The Causes,Course, and Consequences of Anger Problems in Veterans Returning to Civilian Life

While anger is a common problem for veterans returning from wars in Afghanistan and Iraq, veterans' understanding of the causes, course, and consequences of anger has not been explored. We conducted this qualitative study to learn veterans' perspectives about their anger problems. We identify and describe three distinct patterns of anger problems that emerged as a consequence of (a) loss of structure during reintegration to civilian life, (b) moral injury sustained through a wartime experience, and (c) posttraumatic stress disorder (PTSD). While anger problems tended to be short lived for those experiencing loss of structure, problems persisted for years for those with moral injury or PTSD. Anger following all three patterns negatively impacted veterans' experiences with reintegration. We discuss the implications of these findings.     

Social Neuroscience: Progress and Implications for Mental Health

ABSTRACT— Social neuroscience is a new, interdisciplinary field devoted to understanding how biological systems implement social processes and behavior. Social neuroscience capitalizes on biological concepts and methods to inform and refine theories of social behavior, and it uses social and behavioral constructs and data to inform and refine theories of neural organization and function. We focus here on the progress and potential of social neuroscience in the area of mental health. Research in social neuroscience has grown dramatically in recent years. Among the most active areas of research we found are brain-imaging studies in normal children and adults; animal models of social behavior; studies of stroke patients; imaging studies of psychiatric patients; and research on social determinants of peripheral neural, neuroendocrine, and immunological processes. We also found that these areas of research are proceeding along largely independent trajectories. Our goals in this article are to review the development of this field, examine some currently promising approaches, identify obstacles and opportunities for future advances and integration, and consider how this research can inform work on the diagnosis and treatment of mental disorders.     

Mild Traumatic Brain Injury and Posttraumatic Stress Disorder in Returning Iraq and Afghanistan War Veterans: Implications for Assessment and Diagnosis

Mild traumatic brain injury (MTBI) and posttraumatic stress disorder (PTSD) are considered the “signature injuries” of combat soldiers returning from Iraq and Afghanistan. Both disorders can greatly affect the functioning of soldiers, yet the disorders often go undetected or are misdiagnosed by both military and civilian health care providers. This article provides information about MTBI and PTSD in returning combat soldiers along with implications for assessment and diagnosis.     

Quality of Life in Gulf War Veterans: the Influence of Recency and Persistence of Psychiatric Morbidity

Important contributors to quality of life (QOL), such as psychosocial factors, have received limited exploration in veteran populations, in contrast to a significant amount of research focused on health-related quality of life (HRQL). This study investigated QOL and HRQL amongst Gulf War veterans compared with an era-military comparison group 20 years after the 1990/91 Gulf War, and whether psychiatric status over time and psychiatric comorbidities predicted QOL and HRQL. We then investigated which of a range of psychological health, physical health and social factors contribute greatest to QOL. Psychological interviews and postal questionnaires were administered to a cohort of Gulf War veterans and a military-era comparison group in 2000–02 and 2011–12. Gulf War veterans had poorer QOL and HRQL compared with a military comparison group, but the pattern of factors that influenced QOL was the same for both groups. Poorer QOL and HRQL were significantly associated with more recent and persistent psychiatric morbidity over time. Further analyses showed that affective disorders, followed by anxiety disorders had the largest impact on QOL and HRQL, and that QOL and HRQL were negatively affected by each additional psychiatric diagnosis. The importance of these findings was highlighted in a structural equation model that revealed psychological health contributed most to QOL, social support contributed a moderate amount, but physical health contributed only a very small amount. QOL in veterans is an important issue even many years after deployment and psychological health plays a predominant role in QOL.

     

Associations of Stress Exposures and Social Support With Long-Term Mental Health Outcomes Among U.S. Iraq War Veterans

The long-term mental health effects of war-zone deployment in the Iraq and Afghanistan wars on military personnel are a significant public health concern. Using data collected prospectively at three distinct assessments during 2003–2014 as part of the Neurocognition Deployment Health Study and VA Cooperative Studies Program Study #566, we explored how stress exposures prior, during, and after return from deployment influence the long-term mental health outcomes of posttraumatic stress disorder (PTSD), depression, anxiety disorders, and problem drinking. Longer-term mental health outcomes were assessed in 375 service members and military veterans an average of 7.5 years (standard deviation = 1.0 year) after the initial (i.e., “index”) Iraq deployment following their predeployment assessment. Anxiety disorder was the most commonly observed long-term mental health outcome (36.0%), followed by depression (24.5%), PTSD (24.3%), and problem drinking (21.0%). Multivariable regression models showed that greater postdeployment stressors, as measured by the Post-Deployment Life Events scale, were associated with greater risk of depression, anxiety disorders, and problem drinking. Anxiety disorder was the only outcome affected by predeployment stress concerns. In addition, greater postdeployment social support was associated with lower risk of all outcomes except problem drinking. These findings highlight the importance of assessing postdeployment stress exposures, such as stressful or traumatic life events, given the potential impact of these stressors on long-term mental health outcomes. This study also highlights the importance of postdeployment social support as a modifiable protective factor that can be used to help mitigate risk of long-term adverse mental health outcomes following war-zone exposure.     

Spiritual Maturity and Mental Health: Implications for Counseling

Evidence was found to support the validity of Genia's (1997) spiritual maturity typology. Participants (N = 256) were categorized as spiritually growth-oriented, transitional, dogmatic, or underdeveloped. Those in the underdeveloped and dogmatic groups seemed to be more emotionally distressed than those in the growth oriented group. The authors also formed a group, based on scores above the mean on both the Dissociation Scale and the Sexual Abuse Trauma Index (SATI) of the Trauma Symptom Checklist-40 (TSC-40; Elliott & Briere, 1992), that they hypothesized were traumatized in childhood. They found that those individuals, compared to the nontraumatized persons, experienced lower levels of spiritual support and were more symptomatic on mental health measures. The traumatized women, especially, experienced psychological distress, particularly in areas of depression, anxiety, and sexual problems. Although trauma generally was associated negatively with spiritual development, some traumatized persons also scored among the spiritually growth oriented, suggesting that such trauma is not associated in all cases with a detrimental effect in the process of spiritual development.     

The Gulf War and the Rodney King Beating: Implications of the General Conservatism and Social Dominance Perspectives

Abstract

Both general conservatism and social dominance theory require relatively strong and significant relationships among indicators of racism, support for the Persian Gulf War, and approval of police actions in the Rodney King incident. With a nonprobability sample of 131 adults from Los Angeles, significant relationships were found among these variables as predicted by both theories. However, structural equation analysis disclosed that only social dominance theory was able to give a fully acceptable account of the entire matrix of correlations among the background and attitudinal variables involved. The data indicated that political conservatism, belief in racial superiority, caste-maintenance orientation, support of the Gulf War, and approval of police behavior in the beating of Rodney King were all significantly related to and possibly driven by a person's desire for group dominance (i.e., social dominance orientation). The relatively strong and consistent relationships among these variables were considered as possible evidence of a group-based form of ideological coherence (Converse, 1964).     

Improving Mental Health Treatment Utilization in Military Veterans: Examining the Effects of Perceived Need for Care and Social Support

Many veterans with mental health problems do not adequately utilize needed care. Research has focused on identifying barriers to mental health care in veterans. The current study adds to existing literature by examining whether perceived need for treatment and social support affect treatment utilization in a national longitudinal survey of Iraq and Afghanistan veterans (n = 1,090). The Health Beliefs Model (HBM) postulates that a key reason why patients fail to obtain needed care is their belief “it’s up to me to handle my own problems.” This view was endorsed by 42% in the current national sample of veterans and was found in multivariate analysis to predict less treatment seeking in the next year. Mediation analysis revealed that veterans with higher ratings of social support were less likely to believe they needed to solve mental health problems on their own, indirectly equating to higher odds of treatment use. Simultaneously, findings indicated that posttraumatic stress disorder (PTSD) had a direct effect on more mental health visits but was also associated with higher endorsement that one needed to handle one’s own problems and thus had an indirect effect of reducing mental health visits. Both social support and PTSD affected veterans’ perceptions of needing to solve one’s own problems, significantly predicted follow-up with mental health care. As a result, the findings indicate that clinicians’ should explore veterans’ belief systems about perceived treatment need as well as investigate the role of social support to improve mental health treatment utilization.     

Emerging Adulthood and Leaving Foster Care: Settings Associated with Mental Health

The present study examined the role of contextual support on mental health during the transition to adulthood within a vulnerable group, adolescents leaving foster care because of their age. Participants were 265 19- to 23-year-olds who retrospectively reported on 3 main contexts of emerging adulthood: housing security, educational achievement, and employment attainment in the first 2 years after leaving foster care. Mental health measured self-reported emotional distress, substance abuse, and deviancy at the time of interview. Growth Mixture Modeling empirically identified 3 latent trajectory classes. Stable-Engaged (41%) experienced secure housing and increasing connections to education and employment over time. Stable-Disengaged (30%) maintained housing but reported decreasing rates of education and small increases in employment. Instable-Disengaged (29%) experienced chronic housing instability, declined connection to education, and failed to attain employment. Stable-Engaged and Stable-Disengaged classes reported better mental health compared to the Instable-Disengaged class, indicating the importance of housing in transitioning to adulthood.     

Longitudinal Pathways to Educational Attainment and Health of Immigrant Youth in Young Adulthood: A Comparative Analysis

Journal of Child and Family Studies - This study examined longitudinally sequential pathways between parental socioeconomic status and immigrant children’s school performance and depressive...     

Empathy is Associated with Meaning of Life and Mental Health Treatment but not Religiosity Among Brazilian Medical Students

The purpose of this study was to investigate the influence of spirituality, religiosity, personal beliefs, and previous contact with health issues on the level of empathy in medical students. Jefferson Scale of Empathy—Student Version, WHOQOL-Spirituality, Religiousness and Personal Beliefs, and Duke University Religion Index were applied to 285 Brazilian medical students. The findings suggest that meaning of life and previous mental health treatment but not Religiosity were positively related to empathy. We suggest that more attention should be given for prevention and treatment of mental health issues, and further studies are needed to understand and replicate these findings.     

Helicopter Parenting and Emerging Adult Self-Efficacy: Implications for Mental and Physical Health

Helicopter parenting has become an increasing concern among practitioners, college administrators, and professors. Further, some research has indicated that this form of parenting may have a deleterious effect on emerging adult college students’ mental health. This study examines the factor structure of the Helicopter Parenting Behaviors measure, a recent scale developed to examine intrusive and supportive parenting behaviors, by using confirmatory factor analysis. We utilized a self-determination theoretical framework to replicate and expand current research regarding the impact of helicopter parenting and autonomy supportive parenting on emerging adult mental and physical well-being. Further, we examined self-efficacy as a mechanism for helicopter parenting and autonomy supportive parenting to impact well-being, using structural equation modeling with a sample of 461 emerging adult college students from a large southeastern, United States university. The two-factor structure of the Helicopter Parenting Behaviors measure was confirmed, indicating helicopter parenting and autonomy supportive parenting are two unique, but related, constructs. Both autonomy supportive parenting and helicopter parenting were found to have indirect effects on anxiety, depression, life satisfaction, and physical health through self-efficacy. Results also indicated autonomy supportive parenting was directly related to life satisfaction and physical health when accounting for self-efficacy, whereas helicopter parenting was not directly related to well-being. This study adds to the extant literature by its’ application of a family-level lens to the self-determination theory, its’ advancement of parenting behaviors measurement, and its’ exploration of the continued influence of parenting during emerging adulthood.     

Social and Situational Factors Associated With Contraceptive Switching: Implications for Practitioners1

This study was an investigation of contraceptive switching in the context of a 5-wave panel design of diaphragm and pill users from the New York City metropolitan area. The respondents were 525 women between the ages of 14 and 46, who came to one of 10 family planning clinics to obtain birth control, Results indicated a hazard function for switching in which the hazard rate increased in the initial weeks and then gradually declined over time. Clinic experiences on the part of the women were found to alter survivorship trends. Implications of the data for service providers were developed.     

Marital Functioning and Physical Health: Implications for Social and Personality Psychology

Marriage – the most important adult relationship in most people’s lives – has been theorized to affect biological processes, physical health, and mortality. This article highlights key findings in marriage and health research, focusing on the interpersonal processes through which marriage has been proposed to affect health. A model of marriage and health is presented that incorporates both main and stress-moderating effects of negative marital experiences –marital strain– and positive marital experiences –marital strength. Although many more studies have investigated marital strain than marital strength, current evidence suggests that both have potent effects on biology and health. The article concludes with a discussion of implications of this research for social and personality psychology, focusing on insights that may be gained from basic relationship science. Examples of three areas of relationship research – intimacy processes, commitment processes, and dyadic analysis – and their potential relevance for marriage and health research are presented.     

Mental Health, Social Environment and Sexual Risk Behaviors of Adolescent Service Users: A Gender Comparison

We examined individual mental health problems (depression, conduct disorder, and substance abuse) and social environment (family, peer, and neighborhood) factors associated with the sexual risk behaviors of male and female adolescents. Interviews with 778 adolescents, aged 14 to 18, showed that both mental health problems and social environment were related to adolescents' involvement in sexual risk behaviors. Conduct disorder symptoms, substance abuse or dependence symptoms, and the interaction between peer misbehavior and neighborhood problems were significantly associated with risky sexual behaviors. Peer misbehavior was a particularly strong factor related to sexual risk behaviors for youths who lived in neighborhoods with multiple problems. The only gender differences were found in age, with older males more likely to report engaging in high risk sexual behaviors. This study suggests the utility of multidimensional intervention strategies to deal with various adolescent problem behaviors, including risky sexual behaviors, within the context of their social environment.     

Dyadic Influence of Adverse Childhood Experiences: Counseling Implications for Mental and Relational Health

Adverse childhood experiences (ACEs) predict physical and mental health. We examined dyadic differences in intimate partner relationship health by ACE score among couples with low to moderate income enrolled in a relationship education program. Overall, we found a high prevalence of ACEs, disproportionate representation in the highest risk ACE group, and a significant effect between ACEs and indicators of mental and relational health. Implications for counselors include support for an ACE‐informed approach to couples counseling services, as well as a holistic and systemic view of mental and relational health.     

The Association Between Physical Functioning and Self-rated General Health in Later Life: The Implications of Social Comparison

Self-rated general health has been used widely in health surveys as a single-item measurement of health-rated quality of life. Heterogeneity in self-evaluation of health has been well documented, yet the causes of this heterogeneity are poorly understood. This study evaluated the moderating effects of age, aging, gender, race, education and income on the relationship between physical functioning and self-rated general health using social comparison theory as a guiding framework. A longitudinal mixed-effects regression model was used to analyze a cohort enrolled into the Health and Retirement Study in 1993 that was interviewed at baseline and during four subsequent waves. The results revealed that the association between physical functioning and self-rated general health is weaker among subgroups that tend to have lower health status; i.e., older individuals, non-Caucasians and less educated individuals. These findings suggest the usefulness of social comparison theory in explaining self-rated general health and provide the basis for future research.     

Implementation of Primary Care-Mental Health Integration Services in the Veterans Health Administration: Program Activity and Associations with Engagement in Specialty Mental Health Services

This paper describes the status of the Veterans Health Administration (VHA) Primary Care-Mental Health Integration (PC-MHI) services implementation and presents an assessment of associations between receipt of PC-MHI services and likelihood of receiving a second specialty mental health (SMH) appointment following an initial SMH encounter. The total PC-MHI service recipients and encounters/month rose substantially between October 2007 and April 2011. Adjusting for important covariates, the likelihood of receiving a second SMH encounter within 3 months of an index SMH appointment was 1.37 times greater among individuals who had received a PC-MHI encounter within 3 months of the initial SMH appointment. Implementation of VHA PC-MHI services has substantially increased VHA capacity to deliver mental health services in primary care and findings indicate that PC-MHI services are associated with greater engagement in SMH treatment. Implementation of VHA PC-MHI services is progressing with new technical assistance strategies being deployed.