Civilian Participants Research Articles

Assessing complex PTSD and PTSD: validation of the German version of the International Trauma Interview (ITI)

ABSTRACT Background: With the introduction of the ICD-11 into clinical practice, the reliable distinction between Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) becomes paramount. The semi-structured clinician-administered International Trauma Interview (ITI) aims to close this gap in clinical and research settings. Objective: This study investigated the psychometric properties of the German version of the ITI among trauma-exposed clinical samples from Switzerland and Germany. Method: Participants were 143 civilian and 100 military participants, aged M = 40.3 years, of whom 53.5% were male. Indicators of reliability and validity (latent structure, internal reliability, inter-rater agreement, convergent and discriminant validity) were evaluated. Confirmatory factor analysis (CFA) and partial correlation analysis were conducted separately for civilian and military participants. Results: Prevalence of PTSD was 30% (civilian) and 33% (military) and prevalence of CPTSD was 53% (civilians) and 21% (military). Satisfactory internal consistency and inter-rater agreement were found. In the military sample, a parsimonious first-order six-factor model was preferred over a second-order two-factor CFA model of ITI PTSD and Disturbances in Self-Organization (DSO). Model fit was excellent among military participants but no solution was supported among civilian participants. Overall, convergent validity was supported by positive correlations of ITI PTSD and DSO with DSM-5 PTSD. Discriminant validity for PTSD symptoms was confirmed among civilians but low in the military sample. Conclusions: The German ITI has shown potential as a clinician-administered diagnostic tool for assessing ICD-11 PTSD and CPTSD in primary care. However, further exploration of its latent structure and discriminant validity are indicated.

The relationship between socio-demographic factors and depression: a cross sectional study among civilian participants in hostilities in Ukraine

There is still a gap in scientific knowledge in relation to civilian participants in hostilities. This is despite the fact that there is an extensive body of literature on major depressive disorder (MDD) in individuals who have experienced armed conflict. The purpose of this article is to identify socio-demographic factors which are related to levels of depression among civilian participants in the war in Ukraine, based on a cross-sectional study that was conducted in 2019 from a convenience sample of 314 Ukrainian adults (235 males). Depression was assessed via the Beck Depression Inventory. Multiple regression analyses were conducted to identify possible predictors of depression. Significant predictors were: loss of a loved one, place of residence, age, health insurance, financial situation, and marital status (F (6, 224) = 10.515, p < 0.001, R2 = 0.21; Adjusted R2 = 0.19). They also show that symptoms of depression resulting from the loss of a loved one due to war can be reduced through participation in an educational system. Having children is associated with a risk of more severe depression. Specialists are encouraged to engage in face-to-face interviews and to maintain a supportive and safe environment for participants in hostilities, e.g., in the area of education.

The association of stroke with mental and physical disorders in US adults: A nationally representative study

Stroke has been linked to various physical and mental disorders, with both stroke and its comorbidities significantly impacting public health. In this population-based study, we evaluate the relationships between stroke, physical conditions, mental disorders, and their effect on quality of life.Data were gathered from a nationally representative sample of 36,309 civilian participants aged 18 years and older in the National Epidemiologic Survey on Alcohol and Related Conditions-III. We examined the prevalence of past-year stroke, its sociodemographic characteristics, and its associations with past-year mental disorders (according to the DSM-5) and physical conditions. Furthermore, we explored the connections between stroke and health-related quality of life, accounting for comorbidities.The past 12-month stroke prevalence was estimated at 0.82%. Participants with stroke exhibited a significantly higher past 12-month mental disorder prevalence than those without stroke. Specifically, individuals with stroke faced a higher risk of mood disorders, anxiety disorders, tobacco use disorder, and opioid use disorder compared to those without stroke. Stroke was also positively associated with 24 out of the 27 physical conditions assessed in this study. Participants with stroke experienced lower mental and physical quality of life compared to those without stroke.Stroke was significantly related to numerous mental and physical disorders. The association of stroke with diminished health-related quality of life was not only mediated by these comorbidities but should also be considered as inherently linked to stroke itself.

Civilian participants’ responses to veteran artwork: exploring empathy and understanding

ABSTRACT Background Military-to-civilian transition is complicated for U.S. veterans when civilians lack detailed knowledge of their experiences and military culture. Aims The purpose of this research was to: (1) examine the experiences of a group of civilian participants who viewed a veteran art exhibition and engaged in responsive art making, and (2) to identify participants understanding of military service and the veteran experience may shift as a result of participation in study activities. Methods Case study research was used to examine the experiences of a group of civilian participants who engaged in a workshop that involved viewing veteran artwork and making response art. Data were collected through surveys, participant artwork and written responses, and researcher observation. Case studies were presented using thick description with interpretive and linked narratives to interpret the results. Results Participant experiences demonstrated that the pilot study interventions promoted four outcomes: (1) authentic and meaningful exchanges and engagement with veterans (2) challenged to think about veterans’ experiences more deeply, (3) inspired to show support for people who have served in the military in new ways, and (4) promoted empathy and understanding. Conclusions Results illustrate how active participation in an art exhibition through response art making can help to increase understanding of people with different lived experiences by promoting authentic and meaningful exchanges through art. Implications for practice/policy/future research Interdisciplinary partnerships between art therapists and museum professionals can support the development of programming that bridges divides between groups with different lived experiences and prompts social change through participatory action. Plain-language summary Civilian citizens often lack a complete understanding of veteran experiences and military culture. A civilian citizen is a person who has not serve in the armed forces, and therefore may hold stereotypical beliefs or limited knowledge about veteran experiences. Misunderstandings and assumptions between civilian citizens and veterans can result in a cultural gap, often referred to as the military-civilian divide. This divide can impact the amount and quality of social support veterans receive from civilian citizens as they transition from the military back to civilian life. Poor social support may increase veterans’ risk for mental health issues. Therefore, there is a need for increased understanding of veteran experiences. Public spaces, like art museums, can help veteran experiences to be seen and heard by the larger civilian population. This study explores the experiences of a group of civilian citizens who participated in a workshop. The group of civilian participants viewed a veteran art exhibition and then engaged in making response art. Response art is a tool commonly used in the field of art therapy to express and share complex or difficult experiences. Participants also completed three surveys where they were asked questions about their understanding of veteran experiences. A review of participants survey answers and written responses showed how viewing and creating art promoted personal exchanges veterans, challenged participants to think about veterans’ experiences more deeply, inspired participants to show support for people who have served in the military in new ways, and promoted empathy and understanding. These outcomes show how art can be used to increase understanding across groups with different lived experiences.

Failure of tDCS to impact militarised threat-detection in a military cohort

Abstract Transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, has become a focus of military organisations due to its reported positive effects on cognitive and motor performance. However, the majority of tDCS research in this space is conducted with civilian participants and/or uses abstract tasks. Additionally, of the small subset of studies that have used military participants or military-relevant tasks, few have employed both, and none with a considerable sample size. Here, we extend on previous work by exploring whether tDCS to the right inferior frontal gyrus (rIFG) enhances the performance of a large military cohort during a militaristic threat-detection task. 98 participants aged between 18 and 45 were randomly assigned to one of three conditions: (1) 2 mA anodal tDCS to the rIFG; (2) Sham stimulation to the rIFG; or (3) 2 mA anodal tDCS to the visual cortex (V1). Participants viewed serially presented, virtually generated militaristic images, and responded Yes/No via keypress to a threat being present. tDCS was applied for 25 min during the first two training blocks of the 50 min task. Results showed evidence for the null hypothesis: tDCS did not influence mean accuracy or reaction time across the task, in contrast to previous work. We discuss possible methodological and population factors that may explain why previously published effects of tDCS were not reproduced.

0131 Sleep Deprivation Alters Two Physiological Systems' Responses to Repeated Stressors Differentially

Abstract Introduction The hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal-medullary (SAM) axes activate in response to stressors. Real-world exposure to stressors often co-occurs with total sleep deprivation (TSD). The SAM response to a single stressor appears unchanged by TSD, but salivary alpha-amylase (sAA) has shown that TSD blunts the SAM response to repeated stressor exposure. Using salivary cortisol concentration (SCC), we investigated the HPA response to repeated stressors under well-rested and TSD conditions. Methods N=10 healthy adults (ages 28.3±5.78; 5f) completed a 4-day/3-night in-laboratory study with 38h TSD preceded and followed by 10h sleep opportunities. On day 2 (well-rested) and day 3 (TSD), participants completed two stressor sessions in a high-fidelity shooting simulator, separated by 30min. Acting as police officers, civilian participants verbally interacted with emergency response scenarios and decided whether to use (simulated) deadly force. Seven saliva samples were collected each day: pre-stressor, and 0min, 15min, and 30min after each session. Samples were assayed for SCC and normalized against each day’s pre-stressor sample. Results Mixed-effects ANOVA showed a significant effect of sample time (F[5,99]=19.85, p&amp;lt; 0.001), with SCC peaking 15min after the first stressor session and steadily declining thereafter. The SCC peak was significantly blunted during TSD compared to well-rested (t[99]=2.84, p=0.006). Correlations with previously reported, simultaneously assessed sAA concentrations, which peaked right after the first stressor session, were not significant (p&amp;gt;0.2). Additionally, whereas sAA showed a second peak after the second stressor session when participants were well-rested, no second peak was found in SCC. Conclusion The SCC response after one stressor session with simulated emergency response scenarios was blunted during TSD, unlike the sAA response. However, while sAA peaked twice in response to repeated stressor exposure when participants were well-rested (though not during TSD), SCC continued to decline after the first stressor exposure, potentially indicating a HPA refractory mechanism or habituation. Also, over participants there was no significant relationship between the magnitude of the stressor response between SCC and sAA. Taken together, our results suggest fundamentally distinct SAM and HPA axis responsivity to repeated acute stressors, with differential impact of TSD. Support (if any) ONR N00014-13-1-0302, PRMRP W81XWH-20-1-0442.

Shooter biases and stereotypes among police and civilians

The present research assesses potential correlates of discriminatory police behavior, comparing police and civilian participants in a first person shooter task (FPST) as well as on various self-report measures of intergroup contact, intergroup attitudes, and ideological beliefs in three preregistered studies. Study 1 (N = 330), using a FPST with a short response window (630 ms), did not observe shooter biases in reaction times, error rates and signal detection parameters in neither police nor civilian participants. Study 2a (N = 290), using a longer response window (850 ms), observed a shooter bias in reaction times, error rates, and response criterion in both civilian and police participants. These shooter biases were largely driven by faster reactions, fewer errors, and more liberal shoot decisions for armed Arab (vs. White) targets. Study 2b (N = 191; 850 ms response window) closely replicated shooter biases in reaction times, error rates, and response criterion in a sample of civilian online participants. Across studies, we observed similar results in the shooter task for police and civilian samples. Furthermore, both police and civilian participants expressed anti-Muslim and anti-Arab attitudes across a variety of self-report measures. However, compared to civilians, police participants reported higher levels of anti-Muslim attitudes on some measures as well as higher levels of social dominance orientation, which might pose additional risk factors for discriminatory behavior. Lastly, while we observed reliable individual differences in self-reported intergroup attitudes, ideologies, and intergroup contact, none of these characteristics correlated with shooter biases.

COGNITIVE AGING IN THE SHADOW OF THE CLOSET: THE EFFECTS OF IDENTITY CONCEALMENT AND DISCRIMINATION

Abstract Lesbian, gay, and bisexual (LGB) people tend to experience poorer cognitive health as they age; discrimination and identity concealment are common LGB experiences that carry emotional, health, and cognitive tolls. Previous research utilized data on research participants in same-sex relationships (SSR) to successfully identify a subset of LGB people and analyze their aging experiences. The present study relied on one situation in which identity concealment was legally mandated: military service. Until 2011, LGB people were banned from participating in military service in the U.S., leading to either concealment or institutionalized discrimination (i.e., discharge) for most LGB servicepeople. Using Health and Retirement Study (HRS; 1998–2016) data, this project analyzed the combined effects of veteran status and SSR on cognitive performance. Using multilevel longitudinal modelling, we found that while non-SSR veterans had higher mean scores than non-SSR civilian participants (the reference group), SSR civilians and veterans both had mean scores lower than the reference (SSR: β=-0.514, p=0.031; SSR+veteran (β=-1.065 p=0.081). These results may be limited due to the low number of SSR+veteran participants (n = 28). Nevertheless, these results suggest the potential for using veteran status among LGB people to study the health effects of identity concealment and discrimination on aging.

Event centrality and posttraumatic stress symptoms after traumatic injury: A longitudinal investigation.

The development of posttraumatic stress symptoms (PTSS) can occur following a traumatic injury, which may include an increase in negative cognitions. One cognitive construct shown to be associated with the development of PTSS is event centrality, or the degree to which an individual views a traumatic experience as central to their life story. Although cross-sectional work has demonstrated a robust connection between event centrality and PTSS, the directionality of this association remains unclear. Most previous work has investigated centrality as a predictor of PTSS, although one recent study suggests that PTSS may, in fact, predict event centrality. The current longitudinal study enrolled adult civilian participants (N = 191) from a Level 1 trauma center following a traumatic injury and assessed both event centrality and PTSS at three points posttrauma (3, 12, and 18 months). A time-constrained random intercept cross-lagged panel analysis showed that PTSS predicted event centrality over the 18-month follow-up period, B = 0.16, p = .021, but event centrality did not predict PTSS, B = -0.27, p = .340. These findings suggest that the development of PTSS following trauma exposure may lead to the perception of the traumatic event as central to an individual's story over time. Further longitudinal research is necessary to determine what variables may influence the connection between PTSS and event centrality.

P626. Epigenome-Wide Meta-Analysis of >2100 Military and Civilian Participants Reveals New DNA Methylation Patterns Associated With PTSD

Epigenetic factors, including DNA methylation (DNAm), participate in adaptation to traumatic stress, and may help to distinguish between individuals with and without PTSD. Here, we present the results of the largest epigenome-wide association study (EWAS) of PTSD to date.

Relationship between Socio-Demographic Factors and Posttraumatic Stress Disorder: A Cross Sectional Study among Civilian Participants' Hostilities in Ukraine.

Background: Even though there is an extensive body of literature on posttraumatic stress disorder (PTSD) in individuals who have experienced armed conflict, there are still many grey areas, especially in relation to civilian participants in hostilities. This article evaluates how socio-demographic factors and the interactions between them have influenced PTSD among civilians involved in the recent war in Ukraine. Methods: This cross-sectional study included a convenience sample of 314 adults, 74 women, and 235 men. The mean age was 34.08 years. We used the Posttraumatic Stress Disorder (PTSD) Checklist–Civilian Version (PCL-C). Results: Our findings show that predictors of posttraumatic stress are loss of a loved one, place of residence, gender, continuation of education, and health insurance. We demonstrated that PTSD produced by the loss of a loved one as a result of war is determined by participation in the education system, whatever the level of education. The literature emphasises the importance of social support, e.g., from the family. We demonstrated that having children is associated with a risk of more severe PTSD, causing serious mental strain among participants of hostilities. We discovered that material security lowers PTSD, but only among people who have no children. Conclusions: PTSD is the result of not only the violence and damage caused by war but also of other stressful circumstances associated with the social and financial conditions of life. Further research needs to focus on identifying modifiable risk factors and protective factors that could be embraced by intervention strategies. Our findings can inform the goals behind therapeutic support for civilian participants of hostilities, and implications for social work. Social work professionals are encouraged to engage in direct questioning and to maintain a supportive and safe environment for participants in hostilities, e.g., in the area of education. Trauma-affected people need to be given opportunities to build up their strengths and increase their psychological resources towards well-being. Social security (health insurance, savings, material security) should be taken into account when working with people affected by PTSD.

Estimated Radiation Doses and Projected Cancer Risks for New Mexico Residents from Exposure to Radioactive Fallout from the Trinity Nuclear Test

The first dose reconstruction and cancer risk projection for the population of New Mexico as a consequence of exposure to radioactive fallout from the Trinity nuclear test was published in 2020. This comprehensive evaluation was conducted by investigators from the National Cancer Institute (NCI) with collaborators over a 7-year time period. This technical note primarily summarizes the already published design considerations of that study, the methods of data collection, study limitations, and findings, though it also summarizes important events that took place over several decades that led to the NCI Trinity study. In addition, we discuss two related investigations that were part of the NCI Trinity study: the possibility of intergenerational (genetic) effects among those exposed and an analysis of the whereabouts, quantity, and health implications of the unfissioned plutonium from Trinity. Finally, we provide doses received by the military and civilian participants in the Trinity test as reported by other organizations.

Do you hear what I hear?: A comparison of police officer and civilian fairness judgments through procedural justice

ABSTRACT Procedural justice theory posits that people care at least as much about how a decision was made as they do about the outcome. Although policymakers and researchers argue that procedural justice-based interventions can improve police-civilian interactions, little research has examined how authorities evaluate decision-making processes. This research examined whether police officers and civilians evaluate fairness in police-civilian encounters through the same mechanisms. 69 police officer and 113 civilian participants, recruited through Qualtrics professional panels and Amazon’s Mechanical Turk respectively, read a vignette describing a police-civilian interaction in which the civilian explained why they violated the law (procedural justice) or were interrupted by the officer (procedural injustice) and made evaluations of the interaction. Multiple-group analyses using bootstrapping revealed that both police officers and civilians rated the procedural justice condition as more fair because they rated the officer as more respectful and trustworthy and because they perceived the civilian had more voice than in the procedural injustice condition. Further, direct and indirect pathways through respect were not present when police officer pathways were allowed to vary, suggesting police may rely on social information differently than civilians.

An Examination of Suicide Exposure and Fearlessness about Death on Suicide Risk among Active Duty Service Members, Veterans, and Civilians

Suicide exposure is associated with an increased risk for suicide. There is limited research on the mechanisms that increase this risk. This study aims to: (1) compare suicide exposure and associated variables in veteran, active duty, and civilian participants, (2) examine the extent to which fearlessness about death and suicide risk factors differ as a function of group membership and suicide exposure, and (3) determine the degree to which relationship to the decedent, perceived closeness, and reported impact of the death are associated with fearlessness about death and suicide-related outcomes. 1,533 participants were included, of whom 48% of active duty service members, 65% of veterans, and 58% of civilians reported knowing someone who died by suicide. A series of regressions were conducted. There were group differences by military service on the suicide exposure variables. Furthermore, there were significant main effects for military service group and suicide exposure on the outcome variables. In general, civilians reported greater suicide risk and active duty service members reported greater fearlessness about death. Fearlessness about death mediated the associations between perceived closeness and a history of suicide attempts. The loss of a military colleague to suicide was found to be unique and distinguishable from other important relationships. Results suggest the need to consider suicide exposure and closeness as salient variables associated with fearlessness about death and suicide risk factors. Inquiring about suicide exposure, closeness to the decedent, fearlessness about death, and beyond familial losses to suicide may indicate important avenues of intervention.

Gambling and military Service: Characteristics, comorbidity, and problem severity in an epidemiological sample

Active military members and veterans both show elevated risk of Gambling Disorder. However, research comparing these groups to civilians in epidemiological samples is sparse. There is also some research suggesting that there is a stronger association between military service and poor mental outcomes for women.The current study applies bivariate analyses and generalized linear modelling predicting Problem Gambling Severity Index scores to a representative, complex survey sample of 2176 New Jersey adult residents.The results show that problem gambling scores for past and current military service members were more than double that of the civilian participants after controlling for relevant demographic and behavioral characteristics. Additionally, the relationship between problem gambling scores and military service was significantly stronger for women than men. Bivariate analyses indicated that active military service members scored higher on the Problem Gambling Severity Index, indicated greater weekly participation in online gambling, lottery, electronic gambling machine, and sports betting, and nearly 20 times the rate of suicidal ideation compared with civilians. Additional regression analysis show that among military service members problem gambling scores were associated with suicidal ideation, tobacco use, and substance use problems.The results are discussed in the context of a period of expansion of online gambling opportunities. Constrained options for leisure coupled with the high propensity for risk taking among military service members and the relative ease of concealing online gambling on base may expose military service members to disproportionately higher risk of Gambling Disorder.

Effectiveness of online OurRelationship and ePREP programs for low-income military couples.

Military couples need and desire relationship interventions. Online interventions improve access; however, their effectiveness within the military population is untested. Using a subsample from a larger randomized controlled trial of OurRelationship and ePREP online relationship programs for low-income couples, this study examined baseline characteristics of military compared with civilian couples enrolled (Aim 1), treatment effects within military couples (Aim 2), and treatment differences between military and matched civilian participants (Aim 3). Military couples (n = 90 couples) in which 1 or both partners were active duty (11%) or veterans (89%) were selected from the larger randomized controlled trial along with a matched civilian sample selected using propensity scores. No differences were found between military and civilian couples regarding baseline individual or relationship functioning. Program completion was lower among military couples (57%) compared with civilians (71%), whereas program satisfaction was equally positive. Among military couples, relationship satisfaction, conflict, emotional support, and breakup potential were significantly improved after treatment (between-groups d = 0.31-0.46) and maintained at follow-up; intimate partner violence and individual functioning domains did not improve. When comparing military and civilian samples, there was a pattern of stronger treatment impacts on individual functioning for civilians, although only the impact on insomnia evidenced a significant difference. These online relationship interventions improved relationship functioning for military couples. More research is needed to test these interventions among clinically impaired military populations and to explore potential for improving program completion and effects on relationship violence and individual wellbeing. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Exploring the Victimization of British Veterans: Comparing British Beliefs About Veterans With Beliefs About Soldiers

Evidence suggests that most of the UK public appreciate currently serving UK Armed Forces personnel but are less positive in their beliefs about veterans. This research examined the social representations held by civilian participants of UK veterans and serving soldiers to understand why veterans may be seen more negatively. An open-ended word association task was completed by 234 UK participants where they were asked to provide three initial responses to the words “veteran” and “soldier” and to evaluate their responses in accordance to prototypicality. The 1,404 resultant associations were grouped into 14 thematic clusters. Using the hierarchical evocation method, the results suggest “heroizing associations” to be a defining core element for “soldier” and “veteran” but “victimizing associations” to be an element only for “veteran.” Principal component analyses suggest victimizing associations are related to war and deindividuated associations; “heroizing associations” are related to characterizations of the veteran’s personality. Implications and future directions are discussed.

High Rates of Mental Health Disorders in Civilian Employees Working in Police Organizations.

Working in a police organization often involves being exposed to potentially traumatic events and stressful circumstances regardless of occupation or rank. Police mental health is a public health concern, but the mental health of civilian employees working in police organizations has been much less studied. The current study aims to compare the frequency of mental health conditions in both police officers and civilians. This was evaluated by measuring mean scores on several mental health screening tools including scales to determine symptom severity for posttraumatic stress disorder (PTSD) with the PTSD Checklist – PCL-5, depression with the Patient Health Questionnaire-9 (PHQ), general anxiety with the Generalized Anxiety Disorder 7-item scale (GAD-7), and alcohol use with the Alcohol Use Disorders Identification Test (AUDIT). The total potential population was 1,225 civilian employees and 3,714 police officers, of which 513 (10%) participated. Of these, 201 (16%) were civilians, and 312 (8%) were police officers (p<0.001). In the study population, 26% screened positive for any mental health disorder. Somewhat surprisingly, we found significantly more civilians (32.8%) than police officers (22.7%) met diagnostic criteria. We also found that civilian participants had higher mean scores in measures of PTSD, anxiety, and depression, although only for depression did this reach statistical significance. Civilians were 1.7 times more likely to screen positive for depression compared to police officers, a statistically significant difference. In contrast, police officers demonstrated statistically higher scores for alcohol use than civilians. One limitation of this study is that the data reflects responses from only a minority of the overall population and, therefore, may not accurately reflect the frequency of mental health issues in the total police organization including civilian employees. Nonetheless, the results strongly suggest that the mental health of all employees can be negatively impacted by working in a police environment, and this is important given the growing number of civilians employed within police organizations. These findings support initiatives aimed at destigmatizing mental health disorders, improving stress management, and increasing access to mental health care on an organization-wide basis, and not just limited to front-line police officers.

Designing and implementing a practical prehospital emergency trauma care curriculum for lay first responders in Guatemala

BackgroundInjury disproportionately affects low-income and middle-income countries, yet robust emergency medical services are often lacking to effectively address the prehospital injury burden. A half-day prehospital emergency trauma care curriculum was...

Ankle and knee moment and power adaptations are elicited through load carriage conditioning in males

Soldiers routinely conduct load carriage and physical training to meet occupational requirements. These tasks are physically arduous and are believed to be the primary cause of musculoskeletal injury. Physical training can help mitigate injury risk when specifically designed to address injury mechanisms and meet task demands. This study aimed to assess lower-limb biomechanics and neuromuscular adaptations during load carriage walking in response to a 10-week evidence-based physical training program. Thirteen male civilian participants donned 23 kg and completed 5 km of load carriage treadmill walking, at 5.5 km h−1 before and after a 10-week physical training program. Three-dimensional motion capture and force plate data were acquired in over-ground walking trials before and after treadmill walking. These data were inputs to a musculoskeletal model which estimated lower-limb joint kinematics and kinetics (i.e., moments and powers) using inverse kinematics and dynamics, respectively. A two-way analysis of variance revealed significant main effect of training for kinematic and kinetics parameters at the knee and ankle joints (p < 0.05). Post-Hoc comparisons demonstrated a significant decrease (4.2%) in total negative knee power between pre- and post-March 5 km measures after training (p < 0.05). Positive power contribution shifted distally after training, increasing at the post-march measure from 39.9% to 43.6% at the ankle joint (p < 0.05). These findings demonstrate that a periodised training program may reduce injury risk through favourable ankle and knee joint adaptations.