Research report
Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: The role of resilience, unit support, and postdeployment social support

https://doi.org/10.1016/j.jad.2009.04.015Get rights and content

Abstract

Background

Little research has examined the role of protective factors such as psychological resilience, unit support, and postdeployment social support in buffering against PTSD and depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF).

Materials and methods

A total of 272 OEF/OIF veterans completed a survey containing PTSD and depression screening measures, and questionnaires assessing resilience, social support, and psychosocial functioning.

Results

Lower unit support and postdeployment social support were associated with increased PTSD and depressive symptoms, and decreased resilience and psychosocial functioning. Path analyses suggested that resilience fully mediated the association between unit support and PTSD and depressive symptoms, and that postdeployment social support partially mediated the association between PTSD and depressive symptoms and psychosocial functioning.

Limitations

Generalizability of results is limited by the relatively low response rate and predominantly older and reserve/National Guard sample.

Conclusions

These results suggest that interventions designed to bolster unit support, resilience, and postdeployment support may help protect against traumatic stress and depressive symptoms, and improve psychosocial functioning in veterans.

Introduction

Epidemiologic surveys of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans have found high rates of posttraumatic stress disorder (PTSD), depression, and related conditions (Tanielian and Jaycox, 2008). While it is well known that these conditions may negatively affect psychosocial functioning and quality of life in this population (e.g., Milliken et al., 2007), little research has examined the role of protective factors such as psychological resilience, unit support, and postdeployment social support in buffering against PTSD and depressive symptoms, and psychosocial difficulties.

Psychological resilience, which refers to an individual's capacity to successfully adapt or change in the face of adversity, protects against the development of combat-related PTSD in Vietnam veterans (King et al., 1998, Waysman et al., 2001) and Army Reserve soldiers (Bartone, 1999). Aspects of resilience such as positive emotions, cognitive flexibility, meaning-making, and active coping also protect against the deleterious effects of depression (Southwick et al., 2005).

Social support also protects against depression (Paykel, 1994, Southwick et al., 2005), and PTSD, with meta-analyses suggesting that it is among the strongest negative predictors of PTSD (Oliver et al., 1999, Brewin et al., 2000, Ozer et al., 2008). Higher perceived social support has also been linked to increased resilience (Bonanno et al., 2007) and lower risk of PTSD in Vietnam veterans (King et al., 1998), prisoners of war (Engdahl et al., 1997) and United Nations soldiers (Kaspersen et al., 2003). An understanding of associations between resilience, social support, PTSD and depressive symptoms, and functioning in OEF/OIF veterans is important, as it may help guide the development of interventions to enhance resilience and support, and promote successful readjustment to civilian life after deployment.

This study examined associations between resilience, unit support, postdeployment social support, traumatic stress and depressive symptoms, and psychosocial functioning 2 years following return from deployment in a sample of OEF/OIF veterans. Path analyses tested the hypotheses that unit support may help enhance psychological resilience (Bartone, 2006, Oliver et al., 1999), which in turn reduces PTSD and depressive symptom severity, and that postdeployment social support may mediate the relationship between PTSD and depressive symptoms and psychosocial difficulties (Oxman and Hull, 2001, Zatzick et al., 1997). We hypothesized that resilience would mediate the relationship between unit support and PTSD and depressive symptoms, and that postdeployment social support would mediate the relationship between PTSD and depressive symptoms and psychosocial difficulties.

Section snippets

Sample

Participants (N = 272) completed the Connecticut OEF/OIF Veterans Needs Assessment Survey. OEF/OIF veterans were identified alphabetically from a review of copies of discharge papers (DD-214s) by the Connecticut Department of Veterans' Affairs until names and addresses of 1000 potential respondents were obtained. To maintain confidentiality, surveys were addressed and mailed by the Connecticut Department of Veterans' Affairs. No personal identifying information was made available to the authors.

Results

The mean age of the total sample was 34.9 ± .4 years, 89% were white, 82% completed at least some college education, the majority (72%) were in the National Guard or reserves and 28% were on active duty; 87% were in the Army, 9% Marines, 2% Air Force, and 2% multiple branches.

Table 1 shows mean scores and standard errors, and correlations between all measures. Unit support scores correlated with scores on all other variables except combat exposure and psychosocial difficulties. Postdeployment

Discussion

This study examined the role of protective factors such as resilience and social support in protecting against traumatic stress and depressive symptoms, and psychosocial difficulties in OEF/OIF veterans. Results suggested that resilience, unit support, and postdeployment social support serve as psychosocial buffers of PTSD and depressive symptoms, and psychosocial difficulties at 2 years after deployment.

Resilience fully mediated the relationship between unit support and PTSD and depressive

Role of funding source

None of these funding sources had a role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

Conflict of interest

None of the authors have any conflicts of interest.

Acknowledgements

We thank the veterans who participated in this survey. We appreciate the assistance of the Center for Public Policy and Social Research at Central Connecticut State University and the Connecticut Department of Veterans' Affairs in conducting this research. This work was supported by a grant from the State of Connecticut, Department of Mental Health and Addiction Services, the National Center for PTSD, and a private gift.

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