Page 133 - JSOM Fall 2022

An Ongoing Series

Active Warfighter Mental Health Lower in Mid-Career

1
Nikki E. Barczak-Scarboro *; Wesley R. Cole ; J.D. DeFreese ;
3
2
5
Barbara L. Fredrickson ; Adam W. Kiefer ; MaryBeth Bailar-Heath ;
4
6
Riley J. Burke ; Stephen M. DeLellis ; Shawn F. Kane, MD ; James H. Lynch ;
8
7
10
9
11
12
Gary E. Means ; Patrick J. Depenbrock ; Jason P. Mihalik 13
ABSTRACT
Purpose: The present study investigated Special Operations population. Accordingly, there are clear mental illness conse­
7
Forces (SOF) combat Servicemember mental health at differ­ quences associated with military service. Presently, there lacks
ent SOF career stages in association with resilience. Methods: specific research on mental health in the Special Operations
Fifty­eight SOF combat Servicemembers either entering SOF Forces (SOF) military sub­population. The purpose of the
(career start; n=38) or multiple years with their SOF organi­ present study was to characterize mental health in this group
zation (mid­career; n=20) self­reported mild traumatic brain with consideration to stress­related factors.
injury history, resilience, subjective well­being, depression,
anxiety, and posttraumatic stress. Poisson regression analyses Most extant research in this area focuses primarily mood and
were employed to test SOF career stage differences in mental stress­related disorders. While the absence of mental illness is
health symptoms using resilience, while accounting for other a key factor, it is posited that individuals must also endorse
pertinent military factors. Results: There were significant in­ high levels of subjective well­being to experience complete
teraction effects of SOF career stage and resilience on mental mental health. Subjective well­being consists of three main
10
health symptoms. SOF career start combat Servicemembers components: 1) emotional (e.g., joy, love, happiness), 2) psy­
endorsed lower depression and posttraumatic stress and chological, and 3) social (e.g., support satisfaction) well­being.
higher subjective well­being with higher resilience, but these Although an individual experiencing mental illness symptoms
associations between resilience and mental health symptoms may also report lower subjective well­being, mental illness and
were not seen in SOF mid­career combat Servicemembers. well­ being exist on two separate continua. These concepts are
Conclusions: Although preliminary, the adaptive association related but independent of one another and, therefore, should
between resilience and mental health seemed to be blunted in be investigated concurrently. 11
combat Servicemembers having served multiple years in SOF.
This information informs the creation of evaluation tools to Combat Servicemembers may also experience symptoms re­
support performance and prophylactic health preservation in lated to these disorders prior to clinical diagnosis, and there­
military populations. fore a more detailed mental health characterization can be
provided by measuring sub­clinical symptomology. Indeed,
Keywords: depression; anxiety; posttraumatic stress; subjective assessing symptoms rather than clinical diagnoses has been
well-being; military; concussion supported in order to capture more individuals afflicted with
these health problems. It may also be cost effective to take a
8,9
prophylactic approach to mental health by monitoring symp­
toms rather than disorders. Explaining the experiences of
8
Introduction
these symptoms involves considering the exposure to military
The purported negative mental health consequences of mil­ life and injury­related stressors in combat Servicemembers.
itary service have been studied for decades. Posttraumatic
1
stress symptoms, depressive symptoms, aggression, and sui­ The mechanisms underlying why Servicemembers experi­
cidal ideation are particular mental health concerns for those ence mental health consequences may be due in part to the
deployed during Operation Enduring Freedom, Operation inherent stress of military service, including high exposure to
Iraqi Freedom, and Operation New Dawn. More current psychological (e.g., aggression, death, fear, and responsibil­
2,3
initiatives, such as the Millennium Cohort Study and the ity) and physical (e.g., exhaustion, deprivation, and endur­
Health­Related Behavior Survey, have continued to find these ing natural elements) stressors. Stress exposure can result
12
same health problems in this population. 4–6 Their findings in maladaptive mental health outcomes, and the exposure
depict a prevalence greater than that of the general US adult may be greater for specialized combat Servicemembers whose
*Please see correspondence and bio information listed on page 135.

129