Bernardette C.E.M. Blom, F. J. June ter Heide, Bart Nauta, T. Mooren, M. Olff
LAY SUMMARY Research has shown time and time again that war has an impact on the mental well-being of Veterans and their families. But what does that impact look like when a mission is characterized by severe violations of norms and values (in other words, moral injury)? In this study, family members of Dutch Veterans talked about the impact on their lives of a mission gone bad in the former Yugoslavia, 25 years after it happened. Although most of the families were doing well, all of the families felt left alone in taking care of their Veterans after they returned and in dealing with negative press coverage. For the well-being of all, they expressed the need for more appreciation for and acknowledgement of Veterans and their families.
{"title":"‘Where am I in all of this?’ Impact of a morally injurious mission on the home front of Dutchbat III military Veterans","authors":"Bernardette C.E.M. Blom, F. J. June ter Heide, Bart Nauta, T. Mooren, M. Olff","doi":"10.3138/jmvfh-2022-0065","DOIUrl":"https://doi.org/10.3138/jmvfh-2022-0065","url":null,"abstract":"LAY SUMMARY Research has shown time and time again that war has an impact on the mental well-being of Veterans and their families. But what does that impact look like when a mission is characterized by severe violations of norms and values (in other words, moral injury)? In this study, family members of Dutch Veterans talked about the impact on their lives of a mission gone bad in the former Yugoslavia, 25 years after it happened. Although most of the families were doing well, all of the families felt left alone in taking care of their Veterans after they returned and in dealing with negative press coverage. For the well-being of all, they expressed the need for more appreciation for and acknowledgement of Veterans and their families.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":"41 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73719349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amanda Bonson, Dominic Murphy, V. Aldridge, N. Greenberg, V. Williamson
LAY SUMMARY This article looks at how moral injury (MI) may develop by considering what event features may be especially salient and cause MI and what experiences an individual may have after an event that might lead to the occurrence of a MI. It proposes that the beliefs someone has about themselves, others, and the world can be shaped by experiences in childhood and early life. Once an individual has experienced a potentially morally injurious event (PMIE) — for example, witnessing something that violates deeply held moral or ethical codes but being unable to stop it, doing something that violates these ethical codes, or experiencing a significant betrayal — they may try to make sense of it by changing the way they see the world, themselves, and others. This can lead to problems in the individual’s relationship with themselves and others, leading to feelings of shame and guilt and withdrawal from other people. More important, for an event to be a PMIE, it must significantly challenge strongly held moral beliefs and a sense of right and wrong.
{"title":"Conceptualization of moral injury: A socio-cognitive perspective","authors":"Amanda Bonson, Dominic Murphy, V. Aldridge, N. Greenberg, V. Williamson","doi":"10.3138/jmvfh-2022-0034","DOIUrl":"https://doi.org/10.3138/jmvfh-2022-0034","url":null,"abstract":"LAY SUMMARY This article looks at how moral injury (MI) may develop by considering what event features may be especially salient and cause MI and what experiences an individual may have after an event that might lead to the occurrence of a MI. It proposes that the beliefs someone has about themselves, others, and the world can be shaped by experiences in childhood and early life. Once an individual has experienced a potentially morally injurious event (PMIE) — for example, witnessing something that violates deeply held moral or ethical codes but being unable to stop it, doing something that violates these ethical codes, or experiencing a significant betrayal — they may try to make sense of it by changing the way they see the world, themselves, and others. This can lead to problems in the individual’s relationship with themselves and others, leading to feelings of shame and guilt and withdrawal from other people. More important, for an event to be a PMIE, it must significantly challenge strongly held moral beliefs and a sense of right and wrong.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":"34 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89398558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marie-Louise Sharp, Margaret Jones, H. Burdett, N. Fear
LAY SUMMARY The COVID-19 pandemic influenced ways in which individuals volunteered and created barriers for participation because of differing restrictions. The research assessing how Veterans volunteer is limited, but there may be aspects of military culture that encourage service to others. The authors investigated volunteering among UK Veterans during the COVID-19 pandemic and what factors made Veterans more or less likely to volunteer. The study found that 60% of Veterans had volunteered in the past 12 months, a level similar to that among the UK general population. Overall, Veterans volunteered more often through formal organizations rather than on an informal basis, such as helping individuals such as neighbours. However, in relative terms, levels of formal volunteering decreased and levels of informal volunteering increased during the pandemic. Veterans were more likely to volunteer if they were officers or to increase volunteering if they felt lonely. Veterans who reduced volunteering were more likely to have mental health problems. Understanding volunteering among Veterans may open up more opportunities for participation.
{"title":"Volunteering behaviours among UK military Veterans during the COVID-19 pandemic and associations with health and well-being","authors":"Marie-Louise Sharp, Margaret Jones, H. Burdett, N. Fear","doi":"10.3138/jmvfh-2022-0056","DOIUrl":"https://doi.org/10.3138/jmvfh-2022-0056","url":null,"abstract":"LAY SUMMARY The COVID-19 pandemic influenced ways in which individuals volunteered and created barriers for participation because of differing restrictions. The research assessing how Veterans volunteer is limited, but there may be aspects of military culture that encourage service to others. The authors investigated volunteering among UK Veterans during the COVID-19 pandemic and what factors made Veterans more or less likely to volunteer. The study found that 60% of Veterans had volunteered in the past 12 months, a level similar to that among the UK general population. Overall, Veterans volunteered more often through formal organizations rather than on an informal basis, such as helping individuals such as neighbours. However, in relative terms, levels of formal volunteering decreased and levels of informal volunteering increased during the pandemic. Veterans were more likely to volunteer if they were officers or to increase volunteering if they felt lonely. Veterans who reduced volunteering were more likely to have mental health problems. Understanding volunteering among Veterans may open up more opportunities for participation.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":"52 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73882398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephanie A Houle, Joseph Inhaber, R. Jetly, Andrea R. Ashbaugh
LAY SUMMARY Moral injury (MI) refers to the psycho-spiritual consequences of events that deeply transgress a person’s core moral beliefs and values. Such events are reportedly common in the military context, and strong associations have been demonstrated between exposure to potentially morally injurious events (PMIEs) and suicidality. This study explored differences in negative cognitions between treatment-seeking Canadian Armed Forces members and Veterans with and without current suicidal thoughts and behaviours (STBs), all of whom reported current distress in response to a PMIE. Those exhibiting STBs reported stronger negative beliefs about the self. Scores for event-related guilt cognitions and self-blame were similar across individuals with and without STBs. Individuals reporting STBs also displayed higher depression and symptoms of posttraumatic stress disorder. The results suggest that severity of mental health symptoms and negative self-evaluations may be most pertinent in their association with suicidality in the MI context. Results remain preliminary, however, and additional research is needed to properly examine how event and self-related evaluations affect suicidality after PMIEs.
{"title":"Negative cognition in the context of suicidality after exposure to military-related potentially morally injurious events","authors":"Stephanie A Houle, Joseph Inhaber, R. Jetly, Andrea R. Ashbaugh","doi":"10.3138/jmvfh-2022-0057","DOIUrl":"https://doi.org/10.3138/jmvfh-2022-0057","url":null,"abstract":"LAY SUMMARY Moral injury (MI) refers to the psycho-spiritual consequences of events that deeply transgress a person’s core moral beliefs and values. Such events are reportedly common in the military context, and strong associations have been demonstrated between exposure to potentially morally injurious events (PMIEs) and suicidality. This study explored differences in negative cognitions between treatment-seeking Canadian Armed Forces members and Veterans with and without current suicidal thoughts and behaviours (STBs), all of whom reported current distress in response to a PMIE. Those exhibiting STBs reported stronger negative beliefs about the self. Scores for event-related guilt cognitions and self-blame were similar across individuals with and without STBs. Individuals reporting STBs also displayed higher depression and symptoms of posttraumatic stress disorder. The results suggest that severity of mental health symptoms and negative self-evaluations may be most pertinent in their association with suicidality in the MI context. Results remain preliminary, however, and additional research is needed to properly examine how event and self-related evaluations affect suicidality after PMIEs.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":"46 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86007614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comments on Tien and Beckett’s ‘Medical support for future large-scale combat operations’","authors":"A. Kirkpatrick, Jessica L. Mckee, K. Breeck","doi":"10.3138/jmvfh-2022-0066","DOIUrl":"https://doi.org/10.3138/jmvfh-2022-0066","url":null,"abstract":"","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":"117 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81170415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Census data a step forward in understanding well-being of military members, Veterans","authors":"S. Bélanger, D. Pedlar, Dianne Groll","doi":"10.3138/jmvfh.9.1.ed","DOIUrl":"https://doi.org/10.3138/jmvfh.9.1.ed","url":null,"abstract":"","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":"57 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88246523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LAY SUMMARY Limited research has explored the influence Veterans and their spouses have on each other’s experiences during Veterans’ transition from military to civilian life. Analyses of the Canadian Armed Forces Transition and Well-being Survey were conducted to examine whether perceived challenges among Veterans and their spouses during this transition (i.e., whether they experienced financial difficulties, had trouble finding a health care provider, or felt a loss of military identity) are associated with the extent to which each believes they are able to handle stress, have access to social support, and have a strong sense of belonging to their community. Results show how the experiences of both Veterans and their spouses might be interdependent and emphasize the importance of ensuring each is better prepared for, and supported, during this important period of change.
{"title":"Psychosocial factors and military-to-civilian transition challenges: A dyadic analysis of Veterans and their spouses","authors":"Jennifer E. C. Lee, K. Pearce, Shreena Thapa","doi":"10.3138/jmvfh-2022-0015","DOIUrl":"https://doi.org/10.3138/jmvfh-2022-0015","url":null,"abstract":"LAY SUMMARY Limited research has explored the influence Veterans and their spouses have on each other’s experiences during Veterans’ transition from military to civilian life. Analyses of the Canadian Armed Forces Transition and Well-being Survey were conducted to examine whether perceived challenges among Veterans and their spouses during this transition (i.e., whether they experienced financial difficulties, had trouble finding a health care provider, or felt a loss of military identity) are associated with the extent to which each believes they are able to handle stress, have access to social support, and have a strong sense of belonging to their community. Results show how the experiences of both Veterans and their spouses might be interdependent and emphasize the importance of ensuring each is better prepared for, and supported, during this important period of change.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":"22 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81609012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nuoya Peng, H. Yeh, A. Khavari, Han Zhang-Gao, C. Tenn, Hugh A. Semple, Massimo F. Cau, Andrew Beckett, C. Kastrup
LAY SUMMARY The efficacy of current hemostatic technologies is limited by several factors. Outward blood flow washes hemostatic drugs away from the wound, and hemostatic drugs often require focus, training, and time to use correctly, are highly specific to one type of injury, or pose severe safety risks. CounterFlow is a novel product that could potentially save military and civilian lives by stopping heavy bleeding from a variety of organs and other bodily locations that current technology cannot easily treat. Upon contact with blood, CounterFlow releases bursts of gas to safely self-propel bio-degradable clot-forming and clot-stabilizing drugs against blood flow, delivering them to the source of bleeding. This unique mechanism allows CounterFlow to be applied quickly to a wide assortment of wounds and to act effectively with little management after application. CounterFlow was tested in multiple animal models representing common and deadly bleeding scenarios, including internal bleeding, care under fire without compression, and surgical bleeding, and it was found to outperform current care options by stopping bleeds faster and increasing survival times. CounterFlow is also safe to use and biocompatible. This narrative review summarizes studies testing the effectiveness and safety of CounterFlow, discusses useful applications, and describes future plans for the product.
{"title":"Efficacy and safety of CounterFlow in animal models of hemorrhage","authors":"Nuoya Peng, H. Yeh, A. Khavari, Han Zhang-Gao, C. Tenn, Hugh A. Semple, Massimo F. Cau, Andrew Beckett, C. Kastrup","doi":"10.3138/jmvfh-2022-0014","DOIUrl":"https://doi.org/10.3138/jmvfh-2022-0014","url":null,"abstract":"LAY SUMMARY The efficacy of current hemostatic technologies is limited by several factors. Outward blood flow washes hemostatic drugs away from the wound, and hemostatic drugs often require focus, training, and time to use correctly, are highly specific to one type of injury, or pose severe safety risks. CounterFlow is a novel product that could potentially save military and civilian lives by stopping heavy bleeding from a variety of organs and other bodily locations that current technology cannot easily treat. Upon contact with blood, CounterFlow releases bursts of gas to safely self-propel bio-degradable clot-forming and clot-stabilizing drugs against blood flow, delivering them to the source of bleeding. This unique mechanism allows CounterFlow to be applied quickly to a wide assortment of wounds and to act effectively with little management after application. CounterFlow was tested in multiple animal models representing common and deadly bleeding scenarios, including internal bleeding, care under fire without compression, and surgical bleeding, and it was found to outperform current care options by stopping bleeds faster and increasing survival times. CounterFlow is also safe to use and biocompatible. This narrative review summarizes studies testing the effectiveness and safety of CounterFlow, discusses useful applications, and describes future plans for the product.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":"159 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76629497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Gulliver, Jessica A. Rostockyj, M. Pennington, M. Cardenas, J. Strack, Alton McCallum, J. Dupree, Elizabeth Coe, E. Meyer
LAY SUMMARY Behavioural health peer support connects individuals to needed professional services (e.g., counselling) and provides benefits in groups of people that might face more challenges, like military Veterans. Different training exists for peer supporters, but not a lot of information is available to demonstrate if these trainings, or checking in with trained peers, is helpful. This study took a peer support training program used in fire service and updated it to fit the needs of Veterans and Veteran family members (V/VFM) in Texas, United States. Texas has a lot of Veterans and lacks enough mental health providers (e.g., psychologists). In this study, V/VFM were trained in peer support skills and had six months of peer check-in calls after the training. The trainees completed a test before training asking about their engagement and confidence with helping others, as well as a test after training asking these questions again and assessing satisfaction with training. Results show training was appropriate and acceptable. V/VFM appreciated the check ins and showed increases in confidence in their ability to help others. They tried to help more peers and were more successful when they did reach out. This study describes one way peer support can improve mental health access.
{"title":"A peer support training and supervision program for Veterans and families: Development and preliminary results","authors":"S. Gulliver, Jessica A. Rostockyj, M. Pennington, M. Cardenas, J. Strack, Alton McCallum, J. Dupree, Elizabeth Coe, E. Meyer","doi":"10.3138/jmvfh-2022-0018","DOIUrl":"https://doi.org/10.3138/jmvfh-2022-0018","url":null,"abstract":"LAY SUMMARY Behavioural health peer support connects individuals to needed professional services (e.g., counselling) and provides benefits in groups of people that might face more challenges, like military Veterans. Different training exists for peer supporters, but not a lot of information is available to demonstrate if these trainings, or checking in with trained peers, is helpful. This study took a peer support training program used in fire service and updated it to fit the needs of Veterans and Veteran family members (V/VFM) in Texas, United States. Texas has a lot of Veterans and lacks enough mental health providers (e.g., psychologists). In this study, V/VFM were trained in peer support skills and had six months of peer check-in calls after the training. The trainees completed a test before training asking about their engagement and confidence with helping others, as well as a test after training asking these questions again and assessing satisfaction with training. Results show training was appropriate and acceptable. V/VFM appreciated the check ins and showed increases in confidence in their ability to help others. They tried to help more peers and were more successful when they did reach out. This study describes one way peer support can improve mental health access.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":"139 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73788607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LAY SUMMARY Being aware of and willing to access mental health services are important first steps in seeking help for a self-reported mental health, stress, or emotional problem. Evidence shows that UK military personnel, in particular ex-serving personnel, are not always aware of or willing to access sources of mental health support. This study explored which sources of mental health support UK military personnel were aware of and willing to use if they self-reported a mental health, stress, or emotional problem. It also explored the possible differences between serving and ex-serving military personnel. All UK military personnel were most aware of and willing to access formal medical services. However, among ex-serving personnel, there was a low awareness of and willingness to use ex-serving-specific support services, such as the Veterans and Reserves Mental Health Programme, National Health Services Veterans Service, and Veterans UK helpline. Future service delivery and policy should focus on improving the variety of sources of support that ex-serving personnel are aware of and willing to use.
{"title":"Awareness of and willingness to access support among UK military personnel who reported a mental health difficulty","authors":"A. Mills, N. Fear, S. Stevelink","doi":"10.3138/jmvfh-2022-0009","DOIUrl":"https://doi.org/10.3138/jmvfh-2022-0009","url":null,"abstract":"LAY SUMMARY Being aware of and willing to access mental health services are important first steps in seeking help for a self-reported mental health, stress, or emotional problem. Evidence shows that UK military personnel, in particular ex-serving personnel, are not always aware of or willing to access sources of mental health support. This study explored which sources of mental health support UK military personnel were aware of and willing to use if they self-reported a mental health, stress, or emotional problem. It also explored the possible differences between serving and ex-serving military personnel. All UK military personnel were most aware of and willing to access formal medical services. However, among ex-serving personnel, there was a low awareness of and willingness to use ex-serving-specific support services, such as the Veterans and Reserves Mental Health Programme, National Health Services Veterans Service, and Veterans UK helpline. Future service delivery and policy should focus on improving the variety of sources of support that ex-serving personnel are aware of and willing to use.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":"13 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89725818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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