Risk Factors for Long-Term Posttraumatic Stress Reactions in Unarmed UN Military Observers

Suicide Research and Prevention Unit, Institute of Psychiatry, University of Oslo, Oslo, Norway.
Journal of Nervous & Mental Disease (Impact Factor: 1.69). 11/2006; 194(10):800-4. DOI: 10.1097/01.nmd.0000240189.20531.2d
Source: PubMed


Follow-up data from 187 male Norwegian veteran officers from unarmed UN military observer missions were compared with follow-up data from 211 male veteran officers from Norwegian contingents of the UNIFIL peacekeeping mission in South Lebanon on stress exposure, posttraumatic stress symptoms, level of alcohol consumption, and problems with social adaptation after redeployment from the mission. Observer mission veterans reported exposure to significantly higher levels of war zone stressors than veterans from peacekeeping units did. Observer veterans also reported significantly more posttraumatic stress symptoms at follow-up, higher alcohol consumption levels during service and at follow-up, and more problems with social adaptation to their lives at home in the years after their UN military service. All of these difficulties were most prominent in observers having served in missions with high-intensity stress exposure. Multivariate analyses demonstrated stress exposure during the mission and problems with social adaptation after homecoming to predict posttraumatic stress symptoms at follow-up.

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Available from: Bjørn ODD Koldsland, Jul 30, 2014
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    • "This kind of threat leads to a situation that is one of the most notable differences between soldiers as warriors and soldiers as peacekeepers: the need to maintain restraint and neutrality. A wide variety of psychopathological conditions have been reported after peacekeeping missions, such as depression, alcoholism, drug abuse, somatization disorders, acute stress disorder, and posttraumatic stress disorder (Mehlum et al. 2006; Orsillo et al. 1998). Some studies have proposed that negative personality traits in peacekeepers are associated with an increased risk for developing stressrelated symptoms (Bramsen et al. 2000; Souza et al. 2008). "
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    ABSTRACT: The body's adaptive reaction to a stressful event, an allostatic response, involves vigorous physiological engagement with and efficient recovery from stress. Our aim was to investigate the influence of individual predispositions on cardiac responses to and recovery from a standardized psychosocial stress task (Trier Social Stress Task, TSST) in peacekeepers. We hypothesized that those individuals with higher trait resilience and those with higher resting vagal control would be more likely to present an allostatic response: a vigorous cardiac response to stress (i.e. reduction in interbeat intervals and in heart rate variability) coupled with a significant cardiac recovery in the aftermath. Fifty male military personnel with a mean age of 25.4 years (SD ± 5.99) were evaluated after returning from a peacekeeping mission. Electrocardiogram recordings were made throughout the experimental session, which consisted of 5 conditions: basal, speech preparation, speech delivery, arithmetic task and recovery. Mean interbeat intervals and heart rate variability were calculated for each condition. An ego-resilience scale and resting vagal control assessed individual predispositions. Stress tasks reduced interbeat intervals (tachycardia) and heart rate variability in comparison with basal, with return to basal in the aftermath (p<0.001, for all comparisons). Resilience and resting vagal control correlated positively with cardiac parameters both for stress reactivity and recovery (r≥0.29; p<0.05). In conclusion, peacekeepers showing higher trait resilience and those with higher resting vagal control presented a more adaptive allostatic reaction characterized by vigorous cardiac response to stress (i.e. tachycardia and vagal withdrawal) and efficient cardiac recovery after stress cessation.
    Full-text · Article · Jan 2013 · Stress (Amsterdam, Netherlands)
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    • "Similarly, U.S. military personnel from the 1991 Persian Gulf War were found to have significantly higher rates of alcohol abuse than military personnel from the same time period not deployed to the Persian Gulf (Iowa Persian Gulf Study Group, 1997), although this paralleled higher rates of other health conditions and was not directly linked to combat exposure. Mehlum et al. (2006) found that Norwegian United Nations military observers had significantly higher use of alcohol than Norwegian United Nations peacekeepers. The authors found that the observers experienced more combatrelated war zone stress than peacekeepers and hypothesized that this explained the higher rates of alcohol use. "
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    ABSTRACT: Studies have shown a relationship between combat experiences and alcohol misuse in military personnel; it is not known if there are specific combat experiences that confer a greater risk. The current study examined the association of specific types of combat experiences with a positive screen for alcohol misuse. 1120 U.S. soldiers who were members of brigade combat infantry teams were surveyed anonymously 3-4 months after returning from deployment to Iraq regarding their experiences in combat and their physical and mental health. Combat items were independently rated and placed into the following categories: (1) Fighting; (2) Killing; (3) Threat to oneself; (4) Death/injury of others; (5) Atrocities; and, (6) Positive experiences. Alcohol misuse was measured using a 2-item alcohol screen combined with alcohol-related behavioral items. Of the soldiers sampled, 25% (N=275) screened positive for alcohol misuse 3-4 months post-deployment; 12% (N=125) screened positive and exhibited alcohol-related behavioral problems. Most combat exposure factors were significantly related to alcohol misuse individually. When factors were analyzed simultaneously, soldiers who had higher rates of exposure to the threat of death/injury were significantly more likely to screen positive for alcohol misuse; exposure to atrocities predicted misuse of alcohol with alcohol-related behavioral problems. High exposure to threatening situations and atrocities was associated with a positive screen for alcohol misuse. Clinicians treating combat veterans should be aware of the potential association of alcohol misuse with specific types of experiences and closely follow those soldiers upon their return home.
    Full-text · Article · Apr 2010 · Drug and alcohol dependence
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    • "Although peacekeepers may be less exposed to direct combat than other military people involved in conventional war situations, stressful and life-threatening situations frequently occur during missions (Hotopf et al., 2003). A wide variety of psychopathological conditions have been reported after peacekeeping missions such as depression , alcoholism, drug abuse, somatization disorders, acute stress disorder and, especially, posttraumatic stress disorder (PTSD) (Mehlum et al., 2006). Length of deployment (Adler et al., 2005), perceived lack of meaningfulness to the military mission, high levels of stress exposure (Mehlum and Weisaeth , 2002), and personality traits (Bramsen et al., 2000) have been associated with an increased risk for developing stress-related symptoms. "
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    ABSTRACT: Our study evaluated the relationship between positive affect (PA) and negative affect (NA) traits on the development of posttraumatic stress symptoms (PTSS) among peacekeepers. A longitudinal study with 138 army personnel deployed to a peacekeeping mission in Haiti was conducted. An instrument for measuring PA and NA traits was used before deployment. PTSS, indexed by posttraumatic stress disorder Checklist--Military Version (PCL-M) and frequency of stressful situations were measured after return. Regression analysis showed that both NA and number of stressful situations contributed toward increasing PCL-M scores (Adjusted R = 0.25; p < 0.001). We also found that NA traits interact with intensively stressful situations enhancing the occurrence of PTSS (Adjusted R = 0.32; p < 0.001). These findings suggest that NA traits are an important predictor for PTSS among peacekeepers and also worsen the consequences of being exposed to stressful situations.
    Full-text · Article · Dec 2008 · The Journal of nervous and mental disease
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