Hitting the wall: The impact of barriers to care and cumulative trauma exposure on PTSD among Northern Ireland Veterans
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Introduction: Seeking treatment for posttraumatic stress disorder (PTSD) distress can be complicated by a variety of internal and external factors that prevent an individual from seeking care and treatment while distress worsens. This is especially true for hidden populations with an extensive trauma history, such as UK Armed Forces Veterans residing in Northern Ireland. This study aimed to determine the contribution of barriers to care and cumulative trauma exposure to the severity of PTSD symptomatology, the extent of that contribution, and whether variance existed in the specific types of barriers. Methods: Data from 657 Veterans residing in Northern Ireland (90.6% male) taken from the Northern Ireland Veterans Health and Wellbeing Study were used in a series of regression models to explore the relationships among cumulative trauma exposure, barriers to care, specific barrier types, and PTSD symptomatology. Results: Overall barriers to care and cumulative trauma exposure predicted PTSD (β = 0.385), as did, to a lesser degree, logistical barriers (β = 0.348), trust barriers (β = 0.258), and stigmatic barriers (β = 0.298). Discussion: The accumulation of multiple trauma exposures and experiences is strongly associated with PTSD symptomatology, with barriers to care having a significant impact on distress. Overall barriers, specific subtypes of barriers, and trauma contributed to PTSD in this population of UK Armed Forces Veterans residing in Northern Ireland.
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While some stigmatic beliefs around help-seeking have declined in Northern Ireland, potentially due to awareness campaigns, stigma remains an enduring barrier to support.
“While some stigmatic beliefs around help-seeking have declined in NI (O’Neill & O’Connor, 2020), potentially due to awareness campaigns, stigma remains an enduring barrier to support (Betts & Thompson, 2017; Spikol et al., 2024a).”
From Experiences and Impacts of Intimate Partner Violence Against Men in Northern Ireland: Qualitative Findings from the Male Experiences of Intimate Partner Violence Study (2026) · cites this paper as Spikol et al., 2024a
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- Authors
- Spikol, E., Hitch, C., Robinson, M., McGlinchey, E., & Armour, C.
- Affiliations
- Queen's University Belfast (GB)
- Swansea University (GB)
- Stress Trauma and Related Conditions (STARC) Research Centre, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
- Venue
- Journal of Military, Veteran and Family Health
- Published
- 2024-06-01
- Volume
- 10
- Issue
- 3
- Pages
- 121-134
- ISSN
- 2368-7924 (ISSN-L)
- PMC
- PMC13293201
- OpenAlex
- W4391884401
- Cited by
- 4
- References
- 42
- Citations by year
- 2026: 2 · 2024: 2
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Military Veteran and Family Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (publishedVersion, other-oa)
- Funders
- British Psychological Society
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- post-traumatic stress disorder, barriers to care, cumulative trauma, PTSD symptom severity, trust barriers, logistics barriers, help-seeking, hidden populations
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