{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:57:26Z","timestamp":1791341846741,"version":"4.3.1"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T00:00:00Z","timestamp":1661126400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100012345","name":"Forces in Mind Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012345","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291722002410_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Post-traumatic growth (PTG) is a positive psychological consequence of trauma. The aims of this study were to investigate whether combat injury was associated with deployment-related PTG in a cohort of UK military personnel who were deployed to Afghanistan, and whether post-traumatic stress disorder (PTSD), depression and pain mediate this relationship.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291722002410_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>521 physically injured (<jats:italic>n<\/jats:italic> = 138 amputation; <jats:italic>n<\/jats:italic> = 383 non-amputation injury) and 514 frequency-matched uninjured personnel completed questionnaires including the deployment-related Post-Traumatic Growth Inventory (DPTGI). DPTGI scores were categorised into tertiles of: no\/low (score 0\u201320), moderate (score 21\u201334) or a large (35\u201363) degree of deployment-related PTG. Analysis was completed using generalised structural equation modelling.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291722002410_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>A large degree of PTG was reported by 28.0% (<jats:italic>n<\/jats:italic> = 140) of the uninjured group, 36.9% (<jats:italic>n<\/jats:italic> = 196) of the overall injured group, 45.4% (<jats:italic>n<\/jats:italic> = 62) of amputee and 34.1% (<jats:italic>n<\/jats:italic> = 134) of the non-amputee injured subgroups. Combat injury had a direct effect on reporting a large degree of PTG [Relative risk ratio (RRR) 1.59 (95% confidence interval (CI) 1.17\u20132.17)] compared to sustaining no injury. Amputation injuries also had a significant direct effect [RRR 2.18 (95% CI 1.24\u20133.75)], but non-amputation injuries did not [RRR 1.35 (95% CI 0.92\u20131.93)]. PTSD, depression and pain partially mediate this relationship, though mediation differed depending on the injury subtype. PTSD had a curvilinear relationship with PTG, whilst depression had a negative association and pain had a positive association.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291722002410_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Combat injury, in particular injury resulting in traumatic amputation, is associated with reporting a large degree of PTG.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291722002410","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T09:51:39Z","timestamp":1661161899000},"page":"5322-5331","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":20,"title":["Post-traumatic growth amongst UK armed forces personnel who were deployed to Afghanistan and the role of combat injury, mental health and pain: the ADVANCE cohort study"],"prefix":"10.1017","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0547-8674","authenticated-orcid":false,"given":"Daniel","family":"Dyball","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2985-5304","authenticated-orcid":false,"given":"Alexander N.","family":"Bennett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3135-9783","authenticated-orcid":false,"given":"Susie","family":"Schofield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9314-6468","authenticated-orcid":false,"given":"Paul","family":"Cullinan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3381-5068","authenticated-orcid":false,"given":"Christopher J.","family":"Boos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4473-8264","authenticated-orcid":false,"given":"Anthony M. 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Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use and\/or adaptation of the article.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}