Ms Kristin Graham has over 20 years’ experience as a clinical podiatrist including providing treatment to RAAF personnel at the Edinburgh Base as well as Veterans in the community. She recently returned to study and completed her Bachelor of Psychological Science (Honours) at Flinders University, Adelaide.

Kristin is also a mentoring coordinator for new graduate podiatrists. In this role she has translated research into practice in developing a program to support graduate podiatrists in their transition to the work force. Her experience in both psychological research and as an allied health practitioner, together span the complementary fields of psychology and physical health. Consequently she is uniquely placed to conduct research regarding associations between the physical and mental health of veterans.

War-related stress and trauma create substantial physical and mental strain that can disrupt the body’s ability to function effectively. In particular, experiencing multiple traumas and repeated cycles of stress can affect the body in a number of ways, including physical symptoms (somatic e.g. pain), mental symptoms (e.g. anxiety) or a combination of the two (comorbid). These symptoms may take years to develop, and their type and severity can change over time. This study proposes that it may be possible that identifying physical symptoms could help to distinguish military personnel who are at risk of developing mental health problems in the future. This is particularly important as military personnel may feel more comfortable reporting physical symptoms than mental symptoms, due to the stigma or possible career consequences associated with a mental disorder diagnosis.

The aim of this study is to examine the relationship between war-related trauma exposure and the development and progression of physical and mental health of military personnel, and to identify risk and protective factors that may affect symptoms of illness and resilience. This study will use the largest data bases of Australian military personnel ever collected: The 2010 Military Health Outcomes Program (MilHOP), and the 2015 Transition and Wellbeing Research Program. These unique data bases contain information on currently-serving and retired military personnel, as well as reservists. This data has been collected on three separate occasions over a 5-year time period. Examination of this data may expose patterns that develop in symptoms over time and possible underlying causal pathways by which different trauma types are related to physical and mental symptoms. Early identification of physical symptoms associated with trauma-related mental health may assist clinicians to recognise and treat these problems before they reach the level of clinical disorder, at which point they are much harder to treat. It may also prevent physical symptoms from being treated as isolated, non-stress related symptoms. Early identification and treatment may improve health outcomes and lessen the consequent impact of trauma exposure on the personnel themselves, their family, friends, work colleagues and the wider community.

Supervisors: Professor Alexander Macfarlane AO, Dr Amelia Searle & Dr Miranda Van Hoof

The findings of this PhD project could have major implications both for military and veterans’ health, as well as the broader delivery of health care. The physical symptoms of war-related trauma exposure in veterans are generally poorly understood and managed within the military context. A more sophisticated ability to diagnose and characterise this morbidity would assist greatly in early identification and intervention, to prevent problems from only being recognised when they reach the level of diagnosed disorder, at which point they are harder to treat.

In the civilian sector, approximately one third of medical consultations involve physical symptoms that are not adequately explained by current diagnostic systems leading to unnecessary investigations and often ineffective interventions. Hence, the outcome of this research has broad relevance to the delivery of health care generally.