The association between combat exposure and mental health outcomes among military personnel is well established. However, less is understood about the relationship between combat exposure, military status, and various risk domains. The goal of this study is to examine the impact of combat exposure on various domains of risk and to identify if associations differ based on the military status (current vs. former) of U.S. Army Reserve and National Guard (USAR/NG) soldiers. Data for this analysis comes from Operation: SAFETY (Soldiers and Families Excelling Through the Years), a longitudinal study that seeks to examine the health and well-being of USAR/NG soldiers and their partners. For this report, we used a cross-sectional subset of the data to examine associations between combat exposure and the risk domains of previously deployed male USAR/NG soldiers (N = 192) with Cherpitel's risk behavior scale. Findings revealed a significant interaction between combat exposure and military status on risk perception (p < 0.05), suggesting that perceptions change as exposure increases and that this effect is stronger in current soldiers. The interaction between combat exposure and military status on sensation-seeking was also significant (p < 0.05), where greater combat exposure was associated with greater sensation-seeking among former, but not current soldiers. These findings highlight the importance of developing interventions that can address the role that combat experiences have on risk perception and sensation-seeking behaviors post-deployment.
Suicide safety planning is an intervention involving identifying personal warning signs and coping skills with a trained provider. Considering an individual's perspectives on engagement (i.e., remembering and reviewing) safety plans is necessary to further elucidate its helpfulness. Peer Specialists who provide support to those with mental illness may have a unique opportunity to enhance safety planning given their shared lived experience. In a U.S. Veteran sample (N = 122) with current or lifetime suicidal thoughts or behaviors, we aimed to a) examine the frequency of engagement of safety plans, b) gauge interest in connecting with a Peer Specialist to make safety plans more helpful, and c) determine if those constructs differed based on current suicidal ideation severity, thwarted belongingness, and perceived burdensomeness. A total of 44.2% of Veterans "kind of" or did not remember their safety plans. While 35.2% of Veterans had not reviewed their safety plans, 18.0% reviewed their plans but did not find reviewing it helpful. Overall, 81.1% of Veterans were interested in meeting with a Peer Specialist to make their safety plans more helpful. There were significant differences among levels of reviewing one's safety plan (did not review, reviewed and did not find it helpful, reviewed and found it helpful) and thwarted belongingness and perceived burdensomeness. There were no other significant differences. Although frequency of engagement with safety plans varied across Veterans, a program delivered by peers to enhance safety planning is of interest and may be helpful to Veterans regardless of demographics, diagnoses, or suicide related constructs.
Despite burgeoning evidence of the negative effects of service experiences on service members' spouses/partners, limited research has examined these effects in the context of substance use. Additionally, a strong literature demonstrates the protective role relationship satisfaction can play for health-related outcomes. The goal of the present research is to examine relations between service experiences (i.e., deployment, combat exposure) and partner substance use, as well as how relationship satisfaction may buffer these effects. Data from 275 civilian partners were drawn from Operation: SAFETY (Soldiers And Families Excelling Through the Years), a longitudinal study examining health among US Army Reserve/National Guard (USAR/NG) soldiers and partners. Analyses examined relations between soldier service history (baseline) and civilian partner alcohol/ drug use (two-year follow-up), as well as interactions with relationship satisfaction. Models controlled for civilian partner sex and age, and soldiers' self-reported PTSD symptoms and substance use. Results revealed interactions between service experiences and partner satisfaction for models predicting alcohol consumption and heavy drinking. Higher relationship satisfaction mitigated overall alcohol consumption and heavy drinking frequency among partners of soldiers with two or more deployments, and among partners of soldiers with higher combat exposure. Soldier service experiences were unrelated to civilian partner drug use. The effects of deployment and combat exposure extend beyond the service member to negatively influence civilian partner alcohol consumption and heavy drinking, with relationship satisfaction buffering these risks. Interventions that assist USAR/NG soldiers and spouses in strengthening their relationships may also help protect against spouse substance use related to soldier service experiences.
U.S. Army National Guard and Army Reserve (ANG/USAR) soldiers are at risk for substance use, and research in other populations suggests risk-related behaviors and traits affect the propensity for use. Less is known about how deployment might amplify these effects. Our research explored the relations between risk-related behaviors and substance use among ANG/USAR soldiers and investigated differences by deployment (previously vs. never deployed). We drew a subset of data from Operation: SAFETY, an ongoing study of ANG/USAR soldiers and their partners (married/living together as if married). Cross-sectional regression models examined domains of risk (i.e., risk perception, risk-taking/impulsivity, sensation-seeking) and substance use (any current drug use, current non-medical use of prescription drugs, current illicit drug use, alcohol problems, and frequent heavy drinking [FHD]). Final models controlled for age, sex, anger, and PTSD. Interaction terms between risk behaviors and deployment status on substance use were also noted. Results revealed that greater risk perception was significantly associated with a lower likelihood of and protective against FHD. Greater risk-taking/impulsivity was associated with a higher likelihood of any current drug use and alcohol problems. Additionally, interaction models suggest that non-deployed soldiers at every level of risk-taking/impulsivity had a consistently high likelihood of illicit drug use overall. Sensation-seeking was not associated with any outcome. Findings demonstrate that greater risk-taking/impulsivity was associated with substance use, and never deployed/non-deployed ANG/USAR soldiers might be more vulnerable. Our work can help inform substance use interventions in the military by highlighting the role and impact of risk-related behaviors and non-deployment.
Combat-related physical injuries not only affect the individual but also close family members. Emerging evidence indicates that injuries that change appearance, such as limb loss and physical scarring, may create additional psychosocial challenges for the injured person and their family. However, to date the impact of appearance-altering combat injuries have not been explored among the partners of those who were injured. Using a qualitative individual interview design, this study aimed to gain experiential insights into the appearance-specific impact on the partners of military personnel who sustained appearance-altering injuries during deployments or training. Reflexive Thematic Analysis of interviews with 11 female partners identified two main themes "The challenges of looking different" and "How our life continues." The themes reflect challenges experienced by the partners in relation to their injured partner looking "different" from societally accepted appearance ideals, and the impact this could have on their children. Yet, they had found ways for life to continue such as drawing on positive emotions, having gratitude, pride in their partner's service, and normalizing difference for their children. While the partners found ways to adapt, this study draws attention to unmet needs for appearance-specific support.
A self-report four-item Brief Resilient Coping Scale (BRCS) measures tendencies to cope with stress in a highly adaptive manner. We investigated the level of resilient coping and the psychometric properties of the BRCS among young men participating military call-up. The study sample consisted of a one-year military call-up sample (N = 2184) in the Northern Finland. Most of the participants were at the age of 17–18 years. They completed a study questionnaire including the BRCS and other psychosocial scales during the military call-up. The construct validity of the BRCS was assessed with exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Convergent and discriminant validity were assessed by relating resilient coping with self-reports of dispositional optimism (LOT-R), sense of coherence (SOC-13), perceived stress (PSS-10), general anxiety (GAD-7), and depression (R-BDI). The mean BRCS total score of the participants indicated good resilient coping and was related to specific sociodemographic factors, such as education, relationship status and family structure. The internal consistency of the BRCS was good. EFA and CFA showed that one-factor solution fitted to the data best. BRCS correlated positively with dispositional optimism and sense of coherence, and negatively with perceived stress, general anxiety, and depression. BRCS appears to be psychometrically adequate tool in assessing healthy young men's resilient coping before commencing their compulsory conscript service. The evaluation of resilient coping prior to military service is important to military forces.
Enhancing well-being amongst partners of current serving military personnel is a growing area of interest and concern. Partners of Australian Defence Force (ADF) personnel experience unique challenges because of their military connection above those faced by the broader civilian community. This paper sought to understand undertake an investigation of the most important risk and protective factors which influence well-being in this cohort. This cross-sectional study gathered responses from 444 participants (partners of current serving military members) through an online survey. Bivariate and multivariate regression models found higher well-being scores were associated with younger partners, higher military member rank brackets, existing social support in their location, and partners who were in their desired employment status. Additionally, higher COVID-19 impacts were associated with lower well-being scores. Moving forward, interventions which target social support, desired employment, and periods of national crisis requiring a military response should be the focus. The findings of this study impact policy and programs which aim to provide support to military-connected families.
