Objective To describe new onset and persistence of self reported post-traumatic stress disorder symptoms in a large population based military cohort, many of whom were deployed in support of the wars ...in Iraq and Afghanistan.Design Prospective cohort analysis.Setting and participants Survey enrolment data from the millennium cohort (July 2001 to June 2003) obtained before the wars in Iraq and Afghanistan. Follow-up (June 2004 to February 2006) data on health outcomes collected from 50 184 participants.Main outcome measures Self reported post-traumatic stress disorder as measured by the posttraumatic stress disorder checklist—civilian version using Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria.Results More than 40% of the cohort were deployed between 2001 and 2006; between baseline and follow-up, 24% deployed for the first time in support of the wars in Iraq and Afghanistan. New incidence rates of 10-13 cases of post-traumatic stress disorder per 1000 person years occurred in the millennium cohort. New onset self reported post-traumatic stress disorder symptoms or diagnosis were identified in 7.6-8.7% of deployers who reported combat exposures, 1.4-2.1% of deployers who did not report combat exposures, and 2.3-3.0% of non-deployers. Among those with self reported symptoms of post-traumatic stress disorder at baseline, deployment did not affect persistence of symptoms.Conclusions After adjustment for baseline characteristics, these prospective data indicate a threefold increase in new onset self reported post-traumatic stress disorder symptoms or diagnosis among deployed military personnel who reported combat exposures. The findings define the importance of post-traumatic stress disorder in this population and emphasise that specific combat exposures, rather than deployment itself, significantly affect the onset of symptoms of post-traumatic stress disorder after deployment.
Objective
This study aimed to examine the effectiveness of cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) when administered on a daily basis during a 2‐week period of ...time.
Method
In an open‐label, prospective cohort pilot trial, 20 U.S. military personnel and veterans diagnosed with PTSD or subthreshold PTSD participated in 12 daily sessions of CPT. Primary outcomes included Clinician Administered PTSD Scale for DSM‐5 and PTSD Checklist for DSM‐5 scores. Secondary outcomes included Patient Health Questionnaire‐8 and Beck Scale for Suicide Ideation (BSSI) scores. Interviews and self‐report scales were completed at pretreatment, posttreatment, and 6 months after the treatment.
Results
Relative to baseline, PTSD symptom severity and rates of PTSD diagnosis were significantly reduced at posttreatment and 6‐month follow‐up. Depression symptom severity did not significantly improve, but suicide ideation significantly decreased at 6‐month follow‐up.
Conclusions
Daily administration of CPT is associated with significant reductions in PTSD and suicide ideation.
CONTEXT The US military has conducted population-level screening for mental health problems among all service members returning from deployment to Afghanistan, Iraq, and other locations. To date, no ...systematic analysis of this program has been conducted, and studies have not assessed the impact of these deployments on mental health care utilization after deployment. OBJECTIVES To determine the relationship between combat deployment and mental health care use during the first year after return and to assess the lessons learned from the postdeployment mental health screening effort, particularly the correlation between the screening results, actual use of mental health services, and attrition from military service. DESIGN, SETTING, AND PARTICIPANTS Population-based descriptive study of all Army soldiers and Marines who completed the routine postdeployment health assessment between May 1, 2003, and April 30, 2004, on return from deployment to Operation Enduring Freedom in Afghanistan (n = 16 318), Operation Iraqi Freedom (n = 222 620), and other locations (n = 64 967). Health care utilization and occupational outcomes were measured for 1 year after deployment or until leaving the service if this occurred sooner. MAIN OUTCOME MEASURES Screening positive for posttraumatic stress disorder, major depression, or other mental health problems; referral for a mental health reason; use of mental health care services after returning from deployment; and attrition from military service. RESULTS The prevalence of reporting a mental health problem was 19.1% among service members returning from Iraq compared with 11.3% after returning from Afghanistan and 8.5% after returning from other locations (P<.001). Mental health problems reported on the postdeployment assessment were significantly associated with combat experiences, mental health care referral and utilization, and attrition from military service. Thirty-five percent of Iraq war veterans accessed mental health services in the year after returning home; 12% per year were diagnosed with a mental health problem. More than 50% of those referred for a mental health reason were documented to receive follow-up care although less than 10% of all service members who received mental health treatment were referred through the screening program. CONCLUSIONS Combat duty in Iraq was associated with high utilization of mental health services and attrition from military service after deployment. The deployment mental health screening program provided another indicator of the mental health impact of deployment on a population level but had limited utility in predicting the level of mental health services that were needed after deployment. The high rate of using mental health services among Operation Iraqi Freedom veterans after deployment highlights challenges in ensuring that there are adequate resources to meet the mental health needs of returning veterans.
This book concentrates on the last twenty years of research in the area of goal setting and performance at work. The editors and contributors believe goals affect action, and this volume has a lineup ...of international contributors who look at the recent theories and implications in this area for IO psychologists and human resource management academics and graduate students.
Written by an internationally renowned team of experts and underpinned by cutting-edge research, International Human Resource Management tackles a broad range of controversial and often marginalised ...issues associated with globalisation and its impact on multinational companies and employees. Updated throughout with brand-new case studies, reflective questions and recommended reading, the second edition includes coverage of: • International assignments and worker mobility • The development of new technology and its impact on work • International HRM and the platform economy • The nature of organisational change • The role of sustainability and social responsibility within the firm This innovative and thought-provoking textbook is suitable for students of International Human Resource Management and Employment Relations. Lecturers can visit study.sagepub.com/martinezlucio2e to access PowerPoint slides and additional case study material. Miguel Martínez Lucio is a Professor at the University of Manchester (Alliance Manchester Business School), UK. Robert MacKenzie is Professor of Working Life Science at Karlstad Business School, Karlstad University, Sweden.
This book argues that knowledge management and HRM systems should be integrated. This integration provides the foundation for designing knowledge-oriented high-performance HR practices.
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