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2 results

  • Chapter 38 - Soldiers, Veterans and Psychological Casualties: Legacies of Northern Ireland, the Falklands, Afghanistan and Iraq

  • from Part IV - Special Topics
  • Edited by George Ikkos, Nick Bouras, King's College London
  • Book:
    Mind, State and Society
    Published online:
    17 June 2021
    Print publication:
    24 June 2021, pp 384-392
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  • Summary

    The practice of military psychiatry is, in part, a function of the size and role of a nation’s armed forces. The end of National Service in 1960 and cuts to defence budgets saw the British Army contract by two-thirds, with reductions to its medical services. Despite suffering psychological casualties in the Falklands War and the sustained challenge of counter-insurgency operations in Northern Ireland, no research was conducted into PTSD experienced by British forces until the mid-1990s. The focus on Gulf War syndrome diverted attention from common mental illnesses towards hypotheses of toxic exposure. A Strategic Defence Review conducted by the Labour government in 1998 defined a broader global role for the UK military to enhance the country’s international influence, and deployments to Iraq and Afghanistan followed. Women, integrated within all three services from 1992, joined in rising numbers but reported elevated rates of mental illness and may have been exposed to greater risk of military sexual trauma. A class action for negligence in the detection and treatment of PTSD in 2002 encouraged the Ministry of Defence to fund research into psychological illness and develop services for trauma-related injury.

  • What explains post-traumatic stress disorder (PTSD) in UK service personnel: deployment or something else?

  • M. Jones, J. Sundin, L. Goodwin, L. Hull, N. T. Fear, S. Wessely, R. J. Rona
  • Journal:
    Psychological Medicine / Volume 43 / Issue 8 / August 2013
    Published online by Cambridge University Press:
    13 November 2012, pp. 1703-1712
  • Background

    In previous studies an association between deployment to Iraq or Afghanistan and an overall increased risk for post-traumatic stress disorder (PTSD) in UK armed forces has not been found. The lack of a deployment effect might be explained by including, in the comparison group, personnel deployed on other operations or who have experienced traumatic stressors unrelated to deployment.

    Methods

    The sample comprised 8261 regular UK armed forces personnel who deployed to Iraq, Afghanistan or other operational areas or were not deployed. Participants completed the PTSD CheckList – Civilian Version (PCL-C) and provided information about deployment history, demographic and service factors, serious accidents and childhood experiences.

    Results

    Deployment to Iraq or Afghanistan [odds ratio (OR) 1.2, 95% confidence interval (CI) 0.6–2.2] or elsewhere (OR 1.1, 95% CI 0.6–2.0) was unrelated to PTSD although holding a combat role was associated with PTSD if deployed to Iraq or Afghanistan (OR 2.7, 95% CI 1.9–3.9). Childhood adversity (OR 3.3, 95% CI 2.1–5.0), having left service (OR 2.7, 95% CI 1.9–4.0) and serious accident (OR 2.1, 95% CI 1.4–3.0) were associated with PTSD whereas higher rank was protective (OR 0.3, 95% CI 0.12–0.76).

    Conclusions

    For the majority of UK armed forces personnel, deployment whether to Iraq, Afghanistan or elsewhere confers no greater risk for PTSD than service in the armed forces per se but holding a combat role in those deployed to Iraq or Afghanistan is associated with PTSD. Vulnerability factors such as lower rank, childhood adversity and leaving service, and having had a serious accident, may be at least as important as holding a combat role in predicting PTSD in UK armed forces personnel.