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ABSTRACT: Psychoeducation is increasingly used following trauma. The term covers the provision of information about the nature of stress, posttraumatic and other symptoms, and what to do about them. The provision of psychoeducation can also occur before possible exposure to stressful situations or, alternatively, after exposure. The intention of both is to ameliorate or mitigate the effects of exposure to extreme situations. Educational information can be imparted in a number of ways and can also form part of what has been termed psychological first aid. Despite its ubiquity, however, good evidence as to the value of psychoeducation is rare. Perhaps it could be assumed that psychoeducation, like education in general, is so obviously a "good thing" that it requires no evidence. In this paper we question the assumption, arguing that like any other intervention, psychoeducation needs to be backed up by empirical evidence. We will first present the case for and then the case against psychoeducation before reaching some conclusions and making some recommendations.
Psychiatry Interpersonal & Biological Processes 02/2008; 71(4):287-302. · 3.16 Impact Factor
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Nicola T Fear,
Amy Iversen,
Howard Meltzer,
Lorna Workman,
Lisa Hull,
Neil Greenberg,
Christopher Barker,
Tess Browne, Mark Earnshaw,
Oded Horn,
Margaret Jones,
Dominic Murphy,
Roberto J Rona,
Matthew Hotopf,
Simon Wessely
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ABSTRACT: To examine patterns of drinking in the UK Armed Forces, how they vary according to gender and other demographics, and to make comparisons with the general population.
Large cross-sectional postal questionnaire study (response rate 60%).
United Kingdom.
A random representative sample of the regular UK Armed Forces who were in service in March 2003 (n = 8686; 7937 men, 749 women). Comparisons were made with the general population of Great Britain.
Alcohol consumption was assessed using the Alcohol Use Disorders Identification Test (AUDIT).
Sixty-seven per cent of men and 49% of women in the UK Armed Forces had an AUDIT score of 8+ (defined as hazardous drinking), compared to 38% of men and 16% of women in the general population. In both sexes, for all ages, the military have a higher prevalence of hazardous drinking. Binge drinking was associated with being younger, being in the Army, being single, being a smoker and being white. Among military men, heavy drinking (AUDIT score 16+) was associated with holding a lower rank, being younger, being single, being in the Naval Service or Army, being deployed to Iraq, not having children, being a smoker, having a combat role and having a parent with a drink or drug problem.
Excessive alcohol consumption is more common in the UK Armed Forces than in the general population. There are certain socio-demographic characteristics associated with heavy drinking within the military; for example, young age, being single and being a smoker, which may allow the targeting of preventive interventions.
Addiction 12/2007; 102(11):1749-59. · 4.31 Impact Factor
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ABSTRACT: To assess the relation between frequency and duration of deployment of UK armed forces personnel on mental health.
First phase of a cohort study.
UK armed forces personnel.
Operational history in past three years of a randomly chosen stratified sample of 5547 regulars with experience of deployment.
Psychological distress (general health questionnaire-12), caseness for post-traumatic stress disorder, physical symptoms, and alcohol use (alcohol use disorders identification test).
Personnel who were deployed for 13 months or more in the past three years were more likely to fulfil the criteria for post-traumatic stress disorder (odds ratio 1.55, 95% confidence interval 1.07 to 2.32), show caseness on the general health questionnaire (1.35, 1.10 to 1.63), and have multiple physical symptoms (1.49, 1.19 to 1.87). A significant association was found between duration of deployment and severe alcohol problems. Exposure to combat partly accounted for these associations. The associations between number of deployments in the past three years and mental disorders were less consistent than those related to duration of deployment. Post-traumatic stress disorder was also associated with a mismatch between expectations about the duration of deployment and the reality.
A clear and explicit policy on the duration of each deployment of armed forces personnel may reduce the risk of post-traumatic stress disorder. An association was found between deployment for more than a year in the past three years and mental health that might be explained by exposure to combat.
BMJ (Clinical research ed.). 10/2007; 335(7620):603.
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Matthew Hotopf,
Lisa Hull,
Nicola T Fear,
Tess Browne,
Oded Horn,
Amy Iversen,
Margaret Jones,
Dominic Murphy,
Duncan Bland, Mark Earnshaw,
Neil Greenberg,
Jamie Hacker Hughes,
A Rosemary Tate,
Christopher Dandeker,
Roberto Rona,
Simon Wessely
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ABSTRACT: Concerns have been raised about the mental and physical health of UK military personnel who deployed to the 2003 war in Iraq and subsequent tours of duty in the country.
We compared health outcomes in a random sample of UK armed forces personnel who were deployed to the 2003 Iraq war with those in personnel who were not deployed. Participants completed a questionnaire covering the nature of the deployment and health outcomes, which included symptoms of post-traumatic stress disorder, common mental disorders, general wellbeing, alcohol consumption, physical symptoms, and fatigue.
The participation rate was 62.3% (n=4722) in the deployed sample, and 56.3% (n=5550) in the non-deployed sample. Differences in health outcomes between groups were slight. There was a modest increase in the number of individuals with multiple physical symptoms (odds ratio 1.33; 95% CI 1.15-1.54). No other differences between groups were noted. The effect of deployment was different for reservists compared with regulars. In regulars, only presence of multiple physical symptoms was weakly associated with deployment (1.32; 1.14-1.53), whereas for reservists deployment was associated with common mental disorders (2.47, 1.35-4.52) and fatigue (1.78; 1.09-2.91). There was no evidence that later deployments, which were associated with escalating insurgency and UK casualties, were associated with poorer mental health outcomes.
For regular personnel in the UK armed forces, deployment to the Iraq war has not, so far, been associated with significantly worse health outcomes, apart from a modest effect on multiple physical symptoms. There is evidence of a clinically and statistically significant effect on health in reservists.
The Lancet 06/2006; 367(9524):1731-41. · 38.28 Impact Factor
