Resilience–recovery factors in post-traumatic stress disorder among female and male Vietnam veterans: Hardiness, postwar social support, and additional stressful life events.

Abstract

Structural equation modeling procedures were used to examine relationships among several war zone stressor dimensions, resilience-recovery factors, and post-traumatic stress disorder symptoms in a national sample of 1,632 Vietnam veterans (26% women and 74% men). A 9-factor measurement model was specified on a mixedgender subsample of the data and then replicated on separate subsamples of female and male veterans. For both genders, the structural models supported strong mediation effects for the intrapersonal resource characteristic of hardiness, postwar structural and functional social support, and additional negative life events in the postwar period. Support for moderator effects or buffering in terms of interactions between war zone stressor level and resilience-recovery factors was minimal.

Risk factors for the development versus maintenance of posttraumatic stress disorder

“…Results of univariate analyses were consistent with those from other studies showing that the development of PTSD is associated with numerous premilitary, military, and postmilitary factors (e.g., Green et al, 1990;King et al, 1998). The maintenance of PTSD was associated with ethnicity, lower premilitary education, more severe punishment, a higher amount of warzone exposure, peritraumatic dissociation, lower social support at homecoming, lower current social support, and a higher number of recent life events.…”

“…We followed the selection and creation of variables used in a series of studies that identified risk factors for current chronic PTSD in the NVVRS lay-interview sample (King et al, 1996(King et al, , 1998King, King, Foy, Keane, & Fairbank, 1999). Onset of depression also was examined given findings on the role of depression in the development and maintenance of PTSD (e.g., Freedman, Brandes, Peri, & Shalev, 1999).…”

“…The remaining premilitary scales were adapted from King et al (1996King et al ( , 1998. Differences in items available from the NVVRS and HVVP necessitated some changes, as noted below.…”

“…Risk of chronic PTSD, as reflected by a diagnosis of current PTSD among individuals whose exposure occurred many years prior, also is related to many of the same risk factors (e.g., King, King, Fairbank, Keane, & Adams, 1998;King, King, Foy, & Gudanowski, 1996;Kulka et al, 1990;Schnurr & Vielhauer, 1999;Stein, Walker, Hazen, & Forde, 1997). Yet very few investigations of risk factors for PTSD have attempted to distinguish chronic from less chronic PTSD.…”

Evaluating symptom expression as a function of a posttraumatic stress disorder severity

“…However, numerous factor analytic studies conducted across different trauma populations (e.g., male combat veterans, female sexual assault survivors, etc.) and assessment instruments [e.g., Clinically Administered PTSD Scale (Blake et al, 1995), Posttraumatic Stress Disorder Checklist (Weathers, Litz, Huska, & Keane, 1994), Mississippi PTSD Scale (Keane, Caddell, & Taylor, 1988)] have found differing solutions ranging from two (Buckley, Blanchard, & Hickling, 1998;Foa, Riggs, & Gershuny, 1995;Taylor, Kuch, Koch, Crockett, & Passey, 1998), three (Cordova, Studts, Hann, Jacobsen, & Andrykowski, 2000;Cox, Clara, & Enns, 2002;Thatcher & Krikorian, 2005), and four factors (Andrews, Joseph, Shevlin, & Troop, 2006;Asmundson et al, 2000;King, King, Fairbank, Keane, & Adams, 1998;McWilliams, Cox, & Asmundson, 2005;Palmieri & Fitzgerald, 2005;Simms, Watson, & Doebbeling, 2002). We would expect that if the DSM-IV organization of PTSD symptoms were robust, the organization of three domains would be supported across populations and different operationalizations of symptom indices.…”