The Together Programme: Supporting Caregiving Partners of veterans
Abstract: In a recent analysis conducted by Combat Stress of UK, partners living alongside veterans with mental health difficulties, rates for depression and PTSD were higher compared to the external population (depression 39% Vs 20%, PTSD 17% Vs 3%. (Murphy, Palmer & Busuttil, 2016). As such this suggests the high burden of need within this group. The support currently available here in the UK mainly comprises of peer based support. Whilst research indicates the positive impact peer led groups can have, the clinical severity of partners symptoms implies a need for more structured, bespoke and evidence based intervention. To this end, a bid for funding to support the development of an evidence based intervention ‘The Together Programme’ for UK veterans partners was made and kindly awarded by The Royal British Legion in 2016. Based on review findings, two US psychoeducational programmes, SAFE and Homefront Strong (see glossary) which have been found to be effective and well accepted within the US military population were selected as the most appropriate base to devloop a UK specific injtervention to support military partners.
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.