Mental health of military servicemen

Authors

DOI:

https://doi.org/10.29038/2227-1376-2023-41-kos

Keywords:

mental disorders, addiction, suicide, aggression, anxiety, depression

Abstract

Purpose. The article contains a theoretical overview of research on the mental health of military personnel, the main risks related to the loss of mental well-being.

Methods. The review was carried out using theoretical methods of scientific research, namely analysis, synthesis, structuring and systematization of information.

Results. Military mental health research often focuses on post-traumatic stress disorder (PTSD). However, the literature highlights a consistent relationship between PTSD and increased risks of physical health problems, substance use/abuse, suicide, homelessness, and aggression/violence for veterans. The military profession is constantly associated with stress. Scientists have identified six main dimensions of stress in military operations: isolation, ambiguity, powerlessness, boredom and danger, and workload. Being on the "front line" is said to be the most traumatic, but modern warfare with technological advancements leaves all military personnel under constant threat of attack. Military service can expose you to experiences that undermine a basic sense of humanity and disrupt global values and beliefs. Moral injury is a new construct to more fully capture the many possible psychological, ethical, and spiritual/existential challenges among people who have served in modern wars and other occupational groups affected by trauma.

Conclusions. According to the results of a theoretical review, the greatest risks for servicemen mental health are post-traumatic stress disorder, depression, anxiety disorders, moral trauma, complex grief, feelings of guilt, and suicidal tendencies. The main stress factors in the military profession are: moral dilemmas, conditions of constant danger and threat to life, significant workload, relative isolation, uncertainty, losses and observing the suffering of other people.

References

Armour, C., and Ross, J. (2017). The health and well-being of military drone operators and intelligence analysts: a systematic review. Mil. Psychol. 29, 83–98. https://doi.org/10.1037/mil0000149 DOI: https://doi.org/10.1037/mil0000149

Ashrafioun, L., Kane, C., Bishop, T. M., Britton, P. C., & Pigeon, W. R. (2019). The Association of Pain Intensity and Suicide Attempts Among Patients Initiating Pain Specialty Services. The journal of pain, 20(7), 852–859. https://doi.org/10.1016/j.jpain.2019.01.012 DOI: https://doi.org/10.1016/j.jpain.2019.01.012

Bartone, P. T. (2006). Resilience under military operational stress: can leaders influence hardiness? Mil. Psychol, 18, 131–148. https://doi.org/10.1207/s15327876mp1803s_10 DOI: https://doi.org/10.1207/s15327876mp1803s_10

Blore, J. D., Sim, M. R., Forbes, A. B., Creamer, M. C., & Kelsall, H. L. (2015). Depression in Gulf War veterans: a systematic review and meta-analysis. Psychological medicine, 45(8), 1565–1580. https://doi.org/10.1017/S0033291714001913 DOI: https://doi.org/10.1017/S0033291714001913

Calati, R., Laglaoui Bakhiyi, C., Artero, S., Ilgen, M., & Courtet, P. (2015). The impact of physical pain on suicidal thoughts and behaviors: Meta-analyses. Journal of psychiatric research, 71, 16–32. https://doi.org/10.1016/j.jpsychires.2015.09.004 DOI: https://doi.org/10.1016/j.jpsychires.2015.09.004

Casey, G. W. Jr. (2011). Comprehensive soldier fitness: a vision for psychological resilience in the US Army. Am. Psychol, 66, 1–3. https://doi.org/10.1037/a0021930 DOI: https://doi.org/10.1037/a0021930

Chapa, J. O. (2017). Remotely piloted aircraft, risk, and killing as sacrifice: the cost of remote warfare. J. Military Ethics 16, 256–271. https://doi.org/10.1080/15027570.2018.1440501 DOI: https://doi.org/10.1080/15027570.2018.1440501

Charney, M. E., Bui, E., Sager, J. C., Ohye, B. Y., Goetter, E. M., & Simon, N.M. (2018). Complicated grief among military service members and veterans who served after September 11, 2001. Journal of Traumatic Stress, 31 (1), 157–162. https://doi.org/10.1002/jts.22254 DOI: https://doi.org/10.1002/jts.22254

Clancy, C. P., Graybeal, A., Tompson, W. P., Badgett, K. S., Feldman, M. E., Calhoun, P. S., Erkanli, A., Hertzberg, M. A., & Beckham, J. C. (2006). Lifetime trauma exposure in veterans with military-related posttraumatic stress disorder: association with current symptomatology. The Journal of clinical psychiatry, 67(9), 1346–1353. https://doi.org/10.4088/jcp.v67n0904 DOI: https://doi.org/10.4088/JCP.v67n0904

Currier, J. M., Foster, J. D., & Isaak, S. L. (2019). Moral injury and spiritual struggles in military veterans: A latent profile analysis. Journal of Traumatic Stress, 32(3), 393–404. https://doi.org/10.1002/jts.22378 DOI: https://doi.org/10.1002/jts.22378

Currier, J. M., Holland, J. M., Drescher, K., & Foy, D. (2015). Initial psychometric evaluation of the Moral Injury Questionnaire--Military version. Clinical psychology & psychotherapy, 22(1), 54–63. https://doi.org/10.1002/cpp.1866 DOI: https://doi.org/10.1002/cpp.1866

Doyle, S. T. (2022). Mental Weakness and the Failures of Military Psychiatry. The Journal of Mind and Behavior, 43 (1), 55–66. https://doi.org/10.31234/osf.io/2kgjc DOI: https://doi.org/10.31234/osf.io/2kgjc

Elbogen, E. B., Johnson, S. C., Wagner, H. R., Sullivan, C., Taft, C. T., & Beckham, J. C. (2014). Violent behaviour and post-traumatic stress disorder in US Iraq and Afghanistan veterans. British Journal of Psychiatry, 204(5), 368–375. https://doi.org/10.1192/bjp.bp.113.134627 DOI: https://doi.org/10.1192/bjp.bp.113.134627

Flood, A., Keegan, R.J. (2022). Cognitive Resilience to Psychological Stress in Military Personnel. Front. Psychol, 13, 809003. https://doi.org/10.3389/fpsyg.2022.809003 DOI: https://doi.org/10.3389/fpsyg.2022.809003

Frank, C., Coulthard, J., Lee, J.E.C., Skomorovsky, A. (2022). A moderated-mediation analysis of pathways in the association between Veterans’ health and their spouse’s relationship satisfaction: The importance of social support. Front. Psychol, 13, 988814. https://doi.org/10.3389/fpsyg.2022.988814 DOI: https://doi.org/10.3389/fpsyg.2022.988814

Gettings, R.D., Kirtley, J., Wilson-Menzfeld, G., Oxburgh, G.E., Farrell, D. and Kiernan, M.D. (2022). Exploring the Role of Social Connection in Interventions With Military Veterans Diagnosed With Post-traumatic Stress Disorder: Systematic Narrative Review. Front. Psychol, 13, 873885. https://doi.org/10.3389/fpsyg.2022.873885 DOI: https://doi.org/10.3389/fpsyg.2022.873885

Giacaman, R., Abu-Rmeileh, N.M.E., Husseini, A., Saab, H., Boyce, W. (2007). Humiliation: The invisible trauma of war for Palestinian youth. Public Health, 121(8), 563-571. https://doi.org/10.1016/J.PUHE.2006.10.021 DOI: https://doi.org/10.1016/j.puhe.2006.10.021

Goldson, E. (1996). The effect of war on children. Child Abuse Negl, 20(9), 809–819. https://doi.org/10.1016/0145-2134(96)00069-5 DOI: https://doi.org/10.1016/0145-2134(96)00069-5

Hajek, A., Kretzler, B. & König, H.H. (2022). Fear of war and mental health in Germany. Soc Psychiatry Psychiatr Epidemiol. https://doi.org/10.1007/s00127-022-02394-9 DOI: https://doi.org/10.1007/s00127-022-02394-9

Hall, S. (2023). Comorbidities of Combat Trauma: Unresolved Grief and Moral Injury. Journal of Loss and Trauma, 28:1, 51-60. https://doi.org/10.1080/15325024.2022.2053227 DOI: https://doi.org/10.1080/15325024.2022.2053227

Hawthorne, G., Korn, S., Creamer, M. (2014). Australian Peacekeepers: Long-Term Mental Health Status, Health Service Use, and Quality of Life -Technical Report. Australia: Department of Psychiatry, University of Melbourne.

Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N. Engl. J. Med. 351, 13–22. https://doi.org/10.1056/NEJMoa040603 DOI: https://doi.org/10.1056/NEJMoa040603

Ilgen, M. A., Kleinberg, F., Ignacio, R. V., Bohnert, A. S., Valenstein, M., McCarthy, J. F., Blow, F. C., & Katz, I. R. (2013). Noncancer pain conditions and risk of suicide. JAMA psychiatry, 70(7), 692–697. https://doi.org/10.1001/jamapsychiatry.2013.908 DOI: https://doi.org/10.1001/jamapsychiatry.2013.908

Iversen, A. C., Fear, N. T., Ehlers, A., Hughes, J. H., Hull, L., Earnshaw, M., Greenberg, N., Rona, N. R., Wessely, S., & Hotopf, M. (2008). Risk factors for post-traumatic stress disorder among UK Armed Forces personnel. Psychological Medicine, 38(4), 511–522. DOI: https://doi.org/10.1017/S0033291708002778

Jones, E. (2020). Moral injury in a context of trauma. The British Journal of Psychiatry : The Journal of Mental Science, 216(3), 127–128. https://doi.org/10.1192/bjp.2020.46 DOI: https://doi.org/10.1192/bjp.2020.46

Kadir, A., Shenoda, S., Goldhagen, J. (2019). Effects of armed conflict on child health and development: a systematic review. PLoS ONE, 14(1), e0210071. https://doi.org/10.1371/journal.pone.0210071 DOI: https://doi.org/10.1371/journal.pone.0210071

Knaster, P., Karlsson, H., Estlander, A. M., & Kalso, E. (2012). Psychiatric disorders as assessed with SCID in chronic pain patients: the anxiety disorders precede the onset of pain. General hospital psychiatry, 34(1), 46–52. https://doi.org/10.1016/j.genhosppsych.2011.09.004 DOI: https://doi.org/10.1016/j.genhosppsych.2011.09.004

Koenen, K. C., Stellman, S., Sommer, J., & Stellman, J. (2008). Persisting posttraumatic stress disorder symptoms and their relationship to functioning in Vietnam veterans: A 14-year follow-up. Journal of Traumatic Stress, 21(1), 49–57. https://doi.org/10.1002/jts.20304 DOI: https://doi.org/10.1002/jts.20304

Koenig, H. G., Youssef, N. A., Ames, D., Teng, E. J., & Hill, T. D. (2020). Examining the overlap between moral injury and PTSD in US veterans and active duty military. The Journal of Nervous and Mental Disease, 208(1), 7–12. https://doi.org/10.1097/NMD.0000000000001077 DOI: https://doi.org/10.1097/NMD.0000000000001077

Latham, A. E., & Prigerson, H. G. (2004). Suicidality and bereavement: Complicated grief as psychiatric disorder presenting greatest risk for suicidality. Suicide & Life-Threatening Behavior, 34(4), 350–362. https://doi.org/10.1521/suli.34.4.350.53737 DOI: https://doi.org/10.1521/suli.34.4.350.53737

Lee, H., Aldwin, C. M., & Kang, S. (2022). Do different types of war stressors have independent relations with mental health? Findings from the Korean Vietnam Veterans Study. Psychological trauma : theory, research, practice and policy, 14(5), 840–848. https://doi.org/10.1037/tra0000557 DOI: https://doi.org/10.1037/tra0000557

Martin, K., McLeod, E., Périard, J., Rattray, B., Keegan, R., and Pyne, D. B. (2019). The impact of environmental stress on cognitive performance: a systematic review. Hum. Factors, 61, 1205–1246. https://doi.org/10.1177/0018720819839817 DOI: https://doi.org/10.1177/0018720819839817

Martin, K., Périard, J., Rattray, B., and Pyne, D. B. (2020). Physiological factors which influence cognitive performance in military personnel. Hum. Factors, 62, 93–123. https://doi.org/10.1177/0018720819841757 DOI: https://doi.org/10.1177/0018720819841757

Mastroianni, G. R., Mabry, T. R., Benedek, D. M., Ursano, R. J. (2008). The stresses of modern war. Іn Biobehavioral Resilience to Stress. Eds. B. J. Lukey and V. Tepe (Boca Raton, FL: CRC Press), 50–62.

Meade, E. A., Smith, D. L., Montes, M., Norman, S. B., Held, P. (2022). Changes in guilt cognitions in intensive PTSD treatment among veterans who experienced military sexual trauma or combat trauma. Journal of Anxiety Disorders, 90, 102606. https://doi.org/10.1016/j.janxdis.2022.102606 DOI: https://doi.org/10.1016/j.janxdis.2022.102606

Molendijk, T. (2019). The role of political practices in moral injury: A study of Afghanistan veterans. Political Psychology, 40(2), 261–275. https://doi.org/10.1111/pops.12503 DOI: https://doi.org/10.1111/pops.12503

Nahin, R. L. (2017). Severe pain in veterans: the effect of age and sex, and comparisons with the general population. The journal of pain, 18(3), 247–254. https://doi.org/10.1016/j.jpain.2016.10.021 DOI: https://doi.org/10.1016/j.jpain.2016.10.021

Nash, W. P., Marino Carper, T. L., Mills, M. A., Au, T., Goldsmith, A., & Litz, B. T. (2013). Psychometric evaluation of the Moral Injury Events Scale. Military medicine, 178(6), 646–652. https://doi.org/10.7205/MILMED-D-13-00017 DOI: https://doi.org/10.7205/MILMED-D-13-00017

Nevarez, M. D., Yee, H. M., & Waldinger, R. J. (2017). Friendship in war: Camaraderie and prevention of posttraumatic stress disorder prevention. Journal of Traumatic Stress, 30(5), 512–520. https://doi.org/10.1002/jts.22224 DOI: https://doi.org/10.1002/jts.22224

Osokina, O., Silwal, S., Bohdanova, T., Hodes, M., Sourander, A., & Skokauskas, N. (2022). Impact of the Russian Invasion on Mental Health of Adolescents in Ukraine. Journal of the American Academy of Child and Adolescent Psychiatry, https://doi.org/10.1016/j.jaac.2022.07.845 DOI: https://doi.org/10.1016/j.jaac.2022.07.845

Oster, C., Morello, A., Venning, A., Redpath, P., & Lawn, S. (2017). The health and wellbeing needs of veterans: a rapid review. BMC psychiatry, 17(1), 414. https://doi.org/10.1186/s12888-017-1547-0 DOI: https://doi.org/10.1186/s12888-017-1547-0

Perkins, J, Ajeeb, M, Fadel, L, Saleh, G. (2018). Mental health in Syrian children with a focus on post-traumatic stress: A cross-sectional study from Syrian schools. Soc Psychiatry Psychiatr Epidemiol, 53(11), 1231-1239. https://doi.org/10.1007/s00127-018-1573-3 DOI: https://doi.org/10.1007/s00127-018-1573-3

Racine, M. (2018). Chronic pain and suicide risk: A comprehensive review. Progress in neuro-psychopharmacology & biological psychiatry, 87 (Pt B), 269–280. https://doi.org/10.1016/j.pnpbp.2017.08.020 DOI: https://doi.org/10.1016/j.pnpbp.2017.08.020

Russell, M.C., Figley, C. (2021). Psychiatric Casualties: How and Why the Military Ignores the Full Cost of War. New York: Columbia University Press. DOI: https://doi.org/10.7312/russ18776

Schorr, Y., Stein, N. R., Maguen, S., Barnes, J. B., Bosch, J., & Litz, B. T. (2018). Sources of moral injury among war veterans: A qualitative evaluation. Journal of Clinical Psychology, 74(12), 2203–2218. https://doi.org/10.1002/jclp.22660 DOI: https://doi.org/10.1002/jclp.22660

Shay, J. (2014). Moral injury. Psychoanalytic Psychology, 31 (2), 182–191. https://doi.org/10.1037/a0036090 DOI: https://doi.org/10.1037/a0036090

Simon, N. M., O’Day, E. B., Hellberg, S. N., Hoeppner, S. S., Charney, M. E., Robinaugh, D. J., Bui, E., Goetter, E. M., Baker, A. W., Rogers, A. H., Nadal-Vicens, M., Venners, M. R., Kim, H. M., & Rauch, S. A. M. (2018). The loss of a fellow service member: Complicated grief in post-9/11 service members and veterans with combat-related posttraumatic stress disorder. Journal of Neuroscience Research, 96(1), 5–15. https://doi.org/10.1002/jnr.24094 DOI: https://doi.org/10.1002/jnr.24094

Williamson, V., Greenberg, N., & Murphy, D. (2019). Moral injury in UK armed forces veterans: a qualitative study. European journal of psychotraumatology, 10(1), 1562842. https://doi.org/10.1080/20008198.2018.1562842 DOI: https://doi.org/10.1080/20008198.2018.1562842

Published

2023-06-01

How to Cite

Kostruba, N. (2023). Mental health of military servicemen. Psychological Prospects Journal, 41, 120-132. https://doi.org/10.29038/2227-1376-2023-41-kos

Similar Articles

51-60 of 202

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)