Mental health across the early years in the military

Abstract

Background The mental health impact of the initial years of military service is an under-researched area. This study is the first to explore mental health trajectories and associated predictors in military members across the first 3–4 years of their career to provide evidence to inform early interventions. Methods This prospective cohort study surveyed Australian Defence personnel (n = 5329) at four time-points across their early military career. Core outcomes were psychological distress (K10+) and posttraumatic stress symptoms [four-item PTSD Checklist (PCL-4)] with intra-individual, organizational and event-related trajectory predictors. Latent class growth analyses (LCGAs) identified subgroups within the sample that followed similar longitudinal trajectories for these outcomes, while conditional LCGAs examined the variables that influenced patterns of mental health. Results Three clear trajectories emerged for psychological distress: resilient (84.0%), worsening (9.6%) and recovery (6.5%). Four trajectories emerged for post-traumatic stress, including resilient (82.5%), recovery (9.6%), worsening (5.8%) and chronic subthreshold (2.3%) trajectories. Across both outcomes, prior trauma exposure alongside modifiable factors, such as maladaptive coping styles, and increased anger and sleep difficulties were associated with the worsening and chronic subthreshold trajectories, whilst members in the resilient trajectories were more likely to be male, report increased social support from family/friends and Australian Defence Force (ADF) sources, and use adaptive coping styles. Conclusions The emergence of symptoms of mental health problems occurs early in the military lifecycle for a significant proportion of individuals. Modifiable factors associated with wellbeing identified in this study are ideal targets for intervention, and should be embedded and consolidated throughout the military career.

Time in Service and Resilience in Active Military Personnel during the COVID-19 Pandemic: A Cross-Sectional Study in Northern Peru

“…In contrast, a secondary analysis of the Millennium Cohort, a prospective population-based study of U.S. military personnel prior to operations in Iraq and Afghanistan in 2001, showed that nearly 8 out of 10 military personnel maintained a stable score (around 20 points) on the PCL-C scale, which translates as a consistent level of resilience seven years after their military deployment [ 37 ]. Another descriptive study in Australian servicemen also reported that the majority exhibited resilient characteristics, and the mean score on the PCL-4 remained at a minimum (around 4 points out of 20) four years after the start of military service [ 38 ]. In addition, those who started with higher PTSD symptom severity and then experienced a considerable decrease in PCL-4 score (from 8 to 6 points out of 20) showed a higher frequency of self-blaming (OR = 2.09; 95% CI = 1.91–2.29), risk-taking (OR = 1.97; 95% CI = 1.70–2.29), and avoidance (OR = 1.79; 95% CI = 1.55–2.06) coping styles [ 38 ].…”

“…A secondary analysis of the Millennium Cohort, a prospective population-based study of U.S. military personnel prior to operations in Iraq and Afghanistan in 2001, showed that nearly 8 out of 10 military personnel maintained a consistent level of resilience seven years after their military deployment [ 37 ]. Another descriptive study of Australian servicemen also reported that the majority exhibited resilient characteristics four years after the start of military service [ 38 ].…”

“…In addition, previous studies that have described our association of interest have some methodological limitations, such as small sample size [ 36 ], the non-inclusion of service time rendered by military personnel to their institution [ 36 ] and selection bias [ 39 ]. The development of resilience through years of service has been previously demonstrated in the military population during the pre-pandemic period [ 36 ], and suggested as a protective factor against PTSD [ 37 , 38 ]. Therefore, this study aimed to assess whether work time is associated with resilience using data from a previous survey of front-line military personnel during the second epidemic wave of COVID-19.…”

Social network size and personality traits independently and prospectively predict distress disorders and suicidal behavior in U.S. Army soldiers

“…Results largely supported a linear relationship between social network size and mental health outcomes; the only exception was soon after soldiers returned from deployment (discussed below). Our findings dovetail with recent observations that resilient mental health trajectories in the first several years of military servicei.e., those characterized by stable, low psychological distress or posttraumatic stress symptomsare predicted by increased social support from family, friends, and military peers and leaders (Dell et al, 2022). Identifying new recruits or soldiers preparing for deployment who report particularly impoverished social networks could allow for early intervention targeting mechanisms hypothesized to underpin social disconnection.…”

Perception of operational environment conditions and situations as a prediction of adaptive potential in servicemen

“…A number of scientific papers on predicting the adaptation of military personnel to service show that most of them adapt well, but some people have some difficulties of varying degrees, which can manifest themselves in the form of increased stress and mental disorder [2,6,11,21]. Studies of scientists from the Netherlands have demonstrated that the rate of adaptability in servicemen was higher than that in civilians [20].…”