Wesley H. McCormick

Adverse childhood experiences and risk for suicidal behavior in male Iraq and Afghanistan veterans seeking PTSD treatment.

Objective: Adverse childhood experiences (ACEs) are associated with increased risk for suicide and appear to occur in disproportionately high rates among men who served in the U.S. military. However, research has yet to examine a comprehensive range of ACEs among Iraq/Afghanistan veterans with combat-related posttraumatic stress disorder (PTSD) or whether these premilitary stressors may contribute to suicidal behavior in this highly vulnerable population. Method: A sample of 217 men entering a residential program for combat-related PTSD completed measures for ACEs, combat exposure, and lifetime suicidal ideation and attempts. Results: The majority of patients had experienced multiple types of adversity or traumas during childhood/adolescence. In particular, 83.4% endorsed at least 1 ACE category and 41.5% reported experiencing 4 or more ACEs. When accounting for effects of deployment-related stressors, we further found that accumulation of ACEs was uniquely linked with thoughts of suicide or attempts among these patients. Namely, for every 1-point increase on the ACE Questionnaire, veterans’ risk of suicidal ideation and attempts increased by 23% and 24%, respectively. Conclusion: This brief report provides initial evidence that veterans seeking treatment for combat-related PTSD often have extensive histories of premilitary stressors that may increase suicide risk beyond probable deployment-related traumas.

Mental health treatment-related stigma and professional help seeking among student veterans.

Record numbers of military veterans are enrolling at colleges/universities across the United States. Although a substantive subset might suffer from mental health problems, the majority of these students might not be amenable to utilizing services. The purpose of this study was to examine the role of treatment-related stigma in intentions to seek professional help among undergraduate student veterans at a university on the U.S. Gulf Coast. Focusing on 251 veterans and a gender-matched comparison group of 251 nonveterans, student veterans endorsed higher probabilities of seeking care from physicians (d = .77) and psychologists or other professionals (d = .67). In addition, nonveteran students had greater self-stigma about seeking help (d = −.27) but veterans had more negative beliefs about treatment efficacy (d = 1.07). When compared with veterans who did not exceed clinical thresholds, those with a probable need for treatment had more stigma (ds = .63). Multivariate analyses also revealed an inverse main effect of self-stigma on intentions to seek help from both professional categories. However, military experience differentially moderated associations between treatment-related beliefs and intentions to seek mental health services. Finally, exploratory analyses identified that student veterans were most likely to engage in therapy/counseling at a Veterans Affairs Medical Center or Clinic, Vet Center, or other noninstitutionally sponsored settings in the community (e.g., private practices, faith-based organizations). Looking ahead, these findings will inform research and the provision of services for addressing the mental health needs of this substantive subpopulation of college students in the United States.

Theodicies and professional quality of life in a nationally representative sample of chaplains in the veterans’ health administration

ABSTRACT This study examined the role of theodicies or theological/philosophic attempts to resolve existential dilemmas related to evil and human suffering in chaplains’ professional quality of life (ProQOL). A nationally representative sample of 298 VHA chaplains completed the recently developed Views of Suffering Scale (Hale-Smith, Park, & Edmondson, 2012) and ProQOL-5 (Stamm, 2010). Descriptive results revealed that 20–50% endorsed strong theistic beliefs in a compassionate deity who reciprocally suffers with hurting people, God ultimately being responsible for suffering, and that suffering can provide opportunities for intimate encounters with God and personal growth. Other results indicated that chaplains’ beliefs about human suffering were differentially linked with their sense of enjoyment/purpose in working with veterans. These results suggest that theodicies might serve as a pathway to resilience for individuals in spiritual communities and traditions in USA, particularly for clinicians and ministry professionals who are committed to serving the needs of traumatized persons.

Barriers and resources for veterans’ post-military transitioning in south Alabama: A qualitative analysis.

Estimates suggest that hundreds of thousands of military service members will transition out of the U.S. military in the coming years. The state of Alabama has among the highest concentrations of veterans per capita in the United States. The purpose of this study was to provide an initial picture of the prominent barriers and resources for veterans in Alabama. Data for this study were collected as part of a larger needs assessment aimed at identifying unmet needs and perceived gaps in available services of military veterans and families living in an 8-county region in the southern portion of Alabama. Researchers conducted 2 sets of in-depth qualitative interviews to elicit veteran and family perspectives about unmet needs, available resources, and gaps in using resources for veterans’ post-military transitioning in this region and to collect improvement suggestions. An inductive content analytic approach was implemented to identify the prominent themes and ideas across the focus groups and expert informant interviews. Four broad categories were identified, including barriers for transitioning (e.g., financial difficulties and limited job opportunities), resources for transitioning (e.g., postsecondary degree attainment before discharge), gaps in resources (e.g., transportation health-care appointments) and available resources (e.g., veterans service organizations). Many veterans in Alabama reported a lack of preparedness for their military-to-civilian transition, especially female and minority veterans. County-level supports are needed, including targeted, regional public service announcements that normalize behavioral, mental, and physical health needs. Such announcements should include resource referrals, indicating where veterans can go for additional information on services.

Spiritual struggles and ministry-related quality of life among faith leaders in Colombia.

Faith leaders who are working to promote justice and healing in Colombia might confront stressful circumstances that challenge their spiritual meaning systems and limit ministry-related quality of life. However, whether focusing on domestic or international samples, research has not examined potential effects of spiritual struggles on ministry-related quality of life. In total, 166 faith leaders who were serving in Christian churches and organizations in Colombia completed a Spanish version of Exline, Pargament, Grubbs, and Yali’s (2014) Religious and Spiritual Struggles Scale along with assessments of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) symptomatology. The relative frequencies of different types of spiritual struggles in the sample were as follows: divine = 5.4%, morality = 29.9%, ultimate meaning = 18%, interpersonal = 18%, and doubting = 16.2%. Bivariate results revealed that severity of each of these struggles was concurrently linked with more mental health symptomatology as well as less compassion satisfaction and greater secondary traumatic stress in relation to ministry-related experiences. In addition, when accounting for symptom severity of PTSD and MDD, structural equation modeling results revealed that participants who were experiencing greater moral struggles were particularly vulnerable for struggling in their ministry role at the time of this study. These findings support the need for more research on this topic as well as the possible development of strategies for addressing the emotional, spiritual, and educational needs of faith leaders in Colombia and other nations who are serving persons in contexts of trauma, loss, and displacement.

A Qualitative Examination of VA Chaplains’ Understandings and Interventions Related to Moral Injury in Military Veterans

This study examines VA chaplains’ understandings of moral injury (MI) and preferred intervention strategies. Drawing qualitative responses with a nationally-representative sample, content analyses indicated that chaplains’ definitions of MI comprised three higher order clusters: (1) MI events, (2) mechanisms in development of MI, and (3) warning signs of MI. Similarly, chaplains’ intervention foci could be grouped into three categories: (1) pastoral/therapeutic presence, (2) implementing specific interventions, and (3) therapeutic processes to promote moral repair. Findings are discussed related to emerging conceptualizations of MI, efforts to adapt existing evidence-based interventions to better address MI, and the potential benefits of better integrating chaplains into VA mental health service delivery.

Academic Entitlement: Relations to Perceptions of Parental Warmth and Psychological Control.

Abstract Academic entitlement characterises students who expect positive academic outcomes without personal effort. The current study examined the relations of perceived parental warmth and parental psychological control with two dimensions of academic entitlement (i.e. entitled expectations and externalised responsibility) among college students. Psychology students participated by completing measures of perceived parenting and academic entitlement through an online survey system. Results demonstrated that perceived parental warmth was a negative predictor of externalised responsibility and parental psychological control was a positive predictor of externalised responsibility. Additionally, there was a warmth by control interaction such that parental psychological control was related to greater externalised responsibility only when combined with moderate to high parental warmth. For entitled expectations, both perceived parental warmth and psychological control were positive predictors. The findings suggest that parenting practices may play an important role in academic entitlement and highlight the need for further research to elucidate potential developmental pathways of academic entitlement.

Adverse childhood experiences, religious/spiritual struggles, and mental health symptoms: examination of mediation models

ABSTRACT Emerging research has documented greater risk for posttraumatic stress disorder (PTSD) and depression among young adults with prior adverse childhood experiences (ACEs). Building upon prior findings, we hypothesised that religious/spiritual (R/S) struggles may serve as an intervening pathway through which accumulation of ACEs impacts mental health symptom severity in this population. Young adults (N = 458) were recruited from a southeastern university to complete an online self-report survey that assessed for ACEs, lifetime trauma exposure, R/S struggles, PTSD and depressive symptomatology. Bivariate correlations yielded significant positive relationships between ACEs and all six types of R/S struggles, depression, and PTSD. Additionally, when accounting for non-childhood trauma exposure, the mediational analyses indicated an indirect effect of struggles with ultimate meaning on the well-establish association between ACEs and mental health symptoms. Clinical implications (such as the importance of fostering meaning making), study limitations, and future research directions are discussed.

Professional Quality of Life and Changes in Spirituality Among VHA Chaplains: A Mixed Methods Investigation

A mixed method design was implemented to examine the spirituality and emotional well-being of Veterans Health Administration (VHA) chaplains and how potential changes in spirituality and emotional well-being may affect their professional quality of life. Four distinct categories of changes emerged from the narrative statements of a nationally representative sample of 267 VHA chaplains: (1) positive changes (e.g., increased empathy), (2) negative changes (e.g., dysthymic mood, questioning religious beliefs), (3) combination of positive and negative changes, and (4) no change (e.g., sustenance through spirituality or self-care). Most chaplains reported positive (37%) or no change (30%) in their spirituality and/or emotional well-being. However, quantitative analyses revealed that chaplains who reported negative changes endorsed greater burnout and secondary traumatic stress. Overall, these findings suggest VHA chaplains are predominantly spiritually resilient, but negative changes in the spiritual domain can occur, potentially increasing the risk of adverse changes in professional quality of life.