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Coping With the Impact of Working in a Conflict Zone: A Comparative Study of Diplomatic Staff

Hibberd, Jessamy M. DClinPsy; Greenberg, Neil MD

Journal of Occupational and Environmental Medicine: April 2011 - Volume 53 - Issue 4 - p 352–357
doi: 10.1097/JOM.0b013e3182135973
Original Articles: CME Available for this Article at

Objectives: Diplomats as a result of their work in conflict zones are “at risk” of exposure to intense psychological stressors. This study investigated the mental and physical health of diplomats working in a war zone.

Methods: The study used a comparative retrospective cohort design. Mental and physical health outcomes were compared for two groups of United Kingdom diplomats: those who had completed postings in Iraq and/or Afghanistan, and those deployed overseas to nonhardship posts.

Results: Diplomats posted to Iraq and Afghanistan and individuals who experienced trauma had significantly more symptoms of posttraumatic stress disorder. There were no significant differences between the groups in levels of general psychiatric morbidity, fatigue, and alcohol misuse.

Conclusions: Although personnel who went to war zones or suffered trauma were more psychologically symptomatic, the increased burden of symptoms was not associated with frank illness.

From the Department of Clinical Psychology (Dr Hibberd), Royal Holloway, University of London, Egham, Surrey, United Kingdom; and Academic Centre for Defence Mental Health (Dr Greenberg), Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom.

Address correspondence to: Neil Greenberg, MD, Academic Centre for Defence Mental Health, Weston Education Centre, 10 Cutcombe Rd, London SE5 9RJ, United Kingdom; Email:

The study was funded by a very modest sum of money from the Foreign and Commonwealth Office to allow for data entry costs only.

J.M.H used the data in this article for her DClinPsych and N.G. carries out occasional paid work for the Foreign and Commonwealth Office. Although the Foreign and Commonwealth Office supported this research, it did not direct how the information was presented in this article or how the analyses were carried out.

N.G. provides an occasional advisory & training work for the Foreign and Commonwealth Office. There are no other conflicts of interests.

The JOEM Editorial board and planners have no financial interest related to this research.

©2011The American College of Occupational and Environmental Medicine