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Showing library results for: August 2022

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1 Military and veteran help-seeking behaviors: Role of mental health stigma and leadership

Military and veteran help-seeking behaviors: Role of mental health stigma and leadership

APA Citation:

McGuffin, J. J., Riggs, S. A., Raiche, E. M., & Romero, D. H. (2021). Military and veteran help-seeking behaviors: Role of mental health stigma and leadership. Military Psychology, 33(5), 332-340. https://doi.org/10.1080/08995605.2021.1962181

Focus:

Mental health
Trauma
Veterans

Branch of Service:

Army
Air Force
Marine Corps
Navy
Multiple branches

Military Affiliation:

Active Duty
Veteran

Population:

Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


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Research & Summary

Authors: McGuffin, James J.; Riggs, Shelley A.; Raiche, Emily M.; Romero, Daniel H.

Year: 2021

Abstract

Mental health stigma has been identified as a barrier to help-seeking in the United States. This may be particularly salient for military personnel who tend to report higher mental health stigma than the general population. Evidence suggests that both supportive and destructive military leadership are related to service members’ attitudes toward seeking help. In the current study, a sample of military service members and Veterans (N = 232) completed an online survey regarding mental health stigma, previous experiences with military leaders, and mental health help-seeking behaviors. Findings indicated that destructive and supportive leadership experiences were significantly related to self stigma, public stigma, and help-seeking. Military members and Veterans who experienced destructive leadership were more likely to report internalized mental health stigma, which decreased the likelihood of seeking help. Supportive leadership, on the other hand, was associated with greater likelihood of seeking help for mental health concerns, and was indirectly related to help-seeking through lower self-stigma. Findings suggest that the military leadership style plays a significant role in service members’ and Veterans’ willingness to seek assistance for mental health concerns.

2 Barriers to licensure for military spouse registered nurses

Barriers to licensure for military spouse registered nurses

APA Citation:

Brannock, M. K., & Bradford, N. A. (2021). Barriers to licensure for military spouse registered nurses. Journal of Nursing Regulation, 11(4), 4-14. https://doi.org/10.1016/S2155-8256(20)30170-8

Focus:

Programming
Other

Branch of Service:

Air Force
Army
Coast Guard
Marine Corps
Navy
Multiple branches

Military Affiliation:

Active Duty

Population:

Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


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Research & Summary

Authors: Brannock, Mary K.; Bradford, Nicole A.

Year: 2021

Abstract

Background : By 2030, one million registered nurses (RNs) in the United States are projected to retire, which will exacerbate an existing U.S. nurse shortage. Reasons for the shortage include retiring RNs, an aging population, nurse burnout, and fewer nurse educators. Interestingly, military spouse RNs face unique hurdles to employment. Nursing is among the most common professions for military spouses, yet 89% of spouses did not relicense after a military move (Bradbard et al., 2016). Purpose The aim of this study was to better understand the military spouse RN landscape as it relates to barriers and facilitators to employment and the feasibility of licensure innovation. Methods A mixed methods feasibility review of 191 completed surveys and 14 semi-structured in-depth interviews were completed with military spouse RNs. Additionally, 5 stakeholder in-depth interviews were conducted and represent voices from hospitals, government, patient safety, and non-profit organizations. Results Multiple challenges with licensing were noted. More than 35% of the surveyed RN sample indicated they considered leaving the field of nursing due to constant licensing issues. Stakeholders and nurses aligned on the need for a unified platform that could assist with licensing, and preliminary feasibility was obtained for license innovation. Conclusion Differing state licensure requirements are a significant barrier to military spouses staying in the nursing workforce. Enhancing compacts or allowing special regulation for this population is critical not only to improve patient health outcomes, but also to support military families and the unique challenges they face as a result of frequent relocations.

3 COVID‐19 and the relationships and involvement of nonresident fathers

COVID‐19 and the relationships and involvement of nonresident fathers

APA Citation:

Adamsons, K. (2022). COVID-19 and the relationships and involvement of nonresident fathers. Family Relations, 71(3), 827-848. https://doi.org/10.1111/fare.12663

Focus:

Parents
Children
Mental health

Population:

Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


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Research & Summary

Authors: Adamsons, Kari

Year: 2022

Abstract

Objective Background Method Results Conclusion and Implications To support nonresident fathers in maintaining involvement and relationships with their children during the COVID‐19 pandemic, we must understand how such fathers have been impacted thus far by the pandemic.All families have been impacted by the pandemic, but fathers who do not reside with their children are particularly likely to be negatively impacted. Social distancing, restrictions on travel, job loss/economic downturn, family court closures, and numerous other effects of the COVID‐19 crisis impact the ability of nonresident fathers to maintain relationships and involvement with their children.The current study analyzed retrospective data from 373 nonresident U.S. fathers to assess perceived parenting and coparenting changes during the pandemic, as well as whether coparenting relationships and mental health were associated with their involvement and relationships with their children.On average, fathers' involvement, father–child relationship quality, and coparenting support declined, but wide variability also existed, with a substantial minority of fathers reporting increased involvement. Coparenting support was positively associated with current levels of involvement and relationship quality as well as changes to both since the pandemic, but mental health was inconsistently associated with outcomes.To keep these average declines from becoming permanent, future research should investigate what factors foster higher involvement and improved relationships. Practitioners should offer additional support to nonresident fathers to promote their involvement and relationships in ways compatible with evolving restrictions.

4 Mechanisms of the association between PTSD and sexual arousal and lubrication functioning among trauma-exposed female service members/veterans

Mechanisms of the association between PTSD and sexual arousal and lubrication functioning among trauma-exposed female service members/veterans

APA Citation:

Blais, R. K., Bird, E., Sartin-Tarm, A., Campbell, S. B., & Lorenz, T. (2022). Mechanisms of the association between PTSD and sexual arousal and lubrication functioning among trauma-exposed female service members/veterans. Journal of Affective Disorders, 301, 352-359. https://doi.org/10.1016/j.jad.2021.12.106

Focus:

Mental health
Physical health
Trauma

Branch of Service:

Multiple branches

Military Affiliation:

Active Duty
Veteran

Population:

Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


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Research & Summary

Authors: Blais, Rebecca K.; Bird, Elizabeth; Sartin-Tarm, Annaliis; Campbell, Sarah B.; Lorenz, Tierney

Year: 2021

Abstract

Background The presence of a post-traumatic stress disorder (PTSD) diagnosis or higher PTSD severity is associated with higher overall sexual dysfunction in female service members/veterans. However, the mechanisms linking PTSD to specific components of women's sexual arousal function, like lubrication and mental arousal, are unknown. Methods We conducted a survey among 464 women who reported probable Criterion A exposure for PTSD. Path analysis examined (1) the association of PTSD with sexual arousal, (2) whether specific PTSD symptom clusters were uniquely associated with sexual arousal, and (3) whether this association is indirect, through the effects of higher depression severity and lower romantic relationship satisfaction. Arousal was operationalized to measure both mental (subjective arousal) and physical (lubrication) experiences. Results Higher PTSD severity was associated with lower lubrication and arousal function. The association of PTSD severity with arousal was indirect, through lower romantic relationship satisfaction (estimate: -0.12; 95% CI: [-0.014, -0.007]) and higher depression (estimate: -0.08, 95% CI: [-0.012, -0.002]). The association of PTSD severity with lubrication was also indirect, but only through lower relationship satisfaction (estimate: -0.10, 95% CI: [-0.013, -0.006]). PTSD symptom clusters were not uniquely associated with arousal and lubrication through mediated pathways. Limitations Data were from a cross-sectional study using a convenience sample. Criterion A exposure could not be confirmed. Conclusions PTSD may lead to arousal and lubrication dysfunction by contributing to higher depression severity and strained romantic relationships. Interventions targeting reductions in depressive symptoms and bolstering relationship satisfaction may minimize the burden of PTSD on sexual arousal concerns.

5 Emotionally focused couple therapy within VA healthcare: Reductions in relationship distress, PTSD, and depressive symptoms as a function of attachment-based couple treatment

Emotionally focused couple therapy within VA healthcare: Reductions in relationship distress, PTSD, and depressive symptoms as a function of attachment-based couple treatment

APA Citation:

Ganz, M. B., Rasmussen, H. F., McDougall, T. V., Corner, G. W., Black, T. T., & De Los Santos, H. F. (2022). Emotionally focused couple therapy within VA healthcare: Reductions in relationship distress, PTSD, and depressive symptoms as a function of attachment-based couple treatment. Couple and Family Psychology: Research and Practice, 11(1), 15–32. https://doi.org/10.1037/cfp0000210

Focus:

Couples
Veterans

Branch of Service:

Army
Navy
Marine Corps
Air Force
Coast Guard
Multiple branches

Military Affiliation:

Veteran

Population:

Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


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Research & Summary

Authors: Ganz, Michael B.; Rasmussen, Hannah F.; McDougall, Tatiana V.; Corner, Geoffrey W.; Black, Tabitha T.; De Los Santos, Hector F.

Year: 2021

Abstract

Emotionally Focused Couple Therapy (EFT) is a well-established, attachment-based treatment for relationship distress. This study seeks to further previous research by examining the impact of EFT on veterans’ and their partners’ symptoms of posttraumatic stress disorder (PTSD), depression, and relationship distress, in a real-life clinical setting. The present study uses dyadic data analyses to test three hypotheses: from pre to posttherapy veterans and their partners would report (a) increases in relationship satisfaction and decreases in (b) PTSD and (c) depression symptoms. In addition, we tested whether diagnostic status at the start of therapy, that is, meeting clinical criteria for that outcome, moderated the changes. Data were collected as part of routine care at an outpatient clinic at a Veterans Affairs (VA) Hospital. The sample consisted of 29 couples. Pre and postmeasures were obtained at the first and final sessions (Msessions = 15.52 SD = 7.19). Multilevel models examining changes across time for all partners found that the difference between pre and posttherapy scores for relationship satisfaction (b = 10.85, p b = −1.61, p b = 13.93, p b = −12.39, p b = −7.64, p < .001). Although PTSD and depression are not the focus of treatment, results indicate EFT is effective at reducing relationship distress and individual symptomatology in veterans and their partners.

6 Transgenerational factors associated with military service: Comparison of children of veterans and nonveterans in a nationally representative sample

Transgenerational factors associated with military service: Comparison of children of veterans and nonveterans in a nationally representative sample

APA Citation:

Bommersbach, T. J., Rosenheck, R., & Rhee, T. G. (2022). Transgenerational factors associated with military service: Comparison of children of veterans and nonveterans in a nationally representative sample. Journal of the American Academy of Child and Adolescent Psychiatry, 61, 1141-1154. https://doi.org/10.1016/j.jaac.2022.03.024

Focus:

Children
Mental health
Physical health
Veterans

Branch of Service:

Multiple branches

Military Affiliation:

Veteran
Reserve
Guard

Population:

Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)
School age (6 - 12 yrs)


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Research & Summary

Authors: Bommersbach, Tanner J.; Rosenheck, Robert; Rhee, Greg

Year: 2022

Abstract

Objective While the psychological effects of military service on the children of active-duty personnel have been studied extensively, little is known about the potential effects of military service for children of veterans after service has ended. Method Using nationally-representative data from the 2018-2019 National Survey of Children’s Health (NSCH), we compare the school-age children of veteran families (n=4,028) to those of non-veteran families (n=38,228). Due to large sample sizes, effect sizes (relative risk and Cohen’s d), rather than p values, were used to identify substantial differences in caregiver-reported sociodemographic, clinical, and school performance factors between children and caregivers in families with and without a veteran caregiver. Multivariate analyses were used to adjust for socio-economic factors that could increase health service use. Results Children of veteran families were more likely to have higher family incomes, health insurance, and married caregivers but are also reported to have higher rates of clinically-recognized externalizing behavioral conditions (ADD/ADHD or conduct) (17.6% vs. 12.7%, relative risk, 1.42; 95% confidence intervals (CI), 1.21-1.66) and adverse childhood experiences; but no substantial differences in clinically-recognized anxiety or depression. After adjustment for potentially confounding factors, children in veteran families were still more likely to be reported to have externalizing problems (odds ratio, 1.34; 95% CI, 1.02-1.77). Conclusion After adjustment for socio-economic advantages that may increase health service use, children of veteran families demonstrate substantially higher rates of clinically-recognized externalizing problems. While explanations for this require further study, service systems working with veterans may consider integrating child-focused screening/services.

7 Quantifying the emotional experiences of partners of veterans with PTSD service dogs using ecological momentary assessment

Quantifying the emotional experiences of partners of veterans with PTSD service dogs using ecological momentary assessment

APA Citation:

Nieforth, L. O., Abdul Wahab, A. H., Sabbaghi, A., MacDermid Wadsworth, S., Foti, D., & O’Haire, M. E. (2022). Quantifying the emotional experiences of partners of veterans with PTSD service dogs using ecological momentary assessment. Complementary Therapies in Clinical Practice, 48, Article 101590. https://doi.org/10.1016/j.ctcp.2022.101590

Focus:

Couples
Mental health
Veterans

Branch of Service:

Multiple branches

Military Affiliation:

Veteran

Population:

Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


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Research & Summary

Authors: Nieforth, Leanne O.; Abdul Wahab, Ahmad Hakeem; Sabbaghi, Arman; MacDermid Wadsworth, Shelley; Foti, Daniel; O'Haire, Marguerite E.

Year: 2022

Abstract

The objective of this study was to investigate the day-to-day experiences of positive and negative emotions among partners of veterans assigned service dogs for posttraumatic stress disorder (PTSD). As part of a larger clinical trial, a total of N = 87 partners of post-9/11 veterans with PTSD were recruited from a nonprofit service dog provider and participated in an ecological momentary assessment (EMA) protocol. The sample included partners of veterans who received a PTSD service dog after baseline (n = 48, treatment group) and partners of veterans on the waitlist for a service dog (n = 39, control group). Data were collected twice daily for two weeks at baseline and again at follow-up three months later, for approximately 56 assessments per participant (28 at baseline, 28 at follow up). Participants completed an average of 84% of questionnaires at baseline (n = 23.6) and 86% (n = 24.1) at follow-up. A total of 3780 EMA questionnaires were collected among partners for this analysis. Data were analyzed using a generalized linear mixed model. Three months following baseline, partners of veterans with service dogs reported statistically significant higher levels of positive emotions than the control partners (p = .01, d = 0.39) with small-to-medium effect sizes for each individual positive emotion. No statistically significant differences were reported for negative emotions (p = .77, d = 0.21). This study quantitatively identifies higher levels of positive emotion in partners who are cohabitating with a PTSD service dog compared to those partners who remained on the waitlist. Given the influence that positive emotions have on well-being and coping, findings suggest that the influence of service dogs may go beyond veterans to influence their cohabitating partners.

8 New mental health diagnoses in parents of infants admitted to a neonatal intensive care unit—A retrospective review of the Military Health System database

New mental health diagnoses in parents of infants admitted to a neonatal intensive care unit—A retrospective review of the Military Health System database

APA Citation:

Farr, B. J., Evans, A. M., Rush, T. M., Grabill, C. M., Ricca, R. L., & Rice-Townsend, S. E. (2022). New mental health diagnoses in parents of infants admitted to a neonatal intensive care unit—A retrospective review of the Military Health System database. Journal of Perinatology, 42, 738-744. https://doi.org/10.1038/s41372-022-01331-7

Focus:

Parents
Mental health
Substance use

Branch of Service:

Multiple branches
Navy
Air Force
Marine Corps
Coast Guard

Military Affiliation:

Guard
Reserve
Veteran

Population:

Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


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Research & Summary

Authors: Farr, Bethany J.; Evans, Amber M.; Rush, Toni M.; Grabill, Colette M.; Ricca, Robert L.; Rice-Townsend, Samuel E.

Year: 2022

Abstract

Objective Studies suggest that parents of NICU infants are at increased risk of mental health disorders. We sought to characterize this risk using a large database. Study design The Military Health System was used to retrospectively link records between parents and infants admitted to a NICU over 5 years and were matched to similar families without NICU exposure. The total study population included 35,012 infants. Logistic regression was used to estimate the association between NICU exposure and parental mental health diagnoses within 5 years of infant birth. Results Maternal NICU exposure was associated with incident diagnoses of depression (OR: 1.18–1.27, p < 0.0001), anxiety (OR: 1.06–1.18, p = 0.0151), alcohol/opiate dependence (OR: 1.29–1.52, p = 0.0079), and adjustment disorder (OR: 0.97–1.18, p = 0.0224). Paternal NICU exposure was associated with alcohol/opiate dependence (OR: 0.78–1.42, p = 0.0339). Conclusion Parents of NICU infants are at risk of developing mental health disorders. Future work should identify characteristics that predict highest risk to develop effective interventions.

9 A person-centered approach to identifying at-risk U.S. Army soldiers-in-training based on adverse childhood experiences

A person-centered approach to identifying at-risk U.S. Army soldiers-in-training based on adverse childhood experiences

APA Citation:

Reed-Fitzke, K., Duncan, J. M., Wojciak, A. S., Ferraro, A J., Sánchez, J., & Smith, K. M. (2022). A person-centered approach to identifying at-risk U.S. Army soldiers-in-training based on adverse childhood experiences. Traumatology. Advance online publication. https://doi.org/10.1037/trm0000395

Focus:

Child maltreatment
Mental health
Trauma

Branch of Service:

Army

Military Affiliation:

Active Duty

Population:

Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)


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Research & Summary

Authors: Reed-Fitzke, Kayla; Duncan, James M.; Wojciak, Armeda S.; Ferraro, Anthony J.; Sánchez, Jennifer; Smith, Kevin M.

Year: 2022

Abstract

Military service members are confronted with numerous stressors as they progress through their career. Given the military’s desire to maintain mission readiness, it is imperative to identify areas of early intervention to promote optimal functioning and health. This study used the stress process framework and a person-centered approach to identify subgroups of soldiers-in-training based on adverse childhood experiences (ACEs). Specifically, two questions were addressed: (a) Are there distinct profiles of ACEs among soldiers-in-training, and (b) who are the most at-risk soldiers-in-training? The sample consisted of 30,836 soldiers-in-training from the Army study to Assess Risk and Resilience in Servicemembers. Five subgroups were identified using latent profile analysis: low adversity, moderate emotional adversity, elevated emotional adversity, moderate structural adversity, and high cumulative adversity. Results from a multivariate and univariate analyses of variance indicated significant small main effects of profile membership in anxiety, depression, posttraumatic stress disorder, and resilient mindset. Those with high cumulative adversity and elevated emotional adversity appeared to be the most at-risk regarding mental health, yet those with high cumulative adversity had similar levels of resilient mindset as the lower adversity groups. Those with elevated emotional adversity had the lowest levels of resilient mindset. Findings provide a more holistic understanding of unique combinations of ACEs among individuals’ as they enter military service. ACEs profiles may help providers identify those who may benefit from targeted supports (e.g., trauma-informed mental health providers) prior to or during service for those who may be most vulnerable to poor outcomes.

10 Gender differences in marital and military predictors of service member career satisfaction

Gender differences in marital and military predictors of service member career satisfaction

APA Citation:

Street, T., Lewin, A., Woodall, K., Cruz-Cano, R., Thoma, M., & Stander, V. A. (2022). Gender differences in marital and military predictors of service member career satisfaction. Family Relations, 71(4), 1515-1537. https://doi.org/10.1111/fare.12697

Focus:

Mental health
Couples
Deployment

Branch of Service:

Army
Navy
Coast Guard
Marine Corps
Air Force
Multiple branches

Military Affiliation:

Active Duty
Veteran
Reserve

Population:

Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


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Research & Summary

Authors: Street, Towanda; Lewin, Amy; Woodall, Kelly; Cruz-Cano, Raul; Thoma, Marie; Stander, Valerie A.

Year: 2022

Abstract

Background U.S. servicewomen may face unique military experiences unlike those of servicemen, and stressors can affect their satisfaction with the military. Understanding factors influencing satisfaction among the increasing number of U.S. servicewomen in the U.S. military is important for retention. Methods Using family stress theory, data from service members and their spouses (N = 9325) enrolled in the Millennium Cohort Family Study were analyzed using cross-sectional linear regression to evaluate the relationship between military and family stressors and service members' military satisfaction, and how these relationships differ by gender. Results Service members with more deployment experience and better mental health were more satisfied with the military, while spouse employment outside the home and work–family conflict were associated with less satisfaction. Gender, marital quality, and social support moderated the relationships between stressors and military satisfaction, suggesting they may impact men and women differently. Overall, however, work–family conflict was associated with decrements in the career satisfaction of both men and women. Conclusion This study increases our understanding of the influence military and family stressors have on service members' satisfaction with the military. It also reveals gender differences in military satisfaction and recommends strategies to address the needs of diverse military families.

11 How work-related guilt informs parenting and adolescent psychological distress in military families

How work-related guilt informs parenting and adolescent psychological distress in military families

APA Citation:

Farnsworth, M. L., & O’Neal, C. W. (2022). How work-related guilt informs parenting and adolescent psychological distress in military families. Family Relations, 71(4), 1575-1592. https://doi. org/10.1111/fare.12685

Focus:

Parents
Children
Mental health

Branch of Service:

Army

Military Affiliation:

Active Duty

Population:

Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


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Research & Summary

Authors: Farnsworth, Meredith L.; O'Neal, Catherine W.

Year: 2022

Abstract

Objective The current study examined inconsistent discipline as a linking mechanism connecting parental guilt about work to adolescent psychological distress in military families. Background Military families may face tensions connected to competing demands of family and the military career, which can produce a sense of parental guilt. This guilt may contribute to poor parenting behaviors, such as inconsistent discipline, which can be detrimental for adolescents (e.g., leading to depression and anxiety). Method A structural equation model with data from 223 military families (i.e., active duty father, civilian mother, and adolescent) examined the associations among parental guilt, inconsistent discipline, and adolescent psychological distress. Results Active duty fathers' guilt and inconsistent discipline were related to their perceptions of adolescent psychological distress, whereas civilian mothers' guilt was indirectly related to both their own and their partner's perceptions of adolescent psychological distress through their inconsistent discipline. Conclusion Inconsistent discipline is a parenting behavior related to parental guilt and adolescent psychological distress. More research is needed to better understand the nuances of military contexts for families. Implications Inconsistent discipline is a specific, malleable parenting behavior with implications for prevention and intervention programs designed for military families as well as family-related policies in the military.

12 Unit cohesion during deployment and post-deployment mental health: Is cohesion an individual- or unit-level buffer for combat-exposed soldiers?

Unit cohesion during deployment and post-deployment mental health: Is cohesion an individual- or unit-level buffer for combat-exposed soldiers?

APA Citation:

Campbell-Sills, L., Flynn, P. J., Choi, K. W., Ng, T. H. H., Aliaga, P. A., Broshek, C., Jain, S…Bliese, P. D. (2022). Unit cohesion during deployment and post-deployment mental health: Is cohesion an individual- or unit-level buffer for combat-exposed soldiers? Psychological Medicine, 52, 121-131. https://doi.org/10.1017/S0033291720001786

Focus:

Deployment
Mental health

Branch of Service:

Army

Military Affiliation:

Active Duty

Population:

Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


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Research & Summary

Authors: Campbell-Sills, Laura; Flynn, Patrick J.; Choi, Karmel W.; Ng, Tsz Hin H.; Aliaga, Pablo A.; Broshek, Catherine; Jain, Sonia; Kessler, Ronald C.; Stein, Murray B.; Ursano, Robert J.; Bliese, Paul D.

Year: 2020

Abstract

BACKGROUND: Unit cohesion may protect service member mental health by mitigating effects of combat exposure; however, questions remain about the origins of potential stress-buffering effects. We examined buffering effects associated with two forms of unit cohesion (peer-oriented horizontal cohesion and subordinate-leader vertical cohesion) defined as either individual-level or aggregated unit-level variables. METHODS: Longitudinal survey data from US Army soldiers who deployed to Afghanistan in 2012 were analyzed using mixed-effects regression. Models evaluated individual- and unit-level interaction effects of combat exposure and cohesion during deployment on symptoms of post-traumatic stress disorder (PTSD), depression, and suicidal ideation reported at 3 months post-deployment (model n's = 6684 to 6826). Given the small effective sample size (k = 89), the significance of unit-level interactions was evaluated at a 90% confidence level. RESULTS: At the individual-level, buffering effects of horizontal cohesion were found for PTSD symptoms [B = -0.11, 95% CI (-0.18 to -0.04), p < 0.01] and depressive symptoms [B = -0.06, 95% CI (-0.10 to -0.01), p < 0.05]; while a buffering effect of vertical cohesion was observed for PTSD symptoms only [B = -0.03, 95% CI (-0.06 to -0.0001), p < 0.05]. At the unit-level, buffering effects of horizontal (but not vertical) cohesion were observed for PTSD symptoms [B = -0.91, 90% CI (-1.70 to -0.11), p = 0.06], depressive symptoms [B = -0.83, 90% CI (-1.24 to -0.41), p < 0.01], and suicidal ideation [B = -0.32, 90% CI (-0.62 to -0.01), p = 0.08]. CONCLUSIONS: Policies and interventions that enhance horizontal cohesion may protect combat-exposed units against post-deployment mental health problems. Efforts to support individual soldiers who report low levels of horizontal or vertical cohesion may also yield mental health benefits.

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