There is increasing empirical evidence for the positive mental health effects of compassion-based interventions. Although numerous smartphone apps offering compassion-based interventions (‘compassion apps’) are now available for the general public, the quality of these apps has not yet been reviewed. A qualitative review of existing compassion apps serves as a crucial first step toward testing the efficacy of these apps, by identifying good-quality compassion apps that might be worth the investment of a scientific trial.

The current study focuses on reviewing the quality of existing compassion apps.

Existing compassion apps were identified through searches in the Google Play Store and App Store. The 24 included apps were reviewed on their quality by using the Mobile App Rating Scale, and on their consistency with current evidence by comparing them to existing and studied compassion-based interventions.

Of the 24 included apps, eight were identified that met the criteria of being consistent with existing and studied compassion-based interventions, and acceptable to good overall quality. The other 16 apps failed to meet one or both of these criteria.

Good-quality compassion apps are available, but many of the available apps fail to meet certain quality criteria. In particular, many apps failed to offer sufficient relevant and correct information, or failed to offer this information in an entertaining and interesting way. It is recommended that future compassion apps are based on a clear definition of compassion, offer evidence- and theory-based exercises and implement tools for increasing engagement.

Military personnel deployed to combat and peacekeeping missions are exposed to high rates of traumatic events. Accumulating evidence suggests an important association between deployment and the development of other mental health symptoms beyond post-traumatic stress disorder.

This study examined the prevalence of agoraphobia, anxiety, depression, and hostility symptoms in a cohort of Dutch ISAF veterans (N = 978) from pre-deployment up to 10 years after homecoming. The interaction of potential moderating factors with the change in mental health symptoms relative to pre-deployment was investigated at each time point.

The probable prevalence of agoraphobia, anxiety, depression, and hostility symptoms significantly increased over time to respectively 6.5, 2.7, 3.5, and 6.2% at 10 years after deployment. Except for hostility symptoms, the probable prevalence at 10 years after deployment was the highest compared to all previous follow-up assessments. Importantly, less perceived social support after returning from deployment was found as a risk factor for all different mental health symptoms. Unit support was not associated with the development of mental health problems.

This study suggests a probable broad and long-term impact of deployment on the mental health of military service members. Due to the lack of a non-deployed control group, causal effects of deployment could not be demonstrated. Continued effort should nevertheless be made in the diagnosis and treatment of a wide range of mental health symptoms, even a decade after deployment. The findings also underscore the importance of social support after homecoming and its potential for the prevention of long-term mental health problems.

Post-traumatic stress disorder (PTSD), anxiety, and impulsive aggression are linked to transdiagnostic neurocognitive deficits. This includes impaired inhibitory control over inappropriate responses. Prior studies showed that inhibitory control can be improved by modulating the right inferior frontal gyrus (IFG) with transcranial direct current stimulation (tDCS) in combination with inhibitory control training. However, its clinical potential remains unclear. We therefore aimed to replicate a tDCS-enhanced inhibitory control training in a clinical sample and test whether this reduces stress-related mental health symptoms.

In a preregistered double-blind randomized-controlled trial, 100 active-duty military personnel and post-active veterans with PTSD, anxiety, or impulsive aggression symptoms underwent a 5-session intervention where a stop-signal response inhibition training was combined with anodal tDCS over the right IFG for 20 min at 1.25 mA. Inhibitory control was evaluated with the emotional go/no-go task and implicit association test. Stress-related symptoms were assessed by self-report at baseline, post-intervention, and after 3-months and 1-year follow-ups.

Active relative to sham tDCS neither influenced performance during inhibitory control training nor on assessment tasks, and did also not significantly influence self-reported symptoms of PTSD, anxiety, impulsive aggression, or depression at post-assessment or follow-up.

Our results do not support the idea that anodal tDCS over the right IFG at 1.25 mA enhances response inhibition training in a clinical sample, or that this tDCS-training combination can reduce stress-related symptoms. Applying different tDCS parameters or combining tDCS with more challenging tasks might provide better conditions to modulate cognitive functioning and stress-related symptoms.

Symptoms of post-traumatic stress disorder (PTSD) can manifest several years after trauma exposure, and may impact everyday life even longer. Military deployment can put soldiers at increased risk for developing PTSD symptoms. Longitudinal evaluations of PTSD symptoms in deployed military personnel are essential for mapping the long-term psychological burden of recent operations on our service members, and may improve current practice in veterans’ mental health care.

The current study examined PTSD symptoms and associated risk factors in a cohort of Dutch Afghanistan veterans 10 years after homecoming. Participants (N = 963) were assessed seven times from predeployment up to 10 years after deployment. Growth mixture modeling was used to identify distinct trajectories of PTSD symptom development.

The probable PTSD prevalence at 10 years after deployment was 8%. Previously identified risk factors like younger age, lower rank, more deployment stressors, and less social support were still relevant 10 years after deployment. Four trajectories of PTSD symptom development were identified: resilient (85%), improved (6%), severely elevated-recovering (2%), and delayed onset (7%). Only the delayed onset group reported increasing symptom levels between 5 and 10 years postdeployment, even though 77% reported seeking help.

This study provides insights into the long-term burden of deployment on the psychological health of military service members. It identifies a group of veterans with further increasing PTSD symptoms that does not seem to improve from currently available mental health support, and underlines the urgent need for developing and implementing alternative treatment opportunities for this group.

Globally, millions are exposed to stressors at work that increase their vulnerability to develop mental health conditions and substance misuse (such as soldiers, policemen, doctors). However, these types of professionals especially are expected to be strong and healthy, and this contrast may worsen their treatment gap. Although the treatment gap in the military has been studied before, perspectives of different stakeholders involved have largely been ignored, even though they play an important role.

To study the barriers and facilitators for treatment-seeking in the military, from three different perspectives.

In total, 46 people participated, divided into eight homogeneous focus groups, including three perspectives: soldiers with mental health conditions and substance misuse (n = 20), soldiers without mental health conditions and substance misuse (n = 10) and mental health professionals (n = 16). Sessions were audio-taped and transcribed verbatim. Content analysis was done by applying a general inductive approach using ATLAS.ti-8.4.4 software.

Five barriers for treatment-seeking were identified: fear of negative career consequences, fear of social rejection, confidentiality concerns, the ‘strong worker’ workplace culture and practical barriers. Three facilitators were identified: social support, accessibility and knowledge, and healthcare within the military. The views of the different stakeholder groups were highly congruent.

Barriers for treatment-seeking were mostly stigma related (fear of career consequences, fear of social rejection and the ‘strong worker’ workplace culture) and this was widely recognised by all groups. Social support from family, peers, supervisors and professionals were identified as important facilitators. A decrease in the treatment gap for mental health conditions and substance misuse is needed and these findings provide direction for future research and destigmatising interventions.

Problems with impulsive aggression occur in many forms of psychiatric dysfunction, and are a common complaint among combat veterans. The present study sought to examine the neuroanatomical correlates of combat-related impulsive aggression.

T1-weighted magnetic resonance images were acquired from 29 male veterans with impulsive aggression and 30 non-aggressive combat controls. Subcortical volumetry was conducted with the amygdala and hippocampus and their main constituent subdivisions as regions-of-interest (ROIs) (basolateral, centromedial amygdala; head, body, tail of hippocampus). Cortical thickness measurements were extracted for the dorsolateral prefrontal cortex, orbitofrontal cortex, and anterior cingulate cortex. Within-group correlations with psychometric measures were also explored.

No significant group differences in cortical thickness or subcortical grey matter volumes were observed for any of the ROIs. Also, no significant correlations with any of the psychometric measures were recorded. Exploratory whole-brain analysis of cortical thickness revealed a significant group × anxiety interaction effect in a cluster located in the left lingual gyrus.

The current findings indicate that problems with impulsive aggression may not be directly associated with alterations in cortical thickness or amygdalar/hippocampal (sub)volumes. The observed interplay between impulsive aggression problems and anxiety-related symptoms is consistent with prior work showing the two phenomena may share the same underlying (neural) mechanisms.