Journal zyxwvutsrqpo of zyxwvutsrqponm Traumatic Stress, Vol. 16, No. zyxwvutsrq 6. December 2003, pp. 589-593 zyxwvutsr (0 2003) Stress Reactions Among Swedish Peacekeeping Soldiers Serving in Bosnia: A Longitudinal Study Per-Olof Michel,' zyxwvu p4 zyxwvutsrqponmlkjihgfed Tom Lundin? and zyxwvu Gerry Larsson3 Assessments of mental health (GHQ-28) were performed on a Swedish battalion serving in Bosnia at 4 times: before deployment, immediately after deployment, 6 months after deployment, and 1 year after deployment. Complete responses were obtained from 3 16 participants (61% response rate). No significant change of mental health over time was noted. Individuals having experienced traumatic events in Bosnia, as well as stressful life events postdeployment, reported the poorest mental health. Logistic regression analysis showed that postdeployment stressors made the strongest contribution to registeringa poor mental health score after one year. KEY WORDS: longitudinal study; mental zyxwvuts health; peacekeeping; stress reactions. There are an increasing number of studies on per- sonnel serving in peacekeeping operations, describing the stressors that the individualshave experiencedand the se- quel they will have to deal with. The mental health state among personnel following these missions often seems to vary as a function of the intensity of the conflict in which they are serving. In a study on U.S. soldiers serving in Somalia, 8% met the diagnostic critera for posttraumatic stress disorder (PTSD; Litz, Orsillo, Friedman, Elich, & Baues, 1997). In another study, one-third of 3,461 active duty U.S. military personnel who also served in Somalia met criteria for psychiatric caseness (Orsillo, Roemer, Litz, Ehlich, & Friedman, 1998). A high level of PTSD (16%) was found in a study on British soldiers serving in the early stages of the conflict in former Yugoslavia (Baggaley, Piper, Cumming, & Murphy, 1999). A con- founder in that study was that most of the soldiers had pre- viously served in Northern Ireland. In a follow-upstudy of former Norwegian peacekeepers, 5% suffered from PTSD 'Swedish Armed Forces Medical Centre, Hammarti, Sweden. ZDepartment of Psychiatry, U p p d a University, UppsaIa, Sweden. 3Swedish National Defence College, Karlstad, Sweden. 4T0 whom correspondence should be addressed at Armed Forces Med- ical Centre, SE-663 81 Hammari). Sweden; e-mail: per-olof.michel@ fsc.mi1.w. more than 6 years after service (Mehlum & Weisaeth. 2002). In low-intensity conflicts, PTSD may not be the main problem. Instead peacekeepers find themselves ex- posed to cumulative stress, resulting from boring missions and the ambiguity often present in peacekeeping oper- ations (Carlstrom, Lundin, & Otto, 1990; Elklit, 1998; Huffman et al., 1999; Lundin & Otto, 1992; MacDonald et al., 1998). In spite of that, there is a lack of longitu- dinal studies investigating changeover time, focusing on general mental health rather than on PTSD. A longitudi- nal approach could be of importance in Sweden and other countries where the soldiers are volunteersand go back to their civilian lives after deployment. This situation makes it harder to conduct continuous follow-ups. The first aim of this work was to study the mental health situation among peacekeeping soldiers by using a longitudinal approach. The second aim was to iden- tify stressors encountered before, during, and after de- ployment that would be related to the mental health state among the participants. The mission was carried out after the Dayton agreement and believed to be a low-intensity conflict. Therefore, drawing on the results from the stud- ies cited above, the hypotheses were as follows: (1) there will be a low degree of mental health problems after de- ployment, and (2) mental health problems, at a 1 year 589 0894.9867~Y12a)-O589/10 2003 lnlemational Society for Traumalie Sucsa Sludiea