Hypothesis
1 a) Those who sustained combat injuries will continue to exhibit higher rates of mental illness compared to the uninjured group. b) Those who sustained amputation injuries will continue to present with no differences in rates of mental illnesses compared to the uninjured group. c) Those with non-amputation injuries will continue to present with higher rates of mental illnesses compared to the uninjured group.
2 a) Those who sustained combat injuries will continue to exhibit higher rates of PTG.” compared to the uninjured group. b) Those who sustained amputation injuries will continue to present with higher rates of PTG compared to the uninjured group. c) Those with non-amputation injuries will continue to present with no differences in rates of PTG compared to the uninjured group.
3 a) PTSD symptoms will have a causal effect on cardiometabolic effects, haemodynamic functioning and inflammation. b) Intrusive thoughts will have an indirect effect on cardiovascular outcomes through avoidance behaviours, hyperarousal and emotional numbing.
4 PTG symptoms will have a causal effect on cardiometabolic effects, haemodynamic functioning and inflammation.
5 a) Adverse Childhood Events (ACE) will be different between baseline and FU1. b) Mental illness will be associated with increased rates of reported ACEs. c) Sociodemographic/health factors such as relationship status, socioeconomic status, serving status, health-related quality of life and injury status will be associated with increased rates of reported ACEs.
6 a) Sustaining a physical combat injury will be associated with lower health-related quality of life and overall perceived health. b) Medication use, substance use, employment, and mental health will mediate this relationship.
Summary
There are 6 aims of the project listed below:
- Assess the rates of depression, anxiety, PTSD and mental health multimorbidity of the ADVANCE cohort at follow-up, and whether there are any significant changes from baseline.
- Assess the rates of PTG of the ADVANCE cohort at follow-up, and whether there are any significant changes from baseline.
- Assess the causal association between PTSD symptoms and CVD health indicators between baseline and FU1.
- Assess the causal association between PTG symptoms and CVD health indicators between baseline and FU1.
- Report the changes in perceived Adverse Childhood Events between baseline and FU1 and assess the mental health and sociodemographic factors associated with changes in reported events.
- To report the Quality Adjusted Life Years of combat-injured UK servicemen compared to an uninjured comparison group and assess the enablers and disablers (risk/protective factors) of good quality of life amongst combat injured UK servicemen.
The hypothesis for each of these aims are:
- a) Those who sustained combat injuries will continue to exhibit higher rates of mental illness compared to the uninjured group. b) Those who sustained amputation injuries will continue to present with no differences in rates of mental illnesses compared to the uninjured group. c) Those with non-amputation injuries will continue to present with higher rates of mental illnesses compared to the uninjured group.
- a) Those who sustained combat injuries will continue to exhibit higher rates of PTG compared to the uninjured group. b) Those who sustained amputation injuries will continue to present with higher rates of PTG compared to the uninjured group. c) Those with non-amputation injuries will continue to present with no differences in rates of PTG compared to the uninjured group.
- a) PTSD symptoms will have a causal effect on cardiometabolic effects, haemodynamic functioning and inflammation. b) Intrusive thoughts will have an indirect effect on cardiovascular outcomes through avoidance behaviours, hyperarousal and emotional numbing.
- PTG symptoms will have a causal effect on cardiometabolic effects, haemodynamic functioning and inflammation.
- a) Adverse Childhood Events (ACE) will be different between baseline and FU1. b) Mental illness will be associated with increased rates of reported ACEs. c) Sociodemographic/health factors such as relationship status, socioeconomic status, serving status, health-related quality of life and injury status will be associated with increased rates of reported ACEs.
- a) Sustaining a physical combat injury will be associated with lower health-related quality of life and overall perceived health. b) Medication use, substance use, employment, and mental health will mediate this relationship.
For aims 1 through 6 longitudinal analysis will be completed via structural equation modelling.
Keywords
Mental health, Cardiovascular Health, Post Traumatic Stress Disorder, Post Traumatic Growth