The Army National Guard in OIF/OEF: Relationships among combat exposure, postdeployment stressors, social support, and risk behaviors

With the continued operations in Iraq and Afghanistan, studies of the prevalence of posttraumatic stress disorder and related symptoms are now common. However, lacking is how these symptoms relate to precipitating conditions and the mitigating effects of social support on these symptoms. This is particularly relevant for reserve military personnel, who have been shown to be greater at-risk for postdeployment problems. The present study examined questionnaire data obtained from Army National Guard (ARNG) units immediately after their return from deployment to Iraq and Afghanistan during 2010 (N = 4329 soldiers in 50 units). Findings showed few soldiers displayed risk behaviors (i.e., daily alcohol use, use of illicit drugs, suicide thoughts, and physically threatening others) during and after deployment. Those most likely to have more postdeployment risk behaviors were also those who showed more risk behaviors during deployment. A substantial percentage of soldiers reported combat exposure, postdeployment negative emotions, and postdeployment loss of a personal relationship. These reported outcomes were all related to increased risk behaviors after deployment. The buffering effect of social support on postdeployment risk behaviors was equally evident when data were examined individually and when grouped by unit memberships. Implications of findings for future research, practice, and policies are discussed.

[1]  M. Hotopf,et al.  Risk factors for post-traumatic stress disorder among UK Armed Forces personnel , 2008, Psychological Medicine.

[2]  Karen A. Matthews,et al.  Understanding the association between socioeconomic status and physical health: do negative emotions play a role? , 2003 .

[3]  G. Caplan Principles of Preventive Psychiatry , 1964 .

[4]  L. Berkowitz,et al.  On the formation and regulation of anger and aggression. A cognitive-neoassociationistic analysis. , 1990, The American psychologist.

[5]  Katherine I. Schexneider Stethoscopes and headscarves: female medical students in present-day Afghanistan. , 2010, Military medicine.

[6]  Jolanda Jetten,et al.  Social Identity, Health and Well-Being: An Emerging Agenda for Applied Psychology , 2009 .

[7]  J. Cameron,et al.  The Nature and Consequences of Group Cohesion in a Military Sample , 2007 .

[8]  S. Wessely,et al.  Use of psychological decompression in military operational environments. , 2008, Military medicine.

[9]  Mario Mikulincer,et al.  Attachment theory and group processes: the association between attachment style and group-related representations, goals, memories, and functioning. , 2003, Journal of personality and social psychology.

[10]  D. King,et al.  Deployment stressors and posttraumatic stress symptomatology: comparing active duty and National Guard/Reserve personnel from Gulf War I. , 2008, Journal of traumatic stress.

[11]  M. Hotopf,et al.  Help-seeking and receipt of treatment among UK service personnel , 2010, British Journal of Psychiatry.

[12]  Elazar J. Pedhazur,et al.  Measurement, Design, and Analysis: An Integrated Approach , 1994 .

[13]  Charles W Hoge,et al.  Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. , 2006, JAMA.

[14]  O. Levi,et al.  Combat exposure, posttraumatic stress symptoms and risk-taking behavior in veterans of the Second Lebanon War. , 2010, The Israel journal of psychiatry and related sciences.

[15]  Tyler C Smith,et al.  New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: prospective population based US military cohort study , 2008, BMJ : British Medical Journal.

[16]  Judith Lewis Herman,et al.  Trauma and Recovery , 2015 .

[17]  Jacob Cohen,et al.  Applied multiple regression/correlation analysis for the behavioral sciences , 1979 .

[18]  R. Tedeschi,et al.  TARGET ARTICLE: "Posttraumatic Growth: Conceptual Foundations and Empirical Evidence" , 2004 .

[19]  Anthony S. Bryk,et al.  Hierarchical Linear Models: Applications and Data Analysis Methods , 1992 .

[20]  T. Harford,et al.  Deployment to a combat zone and other risk factors for mental health-related disability discharge from the U.S. Army: 1994-2007. , 2011, Journal of traumatic stress.

[21]  Neil Greenberg,et al.  Mental health of UK military personnel while on deployment in Iraq , 2010, British Journal of Psychiatry.

[22]  Sharon McBride,et al.  Master Resilience Training in the U.s. Army Background of the Penn Resilience Program (prp) , 2022 .

[23]  Christopher Dandeker,et al.  What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study , 2010, The Lancet.

[24]  Charles W Hoge,et al.  Prevalence of mental health problems and functional impairment among active component and National Guard soldiers 3 and 12 months following combat in Iraq. , 2010, Archives of general psychiatry.

[25]  T. Wills,et al.  Stress, social support, and the buffering hypothesis. , 1985, Psychological bulletin.

[26]  D. Jacobson Types and timing of social support. , 1986, Journal of health and social behavior.

[27]  Lynda A. King,et al.  The Impact of Killing on Mental Health Symptoms in Gulf War Veterans , 2011 .

[28]  Helena K. Chandler,et al.  Effects of repeated deployment to Iraq and Afghanistan on the health of New Jersey Army National Guard troops: implications for military readiness. , 2010, American journal of public health.

[29]  Charles W Hoge,et al.  Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. , 2007, JAMA.

[30]  David A. Hofmann,et al.  Centering Decisions in Hierarchical Linear Models: Implications for Research in Organizations , 1998 .

[31]  C. Hoge,et al.  Coming home may hurt: risk factors for mental ill health in US reservists after deployment in Iraq , 2011, British Journal of Psychiatry.

[32]  T. Wells,et al.  Alcohol use and alcohol-related problems before and after military combat deployment. , 2008, JAMA.

[33]  S. Paunonen,et al.  Personality traits and health‐risk behaviours in university students , 2009 .

[34]  James Griffith,et al.  Multilevel Analysis of Cohesion's Relation to Stress, Well-Being, Identification, Disintegration, and Perceived Combat Readiness , 2002 .

[35]  S. Hobfoll Conservation of resources. A new attempt at conceptualizing stress. , 1989, The American psychologist.

[36]  N. Breslau,et al.  Traumatic events and posttraumatic stress disorder in an urban population of young adults. , 1991, Archives of general psychiatry.

[37]  Susan P Proctor,et al.  PTSD symptoms, life events, and unit cohesion in U.S. soldiers: baseline findings from the neurocognition deployment health study. , 2007, Journal of traumatic stress.

[38]  R. Weiss The provisions of social relationships , 1974 .

[39]  S. West,et al.  Multiple Regression: Testing and Interpreting Interactions. , 1994 .

[40]  S E Hobfoll,et al.  Effects of social support and battle intensity on loneliness and breakdown during combat. , 1986, Journal of personality and social psychology.

[41]  J. Griffith The Army's New Unit Personnel Replacement and Its Relationship to Unit Cohesion and Social Support , 1989 .

[42]  J. Griffith Citizens Coping as Soldiers: A Review of Deployment Stress Symptoms Among Reservists , 2010 .

[43]  Yuk Fai Cheong,et al.  HLM 6: Hierarchical Linear and Nonlinear Modeling , 2000 .

[44]  Lawrence G. Calhoun,et al.  TARGET ARTICLE: "Posttraumatic Growth: Conceptual Foundations and Empirical Evidence" , 2004 .

[45]  D. Hofmann,et al.  The application of hierarchical linear modeling to organizational research. , 2000 .

[46]  R. Kessler,et al.  Posttraumatic stress disorder in the National Comorbidity Survey. , 1995, Archives of general psychiatry.