate). The groups under study included Indigenous members, persons with disabilities, racialized members, women not part of another group (non-Indigenous, non-racialized, women without disabilities), and everyone else (non-Indigenous, non-racialized, not women, without disabilities). Our hypotheses were supported overall, such that groups with less representation in the CAF scored lower on inclusion measures than groups with more representation. The number of marginalized identities held by military members predicted the inclusion measures, but did not predict retention-related measures. There were some group differences on retention-related measures, such that women not part of another group scored more favorably than other designated groups, and racialized members scored more favorably than PwD and Indigenous members. Inclusion measures predicted job satisfaction, affective commitment, and intentions to leave equally for all groups studied, suggesting that feeling included is important for all.

Clothing and Equipment Fit Among Male and Female Canadian Armed Forces Members.

The fit of military clothing and equipment is essential for the health and safety of military operators. Given the aim of increasing the proportion of women and the known biological and morphological differences between male and female soldiers, an understanding of fit across different items of kit is needed. The aim of this study was to quantify subjective fit ratings of 8 items of military clothing and equipment, including combat shirt, combat pants, rucksack, small pack, tactical vest, fragmentation vest, helmet, and ballistic eyewear as a function of relative stature and occupational group among male and female Canadian Armed Forces members. An online survey was distributed to male and female Canadian Armed Forces members, where fit was reported by participants according to a 7-point Likert acceptability scale. Participants were binned into 1 of 6 (3 males, 3 females) standing stature categories based on percentiles in a male and female distribution that included (1) under 35th percentile stature, (2) 35th to 80th percentile stature, and (3) over 80th percentile stature. Additionally, participants were separated according to occupational group: Group A: Infantry, Combat Engineer, Artillery, Armored; group B: Signals, Medical Technician, Intelligence, Signals Intelligence/Cyber Ops; group C: Supply Technician, Weapons Technician, Vehicle Technician, Electronic-Optronic Technician, Ammunition Technician; other: Not in other groups, examples include: Financial Services Administrator, Cook. This study was approved by the Defence Research and Development Canada Human Research Ethics Committee under protocol 2019-048, Amendment 2. There were significant effects attributable to stature category and occupational group on the fit of equipment. Specifically, fit acceptability of the rucksack helmet, small pack, and tactical vest was significantly affected by occupational group. Differences between stature categories were detected in all items with the exception of the small pack. Military equipment fit has previously been shown to have implications for protection, performance, and mobility. The results of the investigation demonstrate different patterns of fit acceptability in male and female soldiers across items of clothing and equipment and may require different solutions.

Thwarted belongingness and empathy's relation with organizational culture change.

In response to several high-profile cases of senior leaders in the Canadian Armed Forces (CAF) being accused of various forms of sexual and professional misconduct, the organization has committed to culture change. Drawing on the group engagement model and empirical evidence, we propose that CAF members' experience of thwarted belongingness reduces their capacity to show empathy, which in turn affects their support for culture change. Participants were 139 Naval and Officer Cadets from the Royal Military College of Canada who were predominantly male (61%), between 18 and 21 years old (80%), and not members of a visible minority group (68%). Data was collected via an online self-report survey assessing thwarted belongingness, empathy, and attitudes toward culture change. Whether participants experienced thwarted belongingness was not directly related to their level of support for culture change. Individuals' thwarted belongingness was indirectly and negatively associated with support for culture change, through its impact on empathy. Taken together, the results demonstrate that cadets' experience of belongingness contributed to their level of empathy, which together predicted their support for culture change initiatives. Efforts to change the culture of the CAF may need to consider improving members' levels of belongingness and, by extension, their levels of empathy. Implications for inclusion efforts are discussed.

A Comprehensive Summary of the Meta-Analyses and Systematic Reviews on Platelet-Rich Plasma Therapies for Knee Osteoarthritis.

Osteoarthritis (OA), including that of the knee joint, represents a significant proportion of musculoskeletal injuries in the Canadian Armed Forces (CAF) due to the frequent, high-stress physical activity for which member participation is necessary. Platelet-rich plasma (PRP) is a conservative, autologous treatment that has the potential to relieve symptoms and improve functionality of military members to decrease the impact of the disease and ultimately strengthen the CAF. A search of systematic reviews and meta-analyses was conducted to determine the efficacy of PRP injections in treating knee OA. The Scopus database, PubMed database, and Omni academic search tools were scoped for relevant publications. English literature, published up to and including March 2023, that investigated only clinically randomized controlled trials (RCTs) was eligible for inclusion. The results of network meta-analyses were investigated and summarized independent of reviews and non-network meta-analyses. A total of 225 unique systematic reviews and meta-analyses were initially identified, of which 39 publications, including 7 network meta-analyses, adhered to the defined inclusion and exclusion criteria. PRP was found to significantly alleviate symptoms of pain based on the visual analog scale and Western Ontario and McMaster Universities Arthritis Index pain scores within the 12-month follow-up. Function, activity, sport, quality of life, and stiffness were additionally determined to generally improve to a greater extent from PRP treatment compared to controls, while adverse effects were minor and temporary. PRP placed in the top 3 in 9 reported surface under the cumulative ranking curves, while individually reported rankings of leukocyte-poor and leukocyte-rich PRP both placed in the top 4. The clinical recommendations made were generally positive, with 17 publications acknowledging the benefits of PRP, 3 supporting possible efficacy, and an additional 8 recommending that it be an option for the conservative treatment of knee OA. The results of this review support the efficacy of PRP for relieving symptoms of pain and improving function, stiffness, and quality of life for patients experiencing knee OA within 12 months. As a result, leukocyte-poor-PRP could be considered for members of the CAF with mild to moderate knee OA (Kellgren-Lawrence grades 1-3) to slow the progression of OA and extend the military careers of CAF members. There continues to be a need for future studies to investigate the longer-term effects of PRP to verify sustained benefits at follow-up points greater than 12 months, including findings of improvement in a delayed fashion at the 3- and 6-month timeframe compared to hyaluronic acid treatment.

Transformational leadership, well-being, morale, and readiness: The mediating role of empowerment

ABSTRACT Transformational leadership is embedded in the value system of the Canadian military ethos. Research suggests that transformational leadership can be viewed as a form of empowering leadership facilitating empowered psychological states among their followers, which in turn, enhances their performance, wellbeing, and engagement. The current study examined the associations between transformational leadership and Canadian Armed Forces members’ psychological distress, morale, and pre-deployment readiness and the mediating role of psychological empowerment in these relationships. A path analysis model of the data collected through a pre-deployment survey completed by Canadian Armed Force (CAF) members (N = 2,391) revealed that transformational leadership was associated with lower psychological distress and greater morale and these relationships were partly explained by increased feelings of empowerment, namely higher levels of autonomy, competence, and meaning. Furthermore, transformational leadership was also associated with higher perceptions of pre-deployment readiness, and this was partly explained by increased feelings of meaning and competence. The results of this research suggest that transformational leadership is an effective strategy to bolster psychological resources and readiness in the CAF.

Correlates of cannabis use in a sample of mental health treatment-seeking Canadian armed forces members and veterans

ObjectiveCanadian Armed Forces (CAF) members and Veterans are more likely to experience mental health (MH) conditions, such as posttraumatic stress disorder (PTSD), than the general Canadian population. Previous research suggests that an increasing number of individuals are employing cannabis for MH symptom relief, despite a lack of robust evidence for its effectiveness in treating PTSD. This research aimed to: (1) describe the prevalence of current cannabis use among MH treatment-seeking CAF members and Veterans; and (2) estimate the association between current cannabis use and a number of sociodemographic, military, and MH-related characteristics.MethodUsing cross-sectional intake data from 415 CAF members and Veterans attending a specialized outpatient MH clinic in Ontario, Canada, between January 2018 and December 2020, we estimated the proportion of CAF members and Veterans who reported current cannabis use for either medical or recreational purposes. We used multivariable logistic regression to estimate adjusted odds ratios for a number of sociodemographic, military, and MH-related variables and current cannabis use.ResultsAlmost half of the study participants (n = 187; 45.1%) reported current cannabis use. Respondents who reported current cannabis use for medical purposes had a higher median daily dose than those who reported current cannabis use for recreational purposes. The multivariable logistic regression identified younger age, lower income, potentially hazardous alcohol use, and increased bodily pain as statistically significant correlates of current cannabis use among our MH treatment-seeking sample. PTSD severity, depressive severity, sleep quality, and suicide ideation were not statistically associated with current cannabis use.ConclusionsAlmost half of our treatment-seeking sample reported current cannabis use for medical or recreational purposes, emphasizing the importance of screening MH treatment-seeking military members and Veterans for cannabis use prior to commencing treatment. Future research building upon this study could explore the potential impact of cannabis use on MH outcomes.

Associations Between Rank, Sex, and Parity With Musculoskeletal Injuries Sustained During Annual Military Physical Fitness Test.

Edwards, CM, da Silva, DF, Puranda, JL, Souza, SCS, Semeniuk, K, and Adamo, KB. Associations between rank, sex, and parity with musculoskeletal injuries sustained during annual military physical fitness test. J Strength Cond Res 38(2): 367-373, 2024-Musculoskeletal injuries pose a significant threat to the well-being of military personnel. Attempts to use physical employment standard test results as predictors of injury are underway, but little is known about injuries sustained during the tests. This study sought to identify body regions most likely to be reported as injured during the annual Canadian Armed Forces (CAF) physical fitness evaluation. In addition, sex, rank, and parity status are explored as possible associated factors for injury. A total of 1,796 actively serving CAF members were categorized by sex (1,030 male participants; 766 female participants), rank (1,142 Non-Commissioned Members [NCM]; 638 Officers), and parity (314 parous female participants; 435 nulliparous female participants). Sex, rank, and parity were associated with body regions reportedly injured during an annual CAF fitness assessment (significance p ≤ 0.05). When compared with male participants, female participants were more likely to be injured {aOR: 1.797 (95% [confidence interval] CI: 1.45-2.23)} and more prone to injury of the wrist (adjusted odds ratio [aOR]: 1.933 [95% CI: 1.20-3.12]), hip (aOR: 3.445 [95% CI: 2.07-5.728]), or lower back (aOR: 1.55 [95% CI: 1.18-2.04]). Non-Commissioned Members were more likely to injure the neck (aOR: 2.14 [95% CI: 1.18-3.88]) or shoulder (aOR: 2.03 [95% CI: 1.31-3.15]), when compared with Officers. Parous female participants reported pelvis/abdomen injury at a higher rate than the nulliparous group (5 vs. 1.7%, p = 0.019). Injuries sustained during an annual CAF fitness assessment differ based on sex, rank, and parity. Canadian Armed Forces female participants, NCM, and parous female participants may require specific physical fitness support in preparation for the annual physical fitness test.

Child Maltreatment History, Deployment-Related Traumatic Events, and Past 12-Month Cannabis Use Among Veterans in Canada.

Cannabis use among veterans in Canada is an understudied public health priority. The current study examined cannabis use prevalence and the relationships between child maltreatment histories and deployment-related traumatic events (DRTEs) with past 12-month cannabis use including sex differences among Canadian veterans. Data were drawn from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (response rate 68.7%; veterans only n = 1,992). Five child maltreatment types and 9 types of DRTEs were assessed in relation to the past 12-month cannabis use. The prevalence of lifetime and past 12-month cannabis use was 49.4% and 16.7%, respectively. Females were less likely than males to report lifetime cannabis use (41.9% vs. 50.4%; odds ratio [OR] 0.71; 95% CI, - 0.59 to 0.86). No sex differences were noted for past 12-month cannabis use (14.1% vs. 17.0%; OR 0.80; 95% CI, 0.60 to 1.07). Physical abuse, sexual abuse, neglect, any child maltreatment, most individual DRTEs, and any DRTE were associated with increased odds of past 12-month cannabis use after adjusting for sociodemographic and military variables. Some models were attenuated and/or nonsignificant after further adjustments for mental disorders and chronic pain conditions. Sex did not statistically significantly moderate these relationships. Cumulative effects of having experienced both child maltreatment and DRTEs compared to DRTEs alone increased the odds of past 12-month cannabis use. Statistically significant interaction effects between child maltreatment history and DRTE on cannabis use were not found. Child maltreatment histories and DRTEs increased the likelihood of past 12-month cannabis use among Canadian veterans. A history of child maltreatment, compared to DRTEs, indicated a more robust relationship. Understanding the links between child maltreatment, DRTEs, and cannabis use along with mental disorders and chronic pain conditions is important for developing interventions and improving health outcomes among veterans.

Postpartum Women’s Perceptions of Risk of Musculoskeletal Injuries in the Canadian Armed Forces: A Qualitative Research Study

Musculoskeletal injuries (MSKi) are a major concern within military forces, significantly reducing productivity and military readiness. Within the Canadian Armed Forces (CAF), MSKi are the most common cause of delayed deployment of members. There is a lack of research specifically focused on the experiences of postpartum CAF members and their perceived risk of MSKi. Drawing on Giles et al.’s equity-centered 4 E’s injury prevention framework (education, engineering, enforcement, and equity), we highlight that individuals who experience pregnancy may perceive themselves to be at heightened risk of injury due to sex and gender-based inequities in their workplace. This qualitative research draws on data from focus groups with 32 individuals who experienced pregnancy while serving in the CAF. Using reflexive thematic analysis, we identified the following findings related to perceived increased risk of MSKi: (a) nature of relevant physiological and anatomical changes in pregnancy, (b) unreasonable pressures to return to work at peak physical readiness, and (c) perceived challenges associated with accessing resources and services to support physical recovery. There are opportunities to improve access to injury prevention resources and support for pregnant and postpartum CAF members to reduce rates of MSKi. Findings from this study may be additionally relevant to armed forces more broadly or other professions that require return to physical readiness.

Does a history of childbirth impact injury prevalence and mental health in female military members?

The effect of parity status on the prevalence and impact of musculoskeletal injury (MSKi) among female Canadian Armed Forces (CAF) members is unknown. This study aims to identify whether a history of childbirth and pregnancy-related complications are associated with MSKi occurrence among female members of the CAF. From September 2020 to February 2021, data were collected via an online questionnaire that assessed MSKi, reproductive health, and barriers to recruitment and retention in the CAF. Actively serving, female members were included in this analysis stratified by parous (n=313) or nulliparous (n=435) status. Descriptive analysis and binary logistic regressions were used to identify prevalence and adjusted odds ratios (aOR) of repetitive strain injuries (RSI), acute injuries, and body regions affected. Covariates included in aOR: age, body mass index, and rank. A p valueof <0.05 was considered significant and 95% confidence intervals (CI) were reported. Female members with a history of childbirth were more likely to report an RSI (80.9%vs. 69.9%, OR = 1.57, CI: 1.03 to 2.40), and when stratified by body region, were more likely to have an RSI of the wrist (30.0%vs. 20.5%, aOR = 1.62, CI: 1.09 to 2.40), and foot (39.3%vs. 24.1%, aOR = 1.79, CI: 1.24 to 2.59). When compared to the nulliparous group, parity did not influence prevalence of acute injuries. MSKi and mental health perceptions were different for females who experienced postpartum depression, miscarriage, or preterm birth. Childbirth and pregnancy-related complications impact prevalence of some RSI among female CAF members. Thus, specific health and fitness support may be needed for parous female CAF members.

Sex disparities in self-reported musculoskeletal injuries in the Canadian Armed Forces.

Recent comprehensive systematic reviews indicate that females are at greater risk of musculoskeletal injuries (MSKi) than males in military populations. Considering the Canadian Armed Forces (CAF) goal of increasing female representation in the next few years, exploring these trends is essential. We aimed to determine the association between biological sex and MSKi in the CAF. An online survey was conducted with active-duty and former CAF members aged 18-65 years. Sex disparities in MSKi (acute or repetitive strain [RSI]) were analyzed using bivariate associations and binary logistic regressions with significance level at p<0.05. Analyses were stratified by military environment (i.e., Army, Navy, and Air Force). From the 1947 respondents whose biological sex was reported, 855 were females and 1092 were males. Rates of RSI sustained by females and males while serving were 76.2% and 70.5% (p=0.011), respectively, whereas 61.4% of females reported acute injuries compared to 63.7% of males (p=0.346). Females were more likely to report overall RSI (adjusted odds ratio [aOR]: 1.397; 95% confidence intervals [CI]: 1.068-1.829), RSI having a greater impact on daily activities (aOR [95%CI]: 2.979 [2.093-4.239]) and greater impact on career progress/length (aOR [95%CI]: 1.448 [1.066-1.968]). Acute injuries, also more prevalent in females, were reported to have a greater impact on daily activities (aOR [95%CI]: 1.688 [1.198-2.379]). This study highlights sex disparities in MSKi prevalence and outcomes. Females within the CAF sample presented greater likelihood of reporting RSI, perceived impact of RSI on daily activities and career progress/length, and perceived impact of acute injuries on daily activities.

Characteristics Associated with Pelvic Floor Disorders among Female Canadian Armed Forces Members

ObjectivesUrinary incontinence (UI) and pelvic organ prolapse (POP) are prevalent pelvic floor disorders (PFDs) among the female population. In the military environment, being a non-commissioned member (NCM), and physically demanding occupations are factors associated with higher PFD risk. This study seeks to characterize the profile of female Canadian Armed Forces (CAF) members reporting symptoms of UI and/or POP. MethodsPresent CAF members (18–65 years) responded to an online survey. Only current members were included in the analysis. Symptoms of UI and POP were collected. Multivariate logistic regressions analyzed the relationships between PFD symptoms and associated characteristics. Results765 active members responded to female-specific questions. The prevalence of self-reported POP and UI symptoms were 14.5% and 57.0%, respectively, with 10.6% of respondents reporting both. Advanced age (adjusted odds ratio [aOR]: 1.062, CI 1.038–1.087), a body mass index (BMI) categorized as obese (aOR: 1.909, [1.183–3.081]), parity ≥1 (e.g., aOR for 1: 2.420, [1.352–4.334]) and NCMs (aOR: 1.662, [1.144–2.414]) were factors associated with urine leakage. Parity of ≥2 (aOR: 2.351, [1.370–4.037]) compared to nulliparous and having a perception of a physically demanding job (aOR: 1.933, [1.186–3.148]) were associated with experiencing POP symptoms. Parity of ≥2 increased the odds of reporting both PFD symptoms (aOR: 5.709, [2.650–12.297]). ConclusionParity was associated with greater odds of experiencing symptoms of UI and POP. Higher age, higher BMI, and being an NCM were associated with more symptoms of UI, and the perception of having a physically demanding role increased the likelihood of reporting POP symptoms.

Time use during the military-civilian transition: Exploring concepts of occupational disruption, transition and balance

ABSTRACT Introduction Military-civilian transition (MCT) refers broadly to the process of leaving military employment and becoming re-established in the civilian world. The cultural differences between military and civilian spheres can create challenges for veterans as they make this transition. Objectives To explore the time use and experiences of Canadian Armed Forces members as they progressed through their release from the military. Methods Semi-structured interviews were conducted at two time points with the same participant group (T1 – within 6 months of release date and T2 – 6 to 12 months after the release date) as part of a larger qualitative MCT study. For this study, a secondary analysis of previously coded time use data was conducted using the software program MAXQDA to support our process. We framed our analysis using three theoretical lenses related to time use and MCT: occupational disruption, occupational transition, and occupational balance. Results Data from 75 English-speaking participants at T1 and 68 at T2 were included. Many participants demonstrated experiences of occupational disruption due to health limitations, occupational transition through changes in time use after leaving a highly structured career and seeking occupational balance, including meaningful time use with those who were important to them. There were diverse experiences across the participant group. Conclusions This study is the first to explore the time use experiences of Canadian military members and veterans during MCT. It identified challenges in filling time after leaving a highly structured career, with health limitations impacting time use options. Participants worked to balance demands of home and family, while valuing having discretionary time and spending it in meaningful occupations.

Moral injury associated with increased odds of past-year mental health disorders: a Canadian Armed Forces examination

ABSTRACT Background: Potentially morally injurious experiences (PMIEs) are common during military service. However, it is unclear to what extent PMIEs are related to well-established adverse mental health outcomes. Objective: The objective of this study was to use a population-based survey to determine the associations between moral injury endorsement and the presence of past-year mental health disorders in Canadian Armed Forces (CAF) personnel and Veterans. Methods: Data were obtained from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS). With a sample of 2,941 respondents, the weighted survey sample represented 18,120 active duty and 34,380 released CAF personnel. Multiple logistic regressions were used to assess the associations between sociodemographic characteristics (e.g. sex), military factors (e.g. rank), moral injury (using the Moral Injury Events Scale [MIES]) and the presence of specific mental health disorders (major depressive episode, generalized anxiety disorder, panic disorder, social anxiety disorder, PTSD, and suicidality). Results: While adjusting for selected sociodemographic and military factors, the odds of experiencing any past-year mental health disorder were 1.97 times greater (95% CI = 1.94–2.01) for each one-unit increase in total MIES score. Specifically, PTSD had 1.91 times greater odds (95% CI = 1.87–1.96) of being endorsed for every unit increase in MIES total score, while odds of past-year panic disorder or social anxiety were each 1.86 times greater (95% CI = 1.82–1.90) for every unit increase in total MIES score. All findings reported were statistically significant (p < .001). Conclusion: These findings emphasize that PMIEs are robustly associated with the presence of adverse mental health outcomes among Canadian military personnel. The results of this project further underscore the necessity of addressing moral injury alongside other mental health concerns within the CAF.

Factor structure of the parent-rated strengths and difficulties questionnaire in a sample of Canadian children from military families.

The Strengths and Difficulties Questionnaire is a 25-item screening tool designed to measure the emotional and behavioral well-being of children. It includes five subscales including Emotional Symptoms, Conduct Problems, Peer Problems, Hyperactivity-Inattention and Prosocial Behavior. While the Strengths and Difficulties Questionnaire has been studied extensively on a global scale, it has not yet been evaluated among Canadian children from military families. This study used data collected from spouses and partners of Canadian Armed Forces members who completed a questionnaire assessing their quality of life, including the Strengths and Difficulties Questionnaire for respondents with children aged 3-16 years (N = 651). Using two independent randomized samples drawn from the overall group of respondents, the factorial structure was studied using exploratory factor analysis (n = 323) and confirmatory factor analysis (n = 328). Results of this study provide evidence for the factorial validity of the parent-rated Strengths and Difficulties Questionnaire for a sample of children from military families. Specifically, the exploratory factor analysis and confirmatory factor analysis supported the original proposed five-factor solution (CFI = 0.84; TLI = 0.82; SRMR = 0.073; RMSEA = 0.065) with good internal reliability of the Total Difficulties Scale and subscales. Overall, the results of this study were found to align with past research findings on the Strengths and Difficulties Questionnaire and support the future utility of this tool in assessing the well-being of Canadian children from military families.

Negative cognitions in the context of suicidality after exposure to military-related potentially morally injurious events

LAY SUMMARY Moral injury (MI) refers to the psycho-spiritual consequences of events that deeply transgress a person’s core moral beliefs and values. Such events are reportedly common in the military context, and strong associations have been demonstrated between exposure to potentially morally injurious events (PMIEs) and suicidality. This study explored differences in negative cognitions between treatment-seeking Canadian Armed Forces members and Veterans with and without current suicidal thoughts and behaviours (STBs), all of whom reported current distress in response to a PMIE. Those exhibiting STBs reported stronger negative beliefs about the self. Scores for event-related guilt cognitions and self-blame were similar across individuals with and without STBs. Individuals reporting STBs also displayed higher depression and symptoms of posttraumatic stress disorder. The results suggest that severity of mental health symptoms and negative self-evaluations may be most pertinent in their association with suicidality in the MI context. Results remain preliminary, however, and additional research is needed to properly examine how event and self-related evaluations affect suicidality after PMIEs.

Montreal Cognitive Assessment scores of Veterans and Canadian Armed Forces personnel seeking mental health treatment

LAY SUMMARY The Montreal Cognitive Assessment (MoCA) is a test of mild cognitive impairment that is commonly administered to military personnel seeking mental health treatment. However, there is little research on the average MoCA score for military Veterans. This study looked at MoCA scores provided by Canadian Armed Forces members and Veterans receiving services for an operational-related mental health condition. Scores below the cut-off for mild cognitive impairment were not uncommon and were related to education level, as well as to severity of posttraumatic stress disorder and depression. These findings will help clinicians better contextualize score variation among clients.