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Figure 3.1: Lifetime exposure to traumatic events, percentages
05101520253035404550556065707580859095100
Natural disaster
Fire/Explosion
Transport accident
Serious accident
Exposure to toxic substances
Physical assault
Assault with weapon
Sexual assault
Other unwanted sexual experience
Combat/War zone exposure
Captivity
Life threatening illness/injury
Severe human suffering
Sudden violent death
Sudden unexpected death of someone close
Caused serious harm/death to other
Other stressful experience
Experienced it Witnessed
Experienced the traumatic event:
Learned about
% of peacekeepers
Australian peacekeepers: Long-term mental health status, health service use, and quality of life
Technical report
Authors: Graeme Hawthorne, Sam Korn, Mark Creamer*
Australian peacekeepers: Long-term mental health status, health service use, and quality of life
Technical Report
Graeme Hawthorne
Sam Korn
Mark Creamer*
Mental Health Evaluation Unit & the Australian Centre for Posttraumatic Mental Health Department of Psychiatry, The University of Melbourne
August 2013 (Revised August 2014)
* Due to the unforeseen unavailability of the first author to complete this report, the Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, assumed responsibility for the report in May 2013. The final version of the report was revised and edited by Professor Mark Creamer, in consultation with Professor McFarlane, Professor Sim, members of the original research team, and Professor David Forbes and Associate Professor Meaghan ODonnell.
We would like to acknowledge the passing of Associate Professor Graeme Hawthorne and pay tribute to his outstanding leadership of this research project.
Recommended citation:
Hawthorne, G., Korn, S., & Creamer, M. (2014) Australian peacekeepers: Long-term mental health status, health service use, and quality of life Technical Report. Unpublished manuscript, Department of Psychiatry, University of Melbourne, Australia.
For further information about this report please contact:
Associate Professor Meaghan ODonnell
Director of Research
Australian Centre for Posttraumatic Mental Health
Phone: +61 3 9035 5599
Email: mod@unimelb.edu.au
Research team
Chief investigators
A/Prof Graeme Hawthorne
Principal Research Fellow, Mental Health Evaluation Unit
Department of Psychiatry, The University of Melbourne
Professor Malcolm Sim
Director, Monash Centre for Occupational & Environmental Health
Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences
Monash University
Professor Alexander McFarlane
Director, Centre for Traumatic Stress Studies
University of Adelaide
Research team: Mental Health Evaluation Unit, Department of Psychiatry, The University of Melbourne
Dr Sam Korn
Research Fellow
Mr Andrew Rodsted
Research Assistant
Ms Suzanne Pollard
Research Assistant
Mr David Fallon
Research Assistant
Ms Bianca Anjara
Research Assistant
Professor Mark Creamer
Honorary Professorial Fellow
Department of Psychiatry and the Australian Centre for Posttraumatic Mental Health
Advisory committee
A/Prof Graeme Hawthorne
Principal Research Fellow, Mental Health Evaluation Unit
Department of Psychiatry, The University of Melbourne
Professor Malcolm Sim
Director, Monash Centre for Occupational & Environmental Health
Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences
Monash University
Professor Alexander McFarlane
Director, Centre for Traumatic Stress Studies
University of Adelaide
Dr Sam Korn
Research Fellow, Mental Health Evaluation Unit
Department of Psychiatry, The University of Melbourne
Ms Sandy Bell
Assistant Secretary Transport, Research and Development Branch, Department of Veterans' Affairs
Ms Kyleigh Heggie
Director
Research, Development and Coordination Section Transport, Research and Development Branch, Department of Veterans' Affairs
Ms Tracey Chant
Assistant Director
Research, Development and Coordination Section Transport, Research and Development Branch, Department of Veterans' Affairs
Mr Tim Cummins
Senior Project Officer
Research, Development and Coordination Section Transport, Research and Development Branch, Department of Veterans' Affairs
Dr Eileen Wilson, Ms Megan McDonald and Ms Kerrie Martain
Former Department of Veterans' Affairs members of the Advisory Committee
Mr Paul Copeland
Immediate Past President
Australian Peacekeeper & Peacemaker Veterans Association
Mr Michael Annett
Chief Executive Officer, Victorian Branch
Returned and Services League of Australia
Acknowledgements
We would like to thank the Australian Department of Veterans Affairs for funding this project, with particular acknowledgement to Dr Eileen Wilson, Director Research, Development and Coordination Section, Transport, Research and Development Branch as well as Ms Megan McDonald and Kerrie Martain, Senior Research Officers, Research, Development and Coordination Section, Transport, Research and Development Branch, Department of Veterans' Affairs, Commonwealth of Australia.
Our thanks are extended to Mr Paul Copeland, Immediate National President, Australian Peacekeeper & Peacemaker Veterans Association, and Mr Michael Annett, Chief Executive Officer, RSL Victorian Branch.
We would like to thank the research assistants who interviewed peacekeepers and maintained the study database: Mr Andrew Rodsted, Ms Suzanne Pollard, Mr David Fallon and Ms Bianca Anjara.
Our thanks are also extended to all the peacekeepers who participated in this study. Without their generosity in giving up their time this study would not have been possible.
Table of contents
iiiResearch team
ivAdvisory committee
viAcknowledgements
xList of tables
xiList of figures
xiiAbbreviations
xivGlossary of terms
1Executive summary
11.Background
12.Study aims
13.Study design, data collection, and analysis
24.Study findings
45.Study strengths and limitations
46.Implications
71.0Background and study aims
71.1The nature of peacekeeping
71.2Australias involvement
91.3The nature of mental health problems
91.3.1Psychiatric diagnoses
101.3.2Other mental health and related constructs
111.4The mental health sequelae of peacekeeping operations
121.5Rationale for the current study
121.6Appropriate comparisons for the current study
141.7Aims of the current study
172.0Method
172.1Study design
172.1.1Study deployments
182.1.2High versus low stress deployments
182.2Participants: Sample and selection
182.2.1Sample size
192.2.2Participant selection
202.3Procedures for data collection
202.3.1 Initial recruitment into the study
232.3.2 Data collection
242.4Comparator samples
252.4.1National Survey of Mental Health and Wellbeing (NSMHWB)
262.4.2CMVH East Timor and Bougainville samples
272.4.3 Australian Gulf War Veterans Health Study (AGWVHS)
272.4.4 (ADF) Mental Health Prevalence and Wellbeing Study sample
282.5Measures
292.5.1Composite International Diagnostic Interview (CIDI)
302.5.2Background information
312.5.3Standardised self-report measures mental and physical health
332.5.4Standardised self-report measures associated problems
362.5.5 Standardised self-report measures potential risk and protective factors
372.6Data analysis
372.6.1Data verification and missing data
382.6.2Participation bias
392.6.3Response bias
392.6.4Significance levels and statistical analyses
412.6.5Predictor variables
422.7Ethics
422.7.1Adverse events
433.0Participants
433.1Participation rate
443.2Study generalisability
443.2.1Non-response and partial completion
453.2.2Bias response by questionnaire length
463.2.3Questionnaire response bias
483.2.4Missing data
483.3Demographic details of participants
483.3.1General demographic profile of study participants
513.4Service and deployment history
523.5Trauma exposure
523.5.1Traumatic life events exposure
543.5.2Trauma exposure on deployment: TSES-R2 findings
563.6Summary
584.0Mental health
584.1Pre-deployment mental health
604.2The prevalence of mental health conditions
644.2.1Posttraumatic stress disorder (PTSD)
654.2.2Generalised Anxiety Disorder (GAD)
664.2.3Major Depressive Episode (MDE)
664.2.4Alcohol and other drug abuse and dependence
674.3Predictors and correlates of mental health conditions
674.3.1Univariate associations
704.3.2Multivariate analyses
734.4Associated constructs of mental health and wellbeing
744.4.1PCL
754.4.2General Health Questionnaire (GHQ-12 bimodal)
764.4.3K10
784.4.4Suicidal ideation and
