Institutional Betrayal in Military and Veteran Populations: A Systematic Scoping Review.

Institutional betrayal (IB) refers to the wrongdoings, encompassing both action and inaction, committed by institutions against their affiliated individuals. Military members are particularly vulnerable to IB due to strong social identification with the military, values of loyalty and self-sacrifice, dependence on the institution, the military power structure and legal system, and the complexity of morality in an occupation centered around war. This review examines the state of IB literature within the military/Veteran population, identifying research gaps and implications for future policy and clinical care.

Improving care for veterans' environmental exposure concerns: applications of the consolidated framework for implementation research in program evaluation.

Background: Healthcare systems, like the US Department of Veterans Affairs (VA), need policies and procedures for delivering care to special populations including those with environmental exposure concerns. Despite being common and pervasive, especially among Veterans, environmental exposures are largely overlooked by healthcare providers. To successfully implement care for Veterans with military environmental exposure concerns, an understanding of contextual factors impeding care on the provider (e.

Institutional Courage in Healthcare: An Improvement Project Exploring the Perspectives of Veterans Exposed to Airborne Hazards.

Background: Military environmental exposures and care for subsequent health concerns have been associated with institutional betrayal, or a perception on the part of veterans that the US government has failed to adequately prevent, acknowledge, and treat these conditions and in doing so has betrayed its promise to veterans. Institutional courage is a term developed to describe organizations that proactively protect and care for their members. While institutional courage may be useful in mitigating institutional betrayal, there is a lack of definitions of institutional courage in healthcare from the patient perspective.

Exploring the acceptability of behavioral interventions for veterans with persistent "medically unexplained" physical symptoms.

Objective: This study evaluated the factors that led to enrollment in, and satisfaction with, behavioral interventions for Veterans living with Gulf War Illness (GWI).

Methods: One-on-one interviews were conducted pre- and post-intervention with participants randomized to receive either telephone delivered problem-solving treatment (n = 51) or health education (N = 49). A total of 99 Veterans were interviewed pre-intervention and 60 post-intervention.

"Because the country, it seems though, has turned their back on me": Experiences of institutional betrayal among veterans living with Gulf War Illness.

People living with medically unexplained symptoms (MUS) often have poor quality of life and health outcomes. Many struggle to engage with and trust in healthcare systems. This qualitative study examined how experiences with institutions influence perceptions of medical care for MUS by applying the theoretical framework of institutional betrayal to narratives of U.

Disproportionate multimorbidity among veterans in middle age.

Background: Little is known about the prevalence of multimorbidity among middle-aged veterans. Multimorbidity holds implications for planning for a population with high health care utilization, poor quality of life and marked need for interdisciplinary care.

Methods: The current study used the US 2017 Behavior Risk Factor Surveillance System to measure multimorbidity in three ways: (1) reporting two or more health conditions, (2) reporting two or more conditions controlling for demographic characteristics (e.

Social rehabilitation for military veterans with traumatic brain injury, psychological trauma, and chronic neuropsychiatric symptoms: Intervention development and initial outcomes.

Objective: A subset of military veterans who have experienced both traumatic brain injury and psychological trauma present with chronic neuropsychiatric symptoms and experience persistent obstacles to social reintegration. This project aimed to develop a novel treatment targeting the unmet social rehabilitation needs of these veterans. Initial intervention development, feasibility, and outcome data are explored.

Perceived Race as Variable: Moderating Relationship Between Perceived Discrimination in the Workplace and Mentally Unhealthy Days.

Since race is a social construct, the experience of racial discrimination occurs based on perceived race. This study explores the moderating effects of self-identified race and perceived racial identity on the relationship between perceived discrimination in the workplace and mentally unhealthy days using data derived from the four states (Arizona, Minnesota, Mississippi, and New Mexico) that responded to the 2014 Reactions to Race module of the Behavioral Risk Factor Surveillance System. The study hypothesized that self-identified White people, also perceived as White (WW), would have less perceived workplace discrimination and less mentally unhealthy days than self-identified non-White people perceived as White (NWW); NWW would have less perceived discrimination associated with mentally unhealthy days than self-identified White perceived as non-White (WNW); and, WNW would have less perceived discrimination associated with mentally unhealthy days than self-identified non-White perceived as non-White (NWNW).

Evaluating challenges for improving medically unexplained symptoms in US military veterans via provider communication.

Objectives: Medically unexplained symptoms (MUS) are common, with particularly high rates observed in military veterans. Effective patient-provider-communication is thought to be a key aspect of care; however there have been few empirical studies on the association between communication and outcomes for patients with MUS. We evaluate whether discussing veterans' MUS-illness representations and good interpersonal skills have the potential to promote MUS-treatment adherence and improvement.

Mental health outreach and screening among returning veterans: are we asking the right questions?

This study looked at predictors of mental health treatment utilization in a unique cohort of recently separated Veterans coming to the Department of Veterans Affairs (VA) (N=152). This convenience sample voluntarily completed questionnaires, which included mental health screening tools, during an outreach event at a large urban VA Medical Center. Researchers reviewed computerized medical records of these consenting participants to record VA treatment utilization.

CAM utilization among OEF/OIF veterans: findings from the National Health Study for a New Generation of US Veterans.

Background: Complementary and alternative medicine (CAM) is increasingly seen as an adjunct to traditional plans of care. This study utilized a representative sample of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans and OEF/OIF-era veterans to explore the prevalence and characteristics of CAM users.

Research Design: The National Health Study for a New Generation of US Veterans (NewGen) is a longitudinal health study of a population-based cohort of OEF/OIF (deployed) and OEF/OIF-era (nondeployed) veterans.

PTSD diagnoses among Iraq and Afghanistan veterans: comparison of administrative data to chart review.

To guide budgetary and policy-level decisions, the U.S. Department of Veterans Affairs (VA) produces quarterly reports that count the number of Iraq and Afghanistan veterans with International Classification of Diseases, 9(th) Revision, Clinical Modification (ICD-9-CM) codes for posttraumatic stress disorder (PTSD; 309.