Publication year
2013
Citation Title
What pre-deployment and early post-deployment factors predict health function after combat deployment?: A prospective longitudinal study of Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) soldiers.
Journal Name
Health and Quality of Life Outcomes
Journal Volume
11
Issue Number
73
Page Numbers
1-9
DOI
10.1186/1477-7525-11-73
Summary
Service members' health may be affected by deployment and combat experience. To examine this, scores on measures of Soldiers’ mental and physical health were compared from pre-deployment to immediately post-deployment. Findings indicate that deployment was associated with a general lowering in health status, both physically and mentally.
Key Findings
Physical and mental health functioning immediately after deployment was significantly lower than pre-deployment levels.
Poorer mental health post-deployment was associated with the following pre-deployment variables: younger age, low levels of social support, PTSD symptoms, more physical symptoms, and poor mental health.
Poorer physical health post-deployment was associated with the following pre-deployment variables: older age, poorer physical health, lower blood pressure reactivity, greater severity of physical symptoms, and incurring injuries during deployment.
Implications for Program Leaders
Develop classes to teach military families about the importance of relying on others and asking for help, highlighting ways that military families can support one another
Include curriculum that encourages Service members to actively seek out social support, especially upon return from deployment
Disseminate information regarding possible symptoms of mental and physical health problems Service members may face after deployment and where individuals and families can find help for those problems
Implications for Policy Makers
Continue to support morale, welfare, and recreation programs which are aimed at building social support for Service members
Continue to support programs that address the unique challenges faced by deployed parents
Recommend education for service providers around the possible effects of deployment on Service members’ families
Methods
This longitudinal study included data collection at two time points: Phase 1 (pre-deployment, 2005-2008) and Phase 2 (immediately after return, 2007-2009).
Soldiers deploying to Iraq and Afghanistan were given questionnaires about their physical and mental functioning (assessed with the Veteran’s Rand-36) in addition to basic demographic information, and physiological measures (blood pressure reactivity to stressful situations and body mass index).
Key psychosocial measures included: negative emotionality, the extent to which an individual is absorbed in his own thoughts, stressful life events, social desirability, social support, severity of physical symptoms (measured as number of symptoms and extent to which they impact daily functioning), and coping style (active versus avoidant).
Post-deployment-related measures included: deployment experiences (assessed with Deployment Risk and Resilience Aftermath of Battle subscale), unit cohesion, PTSD symptomology, and physical symptoms.
Participants
Seven hundred ninety members of the Army National Guard (72%), Reserve (26%), and Active Duty personnel (1%) completed questionnaires in Phase 1.
The majority of participants were male (90%) and White (77%), with a mean age of 28 years (SD = 8.3 years, range = 18-57 years).
Among the participants, the Phase 2 completion rate was 53% (n = 422).
Limitations
There was no non-deployed “control” group, so comparative analyses are not possible.
This study had a high rate of attrition from Phase 1 to Phase 2, making it difficult to determine whether Phase 2 data can be generalized.
Measurement error may have been introduced as a result of using different styles of data collection (e.g., phone surveys, paper surveys, and computer surveys were all used).
Avenues for Future Research
Include a non-deployed comparison group to allow for comparisons between the deployed and non-deployed participants across time
Replicate the study and incorporate additional physiological measures for stress reactivity
Explore the extent to which health behaviors (e.g., smoking, diet, etc.) impact Service members' health outcomes
Focus
Army
Target Population
Population Focus
Military Branch
Military Component
Abstract
Physical and mental function are strong indicators of disability and mortality. OEF/OIF Veterans returning from deployment have been found to have poorer function than soldiers who have not deployed; however the reasons for this are unknown. A prospective cohort of 790 soldiers was assessed both pre- and immediately after deployment to determine predictors of physical and mental function after war. On average, OEF/OIF Veterans showed significant declines in both physical (t=6.65, p<.0001) and mental function (t=7.11, p<.0001). After controlling for pre-deployment function, poorer physical function after deployment was associated with older age, more physical symptoms, blunted systolic blood pressure reactivity and being injured. After controlling for pre-deployment function, poorer mental function after deployment was associated with younger age, lower social desirability, lower social support, greater physical symptoms and greater PTSD symptoms. Combat deployment was associated with an immediate decline in both mental and physical function. The relationship of combat deployment to function is complex and influenced by demographic, psychosocial, physiological and experiential factors. Social support and physical symptoms emerged as potentially modifiable factors.
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