Hitting the wall: the impact of barriers to care and cumulative trauma exposure on PTSD in Northern Ireland veterans

Introduction: Seeking treatment for posttraumatic stress disorder (PTSD) distress can be complicated by a variety of internal and external factors which can prevent an individual from seeking care and treatment while their distress worsens. This is especially true for hidden populations with an extensive trauma history, here UK Armed Forces Veterans residing in Northern Ireland. This study aimed to determine the contribution of barriers to care and cumulative trauma exposure on the severity of PTSD symptomology, the extent of that contribution, and if there was variance in specific types of barriers.

Methods: Data from N=657 Veterans resident in NI (90.6% male) was taken from the Northern Ireland Veterans Health and Wellbeing Study (NIVHWS) were used in a series of regression models to explore the relationships between cumulative trauma exposure, barriers to care, specific barrier type, and PTSD symptomatology.

Results: Overall barriers to care and cumulative trauma exposure predicted PTSD (β = 0.385), as did, to a lesser degree, logistic barriers (β = 0.348), trust barriers (β = 0.258), and stigmatic barriers (β = 0.298).

Discussion: The accumulation of multiple trauma exposures/experiences is strongly associated with PTSD symptomology, with barriers to care having a significant impact on distress. Overall barriers/specific subtype barriers and trauma contributed to PTSD in this population of UK Armed Forces Veterans resident in NI.