Hitting the wall: the impact of barriers to care and cumulative trauma exposure on PTSD in Northern Ireland veterans: The impact of barriers to care and cumulative trauma exposure on PTSD among Northern Ireland Veterans

Introduction: Seeking treatment for posttraumatic stress disorder (PTSD) distress can be complicated by a variety of internal and external factors that prevent an individual from seeking care and treatment while distress worsens. Tis is especially true for hidden populations with an extensive trauma history, such as UK Armed Forces Veterans residing in Northern Ireland. This study aimed to determine the contribution of barriers to care and cumulative trauma exposure to the severity of PTSD symptomatology, the extent of that contribution, and whether variance existed in the specific types of barriers. Methods: Data from 657 Veterans residing in Northern Ireland (90.6% male) taken from the Northern Ireland Veterans Health and Wellbeing Study were used in a series of regression models to explore the relationships among cumulative trauma exposure, barriers to care, specific barrier types, and PTSD symptomatology. Results: Overall barriers to care and cumulative trauma exposure predicted PTSD (β = 0.385), as did, to a lesser degree, logistical barriers (β = 0.348), trust barriers (β = 0.258), and stigmatic barriers (β = 0.298). Discussion: The accumulation of multiple trauma exposures and experiences is strongly associated with PTSD symptomatology, with barriers to care having a significant impact on distress. Overall barriers, specific subtypes of barriers, and trauma contributed to PTSD in this population of UK Armed Forces Veterans residing in Northern Ireland.