Holding and rupture: Describing post-traumatic stress among former UK Army and Royal Marine personnel deployed to Iraq and Afghanistan.

Autor: Palmer L; King's Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom., Busuttil W; King's Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom., Simms A; Academic Department of Military Mental Health, King's College London, London, United Kingdom., Fear NT; King's Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom.; Academic Department of Military Mental Health, King's College London, London, United Kingdom., Stevelink SAM; Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Aug 09; Vol. 19 (8), pp. e0308101. Date of Electronic Publication: 2024 Aug 09 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0308101
Abstrakt: Former UK military personnel who were previously deployed to Iraq and Afghanistan in combat roles have exhibited elevated levels of Post-Traumatic Stress Disorder (PTSD) compared to other groups. The present qualitative analyses used semi-structured interviews and a framework analysis to compare the experiences of symptomatic (N=10) and asymptomatic (N=7) former Army and Royal Marine personnel who were exposed to combat. Participants were drawn from a large UK military health and wellbeing cohort study and were sampled based upon probable PTSD status using scores from the PTSD Checklist-Civilian Version (PCL-C). All symptomatic participants attributed the development of post-traumatic stress to deployment events, with one additionally ascribing symptoms to childhood events. Among the participants, post-traumatic stress was temporarily buffered, and held at bay, by the holding function of various military structures, including the military collective; cultural and ethical frameworks that helped to organise traumatic experiences; an operational necessity for psychological compartmentalisation and even the distraction of deployment itself. Leaving the military appeared to elicit a global rupture of these supports. As a result, the military-to-civilian transition led to an intensification of post-traumatic stress, including deployment-related memories, among the symptomatic participants. In contrast, asymptomatic participants tended to report continuity of their holding structures across the lifespan, especially across the military-to-civilian transition. The onset and maintenance of post-traumatic stress may thus be explained by an interplay between the capacity of holding structures and the magnitude of lifetime rupture. Overall, findings might provide an explanation for the widening discrepancies between those with enduring post-traumatic stress and those without and further research is required to determine the fit of our findings for other groups and contexts. This approach further illustrates the need to situate individual experiences of post-traumatic stress in wider structural, ecological, cultural and ethical contexts.
Competing Interests: The authors have read the journal’s policy and have the following competing interests: NTF is supported by a grant from the UK MoD, and is a trustee of a charity supporting the wellbeing of military personnel and veterans, outside of the submitted work. SAMS is supported by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London, Maudsley NHS Foundation Trust, and the National Institute for Health Research (NIHR Advanced Fellowship, NIHR300592), outside of the submitted work. WB works part-time for the veteran’s mental health charity Combat Stress. AS is a serving regular member of the British Army and was seconded to King’s College London during this work. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
(Copyright: © 2024 Palmer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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