Publication year
2012
Citation Title
Grief and physical health outcomes in U.S. soldiers returning from combat.
Journal Name
Journal of Affective Disorders
Journal Volume
136
Issue Number
3
Page Numbers
469-475
DOI
10.1016/j.jad.2011.10.048
Summary
Survey data were used to examine the prevalence of physical health (e.g., back pain, headache, etc.) and somatic symptoms (e.g., dizziness, nausea, sleep problems, etc.), overall general health, and occupational impairment among Army Infantry Soldiers at six months post-deployment. The association of difficulty coping with grief and physical health was also assessed. Results indicate that physical health symptoms post deployment were common and grief uniquely contributed to physical health issues.
Key Findings
The most frequent physical health symptoms reported were: sleep problems (32.8%), musculoskeletal pain (32.7%), fatigue (32.3%), back pain (28.1%), and headaches (16.2%).
As difficulty coping with grief increased, poor general health, physical health and somatic symptoms increased (i.e., fatigue, sleep problems, musculoskeletal pain, back pain, and headaches), as did four occupational impairment outcomes (i.e., missed days, medical visits, difficulty with physical training (PT), and difficulty carrying a heavy load).
After controlling for demographics, combat experiences, injuries, posttraumatic stress disorder (PTSD), and depression, grief contributed significantly to a high prevalence of more somatic symptoms (e.g., dizziness, nausea), poor general health, and all four occupational impairment outcomes (i.e., missed work, medical visits, difficulty carrying a heavy load, and difficulty performing PT).
Implications for Program Leaders
Offer support groups for Service members who are having trouble coping with grief post-deployment
Educate Service members and their families regarding comment mental health and physical health challenges associated with deployment and reintegration
Disseminate information to Service members and military families regarding grief specifically related to deployment and healthy ways to cope
Implications for Policy Makers
Recommend training regarding combat related grief for service providers working with Service members
Continue to support post-reintegration programs that help Service members and their families adjust following deployment
Support collaborative efforts among DoD and community-based services that work with Service members and their families to provide streamlined care
Methods
Infantry Soldiers completed anonymous surveys six months post-deployment.
Participants were recruited via large group recruitment briefings coordinated with unit commanders.
Data collection took place between November and December 2008 from three different Infantry brigades.
Participants
Participants in this study were 1,522 Soldiers (92% male).
In this sample, 73% of participants were under the age of 30, 56% married, and 56% junior enlisted (E1-E4).
Race/ethnicity data were not provided.
Limitations
The current findings, based on a large sample of Active Duty Army Infantry Soldiers, may not generalize to other military branches or components.
The current data utilized a cross-sectional design and self-reported data; therefore, no causal statements can be made and recall bias is possible.
The grief construct was measured using a single item and did not specify the type of loss due to death (e.g., fellow Soldier, a family member) which could impact the results.
Avenues for Future Research
Examine the impact of combat-related losses and the grief response in military populations
Include longitudinal designs with more detailed assessments of grief in military units that sustain combat-related losses
Explore whether type of loss (e.g., fellow Soldier, spouse) influences mental and physical functioning post-deployment differently
Focus
Army
Target Population
Population Focus
Military Branch
Military Component
Abstract
Background: Few studies have measured the burden of physical health problems after Iraq/Afghanistan deployment, except in association with post-traumatic stress disorder (PTSD) or mild traumatic brain injury (mTBI). Grief, a correlate of health problems in the general population, has not been systematically examined. We aimed to identify the prevalence of post-deployment physical health problems and their association with difficulty coping with grief. Methods: Infantry soldiers (n=1522) completed anonymous surveys using validated instruments six months following deployment in November–December 2008. Multiple logistic regression was used to assess the association of difficulty coping with grief and physical health. Results: The most frequent physical health symptoms reported were: sleep problems (32.8%), musculoskeletal pain (32.7%), fatigue (32.3%), and back pain (28.1%). Difficulty coping with grief over the death of someone close affected 21.3%. There was a dose–response relationship between level of difficulty coping with grief and principal physical health outcomes (ps<.002). Controlling for demographics, combat experiences, injuries, PTSD, depression, and other factors, grief significantly and uniquely contributed to a high somatic symptom score (adjusted odds ratio (AOR=3.6), poor general health (AOR=2.0), missed work (AOR=1.7), medical utilization (AOR=1.5), difficulty carrying a heavy load (AOR=1.7), and difficulty performing physical training (AOR=1.6; all 95% confidence intervals >1). Limitations: Data are cross-sectional and grief was measured with one item. Conclusions: Over 20% of soldiers reported difficulty coping with grief. This difficulty was significantly associated with physical health outcomes and occupational impairment. Clinicians should be aware of the unique role grief plays in post-deployment physical health when treating patients.
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