Key predictors of post-trauma symptomatology in military peacekeeping veterans

"Submitted for the degree of Doctor or Philosophy Department of Psychology, Macquarie University""January, 2002"Includes bibliographical references.Chapter 1. Introduction -- Chapter 2. A cross-sectional study of the effects of social support and loneliness on post-trauma symptomatology in military peacekeepers -- Chapter 3. Posttraumatic symptomatology and vulnerability and resiliency factors for military peacekeepers: a longitudinal perspective -- Chapter 4. The effect of trauma history on mission specific chronic post-trauma symptomatology in military peacekeepers: inoculating or sensitising? -- Chapter 5. General discussion.In Australia, the primary role o f military personnel is defence o f the nation; however, due to their specialised skills they are also asked to assist in United Nations peacekeeping missions and disaster relief. All of these duties have a high potential for exposure to traumatic events, which for some individuals could have long-term negative effects. In the literature to date, there has been a growing interest in types o f potentially traumatic events and the nature of psychological reactions, but what is lacking is a comprehensive understanding o f post-trauma factors that may impede or facilitate recovery. The focus o f this research therefore, was to investigate key predictors that may have influenced the development of chronic trauma reactions in a sample of military personal who had been deployed on a peacekeeping mission, in order to provide directions for preventative management and screening strategies.Several studies have shown a relationship between social resources and levels of post-trauma symptomatology. The first study was designed to test a model in which feelings of loneliness mediate both the effect of exposure to potentially traumatic events and social support in the development of chronic posttraumatic stress disorder (PTSD). To test this model 246 Australian Defence Force peacekeepers were surveyed after their return to Australia from duty in Rwanda. They completed measures of trauma exposure, general mental health, PTSD, social support, and loneliness. The model was partially support, with loneliness mediating the effect of support but not the level of trauma exposure. The findings were discussed in relation to theoretical and clinical implications.Two prospective longitudinal studies were then utilised to replicate and extend the findings of the first study, by investigating the relationship between level of traumatic exposure and psychosocial factors measured at four months with chronic posttraumatic distress at three and six years. Members from the second Australian military peacekeeping contingent that serviced in Rwanda were surveyed at four months, as well as three and six years post exposure. Measures of post-traumatic symptoms, level of exposure, social support, and loneliness revealed direct relationships for level of traumatic exposure and initial symptomatology, and indirect relationships for social support and loneliness in the prediction o f chronic symptomatology. Modelling of the relationship between variable revealed two potential pathways to distress with loneliness mediating the impact of social support, as well as having a direct effect on the reporting of level of trauma exposures at six years.The first three studies indicated that high rates of chronic posttraumatic symptomatology in military personnel exposed to multiple traumatic events over a sixmonth period on a peacekeeping mission might be related to perceived levels of traumatic exposure and feelings of loneliness at six years. However, the measurement of Rwanda related symptoms and predictive variables at six years might be confounded by the effect of exposure to other potentially traumatic events. Therefore in the final stage of the research, a cross-sectional study was conducted with 118 Rwanda veterans’ to investigate the impact of other potentially traumatic events, subsequent deployments, employment category, and current service status. Results indicate that lifetime trauma exposure was not related to measures of chronic symptomatology, but that employment category and service status did affected symptomatology. The finds were discussed in relations to their impact on an inoculation versus sensitizing hypothesis to explain adaptation to potentially traumatic life experiences.Overall the research demonstrated that both psychosocial variables and reported level of traumatic exposure are related the development and maintenance of chronic distress and should be considered for inclusion in any future screening protocol. The findings make a contribution to our understanding o f psychosocial variables by identifying loneliness as a potential mechanism that may mediate between social support and adaptive coping. These findings could have important implications for the organisational and clinical management o f personnel after potentially traumatic experiences. Finally, the results draw attention to potential directions for further research, especially in the area of loneliness and social support, but to the impact of these variables on traumatic memory.Mode of access: World Wide Web.1 online resources (x, 138 pages) illustration