Wilderness Adventure Program May Help Combat Perceptions of Stigma Among Veterans

The effectiveness of the National Veterans Summer Sports Clinic for veterans with probable posttraumatic stress disorder

Introduction

Recreational and adaptive sports programs may be beneficial therapeutic interventions for improving psychological outcomes among veterans and service members with posttraumatic stress disorder (PTSD) because they provide opportunities for exercise, socialization, respite, and time outdoors. Although there are an increasing number of sports programs for veterans and service members with PTSD, data evaluating the outcomes of such programs are limited.

Materials and methods

The sample included 74 U.S. veterans who participated in the National Veterans Summer Sports Clinic (NVSSC), an annual, week-long adaptive sports program in San Diego, California. Participants were categorized into two subgroups: those who met criteria for probable PTSD using the PTSD Checklist for DSM-5 (n = 20) and those who did not (n = 54). Participants completed self-report assessments before and after each daily activity, before and after the program, and 3 months following program completion.

Results

Over the course of NVSSC program participation, the diagnostic subgroups (probable PTSD vs. no PTSD) did not significantly differ on changes in depression, positive affect, negative affect, or insomnia. Compared to those without PTSD, veterans with PTSD experienced greater reduction in generalized anxiety during the program (MD = -3.07, p = 0.034). Veterans with PTSD also experienced significant improvements in PTSD symptoms at postprogram (MD = -23.76, p < 0.001). For both groups, significant benefits were shown during the program but rebounded by the 3-month follow-up. Over the course of each daily activity, positive affect (MD = 2.71, p < 0.001) and depression/anxiety scores significantly decreased (MD = -0.75, p < 0.001), with no differences between PTSD diagnostic groups across time (ps = 0.714 and 0.961, respectively).

Conclusion

Veterans with and without PTSD benefited from participation in the NVSSC. Participants with probable PTSD experienced greater improvements in generalized anxiety at postprogram only; there were no other significant differences between the two groups at postprogram or at 3-month follow-up. In line with prior research, benefits for those with PTSD were lost by 3-month follow-up, suggesting that regular engagement in recreational and adaptive sports may be necessary to sustain psychological health improvements.

Gender Differences in Psychological Outcomes Following Surf Therapy Sessions among U.S. Service Members

Surf therapy is increasingly being used as an intervention to address various health problems, including psychological symptoms. Although recent research supports the positive impact of surf therapy on psychological outcomes, it is unclear whether these outcomes differ between men and women. This study compared changes in depression/anxiety (Patient Health Questionnaire-4), positive affect (Positive and Negative Affect Schedule), and pain (Numerical Pain Rating Scale) between U.S. service men and women (N = 74) during six weekly surf therapy sessions. Overall, participants reported decreased depression/anxiety (p < 0.001) and increased positive affect (p < 0.001), but no change in pain rating following each session (p = 0.141). Significant gender differences were found in the magnitude of changes in depression/anxiety (B = -1.01, p = 0.008) and positive affect (B = 4.53, p < 0.001) during surf sessions, despite no differences in pre-session scores on either outcome. Women showed greater improvements in depression/anxiety and positive affect compared with men-an important finding, given that surfing and military environments are often socially dominated by men. Future research is needed to replicate these findings in other samples, extend this research to other underrepresented populations, and identify barriers and facilitators of the sustainable implementation of surf therapy across populations.