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Deployment stress impacts well-being through different mental health issues for female and male vets

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(Boston)– Experiencing stress-related mental health issues following deployment exposures increases risk of reduced well-being in other life domains in the years following military service for veterans. Gender plays an important role in these associations.

The findings, which appear in Clinical Psychological Science, have implications for better understanding the challenges female and male veterans face upon returning from service and may lead to ways care can be optimized with consideration of the role gender may play.

According to the researchers, previous studies have shown a relationship between the development of mental health issues, particularly PTSD, and decreased functioning and satisfaction with family and work for veterans. However, gender often has been overlooked as a variable, and the role of particular deployment stressors have not been extensively examined. "Our study illustrates the complex interplay between specific military exposures, mental health, and subsequent post deployment well-being between the genders," explained lead author Brian Smith, PhD, assistant professor of psychiatry at Boston University School of Medicine and research psychologist in the Women's Health Sciences Division, National Center for PTSD at VA Boston Healthcare System.

In this study, which was completed at the VA Boston Healthcare System, 522 male and female Iraq and Afghanistan War veterans completed two surveys. The first was completed within two years of separation from military service, and included questions about veterans' military experiences as well as their current mental health. The second survey was completed approximately three and a half years later and included questions about functioning and satisfaction in the domains of work, romantic relationships and parenting.

The researchers concluded that each of the deployment stressors examined–warfare exposure, military sexual harassment and family stressors–had implications for veterans' subsequent functioning and satisfaction in the areas of work and family. In addition, these exposures were often indirectly linked to functioning and satisfaction via mental health. Interestingly, the links differed between men and women. While PTSD symptoms played an important role for both genders, depression played a role as well, especially for female veterans. For example, PTSD linked all three deployment exposures and subsequent functioning and satisfaction in romantic relationships for men, while both PTSD and depression played significant roles for women. However, it is important to note that there were some similarities in risk as well. In the context of parenting, PTSD linked deployment exposures with reduced functioning for male and female veterans alike, and depression was the most important link in predicting lower satisfaction.

In addition, there was evidence for direct effects of military exposures on work and family quality of life. Again, some differences between males and females were found. For example, family stressors during deployment were directly associated with increased risk for parental impairment for female veterans, whereas for men the effect was only indirect through PTSD. These findings support the position that men and women may experience different military exposures and react in different ways. "This understanding of risk for reduced well-being, including the role of gender differences, may provide further important insight as to how to best cater post-military services to veterans' unique needs following military service," added Smith. "From a clinical perspective, these findings suggest that services aimed at addressing returning veterans' reintegration into work and family life might pay particular attention to male and female veterans' experiences while deployed, as well as their current mental health."

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Funding for this study was provided by two Department of Veterans Affairs, Health Services Research and Development Service grants: "Validation of Modified DRRI Scales in a National Sample of OEF/OIF Veterans" (DHI 09-086), Dawne Vogt, Principal Investigator, and "Work and Family Functioning in Women Veterans: Implications for VA Service Use" (IIR 12-345), Dawne Vogt and Brian Smith, Principal Investigators.

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