Jennifer E. C. Lee

Longitudinal analysis of psychological resilience and mental health in Canadian military personnel returning from overseas deployment.

The relationship between exposure to combat stressors and poorer postdeployment health is well documented. Still, some individuals are more psychologically resilient to such outcomes than others. Researchers have sought to identify the factors that contribute to resilience in order to inform resilience-building interventions. The present study assessed the criterion validity of a model of psychological resilience composed of various intrapersonal and interpersonal variables for predicting mental health among Canadian Forces (CF) members returning from overseas deployment. Participants included 1,584 male CF members who were deployed in support of the mission in Afghanistan between 2008 and 2010. Data on combat experiences and mental health collected through routine postdeployment screening were linked with historical data on the intrapersonal and interpersonal variables from the model. The direct and moderating effects of these variables were assessed using multiple linear regression analyses. Analyses revealed direct effects of only some intrapersonal and interpersonal resilience variables, and provided limited support for moderating effects. Specifically, results emphasized the protective nature of conscientiousness, emotional stability, and positive social interactions. However, other variables demonstrated unexpected negative associations with postdeployment mental health (e.g., positive affect and affectionate social support). Ultimately, results highlight the complexities of resilience, the limitations of previous cross-sectional research on resilience, and potential targets for resilience-building interventions. Additional longitudinal research on the stability of resilience is recommended to build a better understanding of how resilience processes may change over time and contribute to mental health after adverse experiences.

Prospective Analysis of Premilitary Mental Health, Somatic Symptoms, and Postdeployment Postconcussive Symptoms.

Objectives Many recent studies of service members returning from deployment have focused on the health impacts of mild traumatic brain injury (mTBI), including persistent postconcussive symptoms (PCS). However, cross-sectional study designs have made it difficult to understand the role of mental health in the etiology of persistent PCS. Methods Participants were 3319 military personnel (primarily men [90%] of 25–34 years [54%]) who had completed health surveys at basic training and after deployment, on average, 4.6 years later. Negative binomial regression was used to assess the association of PCS with demographic covariates, premilitary mental health and somatic symptoms, combat experiences and mTBI during deployment, in addition to postdeployment mental health and non-PCS somatic symptoms. Results Premilitary mental health and somatic symptoms predicted PCS even when adjusting for other variables, yielding an elevated incidence rate ratio (IRR) for posttraumatic stress disorder (PTSD; IRR = 1.23, 95% confidence interval [CI] = 1.06–1.41) and somatic symptoms (mild versus minimal somatic symptoms: IRR = 1.43, 95% CI = 1.31–1.55; moderate/severe versus minimal somatic symptoms: IRR = 1.69, 95% CI = 1.43–2.06), but not for depressive symptoms. When postdeployment mental health and somatic symptom measures were added to the model, the effect of premilitary somatic symptoms remained significant. Conclusions Findings point to potential etiological contributions of premilitary characteristics, particularly a tendency to experience somatic symptoms and PTSD, as well as mTBI and combat experiences, to the development of PCS. PCS were also strongly related to concurrent postdeployment mental health.

Prospective Multifactorial Analysis of Canadian Forces Basic Training Attrition

The aim of this prospective study was to identify key predictors of attrition from Canadian Forces basic training. Baseline health data from 5,169 Canadian Forces recruits (85.4% men) collected using the Recruit Health Questionnaire were linked with administrative data on basic training releases. A total of 8.0% of recruits from this sample was released from basic training. A wide range of factors falling within each of the following categories were examined as potential predictors of attrition: demographic characteristics, social environment, health status, lifestyle, and personality. Logistic regression analyses pointed to increased odds of attrition among noncommissioned member candidates, recruits with one or more dependents, as well as those with an annual household income of less than

A Longitudinal Pilot Study of Resilience in Canadian Military Personnel

20,000, poor/ fair self-rated health, medium/high severity of somatic symptoms, higher neuroticism, lower mastery, and higher agreeableness. Overall, results underscored the importance of good general health and resilient personality to basic training success.

Alcohol use among Canadian Forces candidates: The role of psychological health and personality.

Research on psychological resilience is important for occupations involving routine exposure to trauma or critical events. Such research can allow for the identification of factors to target in training, education and intervention programs, as well as groups that may be at higher risk for mental health problems. Although efforts have been made to determine the individual characteristics that contribute to positive outcomes under stress, little is known about whether such characteristics are stable over time or how stressful events can impact psychological resilience in high-risk occupations such as military service. Following a review of the evidence on variations in resilience over time, results of a pilot study of Canadian Armed Forces personnel are presented in which differences in resilience characteristics were examined from military recruitment to several years after enrollment. While there was little change in resilience characteristics over time on average, there was considerable individual variation, with some individuals showing marked improvement and others showing marked deterioration in resilience characteristics. At both time points, individuals who had been deployed showed greater resilience characteristics than those who had never been deployed. Implications for the promotion of psychological resilience in military populations and personnel employed in other high-risk occupations are discussed.

Deployment-related trauma and post-traumatic stress disorder: does gender matter?

There is evidence to suggest that exposure to military stressors may contribute to alcohol consumption among military personnel. The present study analyzed health questionnaire data from 3,852 Canadian Forces (CF) candidates in an effort to identify psychological health and personality characteristics that could be targeted in order to prevent or reduce problem drinking among CF personnel. Results revealed that some of the psychological health and personality characteristics examined (i.e., PTSD, depression symptoms, agreeableness, conscientiousness, and extroversion) were significantly associated with alcohol use. Some methodological constraints and the potential implications for the prevention of problem drinking among military personnel are discussed.

Mental Health Services Use Intentions Among Canadian Military Recruits

ABSTRACT Objective: Military research has attempted to identify whether women have an increased vulnerability to mental health issues following deployment-related trauma, but findings have been mixed. Most studies have controlled for childhood abuse, but not other non-deployment trauma (e.g. life-threatening illness), which may partly explain previous mixed results. This study assessed gender differences in the association between deployment-related trauma and post-traumatic stress disorder (PTSD) while controlling for non-deployment trauma. Methods: Data came from the 2013 Canadian Forces Mental Health Survey. Regular or reserve personnel who had been deployed at least once were included in this study (n = 5980). Logistic regression was used to examine the interaction between gender and deployment-related trauma in predicting lifetime PTSD. Results: After controlling for non-deployment trauma, the association of gender with PTSD went from being significant to being marginally significant. The interaction between gender and deployment-related trauma was not significant. Conclusion: Though controlling for non-deployment trauma did not completely dissipate gender differences in PTSD, such differences were greatly reduced, indicating that these may be partly related to traumatic experiences outside deployment. As gender did not moderate the link between deployment-related trauma and PTSD, the findings suggest that trauma experienced while on deployment does not disproportionately affect women compared to their male counterparts.

Higher-Order Model of Resilience in the Canadian Forces

Identifying the factors associated with mental health services use (MHSU) is an important step in developing strategies to improve services access and delivery. The aims of the present study were to (a) identify personality and individual difference characteristics associated with MHSU intentions within the framework of the Theory of Planned Behavior (TPB) and (b) explore complex relationships that might exist between these characteristics and determinants of MHSU intentions identified in TPB, including attitudes, subjective norms, and perceived behavioral control. Data for 244 Canadian Armed Forces recruits who completed a MHSU questionnaire following mental health training were linked to personality data collected earlier. Multivariate analyses showed that the relationship between agreeableness and MHSU intentions was mediated by instrumental attitudes and subjective norms. The relationship between hardiness and MHSU intentions was mediated by subjective norms and self-efficacy. Findings suggest it may be worthwhile to consider mental health education initiatives to improve MHSU.