Amputation (losing a limb) while serving in the military is a real risk. A challenging recovery follows an amputation. There is usually a lot of early support. Amputations can also lead to later health problems as the person adapts to new restrictions. Artificial limbs (called prostheses) improve function but can lead to wounds, which may not easily heal. Some health problems can occur because of difficulty maintaining healthy physical activities. Some people start new unhealthy habits to cope with pain or stress. These problems should be preventable. Right now, the research on this topic is spread out in many small studies. Most research does not focus on military members, or even similar groups like firefighters and police. This makes it hard for Veterans, health care providers, disability managers, and policymakers to provide the right supports for longer-term health.
We will consult with Veterans to understand their concerns. Then we will bring together all the research on long-term health problems after traumatic amputations. We will focus on military members and Veterans but also compare research on firefighters and police officers. We will carefully study and judge the quality of the research. We will measure the rates of long-term health problems compared to civilians. We will check if these rates differ based on injury, personal, or work factors.
This information will help guide better long-term health plans for Veterans with amputations. It can lead to better follow-up care, health guidelines, and policies to support Veterans.
For many military personnel, involvement in adaptive sports competitions confers positive outcomes such as connectedness, posttraumatic growth, and mental and physical health that extend beyond the duration of the Games; however, research outside of the Invictus Games indicates that barriers at interpersonal, national, and event-specific levels contribute to heterogeneity in experiences and outcomes. Optimizing positive outcomes and competitor performance necessitates supporting the experiences of competitors and their families/caregivers by identifying both drivers and barriers to self-determination. In 2025, the Vancouver-Whistler Games will be the first to include winter adaptive sports. Prior research on seasonal variations in Olympics games participation noted differences in appeal, resource constraints, and infrastructural demands. As such, the novel seasonal setting is expected to add a layer of complexity to our current understanding of the benefits and challenges of Invictus Games participation. Using the Self Determination Theory [1] as a framework for examining the quality of participant experience before, during, and following Invictus Games, we will conduct a review to identify gaps in our understanding of the experience of Invictus Games participation. We will explore the drivers and barriers to the sense of autonomy (i.e., determinants of individual choice and participation), competence (i.e., physical or mental components of training and competition), and social relatedness (i.e., sense of community and belonging) among both competitors and their caregivers in a winter context. Finally, we will engage an international team of experts to contextualize knowledge gaps identified and interpret findings with the goal of developing actionable recommendations that inform policy and programming.
One of the most severe and disabling military injuries is arm amputation. Technological advances have led to complex multiarticulating prostheses that can replace elbow, wrist, and hand movements and provide multiple grasp patterns. However, most persons with upper limb loss do not fully utilize these capabilities. A significant contributing factor to the lack of use is inadequate training on the control and function of the device components. To address this gap, we developed a virtual reality system that allows customized, early, intense training for myoelectric prosthesis control. Virtual reality is rapidly advancing but must be adapted for state-of-the-art myoelectric prosthesis control training. We have solved the problem of using muscle signals to operate the joints of a virtual prosthesis for simulated functional tasks. The next development steps are to add multi-grasp hand patterns and to expand virtual scenes to include more complex tasks with occupational relevance. This project will achieve these development tasks and pilot the virtual system with persons with upper limb loss to gather preliminary data on usability and training effects. We will implement the developed platform within a commercial take-home package that removes the geographical and personnel barriers to accessing intense training. Furthermore, the developed platform will advance our future ability to study the effect of immersive training on multi-joint control, phantom limb pain, and embodiment of prostheses. Understanding these crucial aspects will significantly improve the acceptance and usage of prosthetic devices for veterans and Canadians with upper limb loss.
This research project aims to synthesize the available scholarly evidence on the health outcomes, complications, and patient selection criteria for lower and upper-limb osseointegrated bone-anchored prostheses (BAP) in the limb loss population. This project will also evaluate the compatibility of BAP with military service by comparing the evidence from the scientific literature with current Canadian Armed Forces (CAF) military requirements. This evaluation will be enriched by perspectives from three patients and their caregivers and expert perspectives from two former senior CAF physicians who have treated military members with limb amputations, and experts with firsthand experience in working with individuals who use BAP in Canada. The synthesis and expert review proposed will allow us to identify the main gaps in the literature and determine priority areas for future research that will benefit military members, veterans and their families but also the civilian limb loss population.
Outdoor sports and other types of physical activity are key components of mental and physical recovery. We will conduct a mixed method, biopsychosocial design to understand more specifically how the Invictus Games (IG) contributes to Veteran recovery. We will do this by gaining knowledge on the ways that competing in the IG, or not being accepted to compete in the IG, affects Veterans’ mental and physical health. We have brought together an international team of researchers with expertise and experience collecting data on mental health and physical health in both national samples and in previous large sporting venues (e.g., Vancouver 2010 Olympic and Paralympic Winter Games). This team will work together to develop 1) a virtual mental health survey of psychological and wellbeing measures (e.g., PTSD, anxiety, depression, emotion regulation), 2) conduct virtual interviews to better understand the experiences and benefits/challenges with participation in the IG, and 3) virtually collect biometric data (i.e., aerobic fitness, sleep quality, heart rate). This data will be collected from IG participants and from individuals who were unsuccessful in their application to participate in the IG. Data will be collected during training, during the IG competition, and after the IG. Data from this study will allow us to develop guidelines for the creation, development, delivery and maintenance of adaptive military sports programmes that ultimately support the post-traumatic growth and recovery of Veterans and their families.
Volunteering in the community may help Canadian military members transition to civilian life. We will read and summarize research studies that focus on volunteering for military Veterans. We will try to learn why Veterans volunteer, who does and doesn’t volunteer, what could create barriers to volunteering, and write recommendations for how organizations could support Veterans in volunteering in the future. This summary could help Canadian military, Veterans and their families if it could direct programs and services to enhance volunteering opportunities.
Canadian Armed Forces (CAF) Veteran amputees and their caregivers experience complex needs that differ from others, including requiring additional support for daily tasks, accessibility-related needs in housing and employment, and additional barriers such as applying for status in order to receive disability benefits. In order to ensure their needs are met with appropriate services by the organizations that intend to serve them, a deeper understanding of the landscape of services and resources available and their use by Veteran amputees and caregivers is necessary. This research project seeks to use qualitative (e.g., interviews) and quantitative (e.g., surveys) approaches to explore how Veteran amputees and their caregivers access and use resources and services to support different areas of their lives, including housing, finances, employment, sociocultural, mental, and physical health needs. We will use a collaborative approach in this research by creating an advisory committee composed of Veteran amputees, their caregivers, and leaders and service providers from stakeholder organizations. The advisory committee will aid in the co-design of research tools, engagement of Veterans and their caregivers, the interpretation of research findings, and the dissemination and translation of findings. This approach will maximize the impact of research in championing real change in the types of services that are developed, offered, and implemented across Canada and ensure they are serving the unmet needs of Veteran amputees and their caregivers.
There is a historic lack of research on women in the defence sector as a result of systemic legacy biases rooted in the historic assumption of the male military and Veteran norm. This proposed research will synthesize as well as update and strategically expand existing scoping and literature reviews of research related to Canadian servicewomen and women Veterans. Based on this work, we will identify and prioritize key research gaps and develop a proposal for future research on servicewomen and women Veterans in the Canadian context. We will validate our proposed research agenda in consultation with knowledge holders (women Veterans and their organizations), relevant contacts at the Department of National Defence/Canadian Armed Forces (DND/CAF), Veterans Affairs Canada (VAC), and the Royal Canadian Mounted Police (RCMP), and other researchers in the field. This project will help advance Canadian research on the needs, health, and well-being of military and Veteran women.
Every year, thousands of CAF members released from their services and re-joined the civilian world. However, a good portion of the Veterans suffered from various forms of injury during their training and/or service in the military. Creative arts therapies have been proven in assisting physical and mental rehabilitation. In this environmental scan, our research team will explore what are the existing creative arts therapeutic approaches in Canada. In the second half of this study, we will interview a small group of stakeholders to understand how we can meaningfully adopt create arts therapies to support CAF members and Veterans’ health and well-being. The ultimate goal of this environmental scan is to develop a set of recommendations that can support CAF members and Veterans’ physical and mental rehabilitation as well as to co-create a support network to connect CAF members and Veterans with a wider group of community members that embrace creative arts and personal well-being.
This research project aims to address a gap with a standardized review of several sources to understand the current state of (military) Veterans' mental health data in Canada and how it is currently shared across the country. The research team will review both formal academic research sources (published journal articles) as well as non-academic sources (e.g. government reports, policy papers). The information obtained from these sources will be summarized in four key areas: 1) what are the existing Canadian databases that include information about Veterans' mental health, 2) how do these data sources share information with other organizations, 3) what are the existing provincial/federal policies related to sharing health data, and 4) what are the key challenges that impact national-level data sharing within Canada. This summary would then be shared with key partners who may have the ability to promote change and improve data sharing practices in Canada.
Rudnick, A., Nolan, D., and Daigle, P. (2024). Reflecting on JMVFH’s most popular article of 2022: “Sharing of military Veterans’ mental health data across Canada: A scoping review”. Journal of Military, Veteran and Family Health, 10(4‑EN). https://doi.org/10.3138/jmvfh-0718-0018
Rudnick, A., Nolan, D., and Daigle, P. (2024). Réflexion sur l’article le plus populaire du JMVFH en 2022:«Le partage des données sur la santé mentale des vétéran (e) s militaires dans tout le Canada: une étude de portée». Journal of Military, Veteran and Family Health, 10(4-FR), 123-125. https://utppublishing.com/doi/full/10.3138/jmvfh-0718-0039
Rudnick, A., Nolan, D., and Daigle, P. (2022). Sharing of military Veterans’ mental health data across Canada: A scoping review. Journal of Military, Veteran and Family Health, 8(2), 7–17. https://doi.org/10.3138/jmvfh-2021-0064
Sexual trauma during military service refers to any type of sexual assault or harassment experienced while enlisted in military service. It is a compounding risk factor for the development of posttraumatic stress disorder (PTSD) and depression in service members. Moreover, recent evidence suggests that military members having experienced potential moral injury (MI), which may include incidents of sexual trauma during service, are more likely to develop PTSD than their non-exposed counterparts. In order to develop effective prevention and intervention strategies for sexual trauma during military service and moral injury among Canadian, female-identifying military members and veterans, it is necessary to first characterize this population. Therefore, our primary objectives are: 1) to analyze the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS) to determine whether sexual trauma during military service is an independent risk factor for MI; and 2) to conduct individual interviews with Canadian servicewomen and female-identifying veterans exposed to sexual trauma during military service to capture their unique experiences.
Lade, S., Brown, A., Ritchie, K., Milman, H., Park, R., Heber, A., ... and McKinnon, M. (2025). The Impact of Military Sexual Misconduct on the Deployment Experiences of Woman-Identifying Canadian Veterans. Armed Forces & Society. https://journals.sagepub.com/doi/full/10.1177/0095327X241312206
Brown, A., Millman, H., Tam-Seto, L., Imre-Millei, B., Ibbotson, A., Buchart, L., ... and McKinnon, M. C. (2024). Increasing understanding of the barriers to military sexual trauma-related reporting and treatment seeking in Canada. Journal of Military, Veteran and Family Health, 10(1), 101-106. https://utppublishing.com/doi/pdf/10.3138/jmvfh-2023-0021
The proposed study will utilize clinical outcome and assessment data by leveraging machine learning computational methods and technology among Canadian Armed Forces (CAF) members and veterans, with a particular focus on subtyping of posttraumatic stress disorder (PTSD) and treatment response (e.g., recovery; suicidal behaviour). Critically, approximately 13% of CAF members and veterans will be diagnosed with a deployment-related mental disorder including PTSD and depression [1; Department of Defence]. Our group has already demonstrated the predictive validity of machine learning, where we were successful in classifying with over 90% accuracy: i) PTSD; ii) the dissociative subtype of PTSD; and iii) healthy individuals [2; Nicholson et al., 2018]. Here, we anticipate developing a machine learning tool that will enhance personalized medicine by identifying individualized prevention and treatment approaches, thus preventing illness, improving outcomes, and reducing suicidality among CAF members and veterans.
Park, A. H., Patel, H., Mirabelli, J., Eder, S. J., Steyrl, D., Lueger-Schuster, B., ... and Nicholson, A. A. (2023). Machine learning models predict PTSD severity and functional impairment: A personalized medicine approach for uncovering complex associations among heterogeneous symptom profiles. Psychological Trauma: Theory, Research, Practice, and Policy. https://psycnet.apa.org/fulltext/2024-28593-001.html
PTSD is a common and disabling condition among Canadian military and veterans, and associated with intimate relationship problems and partners’ own mental health problems. Recognizing the need to improve access to evidence-based treatments for military personnel/Veterans and their families, our team is developing a Guided, Internet-delivered intervention to improve PTSD, enhance relationships, and improve partners’ mental health: Couple HOPES. The proposed two-phase project involves providing the intervention to 10 couples in Phase 1 to pilot and refine the assessment processes, intervention, and Coaching manual. Phase 2 involves a RCT with 70 couples across Canada testing Couple HOPES against a delayed intervention group (all couples will be treated within 2 months) to assess safety, desirability, and efficacy. Gold-standard methodology will be used to improve access to psychological interventions for military/Veterans and their families. Barriers to our study to mitigate include: adequate recruitment, retention in the intervention, and minimizing dropout from assessment.
Xiang, A., Monson, C. M., Fitzpatrick, S., Wagner, A. C., Valela, R., Collins, A. M., ... and Crenshaw, A. O. (2024). Partner accommodation associations in intimate couples with posttraumatic stress disorder. Couple and Family Psychology: Research and Practice.
https://psycnet.apa.org/record/2023-81997-001?doi=1
Fitzpatrick, S., Crenshaw, A. O., Donkin, V., Collins, A., Xiang, A., Earle, E. A., ... and Monson, C. (2024). We Have Spent Time, Money, and Effort Making Self-Help Digital Mental Health Interventions: Is Anyone Going to Come to the Party?. Journal of Medical Internet Research, 26, e58198. https://www.jmir.org/2024/1/e58198/
Crenshaw, A. O., Whitfield, K. M., Collins, A., Valela, R., Varma, S., Landy, M. S., ... and Monson, C. M. (2023). Partner outcomes from an uncontrolled trial of Couple HOPES: A guided online couple intervention for posttraumatic stress disorder and relationship enhancement. Journal of traumatic stress, 36(1), 230-238.
https://onlinelibrary.wiley.com/doi/abs/10.1002/jts.22878
Monson, C. M., Wagner, A. C., Crenshaw, A. O., Whitfield, K. M., Newnham, C. M., Valela, R., ... and Fitzpatrick, S. (2022). An uncontrolled trial of couple HOPES: A guided online couple intervention for PTSD and relationship enhancement. Journal of Family Psychology, 36(6), 1036.
https://psycnet.apa.org/record/2022-41008-001
Fitzpatrick, S., Wagner, A. C., Crenshaw, A. O., Varma, S., Whitfield, K. M., Valela, R., ... and Monson, C. M. (2021). Initial outcomes of couple HOPES: A guided online couple intervention for PTSD and relationship enhancement. Internet Interventions, 25, 100423.
https://www.sciencedirect.com/science/article/pii/S2214782921000634
There is a high co-occurrence of posttraumatic stress disorder (PTSD) and chronic pain in military personnel. Unfortunately, the mechanisms behind this relationship are poorly understood, leading to poor treatment outcomes for patients. Beyond occurring together, research suggests that PTSD and chronic pain might interact and aggravate each other through a common vulnerability: one’s susceptibility to fear and avoidance responses. To illuminate this interaction, this project will examine the relationship between pain and traumatic stress symptoms (especially fear and avoidance) in the Canadian military. We will also investigate the role that fear responses play in triggering and facilitating pain by examining “pain flashbacks,” a phenomenon in which individuals report re-experiencing the physical pain they experienced during trauma. If particular symptoms of PTSD prove to be contributing factors to chronic pain, it may be possible to prevent the development or exacerbation of chronic pain through interventions targeting both pain and PTSD.
Maunder, L., Marriott, E., and Salomons, T.V. (2025). Associations of chronic pain and PTSD factors among military personnel: An exploration of the mutual maintenance model. Journal of Military, Veteran and Family Health, 11(1), 75-89. https://utppublishing.com/doi/full/10.3138/jmvfh-2024-0010
Maunder L., Marriott E., Katz J., and Salomons T.V. (2022). Mechanisms of increased pain-related disability in Canadian Armed Forces servicemembers and Veterans with comorbid chronic pain and PTSD. Journal of Military, Veteran and Family Health, 8(3), 32-44. https://utppublishing.com/doi/10.3138/jmvfh-2022-0011
The aim of this study is to examine the first-person lived experience of patients with PTSD in combination with imaging data to allow us to better capture different clinical presentations of PTSD and their unique neural signatures in the brain. By allowing us to identify the many different ways PTSD affects brain functioning, this research will help clinicians to better decide which treatment approach they will use to assist individual patients with PTSD, thus improving clinical care and patient outcomes. This is very important given the devastating impact of PTSD on patients, their families and the economy (e.g., absence from work, lost productivity). Such an approach has the potential to revolutionize PTSD treatment and could therefore affect thousands of individuals.
Programs for military families are targeted towards the needs of young families with young children, emphasizing needs for spouses and children; programs for veteran families are geared towards the ageing veteran. However, for many young serving members who do not have a significant other, ageing parents may need to step into a caregiving role should the member be injured in the line of duty. These parents, who may have their own health, work, and financial concerns, can find themselves unexpectedly navigating a complicated caregiving situation without the benefit of support available through programming, compounding their stress and experience of isolation. We will interview 20 to 30 parents of ill and injured veterans who are providing ongoing caregiving to their adult children. These in-depth interviews will yield new insights into the experiences and needs of ageing parents that can inform the development of relevant and inclusive policy and programming.
Tam-Seto, L., Norris, D., Richardson, M., Gribble, R., Fear, N. T., and Cramm, H. (2024). ‘There’s no club, absolutely nothing’: Experiences of parents of Veterans living with illnesses and injuries in Canada. Journal of Military, Veteran and Family Health, 10(2), 130-139. https://utppublishing.com/doi/full/10.3138/jmvfh-2023-0061
The well-being of the Canadian Armed Forces (CAF) after they leave the military is a national priority. Yet, we do not know very much about the health of Canadian Veterans or how they access the public healthcare system. We want to know if Canadian Veterans use the healthcare system in ways that are similar or different to civilians, and if they have similar patterns of different diseases. We also want to compare health and healthcare use of male and female Veterans, and explore if the length of military service has an impact on health and health use. To answer these questions, we will analyze information that is being routinely collected within the Ontario healthcare system. We will work closely with government, healthcare, and service provider stakeholders to ensure that our findings feed directly into policy for improving health and well-being of Canadian veterans and their families.
St Cyr, K., Saunders, J., Cramm, H., Aiken, A., Kurdyak, P., Sutradhar, R., Mahar, A. (2025). Primary Care Visit Rates Among Canadian Veterans in Ontario: A Retrospective Cohort Study of Sex-and Length of Service-stratified Comparisons With Nonveterans. Military Medicine, usaf072. https://academic.oup.com/milmed/advance-article/doi/10.1093/milmed/usaf072/8071731#508007288
Cyr, K. S., and Mahar, A. L. (2024). Sex-Based Differences in Mental Health Service Use Between Canadian Veterans and Non-Veterans Residing in Ontario. Healthcare Quarterly (Toronto, Ont.), 27(1), 6-9. https://europepmc.org/article/med/38881477
St. Cyr, K., Smith, P., Kurdyak, P., Cramm, H., Aiken, A. B., Mahar, A. (2024). A Retrospective Cohort Analysis of Mental Health-Related Emergency Department Visits Among Veterans and Non-Veterans Residing in Ontario, Canada: Une analyse de cohorte rétrospective des visites au service d’urgence liées à la santé mentale parmi les vétérans et non-vétérans résidant en Ontario, Canada. The Canadian Journal of Psychiatry, 69(5), 347-357. https://journals.sagepub.com/doi/full/10.1177/07067437231223328
St Cyr, K., Aiken, A. B., Cramm, H., Whitehead, M., Kurdyak, P., and Mahar, A. L. (2023). Sex-specific differences in physical health and health services use among Canadian Veterans: a retrospective cohort study using healthcare administrative data. BMJ Mil Health, 169(5), 430-435.
Retrieving data.
https://militaryhealth.bmj.com/content/169/5/430
Saunders, J., St. Cyr, K., Cramm, H., Aiken, A. B., Kurdyak, P., Sutradhar, R., and Mahar, A. L. (2023). Investigating the association between Veteran status and rate of emergency department visits. Journal of Military, Veteran and Family Health, 9(4), 63-76.
https://jmvfh.utpjournals.press/doi/full/10.3138/jmvfh-2023-0007
Cyr, K. S., Kurdyak, P., Smith, P. M., and Mahar, A. L. (2023). Mental health service use among Canadian veterans within the first 5 years following service: methodological considerations for comparisons with the general population. Occupational and environmental medicine, 80(8), 462-468. https://oem.bmj.com/content/80/8/462
Mahar, A. L., Cyr, K. S., Enns, J. E., Aiken, A. B., Whitehead, M., Cramm, H., and Kurdyak, P. (2022). Canadian Veteran chronic disease prevalence and health services use in the five years following release: a matched retrospective cohort study using routinely collected data. BMC Public Health, 22(1), 1678. https://link.springer.com/article/10.1186/s12889-022-14053-4
Mahar, A. L., Aiken, A. B., Cramm, H., Cyr, K. S., Shellenberger, J., and Kurdyak, P. (2022). Cancer incidence among Canadian Veterans: A matched cohort study. Cancer Epidemiology, 79, 102199.
https://www.sciencedirect.com/science/article/abs/pii/S1877782122001047
Mahar, A. L., Cyr, K. S., Enns, J. E., Aiken, A. B., Whitehead, M., Cramm, H., and Kurdyak, P. (2022). Canadian Veteran chronic disease prevalence and health services use in the five years following release: a matched retrospective cohort study using routinely collected data. BMC Public Health, 22(1), 1678. https://link.springer.com/article/10.1186/s12889-022-14053-4#Ack1
Mahar, A. L., Aiken, A. B., Whitehead, M., Tien, H., Cramm, H., Fear, N. T., and Kurdyak, P. (2019). Suicide in Canadian veterans living in Ontario: a retrospective cohort study linking routinely collected data. BMJ open, 9(6), e027343. https://bmjopen.bmj.com/content/9/6/e027343.abstract
In May 2018, DGMPRA launched the DWWS Initiative, a comprehensive, proactive, and systematic approach to addressing the workplace well-being of CAF members and DND employees. This novel initiative will support the Total Health and Wellness Strategy and the Federal Public Service Workplace Mental Health Strategy, and help the CAF/DND maintain its prominent role in this domain within the Federal Public Service. CAF members – and, potentially, their families via spillover effects – will benefit from the proposed research project in that it will ascertain their well-being and pinpoint organizations and groups of individuals in need of attention, including those with high levels of burnout and psychological distress. These results will inform the design and implementation of positive actions where needed, and a future iteration of the DWWS will assess the impact of these actions.
Blais, A. R., Gillet, N., Houle, S. A., Comeau, C. A., and Morin, A. J. (2020). Work fatigue profiles: Nature, implications, and associations with psychological empowerment. Frontiers in Psychology, 11, 596206.
https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2020.596206/full
Military members can experience trauma as a result of combat duties, being in a war zone, or peacekeeping under difficult conditions. It is estimated that up to 10% of those who have been in war zones will experience PTSD. Regarding Moral Injury (MI), of members deployed from 2001-2013, 58% were exposed to events that heightened their risk of engaging in or witnessing (in)actions that violated their deeply held values/beliefs. Feelings of shame, guilt, anxiety, depression and anger, together with loss of relationships, self-worth, and quality of life can manifest, as well as self-harming behaviour and suicide. The recent passage of Bill C-211 - Federal Framework on Post-Traumatic Stress Disorder Act - highlights Canada’s commitment to addressing PTSD among those who serve. This project aims to study the effectiveness of Project Trauma Support - an innovative, physician-led, community-based, 6-day, residential program focused on the treatment of PTSD/MI.
Canadian Armed Forces (CAF) members are exposed to stressors while in garrison, or on deployment that can result in Operational Stress Injuries (OSIs) (e.g., Posttraumatic Stress Disorder (PTSD), depression, and anxiety). Exposure to morally injurious events (MIEs) (i.e.., engaging in or witnessing (in)actions that violate deeply held beliefs/values) that results in development of Moral Injury (MI) has been found to: increase feelings of shame, guilt, and anger; compromise relationships, trust, and hope; perpetuate PTSD, depression, anxiety, and substance abuse; and strongly predict suicide in military personnel and veterans. Of CAF members deployed from 2001-2013, over 50% were exposed to potentially MIEs. Recent studies have examined Moral Injury (MI) and applicable interventions. Developing and testing interventions that address MI is apt and timely. This project aims to study the effectiveness of Adaptive Disclosure Therapy (ADT) as a treatment for MI.
Smith-MacDonald, L., VanderLaan, A., Kaneva, Z., Voth, M., Pike, A., Jones, C., and Bremault-Phillips, S. (2022). “Putting Down and Letting Go”: An Exploration of a Community-Based Trauma-Oriented Retreat Program for Military Personnel, Veterans, and RCMP. Trauma Care, 2(2), 95-113. https://www.mdpi.com/2673-866X/2/2/9
Smith-MacDonald, L., Pike, A., Jones, C., and Bremault-Phillips, S. (2022). Exploration of trauma-oriented retreats: Quantitative changes in mental health measures for Canadian military members, veterans and Royal Canadian mounted police with posttraumatic stress disorder and moral injury. Trauma Care, 2(2), 114-130. https://www.mdpi.com/2673-866X/2/2/10
Nicholson, A. A., Densmore, M., McKinnon, M. C., Neufeld, R. W., Frewen, P. A., Théberge, J., ... and Lanius, R. A. (2019). Machine learning multivariate pattern analysis predicts classification of posttraumatic stress disorder and its dissociative subtype: a multimodal neuroimaging approach. Psychological medicine, 49(12), 2049-2059. https://bit.ly/3KaJZYi
Although stress is a recurring and omnipresent problem, there are major gaps in knowledge about the hallmark condition related to traumatic stress (i.e. posttraumatic stress disorder [PTSD}). Over 70% of Canadians are exposed to traumatic events (e.g. physical injury, accidental death of loved one) in their lives. Although most are resilient, a substantial minority experience subsequent emotional problems. Major gaps exist in the literature on the incidence, longitudinal course, impact, and treatment needs of PTSD in Canadians. In particular, we know very little about the long-term impact of trauma exposure and PTSD among our Canadian soldiers. It is essential to understand the trajectory of PTSD within Canada’s unique demographic, sociocultural, and health care system influences.
The objectives of this research project are to:
1. Define the incidence and longitudinal course of PTSD in Canadian samples.
2. Develop prediction tools to identify those at risk for incident and persistent PTSD.
3. Define the impact of PTSD on subsequent risk for negative health outcomes
4. Describe health care use and treatment needs among people with PTSD.
In the short term, this program of research will determine predictors of PTSD, the impact of PTSD on health outcomes, and treatment needs of civilians, active soldiers, and veterans with PTSD in Canada. In the long term, understanding these important questions will improve recognition and treatment of PTSD across health sectors, and will ultimately improve the lives of people with PTSD.
Asmundson, A. J., Paluszek, M. M., Sommer, J. L., Bolton, S. L., Sareen, J., Afifi, T. O., ... and Asmundson, G. J. (2025). Longitudinal course of posttraumatic stress disorder and chronic pain conditions: A population-based study of Canadian military personnel over 16 years. Journal of Anxiety Disorders, 113, 103025. https://www.sciencedirect.com/science/article/pii/S0887618525000611#sec0070
Afifi, T. O., Taillieu, T., Salmon, S., Stewart-Tufescu, A., Sareen, J., Enns, M. W., ... and VanTil, L. (2024). Child maltreatment history, deployment-related traumatic events, and past 12-month cannabis use among veterans in Canada. The Canadian Journal of Psychiatry, 69(2), 116-125.
https://journals.sagepub.com/doi/full/10.1177/07067437231192740
Mota, N., Sommer, J. L., Bolton, S. L., Enns, M. W., El-Gabalawy, R., Sareen, J., ... and Afifi, T. O. (2023). Prevalence and correlates of military sexual trauma in service members and veterans: Results from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey. The Canadian Journal of Psychiatry, 68(9), 682-690.
https://journals.sagepub.com/doi/full/10.1177/07067437221125292
Sommer, J. L., Mota, N., Thompson, J. M., Asmundson, G. J., Sareen, J., Bernstein, C. N., ... and El-Gabalawy, R. (2022). Associations between courses of posttraumatic stress disorder and physical health conditions among Canadian military personnel. Journal of Anxiety Disorders, 87, 102543.
https://www.sciencedirect.com/science/article/abs/pii/S0887618522000160
Pankratz, L., Sommer, J. L., Bolton, S. L., Sareen, J., Enns, M. W., Afifi, T. O., ... and Mota, N. (2022). Prevalence and predictors of anxiety disorder courses in the Canadian Armed forces. Journal of Anxiety Disorders, 92, 102612. https://www.sciencedirect.com/science/article/pii/S0887618522000858
Gill, G. K., Sommer, J. L., Mota, N., Sareen, J., and El-Gabalawy, R. (2022). Illness-induced post-traumatic stress disorder among Canadian Armed Forces Members and Veterans. Journal of Anxiety Disorders, 86, 102472.
https://www.sciencedirect.com/science/article/pii/S0887618521001195
Mota, N., Sommer, J. L., Bolton, S. L., Enns, M. W., El-Gabalawy, R., Sareen, J., ... and Afifi, T. O. (2023). Prevalence and correlates of military sexual trauma in service members and veterans: Results from the 2018 Canadian armed forces members and veterans mental health follow-up survey. The Canadian Journal of Psychiatry, 68(9), 682-690. https://journals.sagepub.com/doi/full/10.1177/07067437221125292
Perera, E., Thompson, J. M., Asmundson, G. J., El-Gabalawy, R., Afifi, T. O., Sareen, J., and Bolton, S. L. (2021). Chronic pain: The Canadian Armed Forces members and Veterans mental health follow-up survey. Journal of Military, Veteran and Family Health, 7(S2), 29-42.
https://jmvfh.utpjournals.press/doi/full/10.3138/jmvfh-2021-0051
Bolton, S. L., Afifi, T. O., Mota, N. P., Enns, M. W., de Graaf, R., Marrie, R. A., ... and Sareen, J. (2021). Patterns of attrition in the Canadian armed forces members and veterans mental health follow-up survey (CAFVMHS). The Canadian Journal of Psychiatry, 66(11), 996-998.
https://journals.sagepub.com/doi/full/10.1177/07067437211002697
Sareen, J., Bolton, S. L., Mota, N., Afifi, T. O., Enns, M. W., Taillieu, T., ... and Logsetty, S. (2021). Lifetime prevalence and comorbidity of mental disorders in the two-wave 2002–2018 canadian Armed Forces Members and Veterans Mental Health follow-up survey (CAFVMHS): Prévalence et Comorbidité de Durée de vie Des troubles Mentaux Dans l’Enquête de Suivi Sur la Santé Mentale Auprès des Membres des Forces Armées Canadiennes et Des ex-Militaires (ESSMFACM) en deux cycles de 2002 à 2018. The Canadian Journal of Psychiatry, 66(11), 951-960. https://journals.sagepub.com/doi/full/10.1177/07067437211000636
Mota, N., Bolton, S. L., Enns, M. W., Afifi, T. O., El-Gabalawy, R., Sommer, J. L., ... and Sareen, J. (2021). Course and Predictors of Posttraumatic Stress Disorder in the Canadian Armed Forces: A Nationally Representative, 16-Year Follow-up Study: Cours et prédicteurs du trouble de stress post-traumatique dans les Forces armées canadiennes: une étude de suivi de 16 ans nationalement représentative. The Canadian Journal of Psychiatry, 66(11), 982-995. https://journals.sagepub.com/doi/full/10.1177/0706743721989167
Afifi, T. O., Sareen, J., Taillieu, T., Stewart-Tufescu, A., Mota, N., Bolton, S. L., ... and Jetly, R. (2021). Association of child maltreatment and deployment-related traumatic experiences with mental disorders in active duty service members and veterans of the Canadian Armed Forces: Association de la Maltraitance des Enfants et des Expériences Traumatisantes Liées au Déploiement Avec les Troubles Mentaux Chez les Membres du Service Actif et Les Anciens Combattants des Forces Armées Canadiennes. The Canadian Journal of Psychiatry, 66(11), 961-970. https://journals.sagepub.com/doi/full/10.1177/0706743720987086
Enns, M. W., Mota, N., Afifi, T. O., Bolton, S. L., Richardson, J. D., Patten, S. B., and Sareen, J. (2021). Course and Predictors of Major Depressive Disorder in the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey: Cours et Prédicteurs du Trouble de Dépression Majeure Dans l’Enquête de Suivi Sur la Santé Mentale Auprès Des Membres des Forces Armées Canadiennes et des ex-Militaires. The Canadian Journal of Psychiatry, 66(11), 971-981. https://journals.sagepub.com/doi/full/10.1177/0706743720984677
Afifi, T. O., Bolton, S. L., Mota, N., Marrie, R. A., Stein, M. B., Enns, M. W., ... and Sareen, J. (2021). Rationale and methodology of the 2018 Canadian armed forces members and veterans mental health follow-up survey (CAFVMHS): a 16-year follow-up survey: raison d’être et méthodologie de l’enquête de suivi sur la santé mentale des membres des forces armées Canadiennes et des anciens combattants, 2018 (ESSMFACM). The Canadian Journal of Psychiatry, 66(11), 942-950. https://journals.sagepub.com/doi/full/10.1177/0706743720974837
Martin, P., Rakha, M. S., and Whitnall, J. (2021). Data safe haven for military, Veteran, and family health research. Journal of Military, Veteran and Family Health, 7(1), 102-107.
https://jmvfh.utpjournals.press/doi/full/10.3138/jmvfh-2020-0035
Ce project de recherche se fera en deux phases. La première phase consistera à produire une revue de l'état actuel des programmes et des services existant en santé mental au Québec destinés aux familles militaires et aux vétérans.
Quatre catégories de programmes et de services seront présentées par région du Québec:
La seconde phase consistera à développer et à administrer un questionnaire qui sera destiné aux familles militaires et aux vétérans afin de cerner leurs besoins/leurs évaluations/leurs utilisations en matière de programmes et de services en santé mentale. Les deux phases de ce project de recherche se feront avec l'aide de partenaires comme les Centres de la famille du Québec et les organisations de vétérans. Un rapport complet sera produit afin d'exposer les résultats des deux phases du project de recherche et afin de soumettre des recommandations.
The overall objective of this study is to increase accessibility of physical rehabilitation to military or Veterans who have suffered a moderate or severe traumatic brain injury.
The primary objective of this study will be to determine the feasibility and effectiveness of remotely supervised intensive home-based exercise interventions. The secondary objectives will be to: 1) identify the differences between daily and weekly remotely supervised home-based intensive exercise intervention on program implementation measures as well as rehabilitation outcomes (i.e. balance, functional mobility and physical activity levels) for moderate and severe TBI survivors; and 2) identify key strategies for the use of remote supervision and home-based exercise intervention.
This study could have national impact on accessibility of supervised exercise interventions since it looks at integrating participants from rural communities and minority communities including francophones.
O’Neil, J. (2021). Home-based telerehabilitation exercise programs for people living with moderate or severe traumatic brain injury. [Doctoral Dissertation]. University of Ottawa.
O’Neil, J., Egan, M., Marshall, S., Bilodeau, M., Pelletier, L., and Sveistrup, H. (2022). Remotely supervised exercise programs to improve balance, mobility, and activity among people with moderate to severe traumatic brain Injury: Description and feasibility. Physiotherapy Canada. Published online. https://www.utpjournals.press/doi/abs/10.3138/ptc-2021-0039.
O'Neil, J., Egan, M., Marshall, S., Bilodeau, M., Pelletier, L., and Sveistrup, H. (2019). Remotely supervised home-based intensive exercise intervention to improve balance, functional mobility, and physical activity in survivors of moderate or severe traumatic brain injury: protocol for a mixed methods study. JMIR research protocols, 8(10), e14867.
O’Neil, J., Egan, M., Marshall, S., Bilodeau, M., Pelletier, L., and Sveistrup, H. (2023). The impact of two telerehabilitation supervision schedules on physical activity, mobility, and balance among people with moderate to severe traumatic brain injury: A mixed-method single-subject design. Physiotherapy Canada. 75(2), 118-131. https://www.utpjournals.press/doi/abs/10.3138/ptc-2021-0040.
O’Neil, J., Pelletier, L., Bilodeau, M., Egan, M., Marshall, S., and Sveistrup, H. (2023). A physiotherapist’s perception of their own behavior compared to the perception of their behavior by persons with TBI within the context of telerehabilitation: A self-determination theory perspective. Physiotherapy Theory and Practice, 39(8), 1650-1661.https://www.tandfonline.com/doi/abs/10.1080/09593985.2022.2046219.
Military service challenges the stability and functioning of military family members, including children. For some children, however, the stresses associated with mobility, separation and risk build capacity, fostering a sense of belonging, enhanced self-confidence, increased family and community cohesion, and comfort with the unfamiliar. It is not known if these capacities are sustained through adulthood. We will interview 20-30 adult children of Canadian Armed Forces veterans who served from the Korean War through to the Cold War. This is an understudied group whose childhood experiences occured before formal supports were available to military families. Capturing their stories will address two gaps in Canadian military family research, specifically, the inclusion of retrospective accounts from adult children of their experiences growing up in military families and a focus on positive outcomes of military service for family members. This research will provide new insights that will inform policy and program development.
Norris, D., Cox, M., Cramm, H., and Mahar, A. L. (2024). Adult children in Canadian military families (1950–91): Balancing demands with capabilities. Journal of Military, Veteran and Family Health, 10(2), 140-149. https://utppublishing.com/doi/full/10.3138/jmvfh-2023-0060
Preliminary research into 1940s post-war Canadian veterans’ policy indicates that efforts to foster sense of purpose, self-reliance, and to create opportunities for meaningful employment, affordable homes, and sense of community contributed to successful post-war transitions, thereby reducing the ill effects of combat service for injured and non-injured Canadian veterans alike. The original Veterans Charter emphasised re-establishment over compensation so as to better reintegrate Veterans in to civil. University education, vocational training and assistance with business creation and farming stood among priority services. This focus appears to have been successful but to date there has been no scholarly research to measure their performance. This project aims to do that by employing historical case studies on the returned men of 1945 to better understand how some become active and contributing members of their community and others required long-term treatment and compensation. These findings will inform today's Canadian veterans' public policy discussions.
Schoepp, K. R., Dawson, M. R., Schofield, J. S., Carey, J. P., and Hebert, J. S. (2018). Design and integration of an inexpensive wearable mechanotactile feedback system for myoelectric prostheses. IEEE Journal of Translational Engineering in Health and Medicine, 6, 1-11.
https://ieeexplore.ieee.org/abstract/document/8443368