The Impacts of Service Related Exposures on Trajectories of Mental Health Among Aging Veterans

Ureña, Stephanie; Taylor, Miles G.; Kail, Ben Lennox

doi:10.1093/geronb/gbw149

Cited by 9 publications

(10 citation statements)

References 43 publications

(52 reference statements)

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“…Although some combat-exposed veterans demonstrate no long-term consequences (Aldwin et al, 1994; Elder & Clipp, 1989), others experience substantial and lasting negative outcomes. Traumatic combat exposure is related to higher levels of mental health problems, including depression (Marmar et al, 2015; Ureña et al, 2017). However, traumatic service exposures are largely invisible in the aging literature, especially among men who served during WWII, Korean War, and Vietnam War eras (Settersten 2006; Spiro et al 2016).…”

Section: Military Service and Exposuresmentioning

confidence: 99%

“…Approximately, 68% of men aged 55 years and older in the United States are veterans, with approximately 50% of those older veterans serving during World War II, the Korean War, and the Vietnam War (Wilmoth & London, 2016; US Census Bureau, 2016). War service is linked to poorer mental health as individuals age (Aldwin et al, 2018), including increased and decreased psychological well-being in later life (Marmar et al, 2015; Ureña et al, 2017). Further, approximately 11% of older veterans have major depressive disorder, which is double the rate of the general population (Veterans Health Administration [VHA], 2015).…”

mentioning

confidence: 99%

“…Further, approximately 11% of older veterans have major depressive disorder, which is double the rate of the general population (Veterans Health Administration [VHA], 2015). The long-term depression risk for veterans appears to be tied to potentially traumatic combat, which has been measured as exposure to the dead, dying, and wounded (DDW) during service (National Survey of Veterans [NSV], 2010; Ureña et al, 2017). The well-being of the substantial older veteran population is a public health concern because poor mental health in later life is linked to social isolation, chronic conditions, functional impairment, and increased healthcare costs (Centers for Disease Control and Prevention, 2013; Taylor & Lynch, 2004).…”

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confidence: 99%

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The Impact of Military Service Exposures and Psychological Resilience on the Mental Health Trajectories of Older Male Veterans

2020

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Objectives: We examine the impact of exposure to the dead, dying, and wounded (DDW) during military service on the later-life depressive symptom trajectories of male United States veterans, using psychological resilience as an internal resource that potentially moderates negative consequences. Methods: The Health and Retirement Study (2006–2014) and linked Veteran Mail Survey were used to estimate latent growth curve models of depressive symptom trajectories, beginning at respondents’ first report of resilience. Results: Veterans with higher levels of resilience do not have increased depressive symptoms in later life, despite previous exposure to DDW. Those with lower levels of resilience and previous exposure to DDW experience poorer mental health in later life. Discussion: Psychological resilience is important for later-life mental health, particularly for veterans who endured potentially traumatic experiences. We discuss the importance acknowledging the role individual resources play in shaping adaptation to adverse life events and implications for mental health service needs.

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Section: Military Service and Exposuresmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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The Impact of Military Service Exposures and Psychological Resilience on the Mental Health Trajectories of Older Male Veterans

2020

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“…These negative effects are thought to be driven substantially by specific traumas such as exposure to death or hazardous toxins that are often experienced during wartime combat (Taylor, Ureña, Carr, & Min, 2018). Studies now find that measuring these specific exposures is important in understanding the lasting burden of service for today’s older veterans, but often research includes only a marker of likely wartime service as a general proxy (Ureña, Taylor, & Kail, 2017).…”

mentioning

confidence: 99%

“…LS is thought to encompass an appraisal process of the quality of one’s life that unfolds over-time based on individual, subjective criteria (Pavot & Diener, 2008). Negative physical and psychological long-term outcomes extending from wartime service (Taylor, Ureña, & Kail, 2016; Ureña et al, 2017) may work alternately or in tandem with the personal growth and positive reappraisals of experiences often thought to accompany PTG (Elder & Clipp, 1989). In this way, among veterans, LS may be an especially appropriate way to capture the varied implications of combat exposure experienced earlier in life (Settersten, Day, Elder, & Waldinger, 2012).…”

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confidence: 99%

The Role of Maternal Relationship in the Persisting Effect of Combat Exposure

Carr

Taylor

Meyer

et al. 2019

Innovation in Aging

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Background and Objectives The veteran population is aging. Combat exposure is associated with negative health and psychological outcomes in some, but not all veterans; others even appear to experience gains. One mechanism driving these varied responses might be early life relationships. This study investigated the extent to which the quality of early maternal relationships influences the association between combat exposures and life satisfaction (LS) among older male veterans. Research Design and Methods Data were drawn from a pooled sample of male veterans in the Health and Retirement Study who completed the 2013 Veteran Mail Survey (N = 1,160). We used ordinary least squares regression to examine the association between combat exposures (with and without exposure to death) and LS, and the moderating effect of maternal relationship quality on this association. Results We found a significant positive association between maternal relationship quality and LS, and a significant association of combat that was dependent on maternal relationship quality. Specifically, combat-exposed veterans with poor maternal relationship quality reported lower LS, whereas combat-exposed veterans with high relationship quality reported higher LS—relative to their noncombat-exposed counterparts. The effects of exposure to death of hazardous toxins did not mediate or moderate this relationship. Discussion and Implications Findings indicate that maternal relationships had a lasting influence on whether combat contributed to a positive, negative, or neutral long-term effect on wellbeing. Findings support previous studies that suggest early life factors may play an important role in the fostering of resilient health outcomes over the life course. Implications for preventative strategies in soldiers are discussed.

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Age differences in long‐term mortality among male nonveterans, noncombat veterans, and combat veterans

Landes

Piazza

2023

Journal of Traumatic Stress

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Research documenting differences in mortality risk across the life course between veterans and nonveterans has not accounted for combat status. To address this gap in the literature, the current study examined differences in long‐term mortality among midlife and older‐adult male nonveterans, noncombat veterans, and combat veterans. Data were drawn from Wave 2 (2004/2005) of the Midlife Development in the United States survey and linked to 2020 mortality data (N = 2,024). Based on interpretation of a veteran‐combat status by age interaction term, compared to nonveterans, noncombat veterans experienced a mortality advantage at younger ages, ORmain effect = 0.12, 95% CI [0.03, 0.54], p = .006, and a mortality disadvantage at older ages, ORinteraction term = 1.06, 95% CI [1.01, 1.05], p = .004, with the crossover occurring at 73.4 years. A similar pattern was present among combat veterans, with the mortality advantage at younger ages not reaching significance, ORmain effect = 0.16; 95% CI [0.02, 1.18], p = .072; a mortality advantage at older ages, ORinteraction term = 1.03, 95% CI [1.00, 1.05], p = .040; and the crossover occurring 4.2 years earlier at 69.2 years. The findings suggest that combat status may accelerate the age‐related mortality disadvantage among veterans. Studies of health and mortality outcomes among veterans should, therefore, account for combat status. When data allow, future studies should confirm whether this pattern is present in nationally representative samples.

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The Impacts of Service Related Exposures on Trajectories of Mental Health Among Aging Veterans

Abstract: SREs presented varied and significant impacts, suggesting that combat does not work alone in driving poor mental health trajectories, and that exposure to death is a more robust risk marker for later outcomes.

Cited by 9 publications

References 43 publications

The Impact of Military Service Exposures and Psychological Resilience on the Mental Health Trajectories of Older Male Veterans

The Impact of Military Service Exposures and Psychological Resilience on the Mental Health Trajectories of Older Male Veterans

The Role of Maternal Relationship in the Persisting Effect of Combat Exposure

Age differences in long‐term mortality among male nonveterans, noncombat veterans, and combat veterans

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