Medicine and Health Sciences Commons^™

Telehealth Experiences In Canadian Veterans: Associations, Strengths And Barriers To Care During The Covid-19 Pandemic., Deanna L Walker, M S Nouri, R A Plouffe, J J W Liu, T Le, C A Forchuk, D Gargala, K St Cyr, A Nazarov, Don Richardson

MacDonald Franklin OSI Research Centre

INTRODUCTION: Identifying barriers to care in veteran populations is critical, as veterans face increased social isolation, relationship strains and financial insecurities. For Canadian veterans experiencing barriers to accessing healthcare, telehealth may be a promising alternative with comparable effectiveness to in-person services; however, the potential benefits and limitations of telehealth require further examination to determine its long-term utility, and to inform health policy and planning. The goal of the present research was to identify predictors and barriers to telehealth usage in Canadian veterans in the context of the COVID-19 pandemic.

METHODS: Data were drawn from baseline data of a longitudinal survey …

Depression And The Relationship Between Sleep Disturbances, Nightmares, And Suicidal Ideation In Treatment-Seeking Canadian Armed Forces Members And Veterans, Don Richardson, Lisa King, Kate St. Cyr, Philippe Shnaider, Maya L. Roth, Felicia Ketcheson, Ken Balderson, Jon D. Elhai

MacDonald Franklin OSI Research Centre

Background: Research on the relationship between insomnia and nightmares, and suicidal ideation (SI) has produced variable findings, especially with regard to military samples. This study investigates whether depression mediated the relationship between: 1) sleep disturbances and SI, and 2) trauma-related nightmares and SI, in a sample of treatment-seeking Canadian Armed Forces (CAF) personnel and veterans (N = 663). Method: Regression analyses were used to investigate associations between sleep disturbances or trauma-related nightmares and SI while controlling for depressive symptom severity, posttraumatic stress disorder (PTSD) symptom severity, anxiety symptom severity, and alcohol use severity. Bootstrapped resampling analyses were used to …

Disturbed Eeg Sleep, Paranoid Cognition And Somatic Symptoms Identify Veterans With Post-Traumatic Stress Disorder, Harvey Moldofsky, Lorne Rothman, Robert Kleinman, Shawn G. Rhind, Don Richardson

MacDonald Franklin OSI Research Centre

Background

Chronic post-traumatic stress disorder (PTSD) behavioural symptoms and medically unexplainable somatic symptoms are reported to occur following the stressful experience of military combatants in war zones. Aims

To determine the contribution of disordered EEG sleep physiology in those military combatants who have unexplainable physical symptoms and PTSD behavioural difficulties following war-zone exposure. Method

This case-controlled study compared 59 veterans with chronic sleep disturbance with 39 veterans with DSM-IV and clinician-administered PTSD Scale diagnosed PTSD who were unresponsive to pharmacological and psychological treatments. All had standardised EEG polysomnography, computerised sleep EEG cyclical alternating pattern (CAP) as a measure of sleep …

Insomnia, Psychiatric Disorders And Suicidal Ideation In A National Representative Sample Of Active Canadian Forces Members, Don Richardson, A. Thompson, Lisa King, B. Corbett, P. Shnaider, K. St Cyr, C. Nelson, J. Sareen, Jon Elhai, M. Zamorski

MacDonald Franklin OSI Research Centre

Background

Past research on the association between insomnia and suicidal ideation (SI) has produced mixed findings. The current study explored the relationship between insomnia, SI, and past-year mental health status among a large Canadian Forces (CF) sample.

Method

Data was obtained from the 2013 Canadian Forces Mental Health Survey (CFMHS), and included a large representative sample of Canadian Regular Forces personnel (N = 6700). A series of univariate logistic regressions were conducted to test individual associations between past-year mental health status, insomnia, and potential confounds and SI. Mental health status included three groups: 0, 1, or two or more …

A Review Of The Relation Between Dissociation, Memory, Executive Functioning And Social Cognition In Military Members And Civilians With Neuropsychiatric Conditions, Margaret C. Mckinnon, Jenna E. Boyd, Paul A. Frewen, Ulrich F. Lanius, Rakesh Jetly, Don Richardson, Ruth A. Lanius

MacDonald Franklin OSI Research Centre

Dissociative experiences, involving altered states of consciousness, have long been understood as a consequence or response to traumatic experiences, where a reduced level of consciousness may aid in survival during and after a traumatic event. Indeed, the dissociative subtype of post-traumatic stress disorder (PTSD-DS) was added recently to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Dissociative symptoms are present across a host of neuropsychiatric conditions, including PTSD, psychotic spectrum illnesses, anxiety and mood disorders. Transdiagnostically, the presence of dissociative symptoms is associated with a greater illness burden and reduced treatment outcomes. Critically, dissociative symptoms are related …

The Co-Occurrence Of Ptsd And Dissociation: Differentiating Severe Ptsd From Dissociative Ptsd, Cherie Amour, Karen-Inge Karstoft, Don Richardson

MacDonald Franklin OSI Research Centre

Purpose

A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD.

Methods

The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity …

Examining The Association Between Psychiatric Illness And Suicidal Ideation In A Sample Of Treatment-Seeking Canadian Peacekeeping And Combat Veterans With Posttraumatic Stress Disorder, Don Richardson, Kate St. Cyr, Alexandra M. Mcintyre-Smith, David Haslam, Jon D. Elhai, Jitender Sareen

MacDonald Franklin OSI Research Centre

Objective:

Our study examines the association between suicidal ideation and and self-reported symptoms of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), and alcohol use disorder (AUD) in a sample of treatment-seeking Canadian combat and peacekeeping veterans; and identifies potential predictors of suicidal ideation.

Methods:

Actively serving Canadian Forces and Royal Canadian Mounted Police members and veterans seeking treatment at the Parkwood Hospital Operational Stress Injury Clinic (n = 250) completed measures including the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, the Alcohol Use Disorder Identification Test, and the PTSD Checklist—Military Version (PCL-M) …

Guidelines For Peer Support In High‐Risk Organizations: An International Consensus Study Using The Delphi Method, Mark C. Creamer, Tracy Varker, Jonathan Visson, Kathy Darte, Neil Greenberg, Winnie Lau, Gill Moreton, Meaghan O'Donnell, Don Richardson, Joe Ruzek, Patricia Watson, David Forbes

MacDonald Franklin OSI Research Centre

Despite widespread adoption of peer‐support programs in organizations around the world whose employees are at high risk of exposure to potentially traumatic incidents, little consensus exists regarding even the most basic concepts and procedures for these programs. In this article, consensus refers to a group decision‐making process that seeks not only agreement from most participants, but also resolution of minority objections. The aim of the current study was to develop evidence‐informed peer‐support guidelines for use in high‐risk organizations, designed to enhance consistency around goals and procedures and provide the foundation for a systematic approach to evaluation. From 17 countries, 92 …

Post-Traumatic Stress Disorder: Guiding Management With Careful Assessment Of Comorbid Mental And Physical Illness, Don Richardson, Diane Mcintosh, Murray B. Stein, Jitender Sareen

MacDonald Franklin OSI Research Centre

Post-traumatic stress disorder (PTSD) is a common and serious psychiatric condition in the civilian and veteran population. The lifetime prevalence of PTSD in the Canadian general population is 9.2%, which, surprisingly, is not significantly different from the 7.2% lifetime prevalence rate within the Canadian Regular Forces. In Canadian veterans pensioned with a medical condition the 1-month prevalence was 10.3%. Given the serious functional impairment and impaired quality of life associated with PTSD, careful assessment and treatment of PTSD is warranted. Due to the complex clinical presentation of PTSD, which can include symptoms across the continuum from adjustment disorder and subthreshold …

Post-Traumatic Stress Disorder And Health Problems Among Medically Ill Canadian Peacekeeping Veterans, Don Richardson, Jordan Pekevski, Jon D Elhai

MacDonald Franklin OSI Research Centre

OBJECTIVE:

The aim of the present study was to examine the relationship between post-traumatic stress disorder (PTSD) symptom severity and four significant health conditions (gastrointestinal disorders, musculoskeletal problems, headaches, and cardiovascular problems).

METHOD:

Participants included 707 Canadian peacekeeping veterans with service-related disabilities, from a random, national Canadian survey, who had been deployed overseas.

RESULTS:

PTSD severity was significantly related to gastrointestinal disorders, musculoskeletal problems, and headaches, but not to cardiovascular problems. Controlling for demographic factors did not affect PTSD's relationships with the three significant health conditions.

CONCLUSIONS:

The present study supports previous work in finding consistent relations between PTSD severity …

Predictors Of Likelihood And Intensity Of Past-Year Mental Health Service Use In An Active Canadian Military Sample, Deniz Fikretoglu, Jon D Elhai, Aihua Liu, Don Richardson, David J. Pedlar

MacDonald Franklin OSI Research Centre

Objective:
This study examined associations between sociodemographic, military, and psychiatric need variables and past-year mental health service use among active Canadian military members. The likelihood and intensity of services were examined across two provider types— mental health providers and medical providers.
Methods: Data were drawn from the first epidemiological survey of mental health in the Canadian Forces, conducted by Statistics Canada in 2002. Survey instruments included the Composite International Diagnostic Interview, which was used to assess mental health and service use.
Results: Of the 8,441 military members who participated in the survey, 14.5% (N=1,220) met criteria for having a mental …

Posttraumatic Stress Disorder And Health-Related Quality Of Life Among A Sample Of Treatment- And Pension-Seeking Deployed Canadian Forces Peacekeeping Veterans, Don Richardson, Mary E. Long, David J. Pedlar, Jon D Elhai

MacDonald Franklin OSI Research Centre

Objectives: To examine the health-related quality of life (HRQOL) in deployed Canadian Forces peacekeeping veterans, addressing associations with posttraumatic stress disorder (PTSD), and depression severity. Methods: Participants (n = 125) were consecutive male veterans who were referred for a psychiatric assessment. Instruments administered included the Clinician-Administered PTSD Scale, Hamilton Depression Scale, Short-Form-36 Health Survey, and sociodemographic characteristics. Results: Mental HRQOL was significantly lower for peacekeepers with, than without, PTSD. Using univariate analyses, PTSD and depression severity were each significantly negatively related to mental HRQOL. In sequential regression analyses controlling for age, we found that PTSD and depression severity significantly predicted …

Posttraumatic Stress Disorder And Health-Related Quality Of Life Among A Sample Of Treatment- And Pension-Seeking Deployed Canadian Forces Peacekeeping Veterans, Don Richardson, Mary E. Long, David J. Pedlar

MacDonald Franklin OSI Research Centre

Objectives: To examine the health-related quality of life (HRQOL) in deployed Canadian Forces peacekeeping veterans, addressing associations with posttraumatic stress disorder (PTSD), and depression severity.
Methods: Participants (n = 125) were consecutive male veterans who were referred for a psychiatric assessment. Instruments administered included the Clinician-Administered PTSD Scale, Hamilton Depression Scale, Short-Form-36 Health Survey, and sociodemographic characteristics.
Results: Mental HRQOL was significantly lower for peacekeepers with, than without, PTSD. Using univariate analyses, PTSD and depression severity were each significantly negatively related to mental HRQOL. In sequential regression analyses controlling for age, we found that PTSD and depression severity significantly predicted …

Operational Stress Injury Social Support: A Canadian Innovation In Professional Peer Support, Don Richardson, Kathy Darte, Stephan Grenier, Allan English, Joe Sharpe

MacDonald Franklin OSI Research Centre

No abstract provided.

Posttraumatic Stress Disorder And Associated Risk Factors In Canadian Peacekeeping Veterans With Health-Related Disabilities, Don Richardson, James A. Naifeh, Jon D Elhai

MacDonald Franklin OSI Research Centre

Objectives:

This study investigates posttraumatic stress disorder (PTSD) and its associated risk factors in a random, national, Canadian sample of United Nations peacekeeping veterans with service-related disabilities.

Methods:

Participants included 1016 male veterans (age < 65 years) who served in the Canadian Forces from 1990 to 1999 and were selected from a larger random sample of 1968 veterans who voluntarily and anonymously completed a general health survey conducted by Veterans Affairs Canada in 1999. Survey instruments included the PTSD Checklist-Military Version (PCL-M), Center for Epidemiological Studies-Depression Scale (CES-D), and questionnaires regarding life events during the past year, current stressors, sociodemographic characteristics, and military history.

Results:

We found that rates of probable PTSD (PCL-M score > 50) among veterans were 10.92% for veterans deployed once and 14.84% for those deployed more than once. The rates of probable clinical depression (CES-D score > 16) were 30.35% for veterans deployed once and 32.62% for those deployed more than once. We found that, in multivariate analyses, probable PTSD rates and PTSD severity were associated with younger …