Annabel McGuire

Traumatic events, other operational stressors and physical and mental health reported by Australian Defence Force personnel following peacekeeping and war-like deployments.

BackgroundThe association between stressful events on warlike deployments and subsequent mental health problems has been established. Less is known about the effects of stressful events on peacekeeping deployments.MethodsTwo cross sectional studies of the Australian Defence Force were used to contrast the prevalence of exposures reported by a group deployed on a peacekeeping operation (Bougainville, n = 1704) and those reported by a group deployed on operations which included warlike and non-warlike exposures (East Timor, n = 1333). A principal components analysis was used to identify groupings of non-traumatic exposures on deployment. Multiple regression models were used to assess the association between self-reported objective and subjective exposures, stressors on deployment and subsequent physical and mental health outcomes.ResultsThe principal components analysis produced four groups of non-traumatic stressors which were consistent between the peacekeeping and more warlike deployments. These were labelled ‘separation’, ‘different culture’, ‘other people’ and ‘work frustration’. Higher levels of traumatic and non-traumatic exposures were reported by veterans of East Timor compared to Bougainville. Higher levels of subjective traumatic exposures were associated with increased rates of PTSD in East Timor veterans and more physical and psychological health symptoms in both deployed groups. In Bougainville and East Timor veterans some non-traumatic deployment stressors were also associated with worse health outcomes.ConclusionStrategies to best prepare, identify and treat those exposed to traumatic events and other stressors on deployment should be considered for Defence personnel deployed on both warlike and peacekeeping operations.

Risk of Adverse Health Outcomes Associated With Frequency and Duration of Deployment With the Australian Defence Force

The operational tempo of the Australian Defence Force has increased over the last two decades. We examine the relationship between health of personnel and the frequency and duration of their deployment. Self-reported health measures (number of symptoms, Kessler Psychological Distress Scale, and Post Traumatic Stress Disorder Checklist) were compared for people who had never deployed to those who had deployed only once and for those who had deployed at least twice with at least one deployment to East Timor and one deployment to Afghanistan or Iraq. Comparisons were also made between people who had deployed for at least one month and those who had deployed for longer periods. Frequency of deployment but not duration of deployment was associated with poorer health.

Alcohol use in the military: associations with health and wellbeing

BackgroundThis study assessed the extent to which alcohol consumption in a military group differed from the general population, and how alcohol affected the military group’s health and social functioning.MethodsA cross sectional survey of military personnel (n = 5311) collected self-reported data on alcohol use (AUDIT scale) and general health, role limitations because of physical health problems (role physical), and social functioning scores (SF36 subscales). Logistic regression was used to compare drinking behaviours between the military sample and a general population sample, using the categories risky drinkers (>2 units per day), low risk drinkers (≤2 standard drinks per day) and abstainers. Groups in the military sample with the highest levels of alcohol misuse (harmful drinking AUDIT ≥ 16, alcohol dependence AUDIT ≥ 20, and binge drinking) were also identified. Linear regression models were then used to assess the association between alcohol misuse and SF36 scores.ResultsThere were fewer risky drinkers in the military sample than in the general population sample. There were also fewer abstainers, but more people who drank at a lower risk level (≤2 standard drinks per day), than in a sample of the general population. Harmful drinking and alcohol dependence were most commonly observed in men, younger age groups, non-commissioned officers and lower ranks as well as reserve and ex-serving groups. Alcohol misuse was clearly associated with poorer general health scores, more role limitations because of physical health problems, and lower social functioning.ConclusionsAlthough risky drinking was lower in the military group than in the general population, drinking was associated with poorer health, more limitations because of physical health problems, and poorer social functioning in Defence members. These results highlight the potential benefits for Defence forces in reducing alcohol use among members, in both those groups identified at highest risk, and across the military workforce as a whole.

Smoking Prevalence, Its Determinants and Short-Term Health Implications in the Australian Defence Force

The objectives of this study were to determine the prevalence of smoking, identify the effects of deployment on smoking behavior and risk factors for smoking, and determine the short-term health outcomes associated with smoking in Australian Defence Force (ADF) personnel. Participants were randomly sampled from ADF members who deployed to the Solomon Islands between 2003 and 2005 and from a nondeployed comparison group. In total, 435 of 995 (44%) eligible individuals completed the study questionnaires. The prevalence of current smoking was highest in those who had completed less formal education and those who served in the Navy. Nearly two-thirds (63%) of current or former smokers smoked more while on overseas deployment. Current smokers were more likely to report current wheeze, shortness of breath, and persistent cough compared with nonsmokers. The ADF should continue to address cigarette smoking through its health promotion and health review programs and implement activities to reduce cigarette smoking on deployment.

Comparison of self-reported and audiometrically-measured hearing loss in the Australian Defence Force

Abstract Objective: To investigate the relationship between self-reported and audiometrically-measured hearing loss in a sample of Australian Defence Force personnel. Design: Responses to a question regarding hearing problems were compared with contemporaneous audiometric data. Study sample: 3335 members of the Australian Defence Force for whom anonymised medical records were available. Results: The sensitivity of self-report data to identify higher-frequency hearing loss was lower than sensitivity at other frequencies, and positive predictive values were moderate to poor at all frequencies. Performance characteristics of self-report compared with audiometric data also varied with age, sex, and rank. Conclusions: While self-report hearing loss data have good performance characteristics for estimating prevalence of hearing loss as defined by audiometric criteria, this study indicates that the usefulness of self-report data in identifying individuals with hearing loss may be limited in this population.

Effect of Multiple Deployments on Military Families: A Cross-Sectional Study of Health and Well-Being of Partners and Children

This study explored the impact of multiple deployments on the health and well-being of the partners (married or de facto) and children of Australian military personnel who have deployed frequently. Permission to contact military partners was sought from a sample of Australian Defence Force (ADF) members. Partners provided data on deployment history, physical health, mental health, and their childrens emotions, and behaviors. Associations between multiple deployments and health and well-being of partners and children were assessed using logistic regression. Data were collected from 1,332 Australian Defence Force partners (response rate 36%) with 1,095 children aged between 4 and 17 years. Almost half (47%) of partners had experienced more than one deployment, mainly to Timor-Leste, Iraq, and Afghanistan. There was little evidence of associations between numbers of deployments and the health of the partner. In contrast, more behavioral problems were reported for children who experienced two or more deployments with odds ratios generally greater than 2 and significant trends with increasing numbers of deployment. Although military families who experience multiple deployments may, by selection, be more resilient than those who have fewer deployments, these results suggest that adverse impacts on the children may accrue with increasing parental absences because of deployment.

Childhood adversity and traumatic exposures during deployment as predictors of mental health in Australian military veterans

Objective: To examine whether the relationship between traumatic exposure on deployment and poor mental health varies by the reported level of childhood adversity experienced in Australian military veterans deployed to the Bougainville or East Timor military operations.

Self-reported indicators of psychological health

Studies examining the health of military personnel deployed overseas have been published by research teams in the United States and the United Kingdom. This research has examined the effects of combat on the mental and physical health of those who have been deployed.1-8 Recently, a research program on the health of deployed personnel began in Australia.9,10 Here we present data from the 2007 Solomon Islands Health Study, which focuses on a peace-keeping deployment between 2003 and 2005. We draw comparisons with data from major contemporaneous post-deployment epidemiological cohort studies from the United States and the United Kingdom, where deployments were in the same global political environment, but with greatly differing local hazards and exposures. These studies have particularly focused on the rates of posttraumatic stress disorder (PTSD) and alcohol abuse, which are recognized as major adverse health effects of deployment.