Social and Psychological Risk and Protective Factors for Veteran Well-Being: The Role of Veteran Identity and Its Implications for Intervention

Re, Adams; Tg, Urosevich; Sn, Hoffman; Hl, Kirchner; Cr, Figley; Ca, Withey; Jj, Boscarino; Dugan, Ryan J.; Ja, Boscarino

doi:10.1080/21635781.2019.1580642

Cited by 25 publications

(32 citation statements)

References 52 publications

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“…14,15 As described below, the genetic risk factors for PTSD that we assessed were among outpatients, all of whom were formerly deployed military veterans receiving care in a large multi-hospital system in central Pennsylvania. [16][17][18][19] Although the number of veterans in these settings with PTSD has varied, about 7-10% of them have been diagnosed with current PTSD in recent years, 16,18,20 which is consistent with the prevalence rate in the current study.…”

Section: Introductionsupporting

confidence: 85%

<p>Predictors of Current DSM-5 PTSD Diagnosis and Symptom Severity Among Deployed Veterans: Significance of Predisposition, Stress Exposure, and Genetics</p>

Hu¹,

Chu²,

Urosevich³

et al. 2020

NDT

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Background: Previously we reported a genetic risk score significantly improved PTSD prediction among a trauma-exposed civilian population. In the current study, we sought to assess this prediction among a trauma-exposed military population. Methods: We examined current PTSD diagnosis and PTSD symptom severity among a random sample of 1042 community-based US military veterans. Main effects and interaction effects were assessed for PTSD genetic risk by trauma exposure using cross-product terms for PTSD x trauma exposures, including combat, lifetime trauma, and adverse childhood exposures. The PTSD risk variants studied were within genetic loci previously associated with PTSD, including CRHR1, CHRNA5, RORA, and FKBP5 genetic variants, which were used to calculate a total PTSD genetic risk score (range=0-8, mean=3.6, SD=1.4). Results: Based on DSM-5 PTSD criteria, 7.1% of veterans (95% CI=5.6-8.8) met criteria for current PTSD. The PTSD genetic risk count was significantly higher among PTSD cases vs noncases (3.92 vs 3.55, p=0.027). Since the PTSD genetic risk score was not significant in the PTSD diagnosis model, we assessed this association using PTSD symptom severity. Because these symptom data were skewed (mean=9.54, SD=12.71, range=0-76), we used negative binomial regression to assess this outcome. This symptom model included a PTSD genetic risk score, demographic factors, trauma exposures, current insomnia, current depression, concussion history, and attention-deficit disorder, expressed as incident rate ratios (IRR), which is an estimate of oneunit increase in PTSD severity, given other variables are held constant. Variables in the final model included age and sex (both p<0.001), PTSD genetic risk (IRR=1.02, p=0.028), warzone tours (IRR=0.94, p=0.003), childhood abuse (IRR=1.50, p<0.0001), current depression (IRR=1.89, p<0.0001), current insomnia (IRR=2.58, p<0.0001), low social support (IRR=1.19, p<0.0001), attention-deficit disorder (IRR=1.51, p<0.0001), agreeable personality (IRR=0.77, p<0.0001), and concussion (IRR=1.38, p<0.0001). Significant interactions were detected for combat and lifetime trauma exposure by PTSD genetic risk (both p<0.0001), suggesting that the impact of trauma exposures on PTSD severity was lower when the PTSD genetic risk was higher. Conclusion: Both warzone and non-warzone factors predicted current PTSD symptoms among veterans, including a PTSD genetic risk score. Interaction effects were detected for combat exposure and lifetime trauma by genetic risk score for PTSD symptoms, suggesting that PTSD symptom manifestation was more dependent on PTSD risk variants than the level of trauma or combat exposure. This suggests that controlling for other factors, the absence of genetic risk variants may confer PTSD resilience. Further research is planned.

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Section: Introductionsupporting

confidence: 85%

<p>Predictors of Current DSM-5 PTSD Diagnosis and Symptom Severity Among Deployed Veterans: Significance of Predisposition, Stress Exposure, and Genetics</p>

Hu¹,

Chu²,

Urosevich³

et al. 2020

NDT

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“…This study also highlights the need for future research to understand further how identity influences veterans' experiences in recovery homes and other community settings. Finally, future studies would benefit from employing mixed-method research that includes a measure of veteran identity centrality (see Adams et al, 2019) to augment further what is learned from qualitative accounts. Future investigations should also examine how the veteran identity interplays with other identities (e.g., racial/ethnicity, gender) to impact veterans' integration into OH.…”

Section: Discussionmentioning

confidence: 99%

“…Although veterans are diverse individuals who belong to multiple social groups and backgrounds, for many, the veteran identity is particularly salient and central to their self‐concept (Adams et al, 2019; Atuel & Castro, 2018; Brunger et al, 2013; Harada et al, 2005). For instance, among 1730 veterans receiving health services from the Department of Veterans Affairs (VA) and Non‐VA medical healthcare centers, over 50% scored very high on a veteran identity centrality scale (Adams et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“It's like a Brotherhood”: Thematic analysis of veterans’ identity processes in substance abuse recovery homes

Guerrero

Wiedbusch

Abo

et al. 2021

Journal Community Psychology

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This exploratory study aimed to understand how veterans' social identity influenced their experiences living in Oxford Houses (OH)-the largest network of substance use recovery homes in the United States. We conducted three focus groups, with 20 veterans who were current or former OH residents. Thematic analysis revealed several ways in which participants' veteran identity influenced their experiences living in OH, including: (1) thriving through OH organizational similarities with the military, (2) relationships with other OH residents, and (3) and growth and reintegration. The themes were interpreted using the Social Identity Theory and the Social Identity Model of Identity Change perspectives. Social identity processes were found to play an influential role in veterans' experiences in their recovery homes and reintegration into civilian life. Findings highlight the importance of veterans developing a community within a culturally congruent setting to facilitate their recovery from substance use disorders and adjustment to life post-military service.

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“…Prior trauma-related studies have assessed the relationships of demographic variables (e.g., race, age, gender, education level) to happiness (Morgan et al, 2017) as well as the time since a traumatic event and number of traumatic events (Adams et al, 2019). Morgan et al (2017) found education level to be positively related to happiness.…”

Section: Demographicsmentioning

confidence: 99%

“…Responses ranged from 1 = less than 6 months ago, to 14 = over 50 years ago. Such retrospection is common in military-focused TE research (Adams et al, 2019;Tsai et al, 2015).…”

Section: Most Powerful Prior Traumatic Event (Te)mentioning

confidence: 99%

Comparing Work-Related Correlates of Life Satisfaction for Combat Versus Non-Combat Military Veterans

Blau¹,

Miller²

2020

JEL

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Military veterans (n = 153) completed an on-line survey and were broken down into combat (n = 92) versus non-combat (n = 61) veterans. The combat veterans had higher life satisfaction, perceived occupational alternatives, and education level versus the non-combat veterans. Looking at correlates to life satisfaction, for both samples number of prior traumatic events (negative) and personal accomplishment (positive) were significantly related. In addition, for the combat veterans, highest education level and perceived occupational alternatives were significantly related to life satisfaction. A high percentage of both combat and non-combat veterans were currently going to school to further their education. Working with employed combat and non-combat veterans, those currently going to school to further their education had higher perceived occupational alternatives than veterans not going back. Working with a smaller group of combat versus non-combat respondents who did volunteer work, the non-combat veterans were higher on perceived meaningfulness of volunteer work than the combat veterans. Returning to school can be one way to help military veterans find rewarding meaningful work, through perceived occupational alternatives, which can help to increase their life satisfaction. If increased education is not an option, volunteer work may also lead to higher perceived meaningful work. As veterans transition from military to civilian life, military out-processing should continue to counsel/prepare transitioning veterans for: finding/interviewing for jobs as well as realistic new careers; identifying meaningful voluntary work opportunities; or finding resources for furthering one’s education.

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Social and Psychological Risk and Protective Factors for Veteran Well-Being: The Role of Veteran Identity and Its Implications for Intervention

Cited by 25 publications

References 52 publications

<p>Predictors of Current DSM-5 PTSD Diagnosis and Symptom Severity Among Deployed Veterans: Significance of Predisposition, Stress Exposure, and Genetics</p>

<p>Predictors of Current DSM-5 PTSD Diagnosis and Symptom Severity Among Deployed Veterans: Significance of Predisposition, Stress Exposure, and Genetics</p>

“It's like a Brotherhood”: Thematic analysis of veterans’ identity processes in substance abuse recovery homes

Comparing Work-Related Correlates of Life Satisfaction for Combat Versus Non-Combat Military Veterans

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