Preventing psychological trauma in soldiers: The role of operational su-ess training and psychological debriefing

Armed conflict is associated with significant long-term psychiatric morbidi ty. Interventions to reduce the incidence of psychiatric disorder following psychological trauma may be classified into, three categories. Primary pre vention includes the selection, preparation and training of individuals lik ely to be exposed to potentially traumatizing events. Secondary prevention comprises a variety of brief psychological techniques immediately or shortl y after traumatizing life events, the best known of which is Psychological Debriefing. Tertiary interventions comprise the treatment of established PT SD and others. Psychiatric morbidity was studied in 106 British soldiers returning from UN peacekeeping duties in thc former Republic of Yugoslavia. All 106 soldiers received an Operational Stress Training Package prior to their deployment and a randomly selected group also received a post-operational PD. Very low rates of PTSD and other psychopathology were found overall and the Operati onal Stress Training Package may have contributed to this. Elevated CAGE sc ores suggestive of significant alcohol misuse were observed in both groups and chemical avoidance behaviours arising from this may have masked psychop athology. CAGE scores diminished significantly in the debriefed group by th e end of the follow-up period suggesting that PD may have been of benefit d espite the apparent absence of PTSD. This study also demonstrates that a hi gh incidence of psychiatric morbidity is not an inevitable consequence of m ilitary conflict.