Publication year
2015
Citation Title
Sex differences in coping strategies in military survival school.
Journal Name
Journal of Anxiety Disorders
Journal Volume
29
Page Numbers
7-13
DOI
10.1016/j.janxdis.2014.10.005
Summary
Two hundred U.S. Service members undergoing a stressful mock-captivity exercise participated in a study examining the role of sex differences in coping as a potential factor that might explain gender differences in PTSD. Analysis indicated that sex had a direct effect on baseline PTSD, self-blame, and denial. Women had higher posttraumatic stress disorder (PTSD) symptom scores than men following the exercise.
Key Findings
After controlling for education, women were significantly more likely than men to report using self-blame, denial, and positive reframing coping strategies than men.
Self-blame and denial were the only coping strategies that emerged as significant mediators between sex and psychological distress following the exercise.
The use of adaptive coping strategies (positive reframing, behavioral disengagement) was not associated with less PTSD.
Prior trauma was indirectly related to follow-up distress through both prior distress and self-distraction.
Implications for Program Leaders
Offer Service members short, informal workshops regarding risk factors for PTSD and effective self-care strategies to promote wellness
Tailor curricula for the unique needs and preferences of male and female Service members, supporting them in coping with stressful incidents
Continue to provide resources for families of Service members with mental health diagnoses
Implications for Policy Makers
Recommend screening Service members for previous traumatic experiences and mental health concerns
Recommend that Service members undergoing this type of exercise be offered immediate mental health care if desired
Continue to provide support for programs that work to increase family readiness
Methods
U.S. Service members undergoing a stressful mock-captivity exercise in 2011-2012 were invited to participate; the first 200 interested were enrolled.
Participants completed a questionnaire including medical history, PTSD symptoms, and prior traumatic experiences before training started, and measures of coping and PTSD symptoms after the training.
Statistical analyses were used to compare the sexes on outcomes, and predict follow-up PTSD symptoms from all the remaining variables.
Participants
Two hundred U.S. Service members participated (78% male).
The average age of the sample was 25.20 years (SD = 4.40 years).
Of the participants, 64% completed more than high school level of education and 36% completed high school/GED.
The sample consisted of participants from the following service branches: 71% Navy and 29% Marine Corps.
Limitations
The study did not assess individual's level of threat assessment or personality which may have important impacts on PTSD symptoms.
The sample was a highly specialized group undergoing a specific experience; these results may not generalize to other Service members or stressful experiences.
All measures were self-report and may be biased.
Avenues for Future Research
Include measures of threat appraisal to explore the reasons why women, particularly in military settings, use more coping strategies compared to men
Explore the relationship between types of prior trauma, this kind of exercise, and PTSD symptoms
Examine which coping techniques employed by Service members during training are associated with decreased rates of PTSD and other mental health concerns
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
A wealth of research has examined psychological responses to trauma among male military service members, but few studies have examined sex differences in response to trauma, such as coping strategies. This study assessed coping strategies used by male and female U.S. service members completing an intensely stressful mock-captivity exercise, compared strategies by sex, and assessed the relationship between coping and posttraumatic stress symptoms (PTSS). Two hundred service members (78% male) completed self-report surveys before and after mock captivity. Surveys assessed demographics, service characteristics, PTSS, and coping strategies used during mock captivity. Participants used seven coping strategies: denial, self-blame, religion, self-distraction, behavioral disengagement, positive reframing, and planning. Women used denial (p ? .05), self-blame (p ? .05), and positive reinterpretation (p ? .05) strategies more frequently thanmen, and theyhadhigher PTSS levels following the exercise. Structural equationmodeling showed that the relationship between sex and PTSS was fully mediated by coping strategies. The results of this study suggest that reducing the use of maladaptive coping strategies may mitigate PTSS among females. Future efforts should targetimproving coping during highly stressful and traumatic experiences.
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