Objective-This study examined the association of lifetime traumatic stress with psychiatric diagnostic status and symptom severity in veterans serving in the US military after 9/11/01. Method-Data from 356 US military veterans were analyzed. Measures included a standardized clinical interview measure of psychiatric disorders, and paper-and-pencil assessments of trauma history, demo-graphic variables, intellectual functioning, posttraumatic stress disorder (PTSD) symptoms, depression, alcohol misuse, and global distress.Results-Ninety-four percent of respondents reported at least one traumatic stressor meeting DSM-IV criterion A for PTSD (i.e., life threatening event to which the person responded with fear, helplessness or horror), with a mean of four criterion A traumas. Seventy-one percent reported serving in a war-zone, with 50% reporting occurrence of an event meeting criterion A. The rate of current psychiatric disorder in this sample was: 30% PTSD, 20% major depressive disorder, 6% substance abuse or dependence and 10% for the presence of other Axis I psychiatric disorders. After accounting for demographic covariates and combat exposure, childhood physical assault and accident/disasters *Corresponding author. Tel.: +1 919 286 0411x7973. E-mail address: beckham@duke.edu (J.C. Beckham). Conflict of interestMy coauthors, Drs. Calhoun, Yoash-Gantz, Taber, Miller, Tupler, Morey, Marx, Weiner and Beckham, as well as Ms. Kimberly Green and I do not have any interests that might be interpreted as influencing the research. APA ethical standards were followed in the conduct of this research. ContributorsDr. Dedert wrote the first version of the manuscript and conducted many of the data analyses. Ms. Green conceptualized and created the poster on which this manuscript was based and participated in data management and writing of the manuscript. Dr. Calhoun participated in the study design, conceptualization and writing of the manuscript as well as assisting in data analyses. He also participated in the study design and data collection. Dr. Yoash-Gantz participated in data collection and edits of the manuscript. Dr. Taber participated in data collection and edits of the manuscript. Dr. Miller participated in data collection and edits of the manuscript. Dr.Tupler participated in the study design, data collection, and edits of the manuscript. Dr. Morey participated in the study design and data collection. Dr. Marx participated in the study design and data collection. Dr. Weiner participated in study design and data collection. Dr. Beckham contributed to each aspect of this project from study design to writing of the manuscript. were most consistently associated with increased likelihood of PTSD. However, PTSD with no comorbid major depressive disorder or substance use disorder was predicted only by combat exposure and adult physical assault. Medical/unexpected-death trauma and adult physical assault were most consistently associated with more severe symptomatology. NIH Public AccessConclusions-Particular categorie...
These results suggest that resilience is a construct that may play a unique role in the occurrence of PTSD and severity of other functional correlates among deployed veterans. Future studies in this area would benefit from a prospective design, the evaluation of other possible protective processes (e.g., social support), and specific examination of particular aspects of resilience and how resilience may be increased.
The present study examined the structural validity of the 25-item Connor-Davidson Resilience Scale (CD-RISC) in a large sample of U.S. veterans with military service since 9/11/2001. Participants (n=1981) completed the 25-item CD-RISC, a structured clinical interview and a self-report questionnaire assessing psychiatric symptoms. The study sample was randomly divided into two sub-samples, an initial sample [Sample 1: n = 990] and a replication sample [Sample 2: n = 991]. Findings derived from exploratory factor analysis (EFA) did not support the five-factor analytic structure as initially suggested in Connor and Davidson’s (2003) instrument validation study. Although Parallel Analyses (PA) indicated a two-factor structural model, we tested one to six factor solutions for best model fit using confirmatory factor analysis (CFA). Results supported a two-factor model of resilience, comprised of adaptability (8-item) and self-efficacy (6-item) themed items however, only the adaptability themed factor was found to be consistent with our view of resilience —a factor of protection against the development of psychopathology following trauma exposure. The adaptability themed factor may be a useful measure of resilience for post 9/11 U.S. military veterans.
Objective The present study sought to investigate the longitudinal effects of psychological resilience against alcohol misuse adjusting for socio-demographic factors, trauma-related variables, and self-reported history of alcohol abuse. Methodology Data were from National Post-Deployment Adjustment Study (NPDAS) participants who completed both a baseline and one-year follow-up survey (N=1090). Survey questionnaires measured combat exposure, probable posttraumatic stress disorder (PTSD), psychological resilience, and alcohol misuse, all of which were measured at two discrete time periods (baseline and one-year follow-up). Baseline resilience and change in resilience (increased or decreased) were utilized as independent variables in separate models evaluating alcohol misuse at the one-year follow-up. Results Multiple linear regression analyses controlled for age, gender, level of educational attainment, combat exposure, PTSD symptom severity, and self-reported alcohol abuse. Accounting for these covariates, findings revealed that lower baseline resilience, younger age, male gender, and self-reported alcohol abuse were related to alcohol misuse at the one-year follow-up. A separate regression analysis, adjusting for the same covariates, revealed a relationship between change in resilience (from baseline to the one-year follow-up) and alcohol misuse at the one-year follow-up. The regression model evaluating these variables in a subset of the sample in which all the participants had been deployed to Iraq and/or Afghanistan was consistent with findings involving the overall era sample. Finally, logistic regression analyses of the one-year follow-up data yielded similar results to the baseline and resilience change models. Conclusions These findings suggest that increased psychological resilience is inversely related to alcohol misuse and is protective against alcohol misuse over time. Additionally, it supports the conceptualization of resilience as a process which evolves over time. Moreover, our results underscore the importance of assessing resilience as part of alcohol use screening for preventing alcohol misuse in Iraq and Afghanistan era military veterans.
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