Depression, Posttraumatic Stress Disorder, and Grade Point Average among Student Servicemembers and Veterans

INTRODUCTION In 2012, just under 1 million U.S. military personnel and veterans received financial assistance from the Department of Veterans Affairs' (VA's) various educational programs, which marks an increase of approximately 75 percent since 2008 [1]. This dramatic increase in the use of educational benefits by military personnel and veterans is due in large part to the Post-9/11 Veterans Educational Assistance Act of 2008, commonly referred to as "the new GI Bill." An additional 121,000 veterans enrolled in college courses through the vocational rehabilitation and employment program, which is intended to assist veterans with certain service-connected disabilities to obtain stable and suitable employment [1]. It is currently unknown how many military personnel and veterans pay for college expenses on their own without accessing VA educational benefits. Military personnel and veterans who attend college and university courses (i.e., student servicemembers and veterans) may differ from traditional college students in several ways [2-3]. First, student servicemembers and veterans are more likely than traditional college students to be male, older in age, married, and have children [2]. Student servicemembers and veterans also behave differently than traditional students because of the unpredictability of the military system (e.g., deployments, training requirements, reassignments). For instance, student service-members and veterans are much more likely to stop attending college completely for a temporary period of time and then resume at a later date [3]. In addition, military personnel and veterans have elevated rates of medical and psychiatric conditions relative to the general population [4]. Up to 75 percent of student servicemembers and veterans have service-connected disabilities, of which the most common is a psychological or emotional condition such as posttraumatic stress disorder (PTSD) or depression [5]. Research among college students suggests that emotional distress is inversely related to academic performance and grades [6]. To date, however, these associations have not been examined among student servicemembers and veterans, a group that may be at elevated risk for anxiety and mood disorders. In a recent sample of student servicemembers and veterans, for instance, 25 percent screened positive for depression and 45 percent screened positive for PTSD [7], rates that are over twice the reported rates among veterans of the conflicts in Iraq and Afghanistan, of whom an estimated 5 to 17 percent meet criteria for PTSD and up to 25 percent report a mental health problem of some kind [8-10]. Research supports a relationship between combat exposure and mental health problems among military personnel [10-11] and student servicemembers and veterans [12]. Given that approximately two-thirds of student servicemembers and veterans report having been in combat while in the military, the relatively high rates of emotional distress among them may be due to military-related stressors. It is also possible that the higher rates of depression and PTSD reported by student servicemembers and veterans relative to military personnel are influenced by contextual demands such as mental health stigma. Specifically, student servicemembers and veterans may be more willing to report emotional distress on surveys conducted external to the military. Although the exact reasons for the higher rates of depression and PTSD among student service-members and veterans are not yet clear, it is clear that many student servicemembers and veterans are reporting elevated levels of emotional distress. Of the anxiety and stressor-related disorders, PTSD has an especially strong relationship with lower academic achievement in general college student populations [13], particularly during the first year of college. Students with PTSD are also more likely to earn a lower grade point average (GPA) during their first year in college, which may partially account for increased attrition among first-year students who report a history of trauma [14-15]. …