Comparing the profiles of UK and Australian military veterans supported by national treatment programmes for post-traumatic stress disorder (PTSD)
Abstract: Introduction: The aim of this study was to compare and contrast the profiles of military veterans seeking formal support for post-traumatic stress disorder (PTSD) in national treatment programmes in Australia and the UK to better understand the needs of this vulnerable population. Methods: Data were extracted from 1926 participants in these treatment programmes. This consisted of 1230 from the UK who had accessed support between 2014 and early 2019, and 696 from Australia who had accessed support between 2014 and 2018. Comparison was made between a number of sociodemographic characteristics (age, sex and educational achievements), military factors (branch of military, time since leaving the military and whether participants were early service leavers or not) and health outcomes (PTSD, anger, alcohol misuse, anxiety and depression). Results: Small differences were observed, with those in the UK cohort appearing to be younger, having lower educational achievement, being more likely to be ex-Army, having longer periods of enlistment in the military and taking longer to seek help. Further, minor differences were reported in health outcomes, with those in the UK cohort reporting more severe symptoms of PTSD, anger, anxiety and depression. Conclusions: Overall, the observed differences between the cohorts were modest, suggesting that treatment-seeking veterans from the Australian and UK cohorts reported similar presentations. This provides evidence to support the establishment of international cohorts of treatment-seeking veterans to improve knowledge within this field.
Abstract: Disordered eating is a prevalent and relevant health concern that remains understudied among U.S. military veterans. Avoidant/restrictive food intake disorder (ARFID) is a newly recognized feeding and eating disorder characterized by overly restrictive eating due to (a) picky eating, (b) lack of appetite, and (c) fear of aversive consequences related to eating. The Nine-Item ARFID Screen (NIAS) is a recently developed ARFID screening tool with initial validation studies demonstrating psychometric support. However, the psychometric properties of the NIAS have not been investigated in a veteran sample. To advance our understanding of ARFID screening tools that may be appropriate for use in veterans, the present study examined the factor structure of the NIAS using survey data from a large national sample of recently separated veterans (N = 1,486). Measurement invariance across key subgroups was tested in addition to exploring differential associations between the NIAS and related constructs. Results suggested that a three-factor model provided an excellent fit of the data and demonstrated scalar invariance across self-identified men and women, race and ethnicity, and sexual and gender minority (SGM) identity. Some subgroups had higher latent means on the picky eating (women, SGM, non-Hispanic Black), appetite (women, SGM), and fear (women) factors. The NIAS had some overlap with another measure of disordered eating and was moderately correlated with psychosocial impairment and mental health. Overall, the NIAS may be a useful screening tool for ARFID in veterans, given support for the three proposed subscales and equivalence across diverse identities.