Publication year
2012
Citation Title
The impact of predeployment functional impairment on mental health after combat.
Journal Name
Psychological Trauma: Theory, Research, Practice & Policy
Journal Volume
4
Issue Number
3
Page Numbers
260-269
DOI
10.1037/a0024373
Summary
Service members preparing for or returning from deployment to Iraq completed written surveys to assess the role of pre-deployment impaired functioning in predicting mental health post-deployment. Service members with pre-deployment impaired functioning who are exposed to high levels of combat are at greater risk for posttraumatic stress disorder (PTSD) symptoms post-deployment.
Key Findings
Soldiers who reported pre-deployment impairment and high combat exposure also reported the highest level of PTSD symptoms after deployment.
Pre-deployment functional impairment predicted post-deployment depression and anger.
Pre-deployment impairment combined with high combat exposure did not predict any other outcomes.
Implications for Program Leaders
Develop services for Service members who are having difficulty functioning pre-deployment as they may be most in need of support to avoid later mental health difficulties
Disseminate information regarding possible symptoms of mental health problems Service members may face after deployment and where individuals and families can find help for those problems
Educate couples who have a history of trauma before deployment on positive coping skills
Implications for Policy Makers
Encourage the development and continuation of programs that can promote resilience in Service members, their partners, and children
Promote reintegration programs that include attention to assisting Service members’ family in adjusting to the Service member’s return
Recommend training for community providers to educate them about unique factors that contribute to marital strain for military couples
Methods
U.S. Soldiers from a combat brigade preparing to deploy to Iraq were invited to complete a written survey two months prior to and three months after deployment; 96% consented at pre- deployment, 93% at post-deployment.
Soldiers completed measures of demographics, PTSD and depression symptoms, anger problems, functional impairment (pre-deployment only), combat exposure (post-deployment only) and disability (post-deployment only).
Functional impairment was assessed by one item asking how difficult their symptoms made it to do work, take care of things at home, or get along with other people.
Participants
Five hundred twenty-two Soldiers who had a one year deployment to Iraq were surveyed.
Ninety-eight percent of the sample was male, 70% was White, 52% was married, and 49% was between 18-25 years.
Fifty-nine percent reported being in the military for five years or less; in the sample 89% were junior enlisted or non-commissioned officers.
Fifty-one percent of the sample reported some schooling, high school diploma or GED, and 37% some college.
Limitations
This study relied on self-report measures of combat exposure that may result in biased reporting.
The assessment of pre-deployment functional impairment was only a single-item measure that may reduce the complexity and multiple dimensions of the construct.
The researchers collapsed the disability scale into one item which results in loss of information.
Avenues for Future Research
Replicate the study using a multi-dimensional measure of functional impairment instead of the single items used for various domains
Examine these relationships in female Soldiers and others in high-risk occupations (e.g., firefighters)
Gather longitudinal data to explore the relationships among disability status, PTSD, and deployment over time
Focus
Army
Target Population
Population Focus
Military Branch
Military Component
Abstract
Impaired functioning in the aftermath of a combat deployment is well-established. What is less clear, however, is the role of impaired functioning prior to deployment in predicting mental health adjustment following a return home. In this study, a longitudinal design was used to assess PTSD and depression symptoms, anger problems, and impaired functioning in a sample of 522 U. S. Army soldiers, two months prior to a 12-month deployment to Iraq and again three months following their return home. The study had two objectives: To determine whether predeployment functional impairment predicted postdeployment psychological adjustment level (in terms of PTSD and depression symptoms, anger problems); and to assess whether predeployment functional impairment interacted with combat exposure such that greater impairment and higher exposure were associated with poorer postdeployment psychological outcomes. A significant interaction effect between predeployment functional impairment and combat exposure in the prediction of PTSD symptoms was found using mixed-effects modeling, suggesting that service members who are exposed to high levels of combat are at greater risk for PTSD symptoms if they deployed with preexisting problems in functioning. Significant independent effects were found in models predicting depression symptoms, anger problems, and postdeployment functional impairment. Results have implications for the health of service members participating in multiple combat deployments who have limited opportunity to recover between deployments.
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