10th immhc rademaker

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

10th immhc rademaker

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