Dawne S. Vogt

Posttraumatic Growth Among Gulf War I Veterans: The Predictive Role of Deployment-Related Experiences and Background Characteristics

In this study, we identified deployment-related and demographic predictors of several factors of posttraumatic growth in a sample of combat-exposed Gulf War I veterans. Participants were obtained via a Veterans Administration registry of Gulf War I veterans and were mailed a survey containing a number of scales assessing predeployment, deployment, and postdeployment factors from the Deployment Risk and Resilience Inventory and the Posttraumatic Growth Inventory. Military status and perceived threat were significant predictors of appreciation of life. Relating to others, personal strength, and posttraumatic growth as a whole were best predicted by the postdeployment variable of social support. Minority status was the only significant predictor of new possibilities, with ethnic minorities reporting more new possibilities postdeployment. Limitations and suggestions for future research are discussed.

Predeployment, Deployment, and Postdeployment Risk Factors for Posttraumatic Stress Symptomatology in Female and Male OEF/OIF Veterans

[Correction Notice: An erratum for this article was reported in Vol 120(4) of Journal of Abnormal Psychology (see record 2011-19996-001). In the article there was an error in the affiliation bylines for Rani Elwy and Susan Eisen. Their affiliations should have been listed as Edith Nourse Rogers Memorial Veterans Hospital and Department of Health Policy and Management, Boston University School of Public Health.] Prior research on risk factors for posttraumatic stress symptomatology (PTSS) in war-exposed Veterans has revealed both direct and indirect mechanisms of risk that span predeployment, deployment, and postdeployment timeframes. The aims of the present study were to identify the mechanisms through which previously documented risk factors contribute to PTSS in a national sample of 579 female and male Veterans deployed to Afghanistan for Operation Enduring Freedom (OEF) or to Iraq for Operation Iraqi Freedom (OIF), as well as to examine the extent to which results mirror associations observed among Vietnam Veterans (King, King, Foy, Keane, & Fairbank, 1999). Consistent with conservation of resources (COR) theory (Hobfoll, 1989, 2001), findings indicated that PTSS is accounted for by multiple chains of risk, many originating in predeployment experiences that place Veterans at risk for additional stress exposure, and foretell difficulty accessing resources in the face of subsequent stressors. Importantly, the majority of previously documented mechanisms were replicated in this study, suggesting key pathways through which risk factors may contribute to PTSS across different Veteran populations. Results also revealed a number of novel risk mechanisms for OEF/OIF female Veterans, particularly with respect to the role of deployment family relationships in risk for PTSS.

Toward Gender-aware Health Care Evaluation of an Intervention to Enhance Care for Female Patients in the VA Setting

In response to identified deficits in the provision of health care to female patients, we sought to improve healthcare workers gender awareness— conceptualized as gender-role ideology, sensitivity, and knowledge related to female patients—through the application of a brief computerized educational intervention. This study, conducted in the Veterans Affairs (VA) health-care setting, involved a pretest—posttest equivalent control group design. We evaluated hypotheses using random coefficients regression, a technique that offers a number of advantages relative to repeated-measures ANOVA. Findings revealed significant improvements in sensitivity and knowledge for participants in the treatment condition compared to the control condition. With several exceptions, the intervention was similarly effective across employee groups.

Gender awareness among Veterans Administration Health-care workers: Existing strengths and areas for improvement

ABSTRACT In response to the growing number of women within the Veterans Health Administration (VHA), along with the challenge of meeting their health-care needs in a historically male-focused setting, VHA has supported a variety of research projects aimed at evaluating and improving the status of womens health and health-care experiences. While these efforts have primarily focused on aspects of care such as the availability and accessibility of services and the provision of timely care, this study focused on the contribution of interpersonal aspects of care. Specifically, staff gender awareness, conceptualized as health-care workers gender-role ideology or attitudes, gender sensitivity, and knowledge was examined. Findings revealed both strengths and weaknesses in domains of staff gender awareness and significant relationships between staff demographics and gender awareness components.

Gender Awareness Inventory-VA: A Measure of Ideology, Sensitivity, and Knowledge Related to Women Veterans' Health Care

Within the Veterans Health Administration, it has become increasingly important to assess health-care workers attitudes toward and beliefs about female patients, sensitivity to the unique needs of female patients, and knowledge about women veterans and the programs and services available to them. The current study describes the development of the Gender Awareness Inventory-VA, an instrument that assesses 3 components: gender-role ideology, gender sensitivity, and knowledge among health-care staff. Data were drawn from various samples of Veterans Health Administration employees in a large geographical region (overall N > 1,100; nationally, this population includes roughly 37% minorities). In a series of psychometric inquiries, evidence for reliability and validity was established, and preliminary evidence was provided for the instruments underlying factor structure.

Deployment-related sequelae and treatment utilization in rural and urban war veterans in Hawaii.

This study compared common deployment-related health issues and correlates of mental health service utilization among rural and urban veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) living in Hawaii. Frequency of utilization of a broad range of mental health resources, including clergy/spiritual leaders, videoconference/online programs, and traditional/alternative healers, was also characterized. A random sample of 116 rural and 117 urban ethnoracially diverse veterans completed a mail survey. Rural veterans were more likely than urban veterans to meet screening criteria for posttraumatic stress disorder (PTSD), deployment-related concussion with persistent postconcussive symptoms, and alcohol use problems. Over one third of veterans who desired help for a mental health problem reported no current use of any services. Rural veterans were more likely than urban veterans to have accessed Veteran Readjustment Centers, but they did not differ with respect to utilization of other services. Correlates of mental health service utilization included higher education, PTSD, and lower mental-health-related quality of life. Results of this study underscore the need for dissemination efforts to enable OEF/OIF/OND veterans to access mental health resources.

Family support, family stress, and suicidal ideation in a combat-exposed sample of Operation Enduring Freedom/Operation Iraqi Freedom veterans

Background and Objectives: Deployment-related risk factors for suicidal ideation among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans have received a great deal of attention. Studies show that mental health symptoms mediate the association between most deployment stressors and suicidal ideation; however, family-related factors during deployment are largely unexplored. We examined posttraumatic stress disorder (PTSD) and depression symptoms as mediators of the associations between deployment family support and stress and post-deployment suicidal ideation in combat-exposed OEF/OIF veterans. Design: National cross-sectional mail survey. Methods: 1046 veterans responded to the survey. The sample for this study was 978 veterans who experienced combat. Regression-based path analyses were conducted. Results: Family support and stress had direct associations with suicidal ideation. When PTSD and depression symptoms were examined as mediators of these associations, results revealed significant indirect paths through these symptoms. Conclusions: This study contributes to the literature on suicidal ideation risk factors among OEF/OIF veterans. Deployment family support and family stress are associated with suicidal ideation; however these associations occur primarily through mental health symptomatology, consistent with findings observed for other deployment factors. This research supports ongoing efforts to treat mental health symptomatology as a means of suicide prevention.