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. 2017 Jul;5(4):664-682.
doi: 10.1177/2167702617705672. Epub 2017 May 31.

The Role of PTSD, Depression, and Alcohol Misuse Symptom Severity in Linking Deployment Stressor Exposure and Post-Military Work and Family Outcomes in Male and Female Veterans

Brian N Smith  1   2 , Emily C Taverna  1 , Annie B Fox  1 , Paula P Schnurr  3   4 , Rebecca A Matteo  3 , Dawne Vogt  1   2
Affiliations

The Role of PTSD, Depression, and Alcohol Misuse Symptom Severity in Linking Deployment Stressor Exposure and Post-Military Work and Family Outcomes in Male and Female Veterans

Brian N Smith et al. Clin Psychol Sci. 2017 Jul.

Abstract

Exposure to stressors during military deployment puts veterans at risk for reduced post-military quality of life. Stress-related mental health problems may lead to decreased well-being within work and family domains, yet few studies have explored associations in the context of gender. We examined relationships between deployment stressors and post-military functioning and satisfaction in the domains of work and family, with a focus on PTSD, depression, and alcohol misuse symptomatology as potential mediators. Participants included 522 male and female Iraq and Afghanistan War veterans assessed longitudinally. Structural equation models supported several direct and indirect pathways linking deployment stressors to work and family outcomes for both men and women. PTSD had an important role in these associations. Depression also played a significant role, particularly for women. These findings build on prior research by elucidating potential gender-specific risk, which may be applied to better tailor services to veterans' unique needs.

Keywords: functional impairment; military; quality of life; well-being.

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Conflict of interest statement

Declaration of Conflicting Interests The authors declared that they had no conflicts of interest with respect to their authorship or the publication of this article.

Figures

Figure 1
Figure 1
Models for work by gender Note: Standardized path coefficients using SEM for the final models (95% confidence intervals are in parentheses) for women (N=212) and men (N=197). Significant and marginally significant paths and estimates have solid (p<.05) and dashed (p<.10) lines, respectively. Significant indirect effects for women: warfare exposure on work functional impairment via depression (β=.08, p=.008); warfare exposure on work satisfaction via PTSD (β=−.10, p=.022); sexual harassment on work functional impairment via depression (β=.07, p=.007) and alcohol misuse (β=.06, p=.046); sexual harassment on work satisfaction via PTSD (β=−.09, p=.029); family stressors on work functional impairment via depression (β=.11, p=.001); family stressors on work satisfaction via PTSD (β=−.07, p=.027). Significant indirect effects for men: warfare exposure on work functional impairment via PTSD (β=.19, p<.001); warfare exposure on work satisfaction via depression (β=−.06, p=.039); family stressors on work functional impairment via PTSD (β=.09, p=.006); family stressors on work satisfaction via depression (β=−.06, p=.049).
Figure 2
Figure 2
Models for romantic relationships by gender Note: Standardized path coefficients using SEM for the final models (95% confidence intervals are in parentheses) for women (N=184) and men (N=173). Significant and marginally significant paths and estimates have solid (p<.05) and dashed (p<.10) lines, respectively. Significant indirect effects for women: warfare exposure on relationship functional impairment via PTSD (β = .09, p = .020); sexual harassment on relationship functional impairment via PTSD (β=.08, p=.043); marginally significant effect for sexual harassment on relationship functioning impairment through depression (β=.05, p=.076) Significant indirect effects for men: warfare exposure on relationship functional impairment via PTSD (β=.16, p=.001); sexual harassment on relationship functional impairment via PTSD (β=.11, p=.010); family stressors on relationship functional impairment via PTSD (β=.11, p=.005).
Figure 3
Figure 3
Models for parenting by gender Note: Standardized path coefficients using SEM for the final models (95% confidence intervals are in parentheses) for women (N=160) and men (N=157). Significant and marginally significant paths and estimates have solid (p<.05) and dashed (p<.10) lines, respectively. Significant indirect effects for women: warfare exposure on parental functional impairment via PTSD (β=.08, p=.050); sexual harassment on parental functional impairment via PTSD (β=.08, p=.025); maginally significant effect for sexual harassment on parental satisfaction via depression (β=−.04, p=.065); marginally significant effect for family stressors on parental functional impairment via PTSD (β=.06, p=.07); family stressors on parental satisfaction via depression (β=−.08, p=.037). Significant indirect effects for men: warfare exposure on parental functional impairment via PTSD (β=.08, p=.022); family stressors on parental functional impairment via PTSD (β=.09, p=.031); marginally significant effect for family stressors on parental satisfaction via depression (β=−.06, p=.080).
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