Holding and rupture: Describing posttraumatic stress among former UK Army and Royal Marine personnel deployed to Iraq and Afghanistan

TY - JOUR

T1 - Holding and rupture

T2 - Describing posttraumatic stress among former UK Army and Royal Marine personnel deployed to Iraq and Afghanistan

AU - Palmer, Laura

AU - Busuttil, Walter

AU - Simms, Amos

AU - Fear, Nicola T.

AU - Stevelink, Sharon A.M.

N1 - Publisher Copyright: Copyright: © 2024 Palmer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2024/8

Y1 - 2024/8

N2 - Former UK military personnel who were previously deployed to Iraq and Afghanistan in combat roles have exhibited elevated levels of Post-Traumatic Stress Disorder (PTSD) compared to other groups. The present qualitative analyses used semi-structured interviews and a framework analysis to compare the experiences of symptomatic (N=10) and asymptomatic (N=7) former Army and Royal Marine personnel who were exposed to combat. Participants were drawn from a large UK military health and wellbeing cohort study and were sampled based upon probable PTSD status using scores from the PTSD Checklist-Civilian Version (PCL-C). All symptomatic participants attributed the development of post-traumatic stress to deployment events, with one additionally ascribing symptoms to childhood events. Among the participants, post-traumatic stress was temporarily buffered, and held at bay, by the holding function of various military structures, including the military collective; cultural and ethical frameworks that helped to organise traumatic experiences; an operational necessity for psychological compartmentalisation and even the distraction of deployment itself. Leaving the military appeared to elicit a global rupture of these supports. As a result, the military-to-civilian transition led to an intensification of post-traumatic stress, including deployment-related memories, among the symptomatic participants. In contrast, asymptomatic participants tended to report continuity of their holding structures across the lifespan, especially across the military-to-civilian transition. The onset and maintenance of post-traumatic stress may thus be explained by an interplay between the capacity of holding structures and the magnitude of lifetime rupture. Overall, findings might provide an explanation for the widening discrepancies between those with enduring post-traumatic stress and those without and further research is required to determine the fit of our findings for other groups and contexts. This approach application for this study. For further discussion, please contact Dr. Sharon Stevelink, the study’s Principal Investigator, and/or King’s Psychiatry, Nursing and Midwifery Research Ethics Subcommittee via email ([email protected]).

AB - Former UK military personnel who were previously deployed to Iraq and Afghanistan in combat roles have exhibited elevated levels of Post-Traumatic Stress Disorder (PTSD) compared to other groups. The present qualitative analyses used semi-structured interviews and a framework analysis to compare the experiences of symptomatic (N=10) and asymptomatic (N=7) former Army and Royal Marine personnel who were exposed to combat. Participants were drawn from a large UK military health and wellbeing cohort study and were sampled based upon probable PTSD status using scores from the PTSD Checklist-Civilian Version (PCL-C). All symptomatic participants attributed the development of post-traumatic stress to deployment events, with one additionally ascribing symptoms to childhood events. Among the participants, post-traumatic stress was temporarily buffered, and held at bay, by the holding function of various military structures, including the military collective; cultural and ethical frameworks that helped to organise traumatic experiences; an operational necessity for psychological compartmentalisation and even the distraction of deployment itself. Leaving the military appeared to elicit a global rupture of these supports. As a result, the military-to-civilian transition led to an intensification of post-traumatic stress, including deployment-related memories, among the symptomatic participants. In contrast, asymptomatic participants tended to report continuity of their holding structures across the lifespan, especially across the military-to-civilian transition. The onset and maintenance of post-traumatic stress may thus be explained by an interplay between the capacity of holding structures and the magnitude of lifetime rupture. Overall, findings might provide an explanation for the widening discrepancies between those with enduring post-traumatic stress and those without and further research is required to determine the fit of our findings for other groups and contexts. This approach application for this study. For further discussion, please contact Dr. Sharon Stevelink, the study’s Principal Investigator, and/or King’s Psychiatry, Nursing and Midwifery Research Ethics Subcommittee via email ([email protected]).

UR - http://www.scopus.com/inward/record.url?scp=85201055923&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0308101

DO - 10.1371/journal.pone.0308101

M3 - Article

C2 - 39121169

AN - SCOPUS:85201055923

SN - 1932-6203

VL - 19

JO - PLoS ONE

JF - PLoS ONE

IS - 8 August

M1 - e0308101

ER -