Psychological Well-Being in Iraq and Afghanistan Veterans: A Broader Model of Risk and Protective Factors

PSYCHOLOGICAL WELL-BEING IN IRAQ AND AFGHANISTAN VETERANS: A BROADER MODEL OF RISK AND PROTECTIVE FACTORS Jeffrey S. Bergmann, Ph.D. George Mason University, 2014 Dissertation Chair: Dr. Keith D. Renshaw Veterans of the recent military conflicts in Afghanistan and Iraq have been the subject of multiple studies, with the majority focusing on elevated rates of posttraumatic stress disorder (PTSD) and other related negative outcomes (traumatic brain injury, suicide, marital problems). There are a handful of studies focusing on quality of life and wellbeing, but most are limited to constructs of meaning in life and posttraumatic growth, and the associations of such constructs with PTSD symptoms. To fully understand positive outcomes in this population, a broader understanding of psychological health and wellbeing, as well as a broader model of risk and protective factors, is needed. The present study focuses on the broad construct of psychological well-being (PWB) in veterans who have served during the recent conflicts in Iraq and Afghanistan, with an examination of other risk factors (sleep problems and depression) beyond PTSD symptoms, as well as a positive facet of the military experience (enhanced self-regulation). Primary hypotheses were that sleep and depression would account for some of the negative association of PTSD with PWB, that self-regulation would be positively associated with PWB even when accounting for these risk factors, and that the association of risk factors with PWB would be weaker at higher levels of self-regulation. Two hundred thirty-eight student veterans completed self-report measures at baseline, with 115 completing measures again 2 to 3 months later. PWB was modeled as a latent variable, and all analyses were completed cross-sectionally at both time points and longitudinally across time points. The significant, negative correlations of PTSD scores with PWB scores within and across both time points confirmed the first hypothesis that PTSD symptoms would have a significant negative association with psychological well-being. Structural equation models examining the simultaneous associations of PTSD, depression, sleep problems, and self-regulation revealed significant, large associations of PWB with depression and self-regulation in expected directions within and across both time points. Associations with PTSD were small, with significant associations in cross-sectional models but not the longitudinal model. Associations with sleep were also small, with a significant association only in one of the cross-sectional models. Overall, the pattern of findings was consistent with the notion that depression, but not sleep problems, accounts for some of the association of PTSD with PWB, in partial support of hypothesis 2. Also, in support of hypothesis 3, self-regulation had a significant positive association with psychological well-being, even when controlling for the effects of PTSD, sleep problems, and depression. Finally, interactions between selfregulation and the three risk factors were nonsignificant in both cross-sectional models, but the interactions of self-regulation with both PTSD and depression were significant in the longitudinal model. Contrary to our hypotheses, however, the negative associations of both PTSD and depressive symptoms with later PWB grew stronger as levels of selfregulation increased. This finding may indicate that higher scores on our measure of selfregulation indicate maladaptive attempts to control one’s emotions, but further research that attempts to replicate these findings is needed. Overall, findings support the need for examining a broader model of risk and protective factors predictive of outcomes in veterans who served during the recent era of wars in Iraq and Afghanistan.