Publication year
2017
Citation Title
Longitudinal changes in combat-related posttraumatic stress disorder among Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans with hazardous alcohol use: The role of avoidance coping.
Journal Name
The Journal of Nervous and Mental Disease
Journal Volume
205
Issue Number
10
Page Numbers
805-808
DOI
10.1097/NMD.0000000000000713
Summary
Veterans are at high risk for posttraumatic stress disorder (PTSD), so it is important to understand the risk factors that contribute to PTSD severity. To explore PTSD risk factors among Veterans, this study analyzed data from two time points (baseline and one year later) regarding their childhood, combat severity, post-deployment social support, coping strategies, and PTSD symptoms. Results revealed that post-deployment social support and an avoidant coping style (i.e., avoidance of dealing with stress) were associated with Veteran's PTSD severity.
Key Findings
Avoidant coping and poor post-deployment social support were associated with Veteran's PTSD symptoms at baseline.
Avoidant coping had a significant effect on Veteran's increase of PTSD symptoms one year after baseline.
Alcohol abuse and childhood family environment were not associated with Veterans' PTSD symptoms at baseline or at one-year follow-up.
Implications for Program Leaders
Offer support groups for Service members who experienced combat trauma to increase their social support
Promote the benefits of social support and proactive coping on Service members' mental health
Educate Service members about common PTSD symptoms and where to seek help
Implications for Policy Makers
Recommend that all Service members with PTSD symptoms be offered support (e.g., workshops, peer support groups) during their reintegration
Raise awareness about the importance of proactive coping strategies on Service members' well-being by providing classes and workshops for Service members and their families
Recommend education of professionals on common risk factors (e.g., avoidant coping, poor social support) that contribute to Service members' PTSD severity
Methods
Participants were recruited from Veterans Affairs (VA) primary care clinics by staff referral. To be eligible for the study, they needed to have hazardous drinking problems and showed at least mild PTSD symptoms.
Each participant completed self-report measures at baseline and one year later (retention rate = 60%). Participants completed measures that included childhood family environment, combat severity, post-deployment social support, coping strategies, and PTSD symptoms.
Data were analyzed to examine the associations between combat severity, post-deployment social support, avoidance coping, and PTSD severity.
Participants
Participants were 150 OIF/OEF/OND Veterans (88% male).
The average age of participants was 29.48 years (SD = 7.01) and most of them were White (83%); the race/ethnicity of the other 17% of participants was not reported.
The military branches that the Veterans used to serve in were not indicated.
Limitations
The sample was limited to Veterans who had PTSD symptoms and drinking problems, so findings may not apply to Veterans who do not have such symptoms.
The length of time that Veterans had left military Service was not collected or reported; without considering that variable, it is difficult to examine the association between combat severity and PTSD symptoms.
Veterans who left the study were more likely to use the avoidant coping strategy than Veterans who stayed; therefore, the effect of avoidant coping on PTSD symptoms may have been understated.
Avenues for Future Research
Recruit Veterans both with and without drinking problems so that the findings can be better generalized
Explore other factors (e.g., socioeconomic status) that may contribute to Veterans' PTSD severity
Use methods to lower the attrition rates (e.g., using web-based assessment) so that the findings are less subject to self-selection bias
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Military personnel who have experienced combat trauma are at risk for developing posttraumatic stress disorder (PTSD). A greater recognition of the complex array of vulnerability factors that contribute to PTSD severity has led researchers to examine other non–combat-related factors. This longitudinal study examined a number of pre-, peri-, and postdeployment factors hypothesized to contribute to PTSD symptomatology among returning Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans presenting with at least subthreshold PTSD symptoms and hazardous alcohol use in a primary care setting. Purported risk factors included childhood family environment, severity of combat exposure, postdeployment social support, alcohol dependence severity, and an avoidant coping style. At baseline, postdeployment social support and avoidant coping contributed to PTSD severity. Only avoidant coping was associated with changes in PTSD symptom at 1-year follow-up. Reducing avoidant coping may deter the maintenance of PTSD among veterans with PTSD symptoms and hazardous alcohol use.
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