Veterans Research Articles

Supplemental Material for Do Appraisals of Military Service Indicate Current Distress in Aging Vietnam War Combat Veterans?

Supplemental Material for Do Appraisals of Military Service Indicate Current Distress in Aging Vietnam War Combat Veterans?

Optimizing Total Knee Arthroplasty Rehabilitation With Telehealth Physical Activity Behavior Change Intervention: A Randomized Clinical Trial.

Conventional total knee arthroplasty (TKA) rehabilitation has little impact on sedentary lifestyles that have negative long-term health consequences. The purpose of this trial was to determine the effect of telehealth-based physical activity behavior change intervention on physical activity and functional outcomes following TKA. This study was a 2-arm, parallel randomized controlled superiority trial at a regional Veterans Affairs medical center. The participants were 92 US military veterans (mean age = 65.7 [SD =7.8] y) undergoing unilateral TKA. The Physical Activity Behavior Change (PABC) intervention included telehealth-based self-management training (10 30-minute sessions) delivered over 12weeks. The control intervention included telehealth-based health education sessions that matched PABC frequency and duration. Both groups participated in standardized conventional outpatient rehabilitation. Physical activity, measured as average daily step count, was the primary outcome. Secondary outcomes were Life-Space Assessment questionnaire, 30-Second Chair-Stand test, Timed "Up & Go" Test, 6-Minute Walk Test, Western Ontario and McMaster Universities Osteoarthritis Index, and Veterans RAND 12-Item Health Survey. The Self Efficacy for Exercise scale and daily time spent in different postures (sitting/lying, standing, stepping) were exploratory variables. Outcomes were measured at baseline (before surgery), mid-intervention (8weeks after surgery), after the intervention (14weeks after surgery; primary endpoint), and follow-up (38weeks after surgery). The PABC group had an estimated 931 (95% CI = 42-1819) more daily steps than the control group from baseline to 14weeks, though a between-group effect was not sustained at 38weeks. There were no group differences in secondary outcomes. Participants included only military veterans using Veterans Health Administration services. The intervention targeted self-management and did not include peer support. The PABC intervention improved physical activity for veterans recovering from unilateral TKA at 14weeks after surgery, though the effect was not sustained at 38weeks. Physical function improved with rehabilitation but was not different between groups, indicating that physical function was not a primary driver of physical activity behavior. Conventional TKA rehabilitation has a negligible effect on free-living physical activity, which is relevant to long-term health outcomes. This trial identified telehealth physical activity self-management as effective in addressing activity behaviors, separate from conventional rehabilitation strategies.

Biomarkers Associated with Depression Improvement in Veterans with Gulf War Illness Using the Low-Glutamate Diet.

Gulf War Illness (GWI) is a chronic multi-symptom neurological disorder affecting veterans of the Gulf War that is commonly comorbid with depression. A secondary data analysis was conducted to examine serum homocysteine and inflammatory cytokines (IFN-γ, IL-6, IL-1β, TNF-α) as potential biomarkers of depression improvement among veterans with GWI after a one-month dietary intervention aimed at reducing excitotoxicity and increasing micronutrients. Analyses, including multiple linear and logistic regression, were conducted in R studio. Dietary adherence was estimated using a specialized excitotoxin food frequency questionnaire (FFQ), and depression was measured using the Center for Epidemiologic Studies Depression (CES-D) scale. After one month on the diet, 52% of participants reported a significant decrease in depression (p < 0.01). Greater dietary adherence (FFQ) was associated with increased likelihood of depression improvement; OR (95% CI) = 1.06 (1.01, 1.11), (p = 0.02). Reduced homocysteine was associated with depression improvement after adjusting for FFQ change (β = 2.58, p = 0.04), and serum folate and vitamin B12 were not mediators of this association. Reduction in IFN-γ was marginally associated with likelihood of depression improvement (OR (95% CI) = 1.11 (0.00, 1.42), (p = 0.06)), after adjustment for potential confounders. Findings suggest that homocysteine, and possibly IFN-γ, may serve as biomarkers for depression improvement in GWI. Larger trials are needed to replicate this work.

Enhancing the Utility of the Moral Injury Experience Wheel: Manualized Applications for Diverse Contexts.

Moral injury has emerged as an important construct for understanding the distress experienced in the aftermath of a moral violation, initially among combat veterans and increasingly among other populations, such as healthcare workers and first responders. While numerous measures have been validated to assess for exposure to potentially morally injurious events and/or sequelae, additional tools are needed to facilitate nuanced discussion of the experience of moral injury in therapeutic encounters. The Moral Injury Experience Wheel (MIEW; Fleming, 2023) is an infographic instrument that is designed to elicit precise language and help differentiate feelings in an effort to process morally perplexing circumstances. This paper describes the contents and potential clinical applications of a newly developed manual to guide the use of the MIEW. The MIEW and manual are designed to be used independently or alongside existing moral injury interventions. A case study featuring the use of the MIEW and manual demonstrates how the tools can be used in a professional healthcare setting. Recommendations for moral injury care practitioners are provided.

US Military Veteran Perspectives on Eating Disorder Screening, Diagnosis, and Treatment: A Qualitative Study.

We aimed to explore US veteran perspectives on eating disorder screening, diagnosis, patient-provider conversations, and care in the Veterans Health Administration (VHA). Rapid qualitative analysis of 30-45 min phone interviews with 16 (N = 16) veterans with an electronic health record ICD-10 eating disorder diagnosis, who received care at one of two VHA healthcare systems in Connecticut or California. Topics covered included: conversations with providers about eating disorder symptoms, diagnosis, and referral to treatment; feedback about an eating disorder screener, and; reflections on eating disorders among veterans and VHA's effort to address them. Most veterans reported difficulty understanding and defining the problems they were experiencing and self-diagnosed their eating disorder before discussing it with a provider. Treatment referrals were almost universally for being overweight rather than for an eating disorder, often leading veterans to feel misunderstood or marginalized. Overall, veterans were enthusiastic about the screener, preferred screening to be conducted by primary care providers, and noted that conversations needed to be non-stigmatizing. There was consensus that VHA is not doing enough to address this issue, that group support and therapy could be beneficial, and that resources needed to be centralized and accessible. For the most part, veterans felt that, at best, eating disorders and disordered eating are overlooked, and at worst, conflated with overweight. The majority of veterans got referred for weight loss or weight management services but would welcome the opportunity to be screened for, and referred to, eating disorder treatment.

Staff and client preferences for the design and delivery of an outcomes monitoring system in a mental health service.

Outcome monitoring can support the delivery of quality service that meets the needs of clients, clinicians and services. However, few studies have examined client or staff perspectives on the design and implementation of outcomes monitoring within a service. Implementation of outcomes monitoring requires understanding the preferences and expectations of relevant stakeholders. Informed by the Consolidated Framework for Implementation Research, this study aimed to investigate the preferences and priorities of relevant staff, clients and family members to inform the design and implementation of an effective outcomes monitoring system in the context of a mental health service for military veterans and their families. Twenty-nine staff participated across five online focus groups, including clinical staff, peer workers, policy staff and supervisors. Ten clients participated in online or telephone semi-structured interviews. Thematic analysis was used to develop themes from the data. Clients and staff agreed that outcomes monitoring should cover more than symptoms, particularly by incorporating functional outcomes. Assessing mental health over time was considered a valuable tool for supporting treatment processes and providing actionable information. Challenges identified by clients and staff included the need for efficient processes, ensuring measures are relevant and acceptable, and maintaining client privacy. The ability to personalise data collection and have a streamlined, responsive system were key attributes of a quality outcomes monitoring framework. Findings suggest that an effective outcome monitoring framework should be client-led, tailored to the individual's needs, and provide feedback on progress. Outcomes monitoring should also be efficient, accessible and allow for safe information sharing.

Internet-Guided Cognitive Behavioral Therapy for Insomnia Among Patients With Traumatic Brain Injury

Many military service members and veterans report insomnia after sustaining traumatic brain injury (TBI). Limitations of first-line treatment, cognitive-behavioral therapy for insomnia (CBT-I), include availability of qualified clinicians, low completion rates, and cost. To investigate the feasibility and efficacy of internet-guided CBT-I (eCBT-I) in military service members and veterans with insomnia and a history of TBI. This randomized clinical trial of fully remote internet-based interventions and evaluations was conducted from September 1, 2020, to June 30, 2021, with 3 months of follow-up. Participants included a volunteer sample of military service members and veterans aged 18 to 64 years with a history of mild TBI/concussion and at least moderately severe insomnia defined as an insomnia severity index (ISI) score of greater than 14 and Pittsburgh Sleep Quality Index of greater than 4. Self-reported race, ethnicity, and educational level were generally representative of the US military. Data were analyzed from October 21, 2021, to April 29, 2024. Internet-based CBT-I delivered over 6 weekly lesson modules with assigned homework activities. The prespecified primary outcome measure was change in ISI score over time. Prespecified secondary outcome measures included self-reported measures of depression symptoms, posttraumatic stress disorder (PTSD) symptoms, sleep quality, migraine impact, and fatigue. Of 204 people screened, 125 were randomized 3:1 to eCBT-I vs online sleep education, and 106 completed baseline evaluations (83 men [78.3%]; mean [SD] age, 42 [12] years). Of these, 22 participants (20.8%) were Hispanic or Latino and 78 (73.6%) were White. Fifty participants completed postintervention evaluations, and 41 completed the 3-month follow-up. Baseline mean (SD) ISI scores were 19.7 (4.0) in those randomized to eCBT-I and 18.9 (5.0) in those randomized to sleep education. After intervention, mean (SD) ISI scores were 13.7 (5.6) in those randomized to eCBT-I and 16.6 (5.7) in those randomized to sleep education. The difference in the extent of reduction in ISI scores between groups was 3.5 (95% CI,-6.5 to -0.4 [P = .03]; Cohen d, -0.32 [95% CI, -0.70 to -0.04]). In the eCBT-I group, the extent of insomnia improvement correlated with the extent of depressive symptom improvement (Spearman ρ = 0.68 [P < .001]), PTSD symptoms (ρ = 0.36 [P = .04]), sleep quality (ρ = 0.54 [P = .001]), and fatigue impact (ρ = -0.58 [P < .001]) but not migraine-related disability. The findings of this randomized clinical trial suggest that fully remote eCBT-I was moderately feasible and effective for self-reported insomnia and depression symptoms in military service members and veterans with a history of TBI. There is great potential benefit for eCBT-I due to low availability and cost of qualified CBT-I clinicians, although optimization of completion rates remains a challenge. Future studies may use home-based objective sleep assessments and should increase study retention. ClinicalTrials.gov Identifier: NCT04377009.

Violence and the Voice Note: The War for Cabo Delgado in Social Media (Mozambique, 2020)

In Cabo Delgado, Mozambique, the year of 2020 marked a dramatic escalation of military activities of the Islamist insurgent group locally known as Al-Shabab or mashababe. This intensification was accompanied by a more immaterial phenomenon: the rise in prominence of social media, both as battleground and as public forum. While the insurgents sacked and occupied major towns and district headquarters, the Web 2.0 networks - Facebook and WhatsApp especially - became the central arena in which the war was apprehended and discussed. This essay is an exploration of the entwining of social media with the 'new war' in Cabo Delgado, focussing on the events that surround the conquest of the Makonde plateau, mythical cradle of the Mozambican liberation struggle. Building on a budding literature on digital militarism, the essay dwells especially on orality and the use of the voice note as a medium to convey information deemed to be more trustworthy and stable than images. Tracking these media and their interrelations, the essay establishes a narrative, however fragmentary, of the downfall of the Makonde plateau; highlights recurring features of violence in the Cabo Delgado conflict; and provides fresh insight into the formation of the Local Force (Força Local), a State-sponsored militia largely constituted by war veterans.

Ecosystem restoration coupled with poverty alleviation in eThekwini Municipality, KwaZulu‐Natal Province, South Africa

Ecosystem restoration is a necessity for addressing socio‐ecological challenges by improving ecosystem resilience and alleviating poverty through local community involvement. Here, we review a community‐based, large‐scale ecosystem restoration program, Working for Ecosystems, implemented by eThekwini Municipality in KwaZulu‐Natal, South Africa, between 2007 and 2022. For this study, we interrogated monthly and annual reports generated by the program between 2011 and 2021 to describe how the program worked to suppress invasive alien plants (IAPs) and provided employment opportunities to marginalized groups (women, youth, military veterans, and people living with disabilities). Annual budget was positively correlated with the area cleared of IAPs and effort (person‐days in the field). The program successfully incorporated marginalized groups, but military veterans and people living with disabilities remained in smaller numbers and were not well quantified. Participants were encouraged to constitute companies—Small, Medium, and Micro Enterprises—that were then subcontracted to the program or could progress to other endeavors, allowing other community members to enter the program. A steady increase in the implementation budget emphasized the need for a long‐term plan to ensure accountability and sustainability of restoration and socio‐ecological systems.

Research Letter: Characterizing Lifetime Mild TBI Exposure Among Female and Male Military Service Members and Veterans in the LIMBIC-CENC Study.

To (1) characterize lifetime mild traumatic brain injury (TBI) exposures among male and female US military service members and Veterans (SMVs) and (2) evaluate sex-related differences in mild TBI exposures. Clinical research laboratory. Participants were enrolled in the ongoing Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) Prospective Longitudinal Study. Cross-sectional. Lifetime history of mild TBI was measured via structured interview. All mild TBI characteristics were collected as part of this interview, including total lifetime number; environment (deployment vs. non-deployment); timing of injury (relative to military service and age); and mechanism of injury (blast-related vs. non-blast). Most participants (n =2323; 87.5% male; 79.6% Veteran) reported ≥1 lifetime mild TBI (n =1912; 82%), among whom, many reported ≥2 lifetime mild TBIs. Female SMVs reported fewer total lifetime mild TBIs than male participants (P <0.001), including fewer deployment-related (P <0.001) and non-deployment (P <0.001) mild TBIs. There were significant sex differences for total number of mild TBIs sustained before (P =0.005) and during (P <0.001) military service but not after separation from military service (P =0.99). Among participants with a lifetime history of mild TBI, female SMVs were less likely to report ≥2 mTBIs (P =0.003); however, male SMVs were more likely to report a mild TBI during military service (P =0.03), including combat-related mild TBI (P <0.001) and mild TBI involving blast (P <0.001). These findings inform clinical and research efforts related to mild TBI in US military SMVs. It may not be sufficient to simply measure the total number of mild TBIs when seeking to compare clinical outcomes related to mild TBI between sexes; rather, it is important to measure and account for the timing, environment, and mechanisms associated with mild TBIs sustained by female and male SMVs.

1141 Mortality and Re-Amputation Rates Following Below Knee Amputation: A Systematic Review and Meta-Analysis

Abstract Aim Below knee amputation (BKA) is undertaken in patients with diabetes or peripheral vascular disease, when limb sparing medical optimisation or vascular interventions are no longer feasible. Mortality and proximal re-amputation rates are poorly defined in the literature. We sought to perform a systematic review to examine mortality and reputation rates across the current literature. Method A systematic search was performed of the MEDLINE (via Pubmed), EMBASE, Cochrane and clinicaltrials.gov databases from inception to August 25th, 2022. Articles were screened by two independent reviewers with conflicts reserved by a third party. Inclusion criteria were all non-traumatic causes of lower limb amputation. Outcomes of interest included Mortality and occurrence of more proximal amputation. Results Studies from 12 countries encompassing a total of 41832 patients were included for analysis. Study dates ranged from 1987 to 2019. Of the total patient number, 38577 (92.2%) were from the USA, with 2599 (6.2%) from Europe and 656 (1.6%) remainder. The mean age at BKA was 70.46 years (Range 62-86). Weighted mortality was 37% (Range 4%-29%) at 1 year, 58% (Range 12% - 60%) at 2 years, 65% (range 19% - 81%) at 5 years and 84% (Range 71-96%) at 10 years. Five studies reported re-amputation rate at any time point (13% Range 1.16- 22%). Conclusions Mortality following BKA is still poor, even in contemporary studies. The few large multicentre studies are US based and in military veteran populations. More robust UK focused studies are needed to accurately inform clinical decision making for patients and clinicians.

Exposure to Gulf war illness-related chemicals exacerbates alcohol-induced liver damage in rodents

Gulf War Illness (GWI) describes a series of symptoms suffered by veterans of the Gulf war, consisting of cognitive, neurological and gastrointestinal dysfunctions. Two chemicals associated with GWI are the insecticide permethrin (PER) and the nerve gas prophylactic pyridostigmine-bromide (PB). In this study we assessed the effects of PER and PB exposure on the pathology and subsequent alcohol (EtOH)-induced liver injury, and the influence of a macrophage depletor, PLX3397, on EtOH-induced liver damage in PER/PB-treated mice. Male C57BL/6 mice were injected daily with vehicle or PER/PB for 10 days, followed by 4 months recovery, then treatment with PLX3397 and a chronic-plus-single-binge EtOH challenge for 10 days. PER/PB exposure resulted in the protracted increase in liver transaminases in the serum and induced chronic low-level microvesicular steatosis and inflammation in GWI vs Naïve mice up to 4 months after cessation of exposure. Furthermore, prior exposure to PER/PB also resulted in exacerbated response to EtOH-induced liver injury, with enhanced steatosis, ductular reaction and fibrosis. The enhanced EtOH-induced liver damage in GWI-mice was attenuated by strategies designed to deplete macrophages in the liver. Taken together, these data suggest that exposure to GWI-related chemicals may alter the liver’s response to subsequent ethanol exposure.

The Effectiveness of Imagery Rescripting Interventions for Military Veterans With Nightmares and Sleep Disturbances: A Systematic Review and Meta-Analysis.

Imagery rescripting (ImRs) interventions have been found effective in improving sleep outcomes, although research has mostly focused on civilian, rather than military, samples. The aim of this review was to estimate the overall effectiveness of ImRs interventions for military veterans on primary outcomes of nightmare frequency and sleep quality. A systematic search was conducted in CINAHL, MEDLINE, PsycArticles, PsycINFO, Psychology and Behavioural Sciences Collection and the PTSDpubs database and was completed on 1 November 2021. Randomised controlled trials, nonrandomised trials and pre-post studies of ImRs interventions in veterans with sleep disturbances or nightmares were included. The methodological quality of the studies was assessed using the Effective Public Health Practice Project (EPHPP) tool, and meta-analysis was performed using Stata. Nineteen articles from 15 empirical studies were included in the review, and data from the 15 studies (involving 658 participants) were included in the meta-analysis. Meta-analysis findings indicated that ImRs interventions are associated with significant positive changes from pretreatment to posttreatment for nightmare and sleep quality. Significantly greater improvements were found in ImRs interventions compared to control groups for sleep quality (Hedges' g = -0.65, 95% CI [-1.20, -0.10]) but not for nightmare frequency (Hedges' g = -0.10, 95% CI [-0.34, 0.14]). Overall, the meta-analysis included a relatively small number of studies with poor methodological quality and considerable heterogeneity; therefore, findings should be cautiously interpreted. Further research should focus on veteran participants with larger samples and from a broader range of sources to determine effectiveness more confidently.

Palliative care in the older adult Veteran.

The United States military Veteran population is aging, thus leading to a group of Veterans who have functional disabilities, sensory impairments, and geriatric syndromes such as frailty and dementia. As they age, Veterans are also at risk of being diagnosed with a variety of serious illnesses, such as neurologic conditions and cancers, some of which are a consequence of prior military service or toxic exposures. In addition to frailty and multicomplexity, Veterans have higher rates of mental health disorders than civilians. All of these factors lead to a population of older Veterans who can benefit from palliative care involvement. Major tenets of palliative care focus on enhancing quality of life and provision of goal-concordant care, which are also aims of the services provided by the Veterans Health Administration (VHA) to all enrolled Veterans. Palliative care involvement in the holistic care of Veterans can deliver expert pain and symptom management, promote Veteran-centric plans of care, and provide crucial support of complex medical decision making often required for those Veterans with serious illness. In this review article, we discuss the unique palliative care needs of Veterans as they age, while also sharing information about relevant resources and services provided by the VHA.

Agitational and Propagandistic Measures to Activate Cossack Volunteer Movement in Don Region during Great Patriotic War

This study addresses the enhancement of agitational and propagandistic measures to activate Cossack volunteerism in the Don region during the Great Patriotic War. Various sources, including archival and published documents, periodicals, testimonies, and contemporaries’ memoirs, were utilized. A comparative-historical analysis of agitational and propagandistic activities conducted in the Don region from 1941 to 1945 indicates significant changes in Soviet approaches and methods of agitation during wartime. Initially, internationalism and socio-political motives (class-based approach) dominated Soviet propaganda at the war’s outset, akin to the pre-war period, leading to the primary involvement of communists, Komsomol members, and Civil War veterans in the Cossack volunteer movement. However, pre-war propaganda approaches quickly lost their effectiveness. By autumn 1941, national-patriotic motives took precedence in Soviet agitation and propaganda efforts. In the Don region, these changes manifested in propaganda appealing to the illustrious combat history of the Don Cossacks and exalting regional patriotism. It is demonstrated that adjusting agitational and propagandistic measures towards strengthening national-patriotic motives proved highly effective, ensuring a steady influx of volunteers into Cossack cavalry formations.

Barriers to Mental Health Care in US Military Veterans

Barriers to Mental Health Care in US Military Veterans

Trauma Exposure and Hopelessness as Predictors of Post-Traumatic Stress Disorder and Depression among War Veterans in SouthEast Nigeria

Trauma Exposure and Hopelessness as Predictors of Post-Traumatic Stress Disorder and Depression among War Veterans in SouthEast Nigeria

Retrospective analysis of surgical treatment of adult patients with trauma and posttraumatic deformities of the middle zone of the facial skeleton

The issues of diagnosis, planning, timing and tactics of surgical treatment, possible risks of postoperative complications in patients with trauma of the middle zone of the facial skeleton have remained relevant for many years. Due to the prevalence and complexity of solving a number of problems facing specialists arising from post-traumatic deformities (PTD) in this area, the problem of treating this category of patients is not only medical, but also socio-economic. Purpose. To carry out a retrospective analysis of the data of medical documentation of adult patients with trauma and PTD of the middle zone of the facial skeleton. Material and methods. We analyzed statistical data on the provision of specialized medical care to patients with trauma and PTD of the middle zone of the facial skeleton in institutions subordinate to the Moscow Department of Health for 2021 and 2022. A sample of 32 495 medical records of patients who were hospitalized at the State Budgetary Healthcare Institution of the Department of Healthcare of the Moscow “Maxillofacial Hospital for War Veterans” was conducted from March 2015 to December 2023. Statistical processing of the obtained data from the study group of patients was carried out. Results. Information is presented on the specialized care provided to adult patients with trauma and PTD of the middle zone of the facial skeleton in institutions subordinate to the Moscow Department of Health for 2021 and 2022. Our study included 233 patients with trauma and PTD of the midfacial skeleton who underwent surgical treatment. Of these, 84.12% (n=196) were men and 15.88% (n=37) women. The average age of the patients was 35.74±11.11 years. The study group was divided into two subgroups: the 1st – patients with injuries to the bones of the midface (n=157, 67.38%), the 2nd – with PTD of the bones of the midface (n=76, 32.62%). The article presents the main characteristics of these patients. The methods of their examination at the prehospital stage are analyzed in detail; the time from the moment of injury to the moment of seeking specialized medical care; channels of hospitalization; causes of injuries; aesthetic and functional disorders as a result of injuries; types of injuries; applied methods and tactics of surgical treatment. Conclusions. The results of the study present a modern characterization of adult patients with trauma and PD of the middle zone of the facial skeleton. Recommendations are given on the use of four main fixation points during operations of metallosteosynthesis of the bones of the zygomatic complex, the need to reduce the time from the moment of injury to the moment of specialized medical care, the need for an integrated approach and treatment of patients with injuries and PTD of the bones of the middle zone of the face in specialized centers of maxillofacial-facial surgery.

Self-compassion and post-traumatic stress disorder in the military experience of veterans

Purpose. The article provides an analytical review of the problem of self-compassion and psychological features of stress disorder in military personnel who have military life experience. Methods. To ensure the realization of the research goal, we involved the methods of scientific and theoretical study: analysis, synthesis, generalization, abstraction, thanks to which it was possible to find out the meaningful and functional purpose and combination of the analyzed phenomena. Results. The theoretical analysis of the thematic scientific and psychological literature on the problems of self-compassion and post-traumatic stress disorder gave reasons to assert the existence of close correlations between them. Self-compassion as one of the basic constructs of self-awareness of veteran combatants who are negatively affected by post-traumatic stress symptoms, together with other psychotechniques of self-support, usually plays a positive psychoprotective, rehabilitative and generally revitalizing and life-affirming function. Conclusions. Self-compassion expresses a person's desire to achieve psychological well-being and, together with self-esteem, self-acceptance, self-approval, self-affirmation, etc., attests to the formation of an important mechanism for holistic self-awareness of a person. Self-compassion allows you to reduce the feeling of guilt associated with the traumatic experience of the past, makes it possible to resist fatigue and burnout, provides the experience of subjective happiness, and serves as a guarantee of maintaining the mental health of military veterans. In general, self-compassion can have a relaxing effect on harmonizing the disturbed affectivity of a person with military experience and significantly optimize recovery after traumatic exposure and the consequences of post-traumatic stress disorder.

The Impact of Peacekeeping on Post-Deployment Earnings for Swedish Veterans

ABSTRACT We study the effect of peacekeeping on post-deployment earnings for military veterans. Using Swedish administrative data, we follow a sample of more than 11,000 veterans who were deployed for the first time during the period 1993-2010 for up to nine years after returning home. To deal with selection bias, we use difference-in-differences propensity score matching based on a rich set of covariates, including measures of individual ability, health and pre-deployment labour market attachment. We find that, overall, veterans’ long run post-deployment earnings are largely unaffected by their service. As such, our findings challenge the notion that Swedish veterans struggle on the labour market. At the same time, we find indications that the zero effect for the full sample hides interesting patterns in the effects from deployment, across sub-groups of veterans. Veterans deployed to Bosnia in the 1990s appear to have suffered a transitory earnings penalty, whereas veterans deployed to Afghanistan in the 2000s, as well as veterans with below average cognitive ability, and veterans with low-educated parents, appear to have earned a long run earnings premium.