Publication year
2017
Citation Title
The Role of PTSD, depression, and alcohol misuse symptom severity in linking deployment stressor exposure and post-military work and family outcomes in male and female veterans.
Journal Name
Clinical Psychological Science
Journal Volume
5
Issue Number
4
Page Numbers
664-682
DOI
2167702617705672
Summary
This study examined the relationship among three deployment stressors (warfare exposure, sexual harassment and assault, and family stress during deployment), three mental health categories (posttraumatic stress disorder (PTSD) symptoms, depression, and alcohol misuse), and six areas of functioning related to post-separation quality of life for Veterans (work functional impairment and satisfaction, relationship functional impairment and satisfaction, and parenting functional impairment and satisfaction).
Key Findings
Overall, deployment stressors increased later mental health symptoms, which decreased quality of life.
For males, PTSD symptoms increased work impairment and decreased both relationship impairment and satisfaction; depression reduced work satisfaction.
For females, PTSD symptoms decreased work satisfaction, depression increased work impairment, and both PTSD symptoms and depression increased relationship impairment and decreased satisfaction.
For both males and females, PTSD symptoms increased parenting impairment and depression decreased parenting satisfaction. Exposure to warfare during service decreased work satisfaction. Alcohol misuse minimally impacted quality of life.
Implications for Program Leaders
Consider gender-specific services to help Service members cope with mental health and deployment stress
Offer classes for military families about stress related to deployment during pre-deployment
Disseminate information about male sexual harassment and assault to Service members to increase awareness
Implications for Policy Makers
Continue to support the development of programs that promote resilience in Service members and their families
Encourage collaboration between the DoD and the Veteran's Administration to help Service members as they transition from post-deployment Active Duty support programs to Veteran support programs
Encourage training of professionals who work with Service members on the differences in the expressions of stress by male and female Service members
Methods
A random sample of participants was identified using data from the DoD Defense Manpower Data Center. To be eligible for the study, participants must have been separated from military service and had returned from deployment to Iraq or Afghanistan between 2008 and 2010.
Participants were surveyed twice, the first time within two years of return from deployment and then approximately three years later. The sample was intentionally evenly split between Active Duty and National Guard/Reservist units, and between women and men.
No significant differences were found between responders and non-responders in the sample.
Participants
One thousand and forty-six Veterans participated in the first survey period. Due to non-responsiveness or the Veteran opting out, the final number of participants was 522 Veterans (54% female, 46% male).
Participants were 70% White, 13% multiracial, 11% Black, 4% Latino, and 2% identified as another race/ethnicity. Age at the first survey was 37.14 years (SD = 11.30).
Participants represented the following service branches: 65% Army, 15% Navy, 13% Air Force, and 7% Marines. Seventy-eight percent were enlisted and 22% were officers.
Limitations
The first survey relied on participants' memory of events, which could have been influenced by experiences since the events or in the moment of completing the survey. Inaccurate recall of events could affect the results' validity.
Males reported very little military sexual harassment which minimized the authors' ability to draw conclusions on this topic.
Surveys about mental health symptoms and functional impairment were self-report rather than clinician-diagnosed, so the data may be over- or underestimated.
Avenues for Future Research
Collect data regarding current levels of impairment and satisfaction in the domains of work, relationships, and parenting, from the Service member, spouse and children, prior to deployment in order to gather longitudinal data
Repeat this study with Veterans deployed in other regions or conflicts
Research the degree to which services could reduce the symptoms demonstrated by the participants and the impact on their families
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Exposure to stressors during military deployment puts veterans at risk for reduced post-military quality of life. Stress-related mental health problems may lead to decreased well-being within work and family domains, yet few studies have explored associations in the context of gender. We examined relationships between deployment stressors and post-military functioning and satisfaction in the domains of work and family, with a focus on posttraumatic stress disorder (PTSD), depression, and alcohol misuse symptomatology as potential mediators. Participants included 522 male and female Iraq and Afghanistan war veterans assessed longitudinally. Structural equation models supported several direct and indirect pathways linking deployment stressors to work and family outcomes for both men and women. PTSD had an important role in these associations. Depression also played a significant role, particularly for women. These findings build on prior research by elucidating potential gender-specific risk, which may be applied to better tailor services to veterans' unique needs.
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