Post-Traumatic Growth amongst UK Armed Forces personnel who deployed to Afghanistan and the role of combat injury, mental health and pain: The ADVANCE cohort study

Daniel Dyball*, Alexander N Bennett, Susie Schofield, Paul Cullinan, Christopher J Boos, Anthony M.J. Bull, Sharon A.M. Stevelink, Nicola T. Fear

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Post-Traumatic Growth (PTG) is a positive psychological consequence of trauma. The aims of this study were to investigate whether combat injury was associated with deployment-related PTG in a cohort of UK military personnel who deployed to Afghanistan, and whether Post-Traumatic Stress Disorder (PTSD), depression and pain mediate this relationship.
Methods: 521 physically injured (n=138 amputation; n=383 non-amputation injury) and 514 frequency-matched uninjured personnel completed questionnaires including the deployment-related Post-Traumatic Growth Inventory (DPTGI). DPTGI scores were categorised into tertiles of: no/ low (score 0-20), moderate (score 21-34) or a large (35-63) degree of deployment-related PTG. Analysis was completed using generalised structural equation modelling.
Results: A large degree of PTG was reported by 28.0% (n=140) of the uninjured group, 36.9% (n=196) of the overall injured group, 45.4% (n=62) of amputee and 34.1% (n=134) of the non-amputee injured subgroups. Combat injury had a direct effect on reporting a large degree of PTG (Relative Risk Ratio (RRR) 1.59 (95% Confidence Interval (CI) 1.17, 2.17)) compared to sustaining no injury. Amputation injuries also had a significant direct effect (RRR 2.18 (95% CI 1.24, 3.75)), but non-amputation injuries did not (RRR 1.35 (95% CI 0.92, 1.93)). PTSD, depression and pain partially mediate this relationship, though mediation differed depending on injury subtype. PTSD had a curvilinear relationship with PTG, whilst depression had a negative association and pain had a positive association.
Conclusions: Combat injury, in particular injury resulting in traumatic amputation, is associated with reporting a large degree of PTG.
Original languageEnglish
JournalPsychological Medicine
Publication statusAccepted/In press - 12 Jul 2022

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