Objective: Prior work has linked exposure to multiple types of trauma (i.e., polyictimization) to increased risk of negative behavioral health outcomes compared with exposure to any single event. However, few studies have attempted to understand how polyvictimization theory relates specifically to veterans' experiences and behavioral health outcomes. The present study assessed heterogeneity in reports of childhood trauma, combat trauma, and military sexual trauma. Method: We recruited 1,230 veterans outside of traditional Veterans Health Administration settings to participate in a study assessing behavioral health. On average, participants were 34.5 years old with the majority identifying as White (79.3%) and male (88.7%). We used latent class analysis to extract classes of traumatic experience exposure including childhood trauma, combat trauma, and military sexual trauma. Results: Five classes emerged: (a) high all; (b) moderate combat trauma, high military sexual trauma; (c) high combat trauma, moderate military sexual harassment; (d) moderate childhood trauma and combat trauma; and (e) combat trauma only. Overall, veterans in profiles that endorsed multiple trauma types (i.e., polyvictimization) evidenced greater symptoms of depression, posttraumatic stress disorder, and hazardous alcohol or cannabis use. Further, women were overly represented in profiles that included multiple victimization typologies, especially when profiles included elevated endorsement of military sexual trauma. Conclusion: A polyvictimization framework was partially supported, with differential effects on behavioral health outcomes noted across trauma experiences. Public Health Significance StatementThis study provides continued support for a polyvictimization framework among a veteran population spanning multiple areas of trauma-related factors. Veterans entering care with multiple traumas may require additional services, particularly women reporting military sexual trauma.
American veterans are a population that suffer from both context specific stressors as well as many population‐specific major‐life events. The present exploratory study utilises a longitudinal cohort of 1230 U.S. veterans surveyed from February 2020 through February 2021. We sought to understand heterogeneity in perceived stress, using growth mixture modelling, over this time period, how COVID‐specific factors such as negative reactions to the pandemic, loneliness, and employment disruptions influence perceived stress trajectories, and how veterans vary across distal outcomes including posttraumatic stress disorder (PTSD), pain, depression, sleep problems, physical health, and alcohol use disorder. Results revealed a 4‐class solution: Stable High, Stable Low, Steady Increasing, and Steady Decreasing classes. In terms of COVID specific factors, negative reactions to COVID were consistently associated with perceived stress for those in the Stable High and Steady Increasing classes whereas loneliness was associated with stress trajectories for all emergent classes. Finally, in terms of our distal outcomes, results showed a relatively robust pattern with veterans in the Stable High or Steady Increasing classes reporting worse scores across all outcomes including PTSD, pain, sleep problems, physical health, depression, and alcohol use disorder. Understanding the interplay between existing vulnerabilities, ongoing stressors, and behavioural health outcomes among veterans is crucial for prevention and intervention efforts.
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.
Postdeployment civilian unemployment has become a common problem and source of additional stress for National Guard (NG) personnel. This study evaluated 126 California NG members, exploring the relationship between immediate postdeployment employment status and self-reported mental health symptoms, including evidence of alcohol misuse. Participants were recruited from a NG unit within the first 3 months after returning home in August 2011. Over one-third of participants reported being unemployed beyond the part-time NG commitment. Mental health symptoms were greater in those participants without civilian employment. Additionally, those participants with comorbid alcohol misuse with either depression or post-traumatic stress disorder were significantly more likely to lack civilian employment. Interaction testing revealed a significant interaction between employment status and alcohol misuse for both depression and post-traumatic stress disorder. Alcohol use was concluded to moderate the relationship between civilian unemployment and mental health symptoms. Results suggest that the part-time employment provided through NG service may serve as a protective factor in the development of negative psychological outcomes, except for cases where alcohol misuse is present.
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