Page 43 - Journal of Special Operations Medicine - Summer 2014

risk for other common mental health conditions such as for Suicidology; and royalties from Springer Publishing.
depression. It is possible that unit support may indirectly The remaining authors indicate they have no financial
protect against PTSD and depression through higher lev- relationships relevant to this article to disclose.
27
els of emotional resilience. Pietrzak et al., for example,
found that higher levels of unit support contribute to References
greater resilience, which in turn is associated with less-
severe PTSD and depression. From a clinical and preven- 1. Hoge CW, Castro CA, Messer SC, et al. Combat duty in
Iraq and Afghanistan, mental health problems, and barri-
tion perspective, the current results suggest that fostering ers to care. N Engl J Med. 2004;351:13–22.
unit support may prevent emotional distress among PJs. 2. Hoge CW, Terhakopian A, Castro CA, et al. Association
To date, however, there is little research focused on fac- of posttraumatic stress disorder with somatic symptoms,
tors associated with increased unit support, although at health care visits, and absenteeism among Iraq war veter-
least one study suggests that unit support is unrelated to ans. Am J Psychiatry. 2007;164:150–153.
the demographic profile of units such as race/ethnicity, 3. Hoge CW, Toboni HE, Messer SC, et al. The occupational
43
marital status, and housing location. Future research burden of mental disorders in the U.S. military: psychiat-
on unit support is therefore needed to identify those fac- ric hospitalizations, involuntary separations, and disabil-
tors that best promote unit support. ity. Am J Psychiatry. 2005;162:585–591.
4. Milliken CS, Auchterlonie JL, Hoge CW. Longitudinal
assessment of mental health problems among active and
It is important to interpret these findings within the con- reserve component soldiers returning from the Iraq War.
text of several limitations. First, the current sample was JAMA. 2007;298:2141–2148.
restricted to one specific military career field, so results 5. Tanielian T, Jaycox LH. Invisible wounds of war: Psy-
might not generalize to other career fields and branches chological and cognitive injuries, their consequences, and
of service. Second, because only men are currently al- services to assist recovery. San Monica, CA: RAND Cor-
lowed to become PJs, the observed relationships in this poration; 2008.
study might not generalize to women. Third, the current 6. Back SE, Killeen TK, Teer AP, et al. Substance use disor-
study’s cross-sectional design limits conclusions about ders and PTSD: an exploratory study of treatment prefer-
how variables are related to each other over time. For ences among military veterans. Addict Behav. 2014;39:
instance, it is possible that unit support reduces emo- 369–373.
tional distress, but it is also possible that emotional 7. Burnett-Zeigler I, Ilgen M, Valenstein M, et al. Prevalence
distress affects Servicemembers’ perceptions of unit sup- and correlates of alcohol misuse among Afghanistan and
Iraq veterans. Addict Behav. 2011;36:801–806.
port; longitudinal studies are therefore needed to estab- 8. Finley EP, Baker M, Pugh MJ, Peterson A. Patterns and
lish causal relationships. Finally, the self-report survey perceptions of intimate partner violence committed by re-
design could introduce response bias, especially among turning veterans with posttraumatic stress disorder. J Fam
special duty military personnel for whom mental stigma Violence. 2010;25:737–743.
may be especially pronounced. It is possible that par- 9. Jakupcak M, Conybeare D, Phelps L, et al. Anger, hos-
ticipants minimized symptom report as a result, which tility, and aggression among Iraq and Afghanistan war
could influence outcomes. The current study should veterans reporting PTSD and subthreshold PTSD. J Trau-
therefore be replicated using other data collection strate- matic Stress. 2007;20:945–954.
gies (e.g., anonymous responding). Despite these limita- 10. Lehavot K, Stappenbeck CA, Luterek JA, et al. Gender
tions, the present study provides important information differences in relationships among PTSD severity, drink-
about the relationship of different types of deployment- ing motives, and alcohol use in a comorbid alcohol de-
pendence and PTSD sample. Psychol Addict Behav. 2013.
related stressors with emotional distress among PJs and 11. Monson CM, Taft CT, Fredman SJ. Military-related
suggests that unit support plays an important protective PTSD and intimate relationships: from description to the-
role regardless of deployment experience. ory-driven research and intervention development. Clin
Psychol Rev. 2009;29:707–714.
12. Oquendo MA, Friend JM, Brodsky BS, et al. Association
Funding
of comorbid posttraumatic stress disorder and major de-
This project was supported by a Department of the Air pression with greater risk for suicidal behavior. Am J Psy-
Force grant (FA8650-12-2-6277) awarded to Lt Col chiatry. 2003;160:580–582.
James Stephenson. 13. Panagioti M, Gooding P, Tarrier N. Post-traumatic stress
disorder and suicidal behavior: a narrative review. Clin
Psychol Rev. 2009;29:471–482.
Disclosures 14. Taft CT, Street AE, Marshall AD, et al. Posttraumatic
stress disorder, anger, and partner abuse among Vietnam
Craig Bryan reports grant funding from the Department combat veterans. J Fam Psychol. 2007;21:270–277.
of Defense and the Department of the Air Force; consul- 15. Taft CT, Watkins LE, Stafford J, et al. Posttraumatic stress
tant fees from Intelligent Automation, Inc., and Kognito disorder and intimate relationship problems: a meta-anal-
Interactive; honoraria from the American Association ysis. J Consult Clin Psychol. 2011;79:22–33.

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