User:Samantha Mitchell/Peacekeeping

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Peacekeepers and Traumatic Stress

Individuals with dangerous occupations have higher rates of traumatic stress and post-traumatic stress disorder (PTSD). PTSD is a psychological disorder that can develop following exposure of a traumatic event. Symptoms of PTSD may include, but are not limited to, being easily startled or frightened, trouble sleeping, flashbacks of the traumatic event, avoiding reminders of the traumatic event, always being on guard for danger, and irritability or angry outbursts. The development of traumatic stress, PTSD, and/or other psychological disturbances within peacekeepers depend on the nature of each deployment. The impact of the deployment is influenced by the deployment's requirements, degree of training, and individual characteristics. Although peacekeepers face lower stress than in combat situations, peacekeepers may face acute and or/ chronic stressors.

During a peacekeeping deployment, peacekeepers confront similar traumatic events to those seen in combat deployments, such as witnessing death and dying, being held hostage, clearing civilians' corpses, unexploded landmines, and sniper attacks. Specifically, a sample of 1025 Australian peacekeepers reported exposure to death (77%), seeing dead bodies (78%), hearing a friend or co-worker injured or killed (64%), and causing death or injury (20%). Older resources in the literature have noted that the experiences of peacekeepers can be broken down into 5 dimensions. These 5 dimensions are isolation and feelings of being forgotten, ambiguity of deployments and the purpose, powerlessness, danger of attacks by local troops and civilians, and boredom.

Prevalence

Most peacekeepers cope well following deployment and will not exhibit traumatic stress symptoms or meet the criteria for PTSD. However, military personnel are at higher risk than the general population of developing PTSD and other psychological disorders. Trends in prevalence rates of traumatic stress and PTSD have found that the peak of traumatic stress is high pre-deployment and post-deployment and lower during the actual deployment. However, some individuals do not report symptoms of PTSD until several months or years after the event has occurred. Specifically, a longitudinal study following Somalia peacekeepers found that 6.5% of the sample did not meet the criteria for PTSD 4 months post-deployment but later met the criteria at 18 months post-deployment.

Furthermore, American peacekeepers returning from a deployment reported symptoms 5-months afterward, and 30% of the sample met the threshold for a psychological disorder. The actual number of reported prevalence is unknown, as samples vary significantly. For example, a meta-analysis found that the prevalence of PTSD among peacekeepers was an average of 5.3%, with ranges of 0.1% to 25.8%. Furthermore, a study conducted on Norwegian peacekeepers deployed between 1978 and 1998 found that 6.2% met the criteria for PTSD. Another study regarding prevalence rates in Dutch peacekeepers found that the overall rates for PTSD were between 5.6% and 8.0%. Out of a sample of 1025 Australian peacekeepers who deployed between 1989 and 2002, 16.8% met the criteria for PTSD. Peacekeepers who served in Cambodia reported rates of PTSD at 3.7%, and those who served in Yugoslavia reported 8.0%, respectively.

Risk Factors

Stressors of peacekeeping deployments include changes in lifestyle, feelings of helplessness, harassment by civilians, separation from family, exhaustion, proximity to hostile individuals, and unfavorable climate conditions. Peacekeepers may experience additional stressors either before or after a deployment. The strongest risk factor for developing traumatic stress and PTSD post-deployment is traumatic exposure, such as direct combat exposure. For example, a sample of Canadian peacekeepers found that witnessing massacres and exposure to combat was associated with developing PTSD. Pre-deployment factors such as personality, previous traumatic stress or other mental health problems, previous past deployments, adjustment due to the possibility of combat, the anticipation of communication difficulties with family members, and attachment styles are likely to increase the risk of traumatic stress developing post-deployment. Further literature yielded that income level, age at deployment, marital status, and employment status increase the risk of developing PTSD post-deployment.

Moreover, peacekeepers can experience post-deployment stressors, such as guilt, changes in emotions, and reintegrating into relationships. An increase in anxiety symptoms and depressive symptoms independently predicts PTSD. Specifically, a sample of Swedish peacekeepers' baseline anxiety levels increased the risk of post-deployment distress. Furthermore, the literature has noted that mild traumatic brain injuries highly correlate with the development of PTSD. Experiencing less social support and more demands related to deployment are related to lower levels of psychological functioning and increased traumatic stress. Older resources in the literature have found that personality traits predict the development of traumatic stress, specifically negativism, somatization, and psychopathology. The type of deployment and the location of the deployment can influence the development of traumatic stress and PTSD symptoms. A systematic review found that peacekeepers in the United Kingdom had significantly higher traumatic stress levels than Bosnia peacekeepers when controlling for other factors. Furthermore, stressful, non-traumatic life events, alcohol use, and unemployment also independently predict the development of PTSD.

Resilience Factors

Models of PTSD have identified that there are a variety of ways in which an individual copes with traumatic stress. Social connections by family and friends and integration into an individual's community contribute to an increase in positive outcomes post-deployment. Respectively, strong and close social connections lead to a decrease in PTSD symptoms. Although support from friends and family is important in mitigating traumatic stress and PTSD symptoms, recent literature has discovered that support from an employee's organization may also be important. Perceived organizational support includes employees’ beliefs about their organization and the organization cares for the individual's well-being. Similarly, experienced leadership and perceptions of group cohesion indicated a decrease in traumatic stress symptoms.

Self-efficacy and self-esteem are two factors that buffer the psychological symptoms of traumatic stress; as such, peacekeepers higher in self-efficacy and self-esteem were less likely to develop symptoms of traumatic stress and PTSD following deployment. A perceived sense of meaningfulness of the deployment decreases the probability of mental health conditions post-deployment. A sense of being able to communities and motivation to serve others also serve as a buffer for psychological disorders, such as PTSD. Coping skills moderate the effects of deployments on psychological distress. Respectively, Dutch peacekeepers who demonstrated coping strategies such as wishful thinking and problem-focused coping were associated with a lower likelihood of developing PTSD.