Publication year
2004
Citation Title
Trauma, change in strength of religious faith, and mental health service use among veterans treated for PTSD.
Journal Name
The Journal of Nervous and Mental Disease
Journal Volume
192
Issue Number
9
Page Numbers
579-584
DOI
10.1097/01.nmd.0000138224.17375.55
Summary
Veterans assessed for inpatient and outpatient posttraumatic stress disorder (PTSD) services at several Veterans Affairs (VA) hospitals were included to examine a model of interrelationships among Veterans’ traumatic exposure, PTSD, guilt, social functioning, change in religious faith, and continued use of mental health services. Results suggest that Veteran's primary motivation for continuing to pursue mental health services was driven more by their guild and the weakening of their religious faith than by the severity of their PTSD symptoms.
Key Findings
Killing others and failing to prevent the death of others weakened the comfort derived from religious faith after military service; this effect was both direct and indirect (impacted by guilt).
Both guilt and comfort from weakened faith contributed independently to more extensive participation in VA mental health sessions.
Social support and functioning did not play a significant role in the number of VA mental health sessions attended.
Implications for Program Leaders
Offer classes in coordination with chaplain services to assist Service members in reconciling their military experiences and their faith
Host support groups in which Service members and families could discuss their faith and religious beliefs related to trauma
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
Implications for Policy Makers
Encourage and continue to support access to chaplaincy programs
Continue to support programs that address the unique challenges faced by deployed parents, especially those who have experienced combat
Promote reintegration programs that include attention to assisting Service members’ family in adjusting to the Service member’s return
Methods
Data from Veterans who were evaluated for VA specialized outpatient PTSD programs (N = 554) from September 1989 to December 1991 and VA inpatient PTSD programs (N = 831) from November 1991 to January 1994 were used.
Clinicians rated Veterans’ combat experiences. Changes in religious faith, PTSD, and guilt were assessed by Veteran report, and use of mental health services was measured by the number of sessions the Veteran reported attending.
Statistical analyses were used to predict changes in religious faith.
Participants
The study included 1,385 Veterans (gender was not reported).
Most Veterans (95%) were from the Vietnam War, while 5% were from World War II.
Average age of the sample was 45.40 years (SD = 2.20). Nearly half of the sample (43%) were married, and most participants were White (74%) or Black (18%).
Ninety-four percent of the sample had a PTSD diagnosis, and the sample reported the following religions: Protestant (52%), Catholic (38%), other (7%), and none (4%).
Limitations
These data were conducted with primarily Vietnam Veterans seeking PTSD treatment and may not generalize to other populations.
The data were retrospective and were often collected years after combat experiences; therefore, results may be biased.
The magnitude of the effects demonstrated were relatively small; more extensive measurement of spirituality may lead to more robust findings.
Avenues for Future Research
Evaluate the impact of the use of chaplaincy services on Service members' functioning and/or spiritual beliefs
Design studies that assess religious faith prospectively
Conduct a similar study among newer cohorts of Service members to see if these findings replicate
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
One of the most pervasive effects of traumatic exposure is the challenge that people experience to their existential beliefs concerning the meaning and purpose of life. Particularly at risk is the strength of their religious faith and the comfort that they derive from it. The purpose of this study is to examine a model of the interrelationships among veterans’ traumatic exposure, posttraumatic stress disorder (PTSD), guilt, social functioning, change in religious faith, and continued use of mental health services. Data are drawn from studies of outpatient (N = 554) and inpatient (N = 831) specialized treatment of PTSD in Department of Veterans Affairs programs. Structural equation modeling is used to estimate the parameters of the model and evaluate its goodness of fit to the data. The model achieved acceptable goodness of fit and suggested that veterans’ experiences of killing others and failing to prevent death weakened their religious faith, both directly and as mediated by feelings of guilt. Weakened religious faith and guilt each contributed independently to more extensive use of VA mental health services. Severity of PTSD symptoms and social functioning played no significant role in the continued use of mental health services. We conclude that veterans’ pursuit of mental health services appears to be driven more by their guilt and the weakening of their religious faith than by the severity of their PTSD symptoms or their deficits in social functioning. The specificity of these effects on service use suggests that a primary motivation of veterans’ continuing pursuit of treatment may be their search for a meaning and purpose to their traumatic experiences. This possibility raises the broader issue of whether spirituality should be more central to the treatment of PTSD, either in the form of a greater role for pastoral counseling or of a wider inclusion of spiritual issues in traditional psychotherapy for PTSD.
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