The Willingness of Military Members to Seek Help: The Role of Social Involvement and Social Responsibility

Anchored in the social organization theory of action and change, we use data from a large sample of active‐duty Air Force members to examine the direct and indirect influence of social involvement and social responsibility on willingness to seek help in times of need via trust in formal systems and informal supports. Group comparisons are conducted between junior male, junior female, senior male, and senior female service members. The key mediational path in the model for all groups is the connection between social involvement and willingness to seek help via trust in formal systems. These results can inform both unit‐ and community‐level interventions intended to increase the likelihood that active‐duty AF members will seek help in times of need.     

Beyond sincerity and pretense: role-playing and unstructured self in the Zhuangzi

This article engages with a recent view that the Daoist Classic Zhuangzi advances an alternative to the Confucian role-ethics. According to this view, Zhuangzi opposes the Confucian idea that we should play our social roles with sincerity and instead argues that we should take the liberty to detach ourselves from the roles we play and ‘pretend’ them. It is argued in this article that Zhuangzi’s ideal of role-playing is based neither on sincerity nor on pretense. Instead, it is akin to the excellence of theatre actors when they enact a role: they are able, for a limited time, to restructure their personality into a particular role, but de-structure it again when the performance is over. The prerequisite for this ability is to keep one’s self fundamentally unstructured, or, as Zhuangzi puts it, ‘empty’ (xu 虛). This reading of Zhuangzian role-playing provides a fresh perspectives on ‘playing’ or ‘rambling’ (you 遊) as the central philosophical concept in the Zhuangzi.     

Anticipatory Anxiety in the Treatment of Combat Veterans with Posttraumatic Stress Disorder

Combat veterans have experienced a transformational process during war zone deployment, including emotional, cognitive, and sensory processing changes. They also return entrenched in military expectations of conduct and behavior. These changes result in anticipatory anxiety that makes it difficult to reintegrate into the civilian world, and are related to symptoms of posttraumatic stress disorder (PTSD). The PTSD Recovery Program at the McGuire Veterans Affairs Medical Center (VAMC) is a manualized treatment that focuses on the personal and daily experiences of combat veterans rather than exposure to traumatic memories. Program evaluation data demonstrated significant reduction in PTSD symptoms and improvements in general self-efficacy and adaptive behaviors. Results support the PTSD Recovery Program as an effective treatment that enhances readjustment to civilian life.     

Sensation seeking as a predictor of psychopathology in Danish soldiers deployed to Afghanistan

Identifying methods that enable prediction of psychopathology that results from military service is crucial for individual and mission readiness, and for postdeployment mental health. In the present study, we investigate the relationship between sensation seeking (SS) and posttraumatic stress disorder (PTSD) and between SS and depression. Data from 743 Danish soldiers deployed to Afghanistan in 2009 were collected 6 times: before deployment, during deployment, 1–3 weeks after homecoming, 2 months after homecoming, 7 months after homecoming, and 2.5 years after homecoming. In this study, we did not find a relationship between SS and PTSD, or between SS and depression. The present study does not support previous findings that link SS with psychopathology. The structural environment in the military setting, the extent of exposure and type of stressful situations may play a moderating role. More extreme environments, such as imprisonment and torture, may favor different expressions of SS. Further research should include other factors such as context and the extent and type of traumatic exposure in relation to SS.     

Biological attributions for postdeployment distress relate to higher likelihood of seeking mental health treatment in Iraq/Afghanistan service members/veterans

Service members/veterans (SM/Vs) underuse mental health care. Attribution theory suggests that attributions for psychological distress might inform help-seeking. Given recent mental health campaigns leveraging military values aimed at facilitating help-seeking for postdeployment distress, understanding how SM/Vs explain psychological distress may contribute to a better grasp of the low help-seeking rate in this population. The authors examined the association of biological and psychological attributions for postdeployment distress with help-seeking intentions from a mental health professional and medical doctor in 162 Iraq/Afghanistan SM/Vs. At the bivariate level, biological attributions were positively associated with help-seeking intentions from a mental health professional and medical doctor with small effect sizes. Psychological attributions were unrelated to help-seeking intentions from either provider. Path analysis revealed that biological attributions were positively correlated with help-seeking intentions from a medical doctor with a small effect size above and beyond the effects of psychological attributions and correlates. Biological attributions were also positively correlated with help-seeking intentions from a mental health professional with a small effect size but the significance value only trended toward significance (p = .06). Emphasizing the role of biology in postdeployment distress may promote help-seeking in SM/Vs, particularly help-seeking from medical professionals. Interventions that test the effectiveness of promoting biological explanations in campaigns aimed at increasing help-seeking may be a necessary next step in this area of inquiry.     

Longitudinal Associations Among Service Members’ PTSD Symptoms,Partner Accommodation,and Partner Distress

Romantic partners’ accommodation of trauma survivors’ posttraumatic stress disorder (PTSD) symptoms (e.g., participating in avoidance and safety behaviors, not expressing one’s thoughts and feelings) is a putative mechanism linking PTSD symptoms and partner distress, but this hypothesis has never been empirically tested. The current study investigated this proposed within-couple mediation process from service members’ PTSD symptoms to partners’ depressive symptoms and relationship satisfaction through partner accommodation, as well as between-couple associations among these constructs and the possible moderating role of partners’ conflict avoidance and helplessness (CAH) motivations for accommodating service members’ PTSD symptoms. We examined these questions in 272 male service member/female civilian couples assessed four times over an 18-month period using the multiple-group version of the random intercept cross-lagged panel model. Within couples, service members’ higher levels of PTSD symptoms at one time point significantly predicted partners being more accommodating at the next time point (βs = .14–.19), which, in turn, significantly predicted higher levels of partner depressive symptoms at the subsequent time point (βs = .09–.19) but did not predict partners’ subsequent relationship satisfaction. At the between-couple level, partner accommodation was significantly positively associated with partners’ depressive symptoms only among those endorsing high CAH motivations for accommodation (r = .50). In addition, accommodation was significantly negatively associated with partners’ relationship satisfaction regardless of CAH motivation level (rs = −.43 to −.49). These findings are discussed in light of the potential for couple-based treatments for PTSD to enhance partner individual and relational well-being.     

Delivered as Described: A Successful Case of Cognitive Processing Therapy With an Older Woman Veteran With PTSD

Cognitive processing therapy (CPT) is a first-line, evidence-based treatment for posttraumatic stress disorder (PTSD). Little is known, however, about the use of CPT for older adults. As the United States population continues to grow and age, an understanding of the utility of CPT for older adults is vital. We present a case study describing the assessment and cognitive treatment of a 74-year-old woman veteran with PTSD secondary to military sexual trauma. CPT was associated with decreased PTSD symptoms as measured before and after treatment. Factors contributing to the veteran’s response, as well as contextual and environmental factors, are discussed. The case demonstrates that CPT may be effective for older adults without major modification.