Trauma

Citation:

Rona, Roberto J., Nicola T. Fear, Lisa Hull and Simon Wessely. 2007. "Women in Novel Occupational Roles: Mental Health Trends in the UK Armed Forces." International Journal of Epidemiology 36 (2): 319-26.

Authors: Roberto J. Rona, Nicola T. Fear, Lisa Hull, Simon Wessely

Abstract:

Background: There is uncertainty about whether women in the military have more psychological symptoms than men and whether psychological symptoms have increased over time. The aims of this study were to assess changes in psychological symptoms in military women over time, to compare them with men, and assess the effect of deployment.

Methods: Two cross-sectional studies based on random samples of the Armed Forces were used to assess the effects of deployment to the Gulf and Iraq Wars. We selected for the analyses all the women and a 20% random sample of men who completed a questionnaire stratified by rank. We assessed psychological distress, number of symptoms, post-traumatic stress reaction (PTSR), chronic fatigue and alcohol misuse.

Results: There has been an increase in psychological symptoms, including alcohol misuse, in those not deployed to the Gulf or Iraq Wars, especially in women. The odds ratios for PTSR [5.82 (95% CI: 1.27–26.71)], multiple symptoms [8.49 (1.97–36.65)] and alcohol misuse [6.20 (2.09–18.37)] were higher in women than in men in the non-deployed samples. Psychological distress and chronic fatigue was more common in women, and alcohol misuse, was more common in men. In women, psychological symptoms were positively associated with deployment in the Gulf War, but not the Iraq War.

Conclusion: Psychological symptoms in the Armed Forces have increased over time regardless of gender, in those not deployed. The association between gender and psychological symptoms has not changed over time. The deployment effect in women is similar to that described in men. 

Topics: Armed Conflict, Combatants, Female Combatants, Gender, Women, Health, Mental Health, Trauma Regions: Europe Countries: United Kingdom

Year: 2007

Citation:

Robertson, Cheryl L., Linda Halcon, Kay Savik, David Johnson, Marline Spring, James Butcher, Joseph Westermeyer, and James Jaranson. 2006. "Somali and Oromo Refugee Women: Trauma and Associated Factors." Journal of Advanced Nursing 56 (6): 577-87.

Authors: Cheryl L. Robertson, Linda Halcon, Kay Savik, David Johnson, Marline Spring, James Butcher, Joseph Westermeyer, James Jaranson

Abstract:

Aim: This paper reports a study identifying the demographic characteristics, self-reported trauma and torture prevalence, and association of trauma experience and health and social problems among Somali and Oromo women refugees.

Background: Nearly all refugees have experienced losses, and many have suffered multiple traumatic experiences, including torture. Their vulnerability to isolation is exacerbated by poverty, grief, and lack of education, literacy, and skills in the language of the receiving country.

Method: Using data from a cross-sectional population-based survey, conducted from July 1999 to September 2001, with 1134 Somali and Oromo refugees living in the United States of America, a sub-sample of female participants with clearly identified parenting status (n = 458) were analysed. Measures included demographics, history of trauma and torture, scales for physical, psychological, and social problems, and a post-traumatic stress symptom checklist.

Finding: Results indicated high overall trauma and torture exposure, and associated physical, social and psychological problems. Women with large families reported statistically significantly higher counts of reported trauma (mean 30, P < 0·001) and torture (mean 3, P < 0·001), and more associated problems (P < 0·001) than the other two groups. Women who reported higher levels of trauma and torture were also older (P < 0·001), had more family responsibilities, had less formal education (P < 0·001) and were less likely to speak English (P < 0·001).

Conclusion: These findings suggest a need for nurses, and especially public health nurses who work with refugee and immigrant populations in the community, to develop a more comprehensive understanding of the range of refugee women's experiences and the continuum of needs post-migration, particularly among older women with large family responsibilities. Nurses, with their holistic framework, are ideally suited to partner with refugee women to expand their health agenda beyond the biomedical model to promote healing and reconnection with families and communities.

Keywords: female refugees, trauma, Torture, posttraumatic stress disorder, mental health

Topics: Age, Displacement & Migration, Refugees, Gender, Women, Gender-Based Violence, Health, Mental Health, PTSD, Trauma, Torture Regions: Africa, East Africa Countries: Somalia

Year: 2006

Citation:

Renner, Walter, and Ingrid Salem. 2009. "Post-Traumatic Stress in Asylum Seekers and Refugees from Chechnya, Afghanistan, and West Africa: Gender Differences in Symptomatology and Coping." International Journal of Social Psychiatry 55 (2): 99-108.

Authors: Walter Renner, Ingrid Salem

Abstract:

Background: Internationally, a high number of refugees are in need of help as a consequence of post-traumatic stress or acculturation problems.

Aims: The present study investigated the gender-specific requirements for such interventions taking clinical symptoms as well as coping strategies into account. 

Methods: Five psychometric instruments assessing anxiety, depression, posttraumatic stress, somatic symptoms, and social adaptation were administered and semi-structured interviews with n = 150 asylum seekers and refugees from Chechnya, Afghanistan, and West Africa were conducted.

Results: On the level of total test scores, women reported significantly more somatic symptoms than men but there were no further gender differences. On the item level of the questionnaires as well as with respect to the categories obtained from the interview data, marked gender differences were found. Women, as compared to men, reported more somatic symptoms, emotional outbursts, and loss of sexual interest, while men reported detachment. For women, typical coping strategies were concentrating on their children and various indoor activities, while men preferred looking for work and socializing. 

Conclusion: Social psychiatric interventions should take gender-specific symptoms and coping strategies into account. For asylum seekers and refugees, same gender client-therapist dyads and groups are highly recommended.

Keywords: posttraumatic stress disorder, female refugees, male refugees, mental health, anxiety, depression

Topics: Displacement & Migration, Refugees, Gender, Health, Mental Health, PTSD, Trauma Regions: Africa, West Africa, Asia, South Asia, Europe Countries: Afghanistan, Russian Federation

Year: 2009

Citation:

Punamäki, Raija-Leena, Ivan H. Komproe, Samir Qouta, Mustafa Elmasri, and Joop T.V.M. de Jong. 2005. "The Role of Peritraumatic Dissociation and Gender in the Association Between Trauma and Mental Health in a Palestinian Community Sample." The American Journal of Psychiatry 162 (3): 545-51.

Authors: Raija-Leena Punamäki, Ivan H. Komproe, Samir Qouta, Mustafa Elmasri, Joop T.V.M. de Jong

Abstract:

Objective: This research focused on gender-specific trauma exposure and mental health symptoms among Palestinians living in conditions of military violence. It also examined the gender-specific role of peritraumatic dissociation in moderating the association between lifetime trauma and mental health.

Method: A random sample of 311 Palestinian women and 274 men ages 16–60 years from the Gaza Strip participated. The subjects were asked about lifetime trauma and peritraumatic dissociation during their most severe traumatic experience. Mental health was indicated by total scores and diagnostic variables of posttraumatic stress disorder (PTSD), anxiety, mood (depression), and somatization disorders. Symptoms of hostility were assessed as a total score.

Results: The women reported a lower level of lifetime trauma than the men, but exposure to trauma was associated with PTSD among both genders. Exposure to lifetime trauma was further associated with anxiety, mood, and somatoform disorders only among women but not among men. No gender differences were found in the level of peritraumatic dissociation. Analyses on moderating effects showed that peritraumatic dissociation made both men and women more vulnerable to symptoms of hostility and men to depressive symptoms when they were exposed to lifetime trauma.

Conclusions: The results are consistent with previous studies in more peaceful conditions: men experience more traumatic events, whereas exposure is associated with more severe psychiatric disorders among women. Peritraumatic dissociation as an acute response to trauma constituted a risk for mental health symptoms in both genders.

Keywords: trauma, mental health, anxiety, depression, posttraumatic stress disorder, military occupation, female civilians, male civilians

Topics: Gender, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Militaries, Violence Regions: MENA, Asia, Middle East Countries: Palestine / Occupied Palestinian Territories

Year: 2005

Citation:

Punamäki, Raija-Leena. 1986. "Stress Among Palestinian Women under Military Occupation; Women's Appraisal of Stressors, Their Coping Modes, and Their Mental Health." International Journal of Psychology 21 (1-4): 445-62.

Author: Raija-Leena Punamäki

Abstract:

Psychological responses and mental health of 174 Palestinian women living in the occupied West-Bank and the Gaza Strip were studied through a stress model. Thirty-five Palestinian women living in Israel proper who had not been exposed to military occupation were interviewed as a comparison group. The stress process studied consists of women's appraisal of threat and the importance of the stressors in their lives, the estimation of their own resources to cope with stress, actual coping modes, and mental health outcomes. Women living under military occupation tended to appraise their environment as highly threatening and their experiences as strain-producing. At the same time they believed they had sufficient assets, especially collective and ideological resources, to deal with the stressors. This tendency was particularly evident among victims of political violence. Women strongly exposed to hardships of military occupation tended to employ more social and political activity and less inactive and accommodative coping modes than did less traumatized women. Exposure to stressful events, characteristic to military occupation and armed conflict, tended to deteriorate women's mental health. as indicated by severe anxiety, depression, hostile feelings and psychiatric symptoms, and also deteriorating their general health. Multiple regression analysis of the data pertaining to the stress process indicated not only the existence of objective stressors but also the appraisal of their harmfulness, the coping modes as well as vulnerability-protective factors which determine the outcomes of the stress process. A good economic situation, sufficient social support, and religious commitment functioned as protective factors in stress process, i.e., they were able to diminish the impact of exposure to stressors on women's mental health. In the case of the Palestinian women the hardships due to military occupation and national struggle initiated a different stress process than did the daily life difficulties. This indicates that in studies on psychological functioning in a political and armed conflict, the collective level of coping, values, norms, ideology as well as the concrete political aims of the society should be included in analysis and interpretation.

Keywords: military occupation, mental health, depression, anxiety, female civilians

Topics: Armed Conflict, Gender, Women, Health, Mental Health, Trauma, Military Forces & Armed Groups, Militarization Regions: MENA, Asia, Middle East Countries: Palestine / Occupied Palestinian Territories

Year: 1986

Citation:

Pierce, Penny F. 1997. "Physical and Emotional Health of Gulf War Veteran Women." Aviation, Space, and Environmental Medicine 68 (4): 317-321.

Author: Penny F. Pierce

Abstract:

BACKGROUND: Numerous questions have been raised about the health consequences to veterans of the Gulf War but most particularly to issues concerning women, who were deployed in unprecedented numbers. Little is known about the health consequences to women of wartime stressors, in general, or the environmental and job-related exposures specific to the theater of the Gulf War.

METHODS: A stratified sample of 525 women participated in the study following the war and again in a follow-up study 2 yr later. The sampling frame was stratified on component of the U.S. Air Force (active, guard or reserve), deployment (in the theater or elsewhere), and parental status (parent or nonparent). Measures included items concerning general physical health, gender-specific health, the "Gulf War Syndrome," and the emotional responses to war, including symptoms of post-traumatic stress disorder (PTSD).

RESULTS: Multiple statistical analyses were used to describe women's physical and emotional health at two time points following the war. Women deployed to the theater reported significantly more general as well as gender-specific health problems than did women deployed elsewhere. A cluster of common health problems included: skin rash, cough, depression, unintentional weight loss, insomnia, and memory problems. Women serving in the theater also reported a significant increase in several gender-specific problems compared to women deployed elsewhere.

CONCLUSIONS: Findings suggest the need for follow-up of a cluster of specific health effects, including those concerning gynecologic and reproductive health.

Keywords: mental health, female veterans, posttraumatic stress disorder, depression

Topics: Combatants, Female Combatants, Environment, Gender, Women, Health, Mental Health, PTSD, Reproductive Health, Trauma, Military Forces & Armed Groups

Year: 1997

Citation:

Nicholson, Barbara L., and Diane M. Kay. 1999. "Group Treatment of Traumatized Cambodian Women: A Culture-Specific Approach." Social Work 44 (5): 470-479.

Authors: Barbara L. Nicholson, Diane M. Kay

Keywords: trauma, counseling, mental health

Topics: Displacement & Migration, Refugees, Gender, Women, Health, Mental Health, Trauma, Humanitarian Assistance, Context-Appropriate Response to Trauma Regions: Asia, Southeast Asia Countries: Cambodia

Year: 1999

Citation:

Musa, Saif A., and Abdalla A.R.M. Hamid. 2010. "The Darfur Crisis: Associated Mental Health Problems among Internally Displaced Women." Journal of Muslim Mental Health 5 (1): 120-30.

Authors: Saif A. Musa, Abdalla A.R.M. Hamid

Abstract:

This study aimed at investigating the effects of the Darfur crisis on the mental health of internally displaced women; in particular, the traumatic events and resulting living conditions inside camps for internally displaced persons. It was hypothesized that a high prevalence of nonpsychotic psychiatric symptoms would be found. Participants were 212 internally displaced women in Darfur between 15 and 80 years old. Participants were interviewed using two measures: the General Health Questionnaire (GHQ-28) and another questionnaire specially designed to assess living conditions and relief services. Results showed that 72% of the participants were classified as nonpsychotic psychiatric cases. Findings also imply that living conditions inside camps need to be improved and security should be provided or enforced. 

Keywords: mental health, internally displaced people, trauma

Topics: Displacement & Migration, IDPs, Refugee/IDP Camps, Gender, Women, Health, Mental Health, Trauma Regions: Africa, East Africa Countries: Sudan

Year: 2010

Citation:

Murdoch, Maureen, John B. Pryor, Melissa A. Polusny, and Gary D. Gackstetter. 2007. "Functioning and Psychiatric Symptoms among Military Men and Women Exposed to Sexual Stressors." Military Medicine 172 (7): 718-725.

Authors: Maureen Murdoch, John B. Pryor, Melissa A. Polusny, Gary D. Gackstetter

Abstract:

Objective: The goal was to describe military men's and women's functioning and psychiatric symptoms according to their military sexual stressor exposure. 

Method: A cross-sectional survey of 204 Army soldiers and 611 other active duty troops (487 men and 327 women) was performed. 

Results: Forty-five percent of men and 80% of women reported at least one sexual stressor type (i.e., sexual identity challenges, sexual harassment, or sexual assault). After adjustment, subjects reporting more types of sexual stressors had poorer physical, work, role, and social functioning; more-severe post-traumatic stress disorder, depression, and anxiety symptoms; and more somatic concerns, compared with subjects reporting fewer or no sexual stressor types (all p < 0.004). Interactions by gender were insignificant (all p > 0.11). Within sexual stressor category, men and women reported similar mean adjusted functioning and psychiatric symptoms. 

Conclusions: For both men and women, impaired functioning and more severe psychiatric symptoms were more common among those reporting more types of sexual stressors.

Keywords: sexual assault, mental health, female soldiers, male soldiers, posttraumatic stress disorder, depression, anxiety

Topics: Combatants, Gender, Women, Men, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Militaries, Sexual Violence, Sexual Exploitation and Abuse, Sexuality Regions: Americas, North America Countries: United States of America

Year: 2007

Citation:

Murdoch, Maureen, Melissa A. Polusny, James Hodges, and Nancy O'Brien. 2004. "Prevalence of In-Service and Post-Service Sexual Assault among Combat and Noncombat Veterans Applying for Department of Veterans Affairs Posttraumatic Stress Disorder Disability Benefits." Military Medicine 169 (5): 392-395.

Authors: Maureen Murdoch, Melissa A. Polusny, James Hodges, Nancy O'Brien

Abstract:

Objective: To describe the prevalence of in-service and post-service sexual assault among combat and noncombat veterans seeking Veteran’s Affairs disability benefits for posttraumatic stress disorder (PTSD). 

Methods: Cross-sectional survey of 4,918 veterans. 

Results: Surveys were returned by 3,337 veterans (effective response rate, 68%). Among men, 6.5% of combat veterans and 16.5% of noncombat veterans reported in-service or post-service sexual assault. Among women, 69% of combat veterans and 86.6% of noncombat veterans reported in-service or post-service sexual assault. 

Conclusions: Reported rates of sexual assault were considerably higher among veterans seeking Veteran’s Affairs disability benefits for PTSD than historically reported rates for men and women in the general population. In this population, male gender and veterans’ combat status should not dissuade clinicians from screening for sexual traumas.

Keywords: military sexual assault, posttraumatic stress disorder, female veterans, male veterans, mental health

Topics: Combatants, Gender, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Sexual Violence Regions: Americas, North America Countries: United States of America

Year: 2004