Bachem R, Zhou X, Levin Y, Solomon Z. Trajectories of depression in aging veterans and former prisoners-of-war: The role of social support and hardiness.
J Clin Psychol 2021;
77:2203-2215. [PMID:
34000063 DOI:
10.1002/jclp.23168]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/14/2021] [Accepted: 03/30/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES
Depression is a prevalent outcome of traumatic experiences, such as combat and war captivity. This study explores the heterogeneity of changes over time and assesses the contribution of trauma exposure (combat vs. war captivity), hardiness, and social support for depression trajectories.
METHODS
Two groups of Israeli veterans were assessed in 1991, 2003, 2008, and 2015: 149 former prisoners-of-war (ex-POWs) and 107 combat veterans. Protective factors were evaluated in 1991. Group-based trajectory modeling was conducted to identify latent trajectories of change.
RESULTS
Four trajectories of "resiliency" (62.8%), "delayed onset" (25.1%), "exacerbation" (6.2%), and "chronicity" (5.9%) were found. The majority of the resilient group were combat veterans whereas the clinical groups consisted primarily of ex-POWs. Lower hardiness and social support were related to more deleterious trajectories.
CONCLUSIONS
Spirals of loss involving hardiness and social support, normative experiences, and contextual factors may present explanations for the various depression trajectories.
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