Post-deployment Support Research Articles

Posttraumatic growth and depreciation in military veterans: A gender-stratified latent profile analysis.

Over the past few decades, there has been a substantial increase of interest worldwide in how trauma can cause posttraumatic changes such as posttraumatic growth (PTG) and posttraumatic depreciation (PTD), and whether there exist gender-specific patterns of such changes. Despite the increase in interest, no studies have yet examined PTG and PTD in gender stratified models. Latent profile analysis was used to explore PTG and PTD using the Posttraumatic Change Scale-Short Form in a gender stratified sample of Afghanistan veterans (n = 6,205, 8.3% females). Associations between profiles and predictors (trauma type), and outcome variables (anxiety, depression, and posttraumatic stress symptoms) were explored using R3STEP and Bolck-Croon-Hagenaars procedures in Mplus. A three-profile model was found to be the best fitting model for female veterans, while a five-profile model was optimal for the male veterans, indicating there are gender-specific patterns in posttraumatic change. For both females and males, higher loads of trauma exposure were associated with conforming to the depreciation profiles, however, growth-related profiles also reported more trauma experiences than the no-change profile. Belonging to the depreciation profiles was associated with higher symptoms of anxiety, depression, and posttraumatic stress for both female and male veterans. A person may experience posttraumatic depreciation in one life domain, and at the same time growth in another. Male and female veterans differ in their unique profiles of posttraumatic change. Awareness of idiosyncratic profiles of growth and depreciation may improve postdeployment support and intervention strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The nature and impacts of deployment-related encounters with children among Canadian military Veterans: a qualitative analysis

ABSTRACT Background: As armed conflict grows increasingly complex, the involvement of children in armed violence across diverse roles is rising. Consequently, military personnel are more likely to encounter children during deployment. However, little is known about deployment-related encounters with children and their impact on the mental health of military personnel and Veterans. Objective: This study qualitatively examines the nature and impacts of deployment-related encounters with children. Methods: We conducted semi-structured interviews with 16 Canadian Armed Forces Veterans, eliciting rich information on the nature of child encounters on deployment, the psycho-social-spiritual impacts of these encounters, and perceptions of support. Interview transcripts were analysed using thematic analysis. Results: Six primary themes were identified: types of encounters (i.e. factual aspects of deployment-related encounters with children), contextual factors (i.e. aspects of the mission, environment, and personal context relevant to one’s experience of the encounter), appraisals of encounters (i.e. sensory or sense-making experiences relevant to the encounter), impacts of encounters (i.e. psycho-social, existential, and occupational impacts), coping strategies engaged in both during and after deployment, and support experiences, describing both formal and informal sources of support. Conclusions: Encounters with children are diverse and highly stressful, resulting in impacts pertinent to mental health, including psychological and moral distress, and difficulties with identity, spirituality, and relationships. These impacts are prompted by complex interactions among appraisals, expectations of morality, cultural norms, and professional duties and are amplified by various personal factors (e.g. childhood maltreatment history, parenthood), feelings of unpreparedness, and lack of post-deployment support. Implications for prevention, intervention, and policy are discussed with the aim of informing future efforts to safeguard and support military personnel facing a high likelihood of encounters with children.

Navigating digital transformation in airports : A disciplined approach to project portfolio selection and execution

Airports are undertaking digital transformation initiatives to achieve operations excellence, improve sustainability and enhance competitiveness. While digital transformation offers many potential benefits for airports, including improved insights, efficiencies, streamlined passenger journeys and new business/ revenue opportunities, there are risks associated with not utilising a disciplined approach when building a digital transformation project portfolio. Just as all airports are not the same, digital transformation initiatives are not ‘one size fits all’. Projects to introduce new systems and deploy new technology under the banner of digital transformation need to be in support of the strategic goals of the airport and in alignment with business and operational objectives. Digital transformation initiatives must also fit within the resource and skills capacity of the airport to successfully perform the work and provide the necessary post-deployment support afterwards. This paper posits that a disciplined and analytical approach to evaluating both the likely effort required for successful execution and the potential impact and value generated can assist airports with the selection and timing of projects, with the aim of avoiding ‘digital disappointment’. It concludes that digital transformation projects selected and sequenced on the basis of objective criteria are most likely to address the business and operational needs of individual airports and generate the most value for airport employees, stakeholders and passengers.

The silent epidemic of substandard and falsified medicines in low- and middle-income countries: heed lessons from the tragic deaths of children in Indonesia

The silent epidemic of substandard and falsified medicines in low- and middle-income countries: heed lessons from the tragic deaths of children in Indonesia

Cannabis Use and Perceptions Among Current and Former Military Service Members.

Research indicates separation from the military may result in increased risk of alcohol use. However, there is little data on cannabis use among military service members, particularly when examining the period after separation from military service. This research examines cannabis-related perceptions and use among U.S. Army Reserve/National Guard (USAR/NG) current and former soldiers. Data come from Operation: SAFETY (Soldiers And Families Excelling Through the Years), an ongoing study examining health among male and female USAR/NG soldiers. The current sample was comprised of 401 current and former USAR/NG soldiers. Logistic regression models examined the associations between past-year cannabis use, military status (i.e., current versus former), attitudes towards recreational cannabis, perceived ease of access, and perceived risk of cannabis use, while controlling for age, problematic alcohol use, and current cigarette smoking. Overall, 7.4% of current and 20.3% of former military service members used cannabis in the past year. Favorable attitudes towards cannabis use and perceived ease of accessing cannabis were associated with increased odds of use among all soldiers. In adjusted models, former military members had greater odds (AOR = 5.28, 95% CI = 2.16, 12.87) of past-year cannabis use compared to current service members. Findings indicate that separation from the military may be an important risk factor to consider when assessing cannabis use in the military. Additional research is needed to examine socioenvironmental factors (e.g., access to post-deployment support services and healthcare, state legalization laws, other behavioral health conditions) that contribute to former service members' cannabis use.

Applicability of an Automated Model and Parameter Selection in the Prediction of Screening-Level PTSD in Danish Soldiers Following Deployment: Development Study of Transferable Predictive Models Using Automated Machine Learning.

BackgroundPosttraumatic stress disorder (PTSD) is a relatively common consequence of deployment to war zones. Early postdeployment screening with the aim of identifying those at risk for PTSD in the years following deployment will help deliver interventions to those in need but have so far proved unsuccessful.ObjectiveThis study aimed to test the applicability of automated model selection and the ability of automated machine learning prediction models to transfer across cohorts and predict screening-level PTSD 2.5 years and 6.5 years after deployment.MethodsAutomated machine learning was applied to data routinely collected 6-8 months after return from deployment from 3 different cohorts of Danish soldiers deployed to Afghanistan in 2009 (cohort 1, N=287 or N=261 depending on the timing of the outcome assessment), 2010 (cohort 2, N=352), and 2013 (cohort 3, N=232).ResultsModels transferred well between cohorts. For screening-level PTSD 2.5 and 6.5 years after deployment, random forest models provided the highest accuracy as measured by area under the receiver operating characteristic curve (AUC): 2.5 years, AUC=0.77, 95% CI 0.71-0.83; 6.5 years, AUC=0.78, 95% CI 0.73-0.83. Linear models performed equally well. Military rank, hyperarousal symptoms, and total level of PTSD symptoms were highly predictive.ConclusionsAutomated machine learning provided validated models that can be readily implemented in future deployment cohorts in the Danish Defense with the aim of targeting postdeployment support interventions to those at highest risk for developing PTSD, provided the cohorts are deployed on similar missions.

Do unit and post-deployment social support influence the association between deployment sexual trauma and suicidal ideation?

Deployment sexual trauma is associated with post-deployment suicidal ideation. No studies have examined the role of social support in this association. The present study examined if perceived unit support and post-deployment support influenced the association between deployment sexual trauma and suicidal ideation. 824 post-9/11 veterans (480 men, 344 women) from the Survey of Experiences of Returning Veterans completed the Deployment Risk and Resilience Inventory-2 and Columbia-Suicide Severity Rating Scale. Age, possible depression, posttraumatic stress disorder symptoms, and lifetime suicide attempt were covaried. Among men, post-deployment support moderated the association between deployment sexual trauma and suicidal ideation; deployment sexual trauma predicted suicidal ideation only for men reporting low post-deployment support. Among women, post-deployment support mediated the association between deployment sexual trauma and suicidal ideation. Unit support neither moderated nor mediated the association between deployment sexual trauma and suicidal ideation. Among men who experience deployment sexual trauma, those with low perceived post-deployment support may be at particularly elevated risk for suicidal ideation and may benefit from more intensive monitoring and interventions that bolster social support. Increasing perceived post-deployment support for women who experience deployment sexual trauma is also warranted. Determining optimal ways to strengthen post-deployment support for sexual trauma survivors is essential.

Mental Health Impact of Homecoming Experience Among 1730 Formerly Deployed Veterans From the Vietnam War to Current Conflicts: Results From the Veterans' Health Study.

We examined the effects of homecoming support on current mental health among 1730 deployed veterans from Vietnam, Iraq/Afghanistan, Persian Gulf, and other conflicts. The prevalence of current posttraumatic stress disorder (PTSD) was 5.4%, current depression was 8.3%, and 5.4% had suicidal thoughts in the past month. Overall, 26% of veterans had low homecoming support, which was more prevalent among Vietnam veterans (44.3%, p < 0.001). In multivariable logistic regressions, controlling for demographics, combat exposure, number of deployments, trauma history, and operational theater, low postdeployment support was associated with PTSD (odds ratio, 2.13; p = 0.032) and suicidality (odds ratio, 1.91; p < 0.030), but not depression. For suicidality, an interaction was detected for homecoming by theater status, whereby Iraq/Afghanistan veterans with lower homecoming support had a higher probability of suicidal thoughts (p = 0.002). Thus, years after deployment, lower homecoming support was associated with current PTSD and suicidality, regardless of theater and warzone exposures. For suicidality, lower support had a greater impact on Iraq/Afghanistan veterans.

Deployment of personnel to military operations: impact on mental health and social functioning.

Deployment of personnel to military operations: impact on mental health and social functioning.

The role of a solutions salesperson: Reducing uncertainty and fostering adaptiveness

Suppliers in business-to-business markets increasingly are seeking growth by providing end-to-end solutions to customers. Customers, on their part, see solutions and accompanying performance-based vendor contracts as ways to assure themselves of performance outcomes they need. This article draws on extant literature in organizational buying behavior, industrial marketing and project marketing, as well as the distinctive nature of customer solutions, to delineate three overarching types of uncertainties among customers and suppliers: (1) need uncertainty, (2) process uncertainty and (3) outcome uncertainty. Each of these types of uncertainties is present across the four stages of a solution process (requirements definition, customization and integration, deployment, and post-deployment support). However, the nature of these uncertainties changes as a solution evolves from one stage to the next. Based on this, we delineate a solution salesperson's role as one of reducing specific uncertainties across the solution process by providing pertinent information to key stakeholders within the customer- and supplier organizations, and encouraging adaptive behavior of the parties involved. We discuss implications for practice, and suggest directions for further research.

Prevalence of hearing loss and tinnitus in Iraq and Afghanistan Veterans: A Chronic Effects of Neurotrauma Consortium study

The purpose of this study was to describe the prevalence of hearing loss and tinnitus in a cohort of Iraq and Afghanistan Veterans (IAV) with common post-deployment conditions, including traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), and other typical post-concussive conditions such as headaches and vertigo/dizziness. This retrospective observational study used data from the national Veterans Health Administration (VA) data repository from fiscal years 2001–2014. Veteran data was included if there were at least three years of VA care, with one or more years of care in 2007 or after. We identified comorbidities that may be associated with post-deployment hearing loss or tinnitus including TBI, PTSD, depression, and common post-concussive symptoms using International Classification of Diseases, 9th Revision, Clinical Modification codes. A multinomial logistic regression analysis was used to examine conditions associated with hearing loss or tinnitus. Among IAV, 570,332 were included in the final analysis. Of these, 7.78% of these were diagnosed with hearing loss alone, 6.54% with tinnitus alone, and 6.24% with both hearing loss and tinnitus. Comorbid TBI, PTSD, and depression were significantly associated with increased rates of hearing loss, tinnitus, or both conditions together. Older individuals, males, and those with TBI, PTSD, or vertigo/dizziness were significantly more likely to have hearing loss, tinnitus, or both. In order to provide more holistic post-deployment support, this myriad of conditions should be carefully considered in the planning of clinical care and beyond.

Isolating effects of moral injury and low post-deployment support within the U.S. military

Suicide rates within U.S. military components, particularly the National Guard, are significantly higher than the general population suicide rate. To better understand and prevent suicide within this population, we must identify mechanisms of risk contributing to these discrepancies. One risk factor relevant to military service is moral injury, a term for experiences that violate one's moral beliefs. Using a series of hierarchical multiple regressions, the current study examined the moderating role of post-deployment social support on the association between moral injury (self-transgressions, other-transgressions, and betrayal) and thwarted belongingness among military personnel. The current sample was comprised of 552 military personnel with at least one previous deployment. Partially consistent with hypotheses, results revealed that other-transgressions and betrayal were significantly associated with thwarted belongingness at low, but not mean or high levels of post-deployment support. In contrast, the interaction of self-transgressions and post-deployment support was not significantly associated with thwarted belongingness, nor was there a significant main effect of self-transgressions on thwarted belongingness. This suggests that experiencing other-perpetrated morally injurious events (i.e., watching a fellow soldier die, being betrayed by a comrade) can be compounded by low post-deployment social support, increasing risk for thwarted belongingness. Implications for prevention and treatment are discussed.

Support Systems: How Post-Deployment Support Impacts Suicide Risk Factors in the United States Army National Guard

Suicide rates within the military have continued to rise in recent years, resulting in re-doubled efforts to understand and remedy this trend. In an attempt to clarify unique pathways to suicide risk in this population, the current study examined the relationship between length of time since most recent deployment and several suicide risk factors (hopelessness, suicidal ideation, and resolved plans and preparations). Furthermore, this study examined the moderating influence of post-deployment social support in the prediction of suicide risk. Results indicated that the interaction of time since deployment and post-deployment support predicted both hopelessness and resolved plans and preparations, but did not predict suicidal ideation. These findings suggest that the negative effects of time spent away from recognized military support may be compounded by the isolating effect of decreased access to alternative supports at home, resulting in increased hopelessness and/or resolved plans and preparations. Implications for the necessity of improved post-deployment programs are discussed.

Mental Well-being Considerations in Preparation for Disaster Health Care: Learning From Deployment.

The mental well-being of internationally deployed disaster-relief workers has become an issue of concern. The psychological consequences for the relief worker being exposed to trauma and threats have been well documented; however, the role of pre-deployment preparation in supporting mental well-being has not received due attention, despite research indicating the need for it. This case series examines the experiences of deployed volunteers of one emergency-relief organization. The aim of this research was to identify the participants' interpretations of the appropriateness of the pre-deployment preparation they had received in light of supporting their mental well-being during and after deployment. The main research questions were: How appropriate was pre-deployment preparation in supporting mental well-being? What elements were lacking, and what else would be useful? Using a hermeneutic phenomenological approach, thematic, semi-structured interviews were conducted with six deployed volunteers of an international emergency-relief organization. Data were analyzed using content analysis. The participants in this study regarded the pre-deployment preparation they had received, on the whole, as appropriate in supporting their mental well-being. The seven main themes identified as important and supportive of mental well-being were: (1) realistic expectations, (2) team building and support, (3) self-awareness and self-care, (4) post-deployment support, (5) practical skills and creative solutions, (6) shared values and beliefs, and (7) safety and security. Specific areas identified as lacking within these themes included communication, self-care, post-deployment support, and safety and security. Themes identified as important for supporting mental well-being in this research largely were consistent with those in previous research. The generally positive experiences of the support received do not reflect results from existing research, where significant shortcomings in worker support have been expressed. However, important elements were also identified as lacking in this specific pre-deployment preparation.

A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans.

Post-traumatic stress disorder (PTSD), a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) were used to search for observational studies (cross-sectional, retrospective, and cohort studies) about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility to PTSD.

Impact of Combat and Social Support on PTSD and Alcohol Consumption in OEF/OIF Veterans

We tested buffering and direct effect theories of social support to determine if combat exposure level moderated relationships between two aspects of social support (unit cohesion and postdeployment support) and two outcomes (post-traumatic stress disorder [PTSD] and alcohol consumption) in 69 hazardous-drinking OEF/OIF veterans (65% Caucasian, 91% male). Combat exposure moderated the relationship between unit cohesion and PTSD. Unit cohesion was related to lower PTSD severity only for veterans with less severe combat exposure. Higher postdeployment support was related to less severe PTSD for all veterans. Alcohol consumption results were not significant.

Potentially Modifiable Pre-, Peri-, and Postdeployment Characteristics Associated With Deployment-Related Posttraumatic Stress Disorder Among Ohio Army National Guard Soldiers

To evaluate potentially modifiable deployment characteristics-- predeployment preparedness, unit support during deployment, and postdeployment support-that may be associated with deployment-related posttraumatic stress disorder (PTSD). We recruited a sample of 2616 Ohio Army National Guard (OHARNG) soldiers and conducted structured interviews to assess traumatic event exposure and PTSD related to the soldiers' most recent deployment, consistent with DSM-IV criteria. We assessed preparedness, unit support, and postdeployment support by using multimeasure scales adapted from the Deployment Risk and Resilience Survey. The prevalence of deployment-related PTSD was 9.6%. In adjusted logistic models, high levels of all three deployment characteristics (compared with low) were independently associated with lower odds of PTSD. When we evaluated the influence of combinations of deployment characteristics on the development of PTSD, we found that postdeployment support was an essential factor in the prevention of PTSD. Results show that factors throughout the life course of deployment-in particular, postdeployment support-may influence the development of PTSD. These results suggest that the development of suitable postdeployment support opportunities may be centrally important in mitigating the psychological consequences of war.

Customer solutions in the capital goods industry: Examining the impact of the buying center

Based on in-depth interviews with customers, this study explores the customers' view of relevant solution criteria in the capital goods industry. Our research examines (1) whether the initial four-process conceptualization of customer solutions also holds for this industry, or whether it has to be extended and (2) which criteria of the customer solution matter the most for each member of the buying center. This study reveals that customers purchasing solutions in the capital goods industry expect the provider to be excellent in terms of six customer/supplier relational processes, namely (1) customer requirements definition, (2) customization and integration of goods and/or services, (3) their deployment, (4) post-deployment support, (5) signaling activities, and (6) inter-process management. Moreover, we found that the relevance of these processes differs across the most important members of the buying center (users, buyers, and deciders) due to their specific organizational function.

Factors associated with suicidal ideation in OEF/OIF veterans

BackgroundThe purpose of this project was to examine factors associated with suicidal ideation in returning Iraq and Afghanistan war veterans. MethodsA cross-sectional review of 1740 veterans' initial mental health screening evaluations. One-hundred and thirteen (6.5%) OEF/OIF veterans reported active suicidal ideation at the time of the interview. ResultsPrior exposures of physical or sexual abuse and having a history of a prior suicide attempt(s) were associated with the presence of current suicidal ideation, as were having a diagnosis of a psychotic disorder, a depressive disorder, or posttraumatic stress disorder (PTSD). Deployment concerns related to training (protective), the deployment environment, family concerns, deployment concerns, post-deployment support (protective), and post-deployment stressors were also associated with current suicidal ideation. Logistic regression analysis revealed the major risk factors were having a prior suicide attempt, female gender, and a depressive disorder diagnosis; while more perceived current social support was a protective factor. Logistic regression analysis also revealed having comorbid PTSD and depression carried a higher odds ratio for risk than did having either PTSD or depression alone; and that the PTSD avoidance symptom-cluster was associated with more risk than either the re-experiencing or hyper-arousal symptom clusters for current suicidal ideation. LimitationsAs a cross-sectional retrospective medical chart review, limitations include limited generalizability and causal relationships cannot be evaluated. ConclusionsFurther investigation of these risk factors is warranted to aid in suicide risk assessment and in the development of targeted interventions to mitigate the identified risk factors and bolster the identified protective factor.

Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: The role of resilience, unit support, and postdeployment social support

Background Little research has examined the role of protective factors such as psychological resilience, unit support, and postdeployment social support in buffering against PTSD and depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF). Materials and methods A total of 272 OEF/OIF veterans completed a survey containing PTSD and depression screening measures, and questionnaires assessing resilience, social support, and psychosocial functioning. Results Lower unit support and postdeployment social support were associated with increased PTSD and depressive symptoms, and decreased resilience and psychosocial functioning. Path analyses suggested that resilience fully mediated the association between unit support and PTSD and depressive symptoms, and that postdeployment social support partially mediated the association between PTSD and depressive symptoms and psychosocial functioning. Limitations Generalizability of results is limited by the relatively low response rate and predominantly older and reserve/National Guard sample. Conclusions These results suggest that interventions designed to bolster unit support, resilience, and postdeployment support may help protect against traumatic stress and depressive symptoms, and improve psychosocial functioning in veterans.