Gettings Richard D, Kirtley Jenna, Wilson-Menzfeld Gemma, Oxburgh Gavin E, Farrell Derek, Kiernan Matthew D
Northern Hub for Veterans and Military Families Research, Northumbria University, Newcastle upon Tyne, United Kingdom.
Department of Violence, Trauma and Criminology, Worcester University, Worcester, United Kingdom.
Front Psychol. 2022 Jul 8;13:873885. doi: 10.3389/fpsyg.2022.873885. eCollection 2022.
It has been identified that military veterans have distinct experiences of loneliness and social isolation and, when comparing this community to other client groups with a PTSD diagnosis, veterans respond less favorably to treatment. However, the link between PTSD and loneliness for veterans remains insufficiently researched and it is unclear if there are effective interventions tackling this distinct experience of loneliness.
This systematic narrative review aimed to synthesize existing evidence incorporating elements of social connection, social isolation, and loneliness within interventions for military veterans with a diagnosis of PTSD, consequently aiming to examine the impact of such interventions upon this community.
Six databases were searched, utilizing relevant search criteria, with no date restrictions. Articles were included if they involved intervention or treatment for military veterans with PTSD and considered elements of social connection, social isolation, and/or loneliness. The initial search returned 202 papers. After exclusions, removal of duplications, and a reference/citation search, 28 papers remained and were included in this review.
From the 28 studies, 11 directly addressed social isolation and two studies directly addressed loneliness. Six themes were generated: (i) rethinking the diagnosis of PTSD, (ii) holistic interventions, (iii) peer support, (iv) social reintegration, (v) empowerment through purpose and community, and (vi) building trust.
A direct focus upon social reintegration and engagement, psychosocial functioning, building trust, peer support, group cohesiveness and empowerment through a sense of purpose and learning new skills may mitigate experiential loneliness and social isolation for veterans with PTSD. Future research and practice should further explore the needs of the PTSD-diagnosed veteran community, seek to explore and identify potential common routes toward the development of PTSD within this community and consider bespoke interventions for tackling loneliness.
已发现退伍军人有独特的孤独和社会隔离经历，与其他被诊断患有创伤后应激障碍（PTSD）的客户群体相比，退伍军人对治疗的反应较差。然而，退伍军人中创伤后应激障碍与孤独之间的联系仍未得到充分研究，目前尚不清楚是否有有效的干预措施来解决这种独特的孤独体验。
本系统叙述性综述旨在综合现有证据，将社会联系、社会隔离和孤独等因素纳入针对被诊断患有创伤后应激障碍的退伍军人的干预措施中，从而研究此类干预措施对该群体的影响。
使用相关搜索标准，对六个数据库进行搜索，无日期限制。如果文章涉及对患有创伤后应激障碍的退伍军人的干预或治疗，并考虑了社会联系、社会隔离和/或孤独等因素，则纳入研究。初步搜索返回202篇论文。经过排除、去除重复项以及参考文献/引用搜索后，剩下28篇论文并纳入本综述。
在这28项研究中，11项直接涉及社会隔离，2项研究直接涉及孤独。产生了六个主题：（i）重新思考创伤后应激障碍的诊断，（ii）整体干预，（iii）同伴支持，（iv）社会重新融入，（v）通过目标和社区实现赋权，以及（vi）建立信任。
直接关注社会重新融入和参与、心理社会功能、建立信任、同伴支持、群体凝聚力以及通过目标感和学习新技能实现赋权，可能会减轻患有创伤后应激障碍的退伍军人的体验性孤独和社会隔离。未来的研究和实践应进一步探索被诊断患有创伤后应激障碍的退伍军人社区的需求，寻求探索和确定该社区内创伤后应激障碍发展的潜在共同途径，并考虑针对解决孤独问题的定制干预措施。
