Mental Health and Psychosocial Functioning in Recently Separated U.S. Women Veterans: Trajectories and Bi-Directional Relationships

Abstract

Prior research on the relationship between veterans’ mental health and psychosocial functioning has primarily relied on male samples. Here, we investigated prospective longitudinal relationships between mental health and psychosocial functioning in 554 female Iraq and Afghanistan War veterans who were surveyed three times between two- and seven-years following separation from service. Mixed effects modeling revealed that increasing depression and posttraumatic stress disorder (PTSD) severity predicted declines in work functioning. Increasing PTSD severity predicted declining parental functioning and worsening depression predicted a decline in relationship functioning. In turn, decreased work and intimate relationship functioning predicted increased PTSD and depression symptom severity suggesting bi-directional effects between mental health and psychosocial functioning. An examination of the effect of deployment stressors on psychosocial functioning revealed that deployment sexual harassment was the strongest predictor of decreased psychosocial functioning across all domains. Evidence for the reciprocal nature of relationships between mental health and psychosocial functioning underscore the need for treatment targeted at PTSD and depression, as well as work and relationship functioning to improve outcomes for women veterans.

Temporal Sequencing of Mental Health Symptom Severity and Suicidal Ideation in Post-9/11 Men and Women Veterans Who Recently Separated from the Military

“…In men, scores for severity of PTSD [T1 Mdn = 34, IQR = 23-50; T2 Mdn = 32, IQR = 21-47; T3 Mdn = 31, IQR = 20.2-49.8, P = .002], depression [T1 Mdn = 21.5, IQR = 15-26; T2 Mdn = 19.5, IQR = 13-24.8; T3 Mdn = 19, IQR = 12-25, P < .001], and alcohol misuse [T1 Mdn = 4, IQR = 2-6; T2 Mdn = 3, IQR = 2-5; T3 Mdn = 3, IQR = 1-5, P < .001] symptom severity improved at T2 and T3 relative to T1. As previously reported, 60 in women, scores for depression severity improved at T2 and T3 relative to T1. Women also showed a decrease in the odds of reporting SI at T2 (OR = 0.177, 95% CI: 0.058, 0.493; P = .001) and T3 (OR = 0.225; 95% CI: 0.074, 0.625; P = .006), relative to T1.…”

“…At T1, PTSD symptom severity was significantly higher (P = . 60 in women, scores for depression severity improved at T2 and T3 relative to T1. Women also showed a decrease in the odds of reporting SI at T2 (OR = 0.177, 95% CI: 0.058, 0.493; P = .001) and T3 (OR = 0.225; 95% CI: 0.074, 0.625; P = .006), relative to T1.…”

“…In women, as previously reported, the statistically significant decrease in depression severity, while an improvement, represented scores that remained in the moderate severity range. 60 …”

“…In women, as previously reported, the statistically significant decrease in depression severity, while an improvement, represented scores that remained in the moderate severity range. 60 For men and women, the T1 to T2 decrease in odds of SI is noteworthy and suggests a propensity for improvement during the first approximately 5 years following military separation. In contrast, SI persistence around approximately the 5-year post-separation mark (T2) may suggest a risk for a chronicity of SI extending beyond this timeframe.…”

Psychosocial functioning deficits impact and are impacted by suicidal ideation in post-9/11 women veterans

“…The present study extends prior research which showed that PTSD and depression symptom severity are bi-directionally related to psychosocial functioning in women veterans ( Lawrence et al, 2021 ). Our objective in this study was to test the hypothesis that a bi-directional association would exist between SI and work, relationship, and parental domains of psychosocial functioning in women veterans, such that worsening functioning would exacerbate subsequent SI, and changes in SI would also impact subsequent psychosocial functioning.…”