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Scoping review of published and grey literature to determine what is known about the mental health experiences and outcomes of minority racial/ethnic groups within the military in the UK and US and to develop recommendations for how to... more
Scoping review of published and grey literature to determine what is known about the mental health experiences and outcomes of minority racial/ethnic groups within the military in the UK and US and to develop recommendations for how to ensure representation of minority racial/ethnic groups in military mental health research.
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LAY SUMMARY There are approximately 16,000 families of lesbian, gay, bisexual, or transgender (LGBT) service members in the U.S. military, but very little is known about how accepted they feel in the communities in which they live. This... more
LAY SUMMARY There are approximately 16,000 families of lesbian, gay, bisexual, or transgender (LGBT) service members in the U.S. military, but very little is known about how accepted they feel in the communities in which they live. This study begins to address this question by considering the perspectives of LGBT service members, which they shared both in response to an online survey and in interviews. Findings suggest that many service members believe their spouses and families are accepted by their chain of command. However, a smaller but important group continued to express concerns about their family being accepted in their military community. Many service members appear concerned that family services available to them through the military are not appropriate for LGBT families. Altogether, this article highlights the need for more research to understand the well-being and needs of this group.
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Military veterans have high rates of mental health problems, yet the majority do not seek treatment. Understanding treatment-seeking in this population is important. This study investigated if symptom severity and self-efficacy are... more
Military veterans have high rates of mental health problems, yet the majority do not seek treatment. Understanding treatment-seeking in this population is important. This study investigated if symptom severity and self-efficacy are associated with treatment-seeking among US Iraq/Afghanistan veterans. Survey data from 525 veterans meeting clinical criteria for PTSD and depression were included of which, 54.4% had sought treatment in the past 12 months. Multivariate logistic regression analysis indicated that high symptom severity was associated with treatment seeking, whereas high self-efficacy was associated with a decreased likelihood to seek treatment. Self-efficacy could be an underlying mechanism of treatment seeking decisions.
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Many myths have grown up surrounding the figure of the military veteran within the civilian population. But military service is an occupation, like many others, with strong health selection and a specific cluster of physical, chemical,... more
Many myths have grown up surrounding the figure of the military veteran within the civilian population. But military service is an occupation, like many others, with strong health selection and a specific cluster of physical, chemical, biological, and psychosocial risks, which may have long-term effects. Well-designed epidemiology should create opportunities to explore the factors associated with health in the transition back to civilian life. Chaired by Simon Wessely, this section of the minisymposium will discuss some of the issues in undertaking epidemiological studies in this topical and important area. For example: Identifying veteran populations is an easier task in some countries than in others. Military service entails a specific and diverse cluster of physical, chemical, biological, and psychosocial risks which may, or may not, be well documented. In particular, exposures during combat may be poorly documented. Military populations are strongly selected, particularly in countries without conscription, and the effects of pre-service lifestyle and environmental factors may continue after the return to civilian life. This panel discussion will sum up the issues raised by both the minisymposium speakers and also the participants on the floor.
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Research Interests: Business and Engineering
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Research Interests: Psychology, Developmental Psychology, Attention, Medicine, Brain development, and 15 moreHippocampus, Malnutrition, Brain, Discrimination Learning, Orientation, Female, Animals, Male, Rats, Rat, Short Term Memory, Threshold Model, Frontal Lobe, Psychology and Cognitive Sciences, and Medical and Health Sciences
Lesbian, gay, and bisexual service members can serve openly in the military with the repeal of the Don't Ask, Don't Tell policy. The fate of transgender service members remains uncertain as the policy preventing them from serving... more
Lesbian, gay, and bisexual service members can serve openly in the military with the repeal of the Don't Ask, Don't Tell policy. The fate of transgender service members remains uncertain as the policy preventing them from serving in the military remains under review. The health care needs of these populations remain for the most part unknown, with total acceptance and integration in the military yet to be achieved. In this paper, we review the literature on the health care needs of lesbian, gay, bisexual, and transgender (LGBT) service members, relying heavily on what is known about LGBT civilian and veteran populations. Significant research gaps about the health care needs of LGBT service members are identified, along with recommendations for closing those gaps. In addition, recommendations for improving LGBT acceptance and integration within the military are provided.
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Little is known about the functioning of children in veteran-connected families, who may experience a unique constellation of stressors including exposure to parental mental health symptoms and unemployment. Further, research has not... more
Little is known about the functioning of children in veteran-connected families, who may experience a unique constellation of stressors including exposure to parental mental health symptoms and unemployment. Further, research has not previously considered the role of school climate in counteracting these stressors for veteran-connected students. This preliminary study examines the relationship between veteran parent’s mental health and employment with adverse outcomes for their school-age children, as well as the potential moderating effect of safe school climate. Participants were 218 veteran parents of children in K-12 schools, who completed the Chicago Veterans Survey, including measures of PTSD and depression, unemployment, a school safety scale drawn from the California School Parent Survey, and an adverse child functioning screening tool. Regression models suggest that depression symptomatology and perceptions of less safe school climate were significantly associated with adverse outcomes among veteran-connected students. Safe school climate buffered against the negative effects of parents’ depression symptoms, particularly at lower levels of depression severity. Findings suggest the need for future research to explore the potentially crucial role for schools, including teachers, administrators, and particularly school-based mental health providers, in supporting the healthy functioning of veteran-connected students and their families.
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Research Interests: Psychology, Stress, Medicine, Military, Emotions, and 15 moreAffect, Humans, Coping, Mood Disorders, Prevalence, Deployment, Psychosomatic, Somatoform disorders, Personal Experience, Software Deployment, Military Personnel, Combat stress reaction, Psychology and Cognitive Sciences, Medical and Health Sciences, and Macho
Research Interests: Mental Health, Principal Component Analysis, Injury Prevention, Adolescent, Medicine, and 15 moreLinear models, Post traumatic stress disorder, Humans, Effect size, Female, Male, Occupational Safety and Health, Mental health services, Operation Iraqi Freedom, Middle Aged, Adult, Alcohol Use, Military Personnel, Life Change Events, and Medical and Health Sciences
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The promotion of inclusion in the U.S. Army requires an understanding of how and why exclusion occurs. As exclusion can have deleterious impacts at both and individual and organizational level, reducing exclusive behaviors can have... more
The promotion of inclusion in the U.S. Army requires an understanding of how and why exclusion occurs. As exclusion can have deleterious impacts at both and individual and organizational level, reducing exclusive behaviors can have positive effects on Soldiers and the Army. To explore exclusion in the Army, 19 focus groups were conducted with 120 active-duty enlisted Soldiers. Two rounds of thematic analysis revealed four themes related to exclusion. Participants indicated exclusion to be often based on low or bad performance, personality factors that were identified as different or toxic, cliques within the Army unwilling to welcome others, and gender, with both men and women identifying exclusionary behaviors toward women within and outside of the work environment. Research findings offer insight into how and why exclusion occurs and how such behaviors can be addressed in the U.S. Army including training and addressing cultural and systemic barriers to inclusion.
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Joining the Army, a new installation or a new unit are times of significant stress for Soldiers. Support provided during these transitions can affect unit cohesion, Soldier well-being, retention, and mission readiness. This research aimed... more
Joining the Army, a new installation or a new unit are times of significant stress for Soldiers. Support provided during these transitions can affect unit cohesion, Soldier well-being, retention, and mission readiness. This research aimed to explore how Soldiers experience the Army onboarding process as well as perceptions of the welcome experience. Nineteen focus groups were conducted with 120 Soldiers using a semistructured interview protocol. Thematic analysis of focus group transcripts revealed two major themes, varied welcome experience and an inconsistent Total Army Sponsorship Program. Soldiers reported varied transition experiences ranging from positive, neutral, nonexistent, to negative. Results indicate that Soldiers welcome experience was dependent on the specific installation, leaders, and unit. Findings demonstrate that at the installation and unit level, the Army currently lacks standardized processes for onboarding new service members. We note the research limitations and offer several recommendations that can be drawn from the present findings.
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Research Interests: Psychology and Medicine
Research Interests: Psychology and Iraq War
Research Interests: Psychology and Medicine
The transition from military service to civilian employment is one of the most important factors related to post-service well-being and success. It is also one of the biggest challenges. The majority of veterans describe finding a job as... more
The transition from military service to civilian employment is one of the most important factors related to post-service well-being and success. It is also one of the biggest challenges. The majority of veterans describe finding a job as the greatest challenge in transitioning to civilian life. While research has demonstrated a number of contributory factors related to difficulty in finding employment, a conceptual framework for understanding such challenges has yet to be proposed. Military transition theory describes the progression through which service members’ transition out of the military and illustrates how certain factors may create susceptibility to negative transition outcomes. The purpose of this chapter is to utilize the military transition theory to provide a foundation for understanding the factors related to successful transition to the civilian workplace after military separation.
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Considerable attention has been devoted to investigating posttraumatic stress disorder (PTSD) and suicidality in military veterans, but nonsuicidal high-risk behaviors (HRBs), like reckless driving, are underexplored and contribute to... more
Considerable attention has been devoted to investigating posttraumatic stress disorder (PTSD) and suicidality in military veterans, but nonsuicidal high-risk behaviors (HRBs), like reckless driving, are underexplored and contribute to elevated rates of premature death in this population. This study is the 1st to employ a structural equation modeling approach to investigate relationships between PTSD symptoms, suicidality, and HRBs in veterans. Data for this study were drawn from a sample of veterans living in Southern California. A multipronged sampling strategy was used to recruit 2,422 veterans, who completed an online battery. A structural equation model examining direct and indirect effects between 4 PTSD symptom factors, a suicidality factor, and an HRB factor was fitted to the data. We found positive direct effects for reexperiencing and negative cognitive–mood symptoms on suicidality and for hyperarousal symptoms on HRBs. We found a negative direct effect for avoidance on suicidality. Suicidality demonstrated a positive direct effect on HRBs. We detected positive indirect effects for reexperiencing and negative cognitive–mood symptoms on HRBs and a negative indirect effect for avoidance on HRBs through the suicidality pathway. Results show that distinct PTSD symptom clusters are associated with different risk profiles in military veterans. High rates of HRBs with the potential for lethal outcomes evident in our sample demonstrate the need for nuanced screening procedures. Veterans who do not meet full clinical criteria for PTSD may be at risk for premature mortality from suicide and HRBs in the context of reexperiencing, negative cognitive–mood, and hyperarousal symptoms.
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Many military veterans face significant challenges in civilian reintegration that can lead to troublesome behavior. Drawing on military transition theory (MTT) and using data from a survey of post-9/ 11 veterans in two metropolitan areas... more
Many military veterans face significant challenges in civilian reintegration that can lead to troublesome behavior. Drawing on military transition theory (MTT) and using data from a survey of post-9/ 11 veterans in two metropolitan areas (n = 783), we investigate previously unexamined relationships between post-discharge strains, resentment, depression, and risky behavior, taking into account a set of control variables, including combat exposure. Results indicated that unmet needs at time of discharge and perceived loss of military identity are associated with increased risky behavior. Much of the effects of unmet discharge needs and loss of military identity are mediated by depression and resentment toward civilians. The results of the study are consistent with insights from MTT, providing evidence of specific ways in which transitions can affect behavioral outcomes. Moreover, the findings highlight the importance of helping veterans meet their post-discharge needs and adapt to changing identity, in order to reduce the risk of emotional and behavioral problems.