Shelley MacDermid Wadsworth

The Development and Implications of Peer Emotional Support for Student Service Members/Veterans and Civilian College Students

Student service members/veterans represent a growing population on college campuses. Despite this growth, scholarly investigations into their health- and adjustment-related issues are almost nonexistent. The limited research that is available suggests that student service members/veterans may have trouble connecting with their civilian counterparts and be at risk for social isolation. The present study compared the development and implications of emotional support from peers among 199 student service members/veterans and 181 civilian students through 3 distinct occasions over the course of 1 calendar year. Data were collected via electronic survey. Measured constructs included perceived emotional support from university friends, mental health, alcohol use, and academic functioning. A series of multilevel models revealed that student service members/veterans reported less emotional support from their peers compared with their civilian counterparts; yet, emotional support from peers increased similarly for both groups over time. Although, increasing peer emotional support was generally related to better academic and mental health outcomes for both groups, the links between emotional support and mental health were stronger for civilian students. Results suggest that mental health practitioners, particularly those on college campuses, should be prepared to deal with veteran-specific experiences that occur before and during college.

Student Service Members/Veterans in Higher Education: A Systematic Review

Abstract We systematically reviewed the data-based peer-reviewed research examining student service members/veterans (SSM/V) in higher education. Compared to civilian peers, SSM/V exhibit disproportionately higher rates of health risk behaviors and psychological symptoms, and personal and educational adjustment difficulties (i.e., inability to connect with peers and faculty on campus). Combat-related trauma is a contributing factor to these differences. The current evidence-base is scant, lacking nationally representative and/or longitudinal data to inform policies and programs for SSM/V.

Implications of Posttraumatic Stress Among Military-Affiliated and Civilian Students

Abstract Objectives: To determine whether posttraumatic stress (PTS) symptoms are associated with problem drinking and alcohol-related consequences, as well as academic correlates among military-affiliated and civilian students. Participants: The final sample (n = 248) included 78 combat-exposed student service members/veterans, 53 non–combat-exposed student service members/ veterans, 38 ROTC (Reserve Officers’ Training Corps) students, and 79 civilian students. Methods: Self-report data were collected spring 2011 via a Web-based survey measuring PTS, problem drinking, alcohol-related consequences, grade point average, educational self-efficacy, academic amotivation, and persistence. Results: Military students exposed to combat-related trauma reported significantly greater PTS symptoms than other military and civilian groups. PTS symptoms were associated with problem drinking and alcohol-related consequences for all groups, yet unrelated to academic correlates among those exposed to combat-related trauma. Conclusion: This study adds to the scant literature base exploring the unique characteristics of student service members/veterans in higher education.

Approaching Family-Focused Systems of Care for Military and Veteran Families

Although current research recognizes robust interdependence among family members, it is not yet evident that such principles have fully integrated into existing systems of care for military and veteran families. Such gaps can create disadvantages in delivering effective support, prevention, and treatment, while including families may yield significant advantages. This article highlights theoretical frameworks and empirical evidence that illustrate the relevance of systemic approaches to supporting service members, veterans, and their families. We discuss examples of family-centered approaches already in place and identify gaps in existing systems of care.

Reported barriers to mental health care in three samples of U.S. Army National Guard soldiers at three time points.

The military community and its partners have made vigorous efforts to address treatment barriers and increase appropriate mental health services use among returning National Guard soldiers. We assessed whether there were differences in reports of treatment barriers in 3 categories (stigma, logistics, or negative beliefs about treatment) in sequential cross-sectional samples of U.S. soldiers from a Midwestern Army National Guard Organization who were returning from overseas deployments. Data were collected during 3 time periods: September 2007-August 2008 (n = 333), March 2009-March 2010 (n = 884), and August 2011-August 2012 (n = 737). In analyses using discretized time periods and in trend analyses, the percentages of soldiers endorsing negative beliefs about treatment declined significantly across the 3 sequential samples (19.1%, 13.9%, and 11.1%). The percentages endorsing stigma barriers (37.8%, 35.2%, 31.8%) decreased significantly only in trend analyses. Within the stigma category, endorsement of individual barriers regarding negative reactions to a soldier seeking treatment declined, but barriers related to concerns about career advancement did not. Negative treatment beliefs were associated with reduced services use (OR = 0.57; 95% CI [0.33, 0.97]).

Military Families Extreme Work and Extreme “Work-Family”

While the U.S. military might at first glance appear to be a model of rigidity rather than flexibility, there are strong incentives to address the work-family concerns of service members and their families. From a work-family perspective, military service generates substantial structural, energy, psychological, and behavioral tensions with family life. Although the U.S. military had already implemented extensive programs, policies, and practices to support families prior to the current conflicts, the wars and demographic changes have spurred the development of innovative new models, some far outside previous boundaries of military workforce flexibility. Future challenges include continuing to adapt as military conflicts and missions evolve, defining the ideal balance between military support and family self-sufficiency, sustaining excellent leadership throughout the military around work-family issues, and caring for the millions of individuals whose lives have been changed by their own or a loved one’s military service during the past decade.

Passport Toward Success: Description and Evaluation of a Program Designed to Help Children and Families Reconnect after a Military Deployment

This paper evaluates Passport Toward Success (PTS). PTS rotates children whose military parent has recently returned from deployment through three interactive stations, where they practice skills related to coping with stress, problem-solving, and discussing feelings along with similar-age peers. Pre- and post-program measures were gathered at 10 PTS events; researchers observed and rated program fidelity at eight events. Results revealed that many children were experiencing difficulties associated with their parents deployment and reunion, children who reported the most difficulties evaluated PTS programming most favorably, and problems occurred with fidelity of program implementation for the youngest children. Discussion centers on implications of these findings for “Phase 2” of PTS and for understanding how communication skills can promote resiliency for coping with repeated military deployments.

Understanding and supporting the resilience of a new generation of combat-exposed military families and their children.

Taking our nation to war has exposed a generation of military families and children to combat and its consequences. Every dollar spent on bullets, trucks, fuel, and food carried a future ‘tax’ in the form of consequences for psychological and physical health and family relationships. In this commentary, I focus on several themes that emerge from the special collection or articles. For example, I consider how best to define the ecological niche(s) occupied by military-connected children and families. Not surprisingly given significant gaps in our knowledge, evidence regarding the well-being of military-connected children is mixed. I also consider the multi-layered environments within which individuals and families function, recognizing both the challenges and opportunities they provide. The need to respond rapidly to the evolving needs of military families has highlighted the value of both prevention science and implementation science. Public health models emphasizing a full continuum of care that emphasizes not only treatment but also universal, selective, and indicated prevention also are appealing given the uneven density, uncertain locations, and unknown identities of military families in civilian communities (Beardslee 2013; Murphy and Fairbank 2013). Finally, it is important to recognize that we are at the beginning, not the end, of the post-war lifetimes for the new generation of veterans and their families.

Prospective Evaluation of Mental Health and Deployment Experience Among Women in the US Military

Previous research has shown that military women often experience potentially severe health outcomes following deployment. Data from the Millennium Cohort Study, a 21-year longitudinal study examining the health effects of military service, were used to examine this issue. In longitudinal analyses (2001-2008) carried out among US military women (n = 17,481), the authors examined positive screens for depression, anxiety, panic, and posttraumatic stress disorder in relation to deployment in support of the operations in Iraq and Afghanistan, while adjusting for relevant baseline and time-varying covariates. Women who were deployed and reported combat-related exposures had greater odds than nondeployed women of reporting symptoms of a mental health condition (odds ratio = 1.91, 95% confidence interval: 1.65, 2.20), after adjustment for demographic, military, and behavioral covariates. In addition, higher stress, problem drinking, and a history of mental illness were significantly associated with increased risk of later mental health conditions. In contrast, women in the Reserves or National Guard and those with higher education were at decreased risk of mental health conditions (all P s < 0.01). As the roles and responsibilities of women in the military expand and deployments continue, designing better prevention and recovery strategies specifically for women are critical for overall force health protection and readiness.

Overview of Depression, Post-Traumatic Stress Disorder, and Alcohol Misuse Among Active Duty Service Members Returning From Iraq and Afghanistan, Self-Report and Diagnosis

Previous studies have found deployment to combat areas to be associated with an increased risk of post-traumatic stress disorder (PTSD), depression, and alcohol abuse, but many previous studies were limited by samples that were not representative of the deployed military as a whole. This study presents an overview of these three mental health problems associated with deployment among Air Force, Army, Marine Corp, and Navy service members returning from deployment to Iraq and Afghanistan between January 2007 and March 2008. With postdeployment health data on over 50,000 service men and women, including diagnostic information, we were able to estimate prevalence of those who screened positive for risk of each disorder in self-report data at two time points, as well as prevalence of diagnoses received during health care encounters within the military health care system. The prevalence ranges of the three disorders were consistent with previous studies using similar measures, but service members in the Navy had higher rates of screening positive for all three disorders and higher prevalence of depression and PTSD diagnoses compared to the other branches. Further, PTSD risk was higher for service members returning from Afghanistan compared to Iraq, in contrast to previous findings.