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8/18/2019 10th IMMHC Rademaker
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10 th IMMHC Tartu 2007
War and PersonalityStudies on the relationship between personalityand deployment related disorders in Dutchsoldiers and veterans Arthur Rademaker, E. Vermetten & R.J. leber
!trecht !niversity, dept o" #linical $sycholo%yResearch #entre 'ilitary 'ental (ealth#are
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/utline
+ntroduction0 "acts
$ersonalityRelationship to psychopatholo%y
Studies1euroticism
$ersonality and stress hormonesEarly trauma and personality
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+ntroduction ctd.
7ecause o" their pro"ession, soldiers are moreo"ten e2posed to such situations. hey constitute apopulation at risk "or the development o" trauma
related psychopatholo%y.
he more o"ten they are e2posed, the %reater therisk o" 5mental6 health problems.
Despite minimi8ation o" known risks and dan%ersand care"ul preparation, post deployment healthcomplaints "re9uently occur.
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+ntroduction ctd.
(owever,
:hile most people are e2posed to a potential traumaticevent at some point in their li"e, only a relatively small
percenta%e develops psychopatholo%ical symptoms as aresult.
Similarly,
1ot all soldiers develop health problems a"ter bein%deployed.
5 essler et al., );;6
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+ntroduction ctd.
(ow can we e2plain these di""erences?
Studies that have sou%ht to e2plain individual di""erencesin susceptibility to post deployment morbidity haveidenti"ied several risk "actors.
hese include 5but are not limited to60a%e, %ender, +@, education, psychiatric history, priortrauma and...
...$ersonality57rewin et al., -***= in% et al., );;>= Shalev, );;>6
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Personality: what is it?
he comple2 and deeply en%rained pattern o"psycholo%ical and lar%ely unconscious characteristicsthat mani"est themselves in almost all aspects o""unctionin%.
$ersonality is a dynamic or%ani8ation, inside the person,o" psychophysical systems that create a person3scharacteristic patterns o" perception, behavior, thou%hts,and "eelin%s.
he endurin% patterns o" perceivin%, relatin% to, andthinkin% about the environment and onesel" that aree2hibited in a wide ran%e o" social and personal conte2ts3
Derksen, );;B#arver & Schreier, -***
'ilton, );C)
A$A, -***
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Personality: (ow is it related to health?
E2aminin% individual di""erences in personality canaid in understandin% why some people are able tocope with stressors, whilst others develop
psychopatholo%ical symptoms.
or e2ample, neuroticism has been "ound to bevulnerability "actor "or a wide ran%e o" disorders0$ SD, depressive disorders, somato"orm
disorders etc.5e.%., ahn et al., -**
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Personality 0 (ow is it related to trauma?
$ersonality can increase the risk o" e2posure topotential traumatic events0 e.%. sensation seekin%,borderline personality, neuroticism
+t may also increase vulnerability to trauma relateddisorders0
1e%ative a""ectivity 5neuroticism6 associated withhi%her risk o" $ SD a"ter Vietnam war and in
Dutch !1 soldiers.ower pre trauma novelty seekin% and hi%her
harm avoidance in colle%e students whodeveloped $ SD a"ter terrorist attacks.
7ramsen et al., -***= Schnurr et al., );;B
Fil, -**<
7reslau et al., );;<
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o complicate thin%s a bit...
$ersonality can also in"luence the process o"5mal6adaptation a"ter deployment as well as thecourse and development o" post deployment illnessesand disorders
and
$ersonality in itsel" may chan%e "ollowin%prolon%ed e2posure to stress"ul situations
$ersonality can chan%e due to the presence o"a mental disorder
5Schnurr et al., -**G6
57ramsen et al., -**-= :(/, );;- 6
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'odels ctd.
#ommon cause model
(mental) healthproblems
stressor
PersonalityChange
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'odels ctd.
#omplicationH scar models
stressor
Personality
(mental) healthproblems
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Summary
$ersonality may play a key role in the aetiolo%y o" postdeployment illness and disorders as it can0
+ncrease the risk o" trauma e2posure
+ncrease the vulnerability "or mental disorders+n"luence illness pro%ression#han%e as a result o" a trauma e2posure#han%e due to the e""ects o" chronic disorders orproblems
1euroticism appears to be a key player
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10 th IMMHC Tartu 2007
estin% the 'odels0A multi-method approach
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Population
Dutch peacekeepin% veterans and active soldiers
#urrently C*.*** have been deployed 0
79-85 Lebanon - UNIFIL92-00 Cambodia - UNTAC 91-98 Iraq - UNSCOM93-9 !"anda - #ro$ide Care92-9% &a'(an) UN#!OFO! * +, ./ba
0 -05 Iraq - nd,rin Freedom05-07 A /ani) an ISAF
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the Stressors
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Examining the pathways: euroticism
!ow is neuroticism related to "nown dispositionalresilience #actors$ coping and psychopathology%
#ross sectional study o" a random sample o" )BCmale !1 veterans= mean a%e G>,) 5 S+ I ,)
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&esults
/nly neuroticism not locus o" control, hardinessor optimism was a direct and si%ni"icant predictoro" %eneral health problems, e2plainin% GB in
variance.
(ardiness 5) 6 and neuroticism 5)< 6 scorespredicted problem oriented copin%.
1euroticism was a si%ni"icant predictor o"perceived social support 5-> 6
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'iological aspects o# personality
Can personality #actors be related to biologicalsystems associated with the stress response%
inkin% #lonin%er3s harm avoidance to the
awakin% cortisol response in a cross sectional study o")*C male soldiers 5mean a%e B-.> years old, S+ I)*.;6.
'easures0 #lonin%er3s #+ S = salivary cortisol atG time points a"ter awakin%.
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&esults
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Early trauma and personality
#an the predisposin% e""ect o" early trauma on adultpatholo%y be e2plained throu%h the relationship withpersonality?
#ross sectional study o" -G- male soldiers 5meana%e B).G years, S+ I )*.;6.
'easures0 #lonin%er3s #+ and Early rauma+nventory
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&esults
'ultiple re%ression analyses showed thate2posure to emotional abuse predicted about )*variance in personality dimensions o" sel"directedness and cooperativeness.
hese personality traits are related to di""iculties inacceptin% responsibility, lack o" %oals, low sel"
esteem, identity problems, hostility, intolerance,e%ocentrism and opportunism.
Sel" directedness predictor o" depression andan2iety 5'atsudaira & itamura, -**>6= owcooperativeness and sel" directedness common inpersonality disorders 5Svrakic et al. -**B6
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Conclusion
$ersonality may increase the risk "or postdeployment health problems throu%h multiple pathwaysincludin% copin% styles, lack o" resilience, diminishedsocial capacity and biolo%ical 5temperamental6di""erences.
'!$S may indeed be $E$S...
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...or not?
hank you
A.R.RademakerKuu.nl