Sara Kintzle

Suicides in the Military: The Post-Modern Combat Veteran and the Hemingway Effect

Suicides in the military have increased over the last ten years. Much effort has been focused on suicide prevention and treatment, as well as understanding the reasons for the sharp increase in military suicides. Despite this effort, the definitive causes of military suicides remain elusive. Further, highly effective suicide prevention and treatment approaches have not yet been developed. The purpose of this article is to present a short review of the current state of suicide prevention interventions within the context of the military. The root causes of suicidal behavior and the role of combat in the military are each discussed. Interpersonal-psychological theory of suicide and the military transition theory are introduced as guiding frameworks for understanding suicides and suicidal behavior amongst active military personnel and military veterans. The article concludes with a set of recommendations for moving forward in understanding and addressing suicides in the military.

Sexual Assault in the Military

Military sexual assault is a pervasive problem throughout the military services, despite numerous initiatives to end it. No doubt the military’s lack of progress stems from the complexity of sexual assaults, yet in order to develop effective strategies and programs to end sexual assault, deep understanding and appreciation of these complexities are needed. In this paper, we describe the root causes and numerous myths surrounding sexual assault, the military cultural factors that may unintentionally contribute to sexual assault, and the uncomfortable issues surrounding sexual assault that are often ignored (such as the prevalence of male sexual assault within the military). We conclude by offering a broad, yet comprehensive set of recommendations that considers all of these factors for developing effective strategies and programs for ending sexual assault within in the military.

Secondary traumatic stress, job satisfaction, and occupational commitment in substance abuse counselors

It has been argued that secondary traumatic stress (STS) may adversely affect the retention of counselors and other helping professionals. However, there has been little research regarding the rela...

Secondary Traumatic Stress in Military Primary and Mental Health Care Providers

The purpose of this study was to explore rates of secondary traumatic stress (STS) in a sample of 70 military primary and mental health care providers. The sample included working professionals within two military hospitals. Participants completed surveys containing a demographic questionnaire and the Secondary Traumatic Stress Scale. Results of data analysis found military participants in the sample to be experiencing relatively low rates of STS. Over half of the sample reported endorsing at least one symptom of STS occurring within the last week, whereas 8% of participants indicated moderate to high symptomatology. The most frequently reported symptoms were feeling emotionally numb and trouble sleeping followed by the intrusive thoughts about clients. The least frequently reported symptom was feeling jumpy. Implications of study findings and recommendations for future research are outlined.

Sexual Trauma in the Military: Exploring PTSD and Mental Health Care Utilization in Female Veterans

Sexual trauma remains a pervasive problem in the military. The deleterious mental health outcomes related to incidents of sexual assault have been well-documented in the literature, with particular attention given to the development of posttraumatic stress disorder (PTSD) and utilization of mental health services. Much effort has focused on addressing issues of sexual trauma in the military. The purpose of this study was to examine the incidences of sexual assault in female veterans, the relationship to PTSD and mental health care utilization. The research explored differences in pre- and post-9/11 veterans. Data were collected using a 6-prong recruitment strategy to reach veterans living in Southern California. A total of 2,583 veterans completed online and in-person surveys, of which 325 female veterans were identified for inclusion in the analysis. Forty percent of the sample reported experiencing sexual assault during their military service. A history of military sexual trauma was found to be a substantial contributor to symptoms of PTSD. A majority of female veterans who indicated being sexually assaulted during their military service met the cutoff for a diagnosis of PTSD. Although only a minority of participants who indicated being a victim of sexual assault reported receiving immediate care after the incident, most had received mental health counseling within the past 12 months. Findings point to the need for additional prevention programs within the military and opportunities for care for victims of military sexual assault.

Social Workers' Knowledge and Perceptions of Effectiveness and Acceptability of Medication Assisted Treatment of Substance Use Disorders

Data from a national study of 345 privately funded, community-based substance use disorder (SUD) treatment centers were used to investigate social workers knowledge, perceptions of effectiveness, and perceptions of the acceptability of medication assisted treatments (MATs) for SUDs. Results reveal the importance of exposure to MATs for social workers to develop a knowledge base regarding the effectiveness of various pharmacological agents. Results also underline the importance of social workers perceptions of effectiveness in forming opinions regarding the acceptability of the use of MATs in SUD treatment. Lastly, a 12-Step orientation toward treatment has a negative influence on social workers opinions regarding the acceptability of MATs.

PTSD symptoms, suicidality and non-suicidal risk to life behavior in a mixed sample of pre- and post-9/11 veterans

ABSTRACT This study investigated relationships between symptom clusters of posttraumatic stress disorder (PTSD), suicidal ideation, suicide plan, and non-suicidal risk to life behavior (NSRB) behavior in a sample of 1,356 pre- and post-9/11-era military veterans. After controlling for a positive PTSD screen, results indicated that suicidal ideation was significantly associated with re-experiencing symptoms (OR = 1.12), White race (OR = 1.82) and use of pain medication (COR = 1.62). Suicide plan was associated with avoidance symptoms (OR = 1.08), and NSRB with hyperarousal symptoms (OR = 1.11) and severe alcohol use (OR = 2.10). Standardized coefficients indicated that re-experiencing symptoms (b = .38) were a stronger predictor of suicidal ideation than White race (b = .16) or pain medication (b = .12) and that hyperarousal symptoms (b = .36) were a stronger predictor of NSRB than severe alcohol use (b = .15). The interpersonal–psychological theory of suicide was used to frame a discussion of military specific suicide risk as well as the risk of premature death among veterans who endorse NSRB but not suicidality. We suggest that this subset of veterans may be overlooked by traditional screening methods while nonetheless presenting with great risk for premature death.

PTSD and Physical Health Symptoms Among Veterans: Association with Child and Relationship Functioning

ABSTRACT This study examines the association between veterans’ physical and mental health symptoms and perceptions of adverse child and relationship functioning. Veteran responses to the PHQ-15, assessing physical health; the PCL-C, assessing PTSD symptoms; and reports of family challenges were drawn from a countywide veterans survey. Findings indicate physical health (OR = 1.048; 95% CI, 1.002, 1.098) and post-traumatic stress disorder (PTSD) symptomatology (OR = 1.019; 95% CI, 1.004, 1.034) independently predicted increased child difficulties. Similarly, physical health (OR = 1.081; 95% CI, 1.012, 1.154) and PTSD symptoms (OR = 1.043; 95% CI, 1.022, 1.065) independently impacted relationship difficulties. Using standardized coefficients to compare, PTSD symptoms were a stronger predictor across both models. Results highlight the dual importance of assessing both veterans’ physical and mental health symptoms to understand family functioning. Additionally, these findings underscore the importance of longitudinal research, which can follow families beyond separation from the military.

Capacity Building for Gerontological Services: An Evaluation of Adult Day Services in a Rural State

As the number of elders in our nation increases, it becomes critical to develop programs and services designed to meet their biopsychosocial and physical needs. This article reports on one component of a mixed methods evaluation study of adult day service programs in Iowa, a critical home and community-based service for elders. After providing a description of their individual services, adult day services (ADS) administrators identified barriers to the growth of this program in the state. It was found that there were three main types of barriers that prevented the growth of ADS in Iowa: (a) systemic, (b) community-based, and (c) funding. It was found that there was a need for capacity building of adult day services in Iowa. A model for addressing these barriers through capacity building at the state and local levels is discussed.

How does discharge status impact suicide risk in military veterans

ABSTRACT Little is known about over 125,000 veterans who received non-honorable military discharges since 2001, even though these veterans face substantial barriers to obtaining services and are likely to be at high risk for negative mental and behavioral health outcomes including suicide. Seven-hundred twenty-two veterans living the in the San Francisco Bay Area participated in the study. The sample comprised honorably discharged (n = 508) and non-honorably discharged veterans (n = 214). T-tests were used to compare means on predictors of suicide risk including Posttraumatic Stress Disorder (PTSD), depression, alcohol use, somatic symptoms, and physical disability. A series of regression models tested relationships between predictors, discharge status, and suicide risk. Non-honorably discharged veterans demonstrated higher mean scores than honorably discharged veterans on all predictors. In regression models, somatic symptoms (β = 0.22, p < 0.001), physical disability (β = 0.16, p < 0.05), and discharge status (β = 0.33, p < 0.001) were associated with suicide risk. The final model showed an interaction effect for discharge status on the relationship between somatic symptoms and suicide risk (β = 0.16, p < 0.05). Non-honorably discharged veterans showed higher rates of mental and physical health problems and suicide risk compared to honorably discharged veterans. The magnitude of the relationship between somatic symptoms and suicide risk was significantly greater in non-honorably discharged veterans.