Background
An estimated 4% of UK service-personnel suffer from PTSD, with estimates for those deployed to combat roles rising as high as 17%. Poor mental health in veterans is associated with an increased risk of developing problems in their social and occupational lives, physical health and alcohol misuse. Barriers preventing access to appropriate support include the stigmatisation of mental health problems and mistrust of mental health services. Health practitioners are also generally unaware of patients’ military service, and are unlikely to link physiological symptoms to previous exposure to trauma or experience of combat.
For veterans who do choose to access mental health support services, obtaining a diagnosis can be problematic. Diagnosis of PTSD is based on self-report measures, such as the Primary Care PTSD Screen for DSM-5. These lack sensitivity for three reasons: First, reported PTSD symptoms overlap with other mental health disorders, reducing the accuracy of diagnosis. Second, veterans may manage self-esteem by under-reporting PTSD symptoms. Third, the PC-PTSD performs better in comparatively older veterans, consequently reducing the sensitivity of clinical measures among working age veterans.
Study Objectives
The cause of PTSD is not well understood, but the complex symptoms are thought to reflect subtle, trauma-related changes in brain processes associated with cognitive functions called "executive control." These functions play a critical role in emotional regulation, and are thought to underpin clinical symptoms of PTSD by reducing sufferers’ ability to disengage from intrusive thoughts and emotional triggers.
The aim of this project is to develop and evaluate objective tests of two components of executive control: inhibition and sustained attention. Scores on these tests will be compared with self-report measures of PTSD to establish their sensitivity to the presence and severity of symptoms in UK service leavers. It is hoped the tests will provide clinicians objective measures of cognitive abilities that are sensitive to the severity of PTSD symptoms in UK service veterans. If effective, the tests will be used to increase the accuracy of PTSD diagnosis and the evaluation of treatments available to veterans via existing and future mental health support services.
Study Details
We are recruiting UK veterans who have been on operational tours with any of the armed services. Participants should be under 65 years of age and can be male or female.
The study includes 2 stages. Stage 1 was conducted at the University of Leicester's George Davies Centre and is now complete. 38 UK veterans completed Stage 1 and we would like to thank those who took time to visit the lab and contribute to the data. In was genuinely great to meet and work with people from the veterans’ community and our initial findings suggest that the visual tests we’ve developed are sensitive to variation in reported PTSD symptoms and severity. We will update the website with full results once we’ve run Stage 2 and reported our findings to the Office of Veterans’ Affairs.
Stage 2 is an online study designed to replicate the tests and findings from the laboratory sessions in Stage 1. Importantly, the online format provides access to UK veterans whose PTSD symptoms make it difficult to travel to the university and for those whose work precludes them visiting our campus during the week. Participants of Stage 2 will receive £30.00 to compensate for their time and the online sessions are expected to last approximately two hours.
Online sessions include a number of questionnaires as well as visual tasks that will run on your internet browser. Your responses and data are all secure and we are using a web-based programme called Prolific to manage payment and data security. We are hoping to recruit up to 200 UK service veterans and are restricting our sample to those who have competed at least one operational tour. The success of the study, and the potential benefit to veterans depends on your participation, so please get involved and pass details of the other study to other veterans if you can.
Stage 2
| Where |
How long |
What is involved |
| Online |
Up to 2 hours
including breaks |
Completing a series of online computer-based visual tasks and questionnaires |
How to Participate
If you would like to know about the study please contact Dr Doug Barrett at: djkb1@le.ac.uk or Joshua Black at: jdb62@le.ac.uk. You can also access the study directly via Prolific, which requires you to register for an account before you can access studies or payment. The process for registering is described here. It's important that you list yourself as a service veteran in the information section about your work.
Once you have signed up to Prolific and had your account confirmed, you can access the session online. Before you complete the questionnaires and the visual tasks, you’ll be presented with an information sheet, which describes the format of the session and asks you to consent to participation. The visual tasks will look like basic computer games, and you’ll need a laptop or computer (not a tablet or phone) to take part.
The images below are example trials from one of the visual tasks. Your objective on each trial is to report the orientation (upwards or downwards) of the “T” in the uniquely shaped object. On some trials, the display will include a uniquely coloured object. The target “T” will never appear in the uniquely coloured object, so you should ignore this and report the orientation of the “T” in the unique shape as accurately and fast as possible.
Displays on each trial will always include a uniquely shaped object (the circle on the left and the triangle on the right). Your objective is to report the orientation of the “T” in the uniquely shaped object using the up and down arrow keys to indicate upright and inverted respectively.
Study Team
The study is being conducted by a team of researchers at the University of Leicester's School of Psychology and Vision Sciences.
Funding
This is a 2 year study funded by the UK Government's Office for Veterans' Affairs.
