Resiliency factors that protect against post-deployment drug use among male US Army Reserve and National Guard soldiers

The relationship of risk-related behaviors and substance use among U.S. Army National Guard/Army Reserve soldiers and deployment differences

U.S. Army National Guard and Army Reserve (ANG/USAR) soldiers are at risk for substance use, and research in other populations suggests risk-related behaviors and traits affect the propensity for use. Less is known about how deployment might amplify these effects. Our research explored the relations between risk-related behaviors and substance use among ANG/USAR soldiers and investigated differences by deployment (previously vs. never deployed). We drew a subset of data from Operation: SAFETY, an ongoing study of ANG/USAR soldiers and their partners (married/living together as if married). Cross-sectional regression models examined domains of risk (i.e., risk perception, risk-taking/impulsivity, sensation-seeking) and substance use (any current drug use, current non-medical use of prescription drugs, current illicit drug use, alcohol problems, and frequent heavy drinking [FHD]). Final models controlled for age, sex, anger, and PTSD. Interaction terms between risk behaviors and deployment status on substance use were also noted. Results revealed that greater risk perception was significantly associated with a lower likelihood of and protective against FHD. Greater risk-taking/impulsivity was associated with a higher likelihood of any current drug use and alcohol problems. Additionally, interaction models suggest that non-deployed soldiers at every level of risk-taking/impulsivity had a consistently high likelihood of illicit drug use overall. Sensation-seeking was not associated with any outcome. Findings demonstrate that greater risk-taking/impulsivity was associated with substance use, and never deployed/non-deployed ANG/USAR soldiers might be more vulnerable. Our work can help inform substance use interventions in the military by highlighting the role and impact of risk-related behaviors and non-deployment.

Training, Deployment Preparation, and Behavioral Health of New York National Guard Personnel Deployed to Assist with COVID-19 Decedent Work

INTRODUCTION

A small body of research conducted mostly among civilians has shown that adequate training and preparation can prevent or reduce the development of behavioral health problems in first responders. Several civilian studies have shown that social support is protective against behavioral health problems. However, very few studies have examined the impact of these factors on the behavioral health of military first responders. Military first responders, who serve in the aftermath of natural disasters and disease outbreaks such as the coronavirus disease 2019 (COVID-19) pandemic, are often members of the National Guard (NG). The purpose of this study was to examine the impact of mortuary affairs training/handling human remains, role preparation, equipment preparation, and unit social support provided to families on the behavioral health of New York (NY) NG personnel deployed to assist the NY Office of Chief Medical Examiner with handling the remains of COVID-19 decedents.

MATERIALS AND METHODS

We invited 410 NYNG personnel who deployed for the Office of Chief Medical Examiner mission to complete an anonymous online questionnaire 3 to 6 months post-mission. Of the 158 participants, we used the data of the 141 participants who provided consent. Standard behavioral health measures (depression, anxiety, post-traumatic stress disorder, alcohol misuse, and insomnia) as well as study-specific items designed to understand the unique dynamics of this deployment were included. Hierarchical logistic regression analysis was used to examine the relationships between mortuary training, role preparation, equipment preparation, and unit support with behavioral health.

RESULTS

Close to two-thirds of the sample reported that they had not been trained in mortuary affairs/handling human remains before the mission. We also found that that lower levels of role preparation and unit support provided to the service members' families increased the odds of meeting criteria for one or more behavioral health problems, but that training in mortuary affairs and equipment preparation was unrelated to behavioral health.

CONCLUSIONS

Our research points to the importance of emotionally and cognitively preparing service members for the specific dynamics of a deployment and the roles that that they are expected to play. Furthermore, it suggests that supporting the families of NG personnel during domestic missions can benefit the behavioral health of the NG personnel. Additional research is needed to corroborate these findings, particularly the impact of unit support provided to family members on service members' behavioral health.

The impact of resilience on the mental health of military personnel during the COVID-19 pandemic: coping styles and regulatory focus

Military personnel encountered multiple stressful events during the COVID-19 lockdown. Reducing non-combat attrition due to mental disorders is crucial for military morale and combat effectiveness. Grounded in stress theory and regulatory focus theory, this study investigates the influence of resilience on military personnel's mental health; coping style and regulatory focus are considered potential mediators and moderators, respectively. We conducted a routine psychological assessment on 1,110 military personnel in China. The results indicate that: (1) resilience has a negative impact on the psychological symptoms of military groups; (2) mature and mixed coping styles in military personnel mediate the association between resilience and psychological symptoms; and (3) regulatory focus predominance has a negative moderating effect on mature coping styles' effects on psychological symptoms. Furthermore, this study supports previous findings that resilience and mental health are interrelated; it demonstrates that military personnel can effectively reduce negative psychological symptoms by improving their resilience level and adopting mature coping styles under stressful situations. The current study presents interventional insights regarding coping styles and mental health from a self-regulatory perspective during the COVID-19 pandemic.

Translating Discovery Science. Fostering relationships: Service provider perspectives on community building among veteran families

Objective

We sought to identify the social process through which communal support can be established among veteran couples and families.

Background

On the basis of the social organization theory of action and change, a sense of community is crucial for military veterans' well-being and may serve as a resource for intervention.

Method

We interviewed service providers (n = 8) and corroborated their perspectives by triangulating evaluations from veteran family participants (n = 143). Data were analyzed using grounded theory techniques.

Results

Providers suggested promoting a sense of community in prevention and intervention programming by (a) establishing a safe and empowering space, (b) bridging existing gaps within family and community systems, and (c) encouraging interpersonal healing by promoting connection and facilitating the sharing of common experiences. Providers also described challenges to facilitating the program, including logistics, time, and funding constraints.

Conclusion

According to our results, fostering community among veterans and their family members may be achieved by applying an integrative approach that goes beyond siloed individual, couple, and group therapy orchestrated by practitioners.

Implications

We recommend multicomponent interventions that create synergy between different levels and forms of social support. Providers recommended being intentional about the program structure to focus on community strengths and shared connection.

Drug use over time among never-deployed US Army Reserve and National Guard soldiers: The longitudinal effects of non-deployment emotions and sex

Some US military service members who have never been deployed experience negative emotions related to never having been deployed, and some work shows these non-deployment emotions (NDE) are cross-sectionally associated with hazardous drinking for male, but not female, US Army Reserve/National Guard (USAR/NG) soldiers. However, it is not known if these effects extend to drug use or persist longitudinally, which is the focus of the current study. We conducted a longitudinal residual change analysis of a subset of data (N = 182 never-deployed soldiers) from Operation: SAFETY, an ongoing survey-based study of USAR/NG soldiers recruited from units across New York State. Outcome measures included current tobacco use, non-medical use of prescription drugs (NMUPD), current cannabis use, and other current illicit drug use (excluding cannabis) at four time points over a 3-year period. Results from bootstrapped residual change generalized estimating equation (GEE) models show that more negative NDE were longitudinally associated with a greater likelihood of current NMUPD among male, but not female, soldiers (p < 0.05). NDE were not longitudinally associated with current tobacco use, cannabis use, or other illicit drug use among male or female soldiers (ps > 0.05). NDE may contribute to ongoing NMUPD among male USAR/NG soldiers who have never been deployed. Never-deployed soldiers, especially those with negative emotions related to never having been deployed, should not be overlooked in military screening and intervention efforts.

Moral injury and cannabis use disorder among Israeli combat veterans: The role of depression and perceived social support

INTRODUCTION

Cannabis use is highly common among military combat veterans, who are also inclined toward developing Cannabis Use Disorder (CUD). The present study examined the association between Moral Injury (MI), which may occur following combat-related acts that violate one's deep moral beliefs, and CUD, as well as the mediating role of depression and the moderating role of perceived social support.

METHODS

Participants were 215 Israel Defense Forces male combat veterans discharged from military service within the past five years, who reported using cannabis regularly (≥3 days weekly) during the past six months. Participants completed a set of validated self-report questionnaires assessing MI, CUD, depression and perceived social support.

RESULTS

Results indicated that MI-perpetration by self and MI-betrayal were positively associated with CUD. Additionally, serial mediation analyses indicated that the associations between MI-self and betrayal and CUD were mediated by depression (direct effect: β = 0.13, p = 0.1, and β = 0.20, p = .04, respectively). Furthermore, moderation analyses indicated that the association between MI and CUD was significant only among participants with average or high levels of perceived social support (for support by a significant other: b = 0.13, p = .006 and b = 0.22, p < .001 for MI-self and betrayal, respectively; for support by family: b = 0.13, p = .009 for MI-betrayal; and for support by friends: b = 0.1, p = .044 for MI-self).

CONCLUSIONS

MI and its association with CUD should be addressed in clinical settings when working with combat veterans.

Resilience to mental health problems and the role of deployment status among U.S. Army Reserve and National Guard Soldiers

PURPOSE

Research suggests that interpersonal and intrapersonal resiliency factors protect against poor post-deployment mental health outcomes among Reserve/Guard soldiers who have been deployed. There is increasing awareness that never-deployed soldiers are also at risk. The purpose of this study was to examine the relationships between resiliency factors and a range of mental health outcomes among a sample of United States Army Reserve and National Guard (USAR/NG) soldiers who have and have not experienced deployment.

METHODS

A subset of data was drawn from Operation: SAFETY (N = 360), an ongoing study examining the health and well-being of USAR/NG soldiers. We used a multivariate path analysis approach to examine the simultaneous effects of unit support, marital satisfaction, and psychological hardiness on the following mental health outcomes, concurrently: anger, anxiety, depression, and posttraumatic stress disorder (PTSD) symptomatology. We also examined interaction effects between resiliency factors and deployment status on mental health outcomes.

RESULTS

Greater unit support (ps < 0.01), marital satisfaction (ps < 0.001), and psychological hardiness (ps < 0.001) were associated with less anger, anxiety, depression, and PTSD symptomatology. Psychological hardiness had significant interactions with deployment status on anxiety, depression, and PTSD, such that the protective effects of psychological hardiness were even stronger among never-deployed soldiers than previously deployed solders.

CONCLUSION

Resiliency factors can be targeted for intervention to prevent poor mental health outcomes among USAR/NG soldiers, regardless of deployment status. Further, psychological hardiness may be an even more important protective factor among soldiers who have never been deployed.

Non-modifiable Risk Factors Associated with Avascular Necrosis in the US Military

INTRODUCTION

Often referred to as aseptic or osteonecrosis, avascular necrosis (AVN) typically affects people between 30 and 50 years of age. Given the substantial morbidity associated with AVN as well as overlapping age groups of both the military and average age at diagnosis for AVN, the military represents an ideal cohort for a large database study to elicit the incidence and epidemiology of AVN. The purpose of this study was to identify demographic risk factors in the United States military.

MATERIALS AND METHODS

First-time occurrences for ICD-9-CM codes for all types of AVN (head of humerus, head and neck of femur, medial femoral condyle, talus, and other bone) between 2004 and 2014 were queried in the Defense Medical Epidemiology Database. Multivariate data analysis was performed to obtain adjusted rate (adjusted for age, sex, race, rank, and branch of service).

RESULTS

Between 2005 and 2014, 2,671 cases of AVN occurred among an at-risk population of 13,820,906 servicemembers for an unadjusted IR of 0.19 per 1,000 person-years. The most common location was located at the proximal femur, responsible for 41.7% of all cases. With an adjusted rate ratio of 18.7, the over 40 age-group accounted for 53.3% of cases. Servicemembers of black race, Senior rank, and the Army branch of service were more at risk for AVN.

CONCLUSIONS

The overall incidence of AVN was 0.19 per 1,000 person-years. Whilte increasing age had the greatest influence on the development of symptomatic AVN, other statistically significant risk factors were found to be increasing age, black race, senior enlisted rank, and Army branch of service.