Posttraumatic Stress Injury (PTSI)
Posttraumatic Stress Injury (PTSI) is a term used within military and PSP communities in Canada. It “refers to a mental health condition that a person acquires as a result of exposure to one or more potentially traumatic events” (CIPSRT, 2020). It is a term preferred by some people to describe those symptoms commonly diagnosed as Posttraumatic Stress Disorder (PTSD). A distinction is made between an “injury” resulting from a traumatic exposure and a “disorder” which is often associated with stigma. For PSP, PTSI can happen at any time. PTSI may become more evident later in a career due to a buildup of exposures over time. PSP family members can be impacted by the PSP’s experience with trauma as well as their own traumatic experiences (direct events that occur independent of the PSP).
Criteria for PTSD
Exposure: 
- Being directly exposed to an potentially traumatic event.
- Witnessing a potentially traumatic event that occurs to others.
- Learning about a potentially traumatic event that occurs to others.
- Experiencing repeated exposure to details of a potentially traumatic event.
Symptoms (lasting more than one month)
- Intrusive symptoms: recurring, involuntary, and distressing memories of a traumatic event; recurring nightmares and/or flashbacks.
- Avoidance: attempts to avoid distressing memories, thoughts, or feelings associated with the event (e.g., avoiding people, places, situations).
- Mood changes: persistent negative thoughts, lack of interest in activities, inability to experience positive emotions, and/or feeling detached.
- Reactivity: irritability, self-destructive behaviour, hypervigilance, exaggerated startle response, poor concentration, and/or disturbed sleep).
Stigma around Posttraumatic Stress Injury (PTSI) in PSP sectors
Some PSP might find it hard or hesitate to seek help for mental health concerns. This can be because of stigma, perceived stigma, or self-stigma around mental illness. Stigma describes the negative attitudes and perceptions around mental illness. Much work is being done to dispel the myth that mental illness is a weakness.
Because of their roles, PSP are often presumed to be strong and courageous in all that they do. There might be a feeling that they are letting the team and community down if PSP seek mental health support. Many PSP have reported feeling this expectation of courage and strength, and so fear the labels that might come with seeking support. PSP also fear that seeking mental health support could have an impact on their jobs.
When stigma prevents PSP from seeking out care, it increases the strain placed on other family members. They may have to cope with behavioural changes in the PSP and an increase in household responsibilities because the PSP is unable or unwilling to contribute. The stigma can also lead to isolation for both the PSP and family members. PSP might be afraid that others will not accept or trust them or will think less of them. They may avoid going out and, in turn, reduce chances for their families to socialize with extended family and friends.
Effects of PTSI on PSP Families
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References for this page (click to expand)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Carleton, R. N., Afifi, T. O., Turner, S., Taillieu, T., Duranceau, S., LeBouthillier, D. M., Sareen, J., Ricciardelli, R., MacPhee, R. S., Groll, D., Hozempa, K., Brunet, A., Weekes, J. R., Griffiths, C. T., Abrams, K. J., Jones, N. A., Beshai, S., Cramm, H. A., Dobson, K. S., Hatcher, S., … Asmundson, G. J. G. (2018). Mental disorder symptoms among public safety personnel in Canada. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 63(1), 54–64. https://doi.org/10.1177/0706743717723825
CIPSRT (2020). Glossary of terms. https://www.cipsrt-icrtsp.ca/en/resources/glossary-of-terms#661
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest : A Journal of the American Psychological Society, 15(2), 37–70. https://doi.org/10.1177/1529100614531398
Jones, S., Agud, K. & McSweeney, J. (2019). Barriers and facilitators to seeking mental health care among first responders: “Removing the Darkness”. Journal of the American Psychiatric Nurses Association 26(1):43-54. https://doi.org/10.1177/1078390319871997
Lewis-Schroeder, N. F., Kieran, K., Murphy, B. L., Wolff, J. D., Robinson, M. A. & Kaufman, M. L. (2018). Conceptualization, assessment, and treatment of traumatic stress in first responders: A review of critical issues. Harvard review of psychiatry, 26(4), 216–227. https://doi.org/10.1097/HRP.0000000000000176
McKeon, G., Wells, R., Steel, Z., Moseley, V. & Rosenbaum, S. (2020). Self-reported physical and mental health of informal caregivers of emergency service workers. Journal of Loss and Trauma, 26(6), 507-518. https://doi.org/10.1080/15325024.2020.1845020
O’Toole, M., Mulhall, C., & Eppich, W. (2022). Breaking down barriers to help-seeking: preparing first responders’ families for psychological first aid. European Journal of Psychotraumatology, 13(1), 2065430-2065430. https://doi.org/10.1080/20008198.2022.2065430
Porter, K. L., & Henriksen, R. C. (2016). The phenomenological experience of first responder spouses. The Family Journal (Alexandria, Va.), 24(1), 44-51. https://doi.org/10.1177/1066480715615651
Public Safety Canada. (2022). Supporting Canada’s Public Safety Personnel: An Action Plan on Post-traumatic Stress Injuries. Retrieved August 29, 2022 from https://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/2019-ctn-pln-ptsi/index-en.aspx
Shepherd-Banigan, M., Shapiro, B., McDuffie, J. R., Brancu, M., Sperber, N. R., Van Houtven, C. H., Kosinski, A. S., Mehta, N. N., Nagi, A. & Williams, J. W. (2018). Interventions that support or involve caregivers or families of patients with traumatic injury: A systematic review. Journal of General Internal Medicine, 33(7):1177-1186. https://doi.org/10.1007/s11606-018-4417-7
Thomson, J. L. (2021). PTSD perceptions in the U.S. military members and their families: A qualitative study. SAGE Open, 11(1). https://doi.org/10.1177/21582440211006393
Wyse, J. J., Ono, S. S., Kabat, M. & True, G. (2020). Supporting family caregivers of Veterans: Participant perceptions of a federally-mandated caregiver support program. Healthcare (Amsterdam, Netherlands), 8(3), 100441. https://doi.org/10.1016/j.hjdsi.2020.100441