Adelaide Medical School
Faculty of Health and Medical Sciences
Dr Kristin Graham.
I have over 25 years’ experience as a clinical podiatrist including regional practice, and the establishment of SA's first private podiatry locum service. I returned to study psychology at Flinders University and am currently a PhD candidate at the Centre for traumatic Stress Studies in the University of Adelaide School of Medicine, supervised by Professor Alexander McFarlane, Dr Miranda Van Hooff, Dr Amelia Searle, and Dr Ellie Lawrence-Wood. I am also supported by the inaugural Rotary Health ANZAC scholarship.
My research is with Australian Defence Force (ADF) members who deployed to the Middle East Areas of Operations (MEAO). I explore the the relationship between traumatic exposures on deployment and mental and physical health symptoms. We aim to understand how experiences on deployment along with psychological, social, and biological factors interact with human health.
Results to date
Post traumatic stress disorder (PTSD) has been found to be an under diagnosed condition. The premise for this study was that a culture where toughness and resilience were highly regarded could bias members toward somatic attribution, that is experiencing physical symptoms rather than psychological distress. As the diagnostic criteria for PTSD are psychologically based, such a bias may contribute to the under diagnosis of PTSD.
This study examined the strength of the relationship between post traumatic stress disorder and self-reported physical symptoms. The data used were from 16944 ADF members who had deployed to the MEAO between 2001 and 2009. We found that there was a strong relationship between PSTD and physical symptoms. Additionally we found that for those who were PTSD positive yet missed by traditional screening methods, the presence of 2 or 3 physical symptoms effectively identified these members.
Current paradigms regarding the effects of combat exposure on military personnel have tended to minimise physical symptoms as a discrete outcome of combat exposure. Rather physical symptoms are characteristically dealt with as a comorbidity of psychopathology.
The aim of this study was to ascertain the proportions of deployed military personnel that experience predominantly (1) physical symptoms, (2) psychological symptoms, and (3) a combination of the two. Additionally to examine the strength of the relationship between traumatic deployment exposures and these different symptomatic groups.
We found that traumatic deployment exposures were significant predictors of symptomatic group membership compared to the low-symptom reference group. The strongest association was with the comorbid group, followed by the physical group, and the weakest associations with the psychological group.
The stronger association between traumatic deployment exposures and physical compared to psychological group membership suggests that physical symptoms are not a comorbidity of psychopathology but a discrete outcome of exposure to trauma.
Date Position Institution name 2017 - ongoing Tutor University of South Australia, Adelaide 2014 - 2016 Mentoring coordinator Podiatry Association of Australia (SA) Podiatry Association of Australia (SA) 2000 - 2015 Founder Spare Feet Podiatry Locum Service 1988 - ongoing Clinical Podiatrist and practice owner Performance Podiatry
Date Institution name Country Title 2015 The University of Adelaide Australia PhD in Medicine 2012 - 2014 Flinders University Australia Bachelour of Psychological Science (Honours) 1984 - 1987 University of South Australia Australia Diploma Applied Science (Podiatry)
Year Citation 2022 Graham, K., Matricciani, L., Banwell, H., Kumar, S., Causby, R., Martin, S., & Nissen, L. (2022). Australian podiatrists scheduled medicine prescribing practices and barriers and facilitators to endorsement: a cross-sectional survey.. J Foot Ankle Res, 15(1), 12 pages.
2022 Ong, E. K. M., Fryer, C., Graham, K., & Causby, R. S. (2022). Investigating the experience of receiving podiatry care in a tertiary care hospital clinic for people with diabetes related foot ulcers. Journal of Foot and Ankle Research, 15(1), 11 pages.
2022 Graham, K., Lawrence-Wood, E., & McFarlane, A. (2022). Longitudinal relationship between posttraumatic stress symptoms and physical symptoms in military veterans. Psychosomatic Medicine, 84(9), 1034-1040.
2022 Ben chmo, M., Matricciani, L., Kumar, S., & Graham, K. (2022). “I was trying to look after myself, but I really wasn’t”: Understanding patient’s perspectives on risk factors for lower extremity amputations. Journal of Foot and Ankle Research, 15(1), 9 pages.
2021 Graham, K., Banwell, H. A., Causby, R. S., Kumar, S., Tian, E. J., & Nissen, L. (2021). Barriers to and facilitators of endorsement for scheduled medicines in podiatry: a qualitative descriptive study. Journal of Foot and Ankle Research, 14(1), 11 pages.
DOI Scopus2 WoS2 Europe PMC2
2021 West, J. C., Spangler, P. T., Dempsey, C. L., Straud, C. L., Graham, K., Thiel, F., & Benedek, D. M. (2021). Riluzole Augmentation in Posttraumatic Stress Disorder: Differential Treatment Effect in a High Hyperarousal Subtype. Journal of Clinical Psychopharmacology, 41(4), 503-506.
2021 McFarlane AO, A. C., & Graham, D. K. (2021). The ambivalence about accepting the prevalence somatic symptoms in PTSD: Is PTSD a somatic disorder?. Journal of Psychiatric Research, 143, 388-394.
DOI Scopus2 WoS2 Europe PMC2
2020 Graham, K., Searle, A., Van Hooff, M., Lawrence-Wood, E., & McFarlane, A. (2020). The Value of Physical Symptoms in Screening For Posttraumatic Stress Disorder in the Military. Assessment, 27(6), 1139-1150.
DOI Scopus5 WoS7 Europe PMC2
2019 Graham, K., Dipnall, J., Van Hooff, M., Lawrence-Wood, E., Searle, A., & AO, A. M. F. (2019). Identifying clusters of health symptoms in deployed military personnel and their relationship with probable PTSD. Journal of Psychosomatic Research, 127, 9 pages.
DOI Scopus5 WoS4 Europe PMC2
2019 Graham, K., Searle, A., Van Hooff, M., Lawrence-Wood, E., & McFarlane, A. (2019). The Associations Between Physical and Psychological Symptoms and Traumatic Military Deployment Exposures.. Journal of traumatic stress, 32(6), 957-966.
DOI Scopus3 WoS3 Europe PMC1
2017 Arnold, M. M., Graham, K., & Hollingworth-Hughes, S. (2017). What's Context Got to Do with It? Comparative Difficulty of Test Questions Influences Metacognition and Corrected Scores for Formula-scored Exams. Applied Cognitive Psychology, 31(2), 146-155.
DOI Scopus3 WoS3
Year Citation 2017 Graham, K., searle., van hooff., lawrence-wood., & mcfarlane. (2017). Can Physical Symptoms predict Posttraumatic Stress Disorder (PTSD) in the Military. In 5th Annual Scientific Conference of the European Association of Psychosomatic Medicine. Barcelona. 2017 Graham, K., Searle, A., Van hooff, M., Lawrence-wood, E., & Mcfarlane, A. (2017). Considering psychological distress is ignoring half the problem. In Australian Pain Society 37th Annual Scientific Meeting: Expanding Horizons. Adelaide Convention Centre, South Australia. 2016 Graham, K., Searle, A., Van hooff, M., Lawrence-wood, E., & Mcfarlane, A. (2016). The diagnostic validity of physical symptoms in PTSD screening in the military.. In 25th Australian Medical Military Association. Crown Prominade, Melbourne. 2016 Graham, K., Searle, A., Van hooff, M., Lawrence-wood, E., & Mcfarlane, A. (2016). Could physical symptoms be an effective PTSD screening measure in the military?. In 19th Australian Conference on Traimatic Stress: Public Issues Private Trauma. Crowne Plaza Surfers Paradise, Queensland. 2015 Graham, K., Searle, A., Van Hooff, M., Lawrence-Wood, E., & McFarlane, A. (2015). Traumatic stress in the ADF: Is physical the new mental?. In Journal of Military and Veterans’ Health Vol. 23 (pp. 76-77). Hobart, Tasmania.
Year Citation 2017 Graham, K., van hooff., lawrence-wood., searle., & mcfarlane. (2017). 1121953_Considering only the psychological distress caused by combat exposure is ignoring half the problem.. Poster session presented at the meeting of 5th Annual Scientific Conference of the European Association of Psychosomatic Medicine. Barcelona. 2017 Graham, K., van hooff., lawrence-wood., searle., & mcfarlane. (2017). The association between combat trauma and physical and psychological health. Poster session presented at the meeting of 11th Annual Florey Postgraduate Research Conference.. National Wine Centre of Australia, Adelaide.. 2016 Graham, K., Searle, A., Van Hoof, M., & Lawrence-Wood, E. (2016). The Relationship Between Physical Symptoms and Posttraumatic Stress Disorder (PTSD) in the Australian Defence Force (ADF): Implications for Screening. Poster session presented at the meeting of 10th Annual Florey Postgraduate Research Conference. National Wine Centre of Australia, Adelaide.
I am supported by the inaugural ANZAC scholarship from Rotary Health.
Adelaide Medical School Research Travel Award for International travel 2017
National Rural and Remote Infrastructure Program Grant 2011
Tutor in Podiatry Clinical Studies 101, University of South Australia in 2017
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