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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this qualitative study was to identify perspectives of female spouses/intimate partners regarding posttraumatic stress disorder (PTSD) in returning Iraq and Afghanistan combat Veterans. Through the use of a self-administered questionnaire based on Flanagan's critical incident technique, reports were obtained from a purposive sample of 34 spouses/intimate partners of Veterans recruited through a social group for military spouses and a university in southeastern North Carolina. Two-thirds of the participants reported not having received formal education about PTSD. The main perceived barriers to PTSD treatment seeking were denial of symptoms, fear, and stigma about disclosing PTSD symptoms. Spouses/intimate partners observed Veterans for changes in behavior and routines, disturbed sleep patterns, and nightmares. In the event of PTSD treatment resistance, spouses/intimate partners reported they would suggest the need for treatment, issue an ultimatum, take action, or offer patience and support without taking any action.
Mil Med 2011 Jul
PMID:Awareness of posttraumatic stress disorder in veterans: a female spouse/intimate partner perspective. 2212 14

Virtual behavioral health (VBH) services are used frequently to address the high demand for behavioral health (BH) services in the military. Few studies have investigated the relationship between the use of VBH services and BH outcomes or preferences for the use of VBH technologies. In this article, we evaluated BH interviews conducted via video teleconferencing (VTC) or face-to-face in terms of BH symptoms, satisfaction rates, stigma, barriers to care, and preferences for future use of BH care. Soldiers (n = 307) from the headquarters element of an operational unit were surveyed 4 months following a 12-month deployment to Iraq. There were no significant differences in satisfaction rates based on interview modality, but significantly more soldiers preferred face-to-face interviews over VTC interviews in the future. Soldiers who preferred face-to-face interviews also reported higher levels of anxiety and depression symptoms than those who preferred VTC interviews. No significant age differences were found in terms of interview modality satisfaction or preference. Soldiers with greater deployment experience were more likely to report that they would not like using VTC if seeking BH care in the future than soldiers with less deployment experience. These findings highlight the importance of promoting choice in type of BH interview modality.
Mil Med 2012 May
PMID:Postdeployment behavioral health screening: face-to-face versus virtual behavioral health interviews. 2264 78

U.S. military service members have been in active combat for more than 10 years. Research reveals that combat exposure increases the risk of substance use disorders, post-traumatic stress disorder, major depression, and tobacco use. The Services and the field of addiction medicine are working hard to find a common definition for prescription drug misuse, which is a growing concern in both the general U.S. population and the force. Meanwhile, leaders at all levels of Department of Defense are diligently working to address barriers to care, particularly stigma related to substance abuse care, by seeking a balance between improving service member privacy in order to encourage self-referral for medical care and a commander's need to know the status of the unit and its combat readiness. The treatment and management of substance abuse disorders are a complex force health issue that requires the use of evidence-based medical interventions and policies that are consistent with them.
Mil Med 2012 Aug
PMID:Epidemiology and prevention of substance use disorders in the military. 2295 38

The Department of Defense is aggressively addressing combat stress reactions (CSRs) through comprehensive Combat/Operational Stress Control (COSC) briefings/programs and referral resources for the prevention, identification, and treatment of stress reactions. The purpose of this study was to develop and administer a survey to assess perceptions of CSRs and barriers to care which affect help-seeking behavior in Marines attending the COSC program. A sample of 553 U.S. Marine Corps Officers and Enlisted personnel from Air (44%), Logistics (38%), and Infantry (18%) communities were recruited for the survey. The results suggested that misconceptions and stigma about CSRs still persist in Marines. The findings reinforced the need to facilitate treatment utilization by focusing on mental health-related stigma as well as organizational barriers.
Mil Med 2012 Oct
PMID:Perceived stigma and barriers to mental health care in Marines attending the Combat Operational Stress Control program. 2311 39

Deployment represents a significant potential strain on military families. The impact of postdeployment stresses may be increased if family coping resources are diminished by returning service members' physical injuries, mental health issues, or substance abuse. This article examines the health and mental health correlates of self-reported concerns regarding interpersonal conflict among married soldiers following return from deployment and the likelihood that soldiers acknowledging such concerns are referred to counseling services. Among 20,166 married Army soldiers completing Post-Deployment Health Reassessments, 18% reported having experienced serious interpersonal conflict with their spouse, family members, close friends, or coworkers. Results indicate that interpersonal conflict was more common among those who reported health problems, depression, post-traumatic stress disorder, and alcohol abuse. Among soldiers reporting interpersonal conflict and not already receiving services, 11% were referred to service. Findings support the need to communicate with soldiers and their spouses about the availability of services following return from deployment and to continue efforts to reduce stigma associated with seeking treatment.
Mil Med 2012 Oct
PMID:Interpersonal conflict and referrals to counseling among married soldiers following return from deployment. 2311 44

Combat and Operational Stress Control (COSC) continues to be a vital component of medical operations in support of military forces serving in Afghanistan in Operation Enduring Freedom and elsewhere. Although numerous studies cover postdeployment mental health, and several cover in-theater conditions, data on behavioral health clinical service provision are presented here to elucidate from COSC provider "boots on the ground" how operations have been executed in one part of the Operation Enduring Freedom theater between 2007 and 2010. The most common types of stressors that led to care included combat, mission demands, home front concerns, and relationships with leaders and peers within units. Classes and consultation for sleep difficulties and anger management were of high interest. Frequent behavioral health diagnoses were depressive and anxiety disorders as well as exacerbation of a previously diagnosed condition. Management of suicidality and other psychiatric emergencies are discussed, as well as care outcomes. The authors present lessons learned regarding the importance of Operational Relationships/Tactical Politics, reducing stigma and barriers to care, collaboration with chaplains, and other strategies seen as supporting COSC success.
Mil Med 2012 Nov
PMID:Description of combat and operational stress control in Regional Command East, Afghanistan. 2319 2

National Guard soldiers experience high levels of mental health symptoms following deployment to Iraq and Afghanistan, yet many do not seek treatment. We interviewed 30 National Guard soldiers with prior deployments to Iraq or Afghanistan to assess mental health treatment barriers and the role of peers in treatment engagement. Interview transcripts were analyzed by a multidisciplinary research team using techniques drawn from grounded theory. The following themes were identified: (1) personal acceptance of having a mental health problem rather than treatment access is the major barrier to treatment entry; (2) tightly connected, supportive peer networks can decrease stigma related to mental health problems and encourage treatment; however, soldiers in impoverished or conflicted peer networks are less likely to receive these benefits; and (3) soldiers are generally positive about the idea of peer-based programs to improve treatment engagement, although they note the importance of leadership support, peer assignment, and unit specialty in implementing these programs. We conclude that some, but not all, naturally occurring peer networks serve to overcome stigma and encourage mental health treatment seeking by soldiers. Formal peer-based programs may assist soldiers not sufficiently benefitting from natural peer networks, although there are barriers to implementation.
Mil Med 2012 Dec
PMID:Peers and peer-based interventions in supporting reintegration and mental health among National Guard soldiers: a qualitative study. 2339 91

Recent military operations have involved repeated trauma exposure while driving vehicles. Combat deployment and post-traumatic stress disorder (PTSD) have been associated with risky driving practices, increasing the likelihood of fatalities and problems adjusting to civilian life. However, no studies have specifically examined the role of driving-related anxiety, including common cues and mental health correlates. This study conducted structured interviews with 46 recently deployed service members. Interviews assessed the prevalence of driving-related anxiety or hyperarousal (anger or irritation) in relation to civilian driving scenarios, combat exposure, post-traumatic stress symptoms, depression symptoms, and help-seeking behavior. The majority of participants reported high driving anxiety or hyperarousal in response to scenarios involving close proximity to other cars. Driving-related anxiety was positively correlated with PTSD and depression. Although PTSD and driving anxiety were positively associated with help seeking, only one-third of soldiers sought help for driving anxiety and most sought help from informal sources (i.e., friend and battle buddy). The findings underscore the need to address driving-related anxiety in combat-exposed service members with mental health symptoms, with a particular focus on specific anxiety-provoking situations. Furthermore, interventions that reduce stigma and improve access to formal care could improve help seeking and treatment for these problems.
Mil Med 2013 Mar
PMID:Driving-related anxiety in recently deployed service members: cues, mental health correlates, and help-seeking behavior. 2370 25

Military health care providers experience considerable stressors related to their exposure to death and traumatic injuries in others. This study used survey data from 799 active duty U.S. Army Combat Medics deployed to Operation Iraqi Freedom/Operation Enduring Freedom. Military experiences, combat exposures, and mental health care seeking of active duty Combat Medics were explored and compared across both genders. Barriers to care were also assessed. Male and female Combat Medics reported surprisingly similar experiences, exposures, and health issues. Overall, results indicate no striking differences in barriers for females compared to their male counterparts, suggesting the barriers to utilization of mental health services may be consistent across gender. Although medics endorsed barriers and stigma related to mental health counseling services, they still sought these health services. Female and male medics who endorsed barriers were more likely to report seeking services than those who did not endorse barriers. This study provides an initial description of utilization of mental health counseling services for U.S. Army Combat Medics, the majority of whom were involved in combat operations in Afghanistan or Iraq. Our findings indicate that comprehensive assessment of the military experiences and combat exposures is needed to appreciate their potential influence on military health care providers.
Mil Med 2013 Jul
PMID:Gender differences in combat medic mental health services utilization, barriers, and stigma. 2382 Mar 52

Eating disorders can have atypical presentations, be challenging to diagnose, and often result in treatment delay, as illustrated here. Bulimia nervosa is characterized by binge eating and inappropriate compensatory behaviors, and is ten times more common in females. Studies show increased prevalence over the past decade, with similar prevalence in young military members and civilians. Risk factors include dieting, gender preference, life-altering events, and history of a psychiatric condition. Relatively little research has focused on eating disorders among military males, but factors unique to this group include rigid weight standards, mandatory semiannual personal fitness assessments, and extended deployments. Bulimia and other eating disorders can have subtle or atypical presentations and are often overlooked in males. Other diagnostic obstacles include career concerns and stigma avoidance, along with provider time constraints, inexperience, or discomfort with the issue. Serious medical complications of bulimia are uncommon, but delayed diagnosis can lead to hospitalization and significant morbidity. This case emphasizes the importance of a thorough history and wide differential when faced with an unusual presentation. Recognizing risk factors and incorporating simple screening tools can aid the timely identification and treatment of service members with disordered eating before unit and mission effectiveness are compromised.
Mil Med 2013 Jul
PMID:Eating disorder in a young active duty male. 2382 Mar 72


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