Gender, Position of Authority, and the Risk of Depression and Posttraumatic Stress Disorder among a National Sample of U.S. Reserve Component Personnel

Cohen, Gregory H.; Sampson, Laura; Fink, David S.; Wang, Jing; Russell, Dale W.; Gifford, Robert; Fullerton, Carol S.; Ursano, Robert J.; Galea, Sandro

doi:10.1016/j.whi.2016.01.001

Cited by 12 publications

(8 citation statements)

References 32 publications

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“…However, to our knowledge, this is the first study to assess direct and indirect effects of gender on depression among a cardiac population, with a particular focus on PTSD as a mediator. Previous studies have found that women are at higher risk of comorbid PTSD and depression symptoms compared to men [53, 54], similar to our findings which showed a direct significant association of female gender with PTSD and a significant indirect effect of gender on depression mediated by PTSD. Reasons for these gender differences could be attributed to the different types of traumatic or stressful situations which men and women are exposed to, different responses to trauma, and different symptom-related responses, all of which may affect the course and severity of symptoms [55].…”

Section: Discussionsupporting

confidence: 91%

Mediators of gender effects on depression among cardiovascular disease patients in Palestine

et al. 2019

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Background Among patients suffering from coronary heart disease (CHD) and comorbid depression, women experience a higher burden compared to men. Little is known on the characteristics that differentiate men and women with both diseases and whether these factors mediate gender effects on depression. This study assessed whether women are more likely to suffer from depression and which characteristics mediate gender effects on depression among a cardiac population in Palestine, specifically addressing the role of post-traumatic stress disorder (PTSD). Methods Using a cross-sectional design, patients consecutively admitted with a CHD to one of the four main hospitals in Nablus, Palestine, were interviewed using a structured questionnaire with validated instruments. Data was also obtained from hospital medical records. Patients were assessed for depression using the Cardiac Depression Scale (CDS). Bivariate analysis was conducted to compare characteristics of women and men with and without depressive symptoms. Mediators (direct and indirect effects) of the association between gender and depression were evaluated using a structural equation model (SEM). Results Women were more likely to suffer from severe depression than men (28.7% vs. 18.8%). Female gender was positively associated with higher PTSD symptoms, comorbidities, somatic symptoms and income, and with lower resilience, self-esteem, quality of life, education, prevalence of smoking and physical activity. Structural equation modeling revealed negative indirect effects of gender on depression (CDS score) through resilience, self-esteem and physical activity, whereas positive indirect effects of gender on depression were observed through PTSD, comorbidities, somatic symptoms and smoking. There was no direct effect of gender on depression. Conclusion This study found a higher prevalence of severe depression in female patients with cardiac disease compared to male cardiac patients. Our findings provide novel information on mediating factors of the association between gender and depression among cardiac patients, in particular PTSD. The results emphasize the need for further research on potential mediating factors that could account for gender differences in depression and the need to provide support programs for female patients with comorbid CHD and depression to improve their psycho-social well-being.

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Section: Discussionsupporting

confidence: 91%

Mediators of gender effects on depression among cardiovascular disease patients in Palestine

et al. 2019

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“…This finding adds to a growing body of research concerning gender-associated health outcome differences in military populations and highlights the need for additional gender-focused research [64]. To that end, an interesting avenue for future research might lie in more deeply documenting the factors, such as social support from fellow unit members, that may be lacking in the post-deployment environment for female servicemembers.…”

Section: Discussionmentioning

confidence: 76%

The evolution of mental health outcomes across a combat deployment cycle: A longitudinal study of the Guam Army National Guard

Russell

2019

PLoS ONE

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Sustained overseas military operations over the last two decades have resulted in large numbers of United States and Allied servicemembers being faced with multiple unique occupational and environmental stressors, from serving in a combat zone, to having to be away from family and home for long periods of time. These stressors result in numerous negative health (physical and mental) and behavioral outcomes. Whereas there is a substantial amount of research focused on deployment-related health outcomes within active duty military populations, reserve forces are less understood. This study focuses on a United States Army National Guard combat unit before, during and after a deployment to Afghanistan. This prospective longitudinal study, conducted over the course of an operational deployment cycle (i.e., before, during and after), documents the trajectories of salient mental health outcomes (i.e., post-traumatic stress, depression, general anxiety, and aggression). The findings show that both combat (e.g., killing others) and non-combat (e.g., boredom) stressors negatively affect mental health outcomes, and the severity of these outcomes increases over the course of a deployment cycle. Of special note, the study reveals key gender differences in the evolution of PTSD, depression and anxiety across a deployment cycle: females report increased PTSD, depression and anxiety 6 months post-deployment whereas the levels reported by males stabilize at their mid-deployment levels. The findings offer insights for medical providers and policymakers in developing more targeted health promotion campaigns and interventions, especially during the post-deployment phase.

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“…In particular, the number of women veterans increased from 2% of troops stationed in Vietnam war to 10% in OEF/OIF (Murdoch et al, 2006), and it is known there are differences in the number of trauma between male and female veterans (Cohen et al, 2016). Thus, it will be worth examining how or if the combat exposure differently influences veterans depending on gender.…”

Section: Discussionmentioning

confidence: 99%

Does combat exposure affect well-being in later life? The VA Normative Aging Study.

Lee

Choun

Spiro

2017

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective Combat exposure has long-term negative effects in later life, and aspects of service may be appraised positively, but the long-term effects of combat on well-being in later life is largely unknown. Method The sample included 1,006 male veterans from the VA Normative Aging Study, surveyed by mail in 1986, 1990, and 1991 (Mage = 62.5, SD = 7.27). They reported on their combat exposure, desirable appraisals of military service, unit cohesion, dispositional optimism, self-rated health, and psychological well-being (PWB), as well as age, military rank, and education. Perceived positive aspects (PPA) of military service was postulated to mediate the effects of combat exposure on PWB. SEM was used to examine both mediating and moderating effects. Results Age, combat exposure, and optimism had independent effects on PPA, but optimism did not moderate the effect of combat exposure on PPA. Combat exposure had only indirect effects on PWB through the PPA, controlling for the direct effects of optimism. Education had no direct effects on the positive outcomes, but did have indirect effects through optimism. Conclusion Combat exposure contributes to positive well-being in later life, indirectly through positive appraisals, and this effect was independent of optimism. Thus, these results support the idea that combat veterans should be encouraged to focus on positive aspects of military service, which may serve as resilience resources to facilitate optimal aging.

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Gender, Position of Authority, and the Risk of Depression and Posttraumatic Stress Disorder among a National Sample of U.S. Reserve Component Personnel

Cited by 12 publications

References 32 publications

Mediators of gender effects on depression among cardiovascular disease patients in Palestine

Mediators of gender effects on depression among cardiovascular disease patients in Palestine

The evolution of mental health outcomes across a combat deployment cycle: A longitudinal study of the Guam Army National Guard

Does combat exposure affect well-being in later life? The VA Normative Aging Study.

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