The PETT Study aimed to investigate the feasibility of:

• Recruiting military veterans in Northern Ireland (N=60) for random allocation to either the experimental treatment (Reconsolidation of Traumatic Memories (RTM)) or control (Trauma-Focused Cognitive Behaviour Therapy (TF-CBT))
• Study compliance from veterans throughout the study (completing treatment and research questionnaires)
• Developing procedures to ensure participant safety during treatment.

Findings from the PETT Study will inform future pilot trials on the efficacy of RTM in both veteran and general populations.

This trial is a collaboration between QUB (Prof. Cherie Armour) and King’s College London (Profs. Jackie Sturt and Neil Greenberg), with therapists from Inspire Wellbeing (Belfast) delivering both the experimental and control therapies. The research is funded by Forces in Mind Trust (FiMT) with an endowment from The National Lottery Community Fund

While the PETT Study’s primary impact would seem to be the participants who received RTM or TF-CBT therapy for their PTSD, it also carries local to national community impact (NI veterans to UK veterans).

• Recruitment began in early 2020 in NI, this paused briefly due to the COVID-19 pandemic, and then expanded to recruiting veterans from across the UK for web-based therapy delivery.
• Therapy delivery and data collection continued throughout 2021, with the study closing at the formal dissemination event in Belfast on 06 May 2022.

That this feasibility trial was successful ‘greenlights’ piloting studies with the aim of using RTM in populations with high trauma exposure (veterans, healthcare workers, etc.) and eventually, if efficacy of RTM is found, in the general population.

The PETT Study could also be used as a basis for replication feasibility studies on an international scale.

Follow @Pettstudy on Twitter or contact Dr Erik Spikol (STARC Research Fellow)

• Aiming to understand the psychosocial determinants of psychological health and wellbeing for veteran families in the UK, as well as experiences of support and the transition to civilian life.
• The study launched in Nov. 2021 is ongoing across the UK through Nov. 2022.
• UKVFS a mixed-methods study, using both qualitative interviews with veteran family members and service providers, as well as a large-population quantitative survey open to the family and veterans.

UKFVS is funded by Forces in Mind Trust (FiMT) and the Big Lottery Fund and is being conducted by Professor Chérie Armour at Queen’s University Belfast and Professor Nicola Fear at King’s College London and in partnership with: Glasgow Caledonian University, Anglia Ruskin University, Veterans NHS Wales, Cardiff and Vale University Health Board, and Combat Stress.

Findings will be used to influence the design and implementation of support programmes and resources for veteran families in the UK, with the psycho-social findings having a potential international impact.

Find out more here.

Follow the UKVFS on Twitter (@Vet_families), Instagram (@Vet_families), or Facebook (UK Veterans Family Study)

Or contact Eric Spikol (STARC Research Fellow)

The study will make use of a two-session experimental design in which participants will be invited into the lab at QUB and assigned to one of three conditions (either writing about a positive memory, speaking about a positive memory or a control condition). Whether recalling or writing down a happy memory positively influences people’s moods and thoughts will be measured.

We hope the outcomes of this project will aid the development of a PTSD-specific positive memory therapeutic technique to reduce hyper-focus on traumatic memories and reduce negative affect. 

To find out more contact Professor Cherie Armour 

• MI-VIDA aims to develop a biopsychosocial model of PTSD, using biological (saliva samples) and survey data to better understand the factors impacting the likelihood of developing PTSD and other mental health conditions after response to trauma; in particular, Armed Conflict.
• Researchers will collect data at 4 time points across a 12 month period regarding life experiences, thoughts, feelings and psychopathological symptoms.
• The role of genetics will also be examined. Colleagues at Los Andes will conduct behavioural experiments with gene edited zebrafish to examine the role of Neuroligin1 in stress responding. This information will then be used to look at the role of Neuroligin1 in humans who do/do not report a PTSD response

To find out more about the project see mi-vida.co or contact Prof Chérie Armour (the project principal investigator), Dr Donncha Hanna (the project co-investigator), or Dr Martin Robinson (STARC Research Fellow)

Mental health wards are under incredible pressure due to high bed occupancy rates and staff shortages. Service users are acutely unwell and often admitted involuntarily (40%). Staff manage aggression when it arises through communication, known as de-escalation. However, de-escalation training is not evidence based and practice varies greatly.

The aim of this NIHR funded study is to identify the communication and teamwork strategies that characterise successful management of aggressive behaviour in acute adult inpatient mental health wards, avoiding the need to use potentially harmful restrictive practices such as restraint (held to prevent movement), seclusion (locked in isolation) and forced tranquillisation (involuntarily injected with psychotropic medication).

This mixed methods study, launched in April 2022 and will continue for 24 months. It employs staff body worn cameras, alongside ethnographic observations of routine practice and interviews with staff and service users to identify successful aggression management approaches on inpatient wards. The findings of this study will provide evidence to inform future training and clinical practice.

The study is currently seeking new sites in Northern Ireland.

If you want to know more, please visit the study website: https://researchcentres.city.ac.uk/carr-project and get in touch mary.lavelle@qub.ac.uk

It is now understood within the literature that mechanisms underlying resilience are multiple component process dependent on flexible responding from moment to moment. The RISE study aims to investigate several aspects of resilience (such as flexible emotion regulation, use of coping strategies and understanding and experience of negative and positive emotions) in the context of individuals daily life and explore how these relate to mental health outcomes such as anxiety, depression and PTSD.  To do this the RISE study employs a novel paradigm called ecological momentary assessment (EMA) to investigate these underlying mechanisms of resilience. EMA is a means of real-world data collection where data is collected in the participant’s natural environment, usually via their mobile phone or other smart device.

To find out more contact Professor Cherie Armour

Study 1. Supporting & Serving Military Veterans in Northern Ireland This report provided the first comprehensive overview of services and support available to veterans living in NI. Additionally, there was a focus on framing these services in line with relevant legislation and policy, alongside the social and political context of Northern Ireland.

Study 2. Current and Future Needs of Veterans in Northern Ireland This report focused on understanding the experience of veterans in Northern Ireland in accessing services and using these perspectives to outline the key needs of the cohort presently and as they are anticipated to develop in the longer term. This study was qualitative in nature, involving 13 veteran-led focus groups, as well as 20 interviews with representatives from voluntary and statutory agencies providing support to veterans in Northern Ireland. This work has been particularly impactful in terms of providing insight into needs of veterans living in NI based on their experiences, and the perceptions of those who come into direct contact with this group. The detailed information provided by participants continues to be used to contribute to the continuation of present and development of new health and social support for NI veterans and their families.

Study 3. Public Attitudes to the UK Armed Forces in Northern Ireland This report examined the attitudes of the public within Northern Ireland toward the UK Armed Forces using data from the Northern Ireland Life and Times Survey. The results have impact in terms of informing discussions on the legacy of the Troubles as well as how support is provided to the Armed Forces population given the political and legal complexities of the situation.

Study 4. Exploring the Need for a Veterans’ Centre in Northern Ireland This report builds on information in the previous reports (above) and examined the perceived need for a support centre for veterans living in Northern Ireland.

Study 5. A Feasibility Study on Accessing Data for Research Purposes on Veterans in Northern Ireland

A Feasibility Study on Accessing Data for Research Purposes on Veterans in Northern Ireland is the fifth in a series of reports from the NIVHWS. The initial aim of this piece of work was to estimate the size and the basic demographic profile of the veteran population in Northern Ireland (NI), including their approximate location in the region, using a self-identification survey and administrative data shared by organisations that work with NI veterans. However, during the NIVHWS, it became clear that accessing data on NI veterans was not a

straightforward process. This study was therefore re-designed to become a feasibility study on accessing data on NI veterans for research purposes, you can access this report here.

Study 6. The Northern Ireland Veterans Health and Wellbeing Survey

The psychological wellbeing survey of the Northern Ireland Veterans Health and Wellbeing Study (NIVHWS) is a unique and valuable resource that is the first of its kind in NI. This piece of work is the sixth and final report in a series of reports from the NIVHWS.

Specifically, the NIVHWS was a large scale cross-sectional self-report survey of the UK Armed Forces veterans living in Northern Ireland (N=1329), which aimed to explore several aspects of life pertaining to the NI veteran population (e.g., sociodemographic factors, military background, mental and physical health, resilience, and coping factors, post military adjustment, alcohol and substance use as well as several others). To date several papers have been published using the data generated by this project (detailed below), as well as full report summarised the key findings.

Current Publications generated from the NIVHWS:

Armour, C. (2021). Identifying and characterising adverse childhood experiences (ACE) in a Northern Irish military veteran population. European Journal of Psychotraumatology, 12(sup1), 1866397. https://doi.org/10.1080/20008198.2020.1866397

Armour, C., McGlinchey, E., & Ross, J. (2021). The health and wellbeing of armed forces veterans in Northern Ireland: The results of a cross-sectional psychological wellbeing survey. http://niveteranstudy.org/mental-health

Hansen, M., Armour, C., McGlinchey, E., Ross, J., Ravn, S. L., Andersen, T. E., ... & Fried, E. (2022). Investigating the DSM–5 and the ICD-11 PTSD symptoms using network analysis across two distinct samples. Psychological trauma: theory, research, practice, and policy. https://doi.org/10.1037/tra0001281

McGlinchey, E., Ross, J., Murphy, D., Shorter, G. W., & Armour, C. (2022). Disentangling the symptom‐level nuances in comorbid posttraumatic stress disorder and problematic alcohol use in northern Irish military veterans: a network analysis. Journal of Traumatic Stress, 35(1), 32-41. https://doi.org/10.1002/jts.22666

McLafferty, M., McGlinchey, E., Travers, A., & Armour, C. (2021). The mediating role of resilience on psychopathology following childhood adversities among UK armed forces veterans residing in Northern Ireland. European Journal of Psychotraumatology, 12(1), 1978176. https://doi.org/10.1080/20008198.2021.1978176

Ross, J., & Armour, C. (2022). A latent profile analysis of the dissociative subtype of PTSD in a sample of UK Armed Forces veterans residing in Northern Ireland. European Journal of Trauma & Dissociation, 6(3), 100267. https://doi.org/10.1016/j.ejtd.2022.100267

Spikol, E., Robinson, M., McGlinchey, E., Ross, J., & Armour, C. (2022). Exploring complex-PTSD comorbidity in trauma-exposed Northern Ireland veterans. European Journal of Psychotraumatology, 13(1), 2046953. https://doi.org/10.1080/20008198.2022.2046953

You can find out more about the NIVHWS and access all published reports here.

COVID-19 and mental health

Professor Armour’s research focusses on adverse and/or traumatic life events, including those that occur because of someone’s occupational role (e.g. Police, Military & Ambulance services), and how those impact on psychological well-being. She is particularly interested in the psychological disorders of Posttraumatic Stress Disorder, Depression, Anxiety and Dissociation.

“My focus is on biopsychosocial factors that exist pre-during- and post-trauma and how they predict someone’s risk of developing, or resilience against developing, mental ill health outcomes,” she explains.

As part of her research, Professor Armour examines the role of a number of things that might impact on the trauma exposure and mental health outcome relationship such as sleep, social support and emotion regulation.

She is now applying her research skills to examine the impact of the COVID-19 pandemic on the overall psychological wellbeing of the population and what people can do to ensure that this impact is minimised for themselves and their families?

The impact of quarantine

The project follows research from Kings College London relating to the psychological impact of quarantine.

“The research found that those quarantined reported heighted psychological distress including confusion, fear, anger, anxiety and difficulties with sleeping,” says Professor Armour. “One study reported that some longer lasting behavioural changes were seen such as vigilant hand washing and the avoidance of large crowds.”

She adds: “The research tells us that some of the key stressors during self-isolation / quarantine relate to fears about becoming infected, having inadequate supplies and inadequate information, a sense of loneliness through isolation, and feelings of boredom and frustration. Research has also found that longer durations of self-isolation / quarantine have a more adverse impact on psychological wellbeing.”

While the Kings College project reviewed a relatively small number of studies (26 in total), it provided the research community with a good evidence base for further research. Professor Armour says it is therefore now vital that the research community mobilise to collect robust and reliable data that will allow us to understand what the psychological impact of COVID-19 is but also how that impact may change over time.

Gathering vital data

To that end, researchers at STARC have designed a longitudinal psychological wellbeing survey that is administered online.

“This survey will ask people a wide variety of questions about their life experiences, physical health, living environments, exposures and worries related to COVID-19, sleeping habits, what social support networks they have, whether they are experiencing loneliness, how they are regulating their emotions, whether they can see meaning and purpose to their life, and whether they are experiencing any symptoms of depression, anxiety, or PTSD in response to the COVID19 situation,” says Professor Armour.

The first survey takes just 20 minutes to complete and then subsequent surveys will take approximately 10 minutes to complete.

The survey will allow researchers to examine the psychological wellbeing of subgroups, such as healthcare professionals and other key workers. 

Professor Armour says “Previous research tells us that when people experience adverse life events those with better health, fewer past trauma experiences, more social support, a feeling of connectedness (i.e., not feeling lonely), those who have a sense of purpose and meaning in their life and those who can regulate their own emotions tend to experience fewer adverse impacts on their psychological wellbeing.

“The survey will allow us to understand if this is indeed the case for COVID-19 and for all those currently self-isolating from within our Queen’s University community and from across the wider community of Northern Ireland. Ultimately, this will inform us in how to best offer pragmatic help, with a view to alleviating some of the pressure that services face during these unprecedented times.”