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The MOD Rehabilitation Department (RD) offers three types of rehabilitation tracks (RTs): (a) education, (b) work placement, (c) economic independence. This study aimed to examine which of the offered RTs predicted a better integration into the workforce. This is an observational, prospective, case‐controlled study. Data were collected from administrative files. The data pertained to soldiers injured in military service, under RD care and recognised as posttraumatic stress disorder (PTSD) patients between 2001 and 2006. As rehabilitation takes 5–6 years, we examined two points in time: 2015 and 5 years later, in 2020. The studied population comprised 462 male military veterans injured during military service and diagnosed with PTSD (mean age at the time of injury was 24.60 [SD 5.70]; median = 22). Of the participants, 87.9% (n = 406) also sustained physical injury, and 12.1% were not injured physically (n = 56; 12.1%). A regression analysis indicated that the educational RT (OR = 19.509; p =.001) predicted integration into the workforce. The whole model explained 49.0% of the variance. Of the three RT types examined, education is the most important. The more years of study, the better the ability to integrate into the workforce. [ABSTRACT FROM AUTHOR]

This study focuses on the subjective well-being (SWB) of a sample of military veterans before and after their engagement with a nonclinical, alternative mental health therapies residential retreat in the United Kingdom. The study findings have relevance for trauma-exposed individuals globally. Military veterans will actively avoid seeking traditional mental health treatments due to factors such as stigma and life-long labels, as well as a reluctance to engage in talk therapies. This is despite the widespread occurrence of diagnosed and undiagnosed chronic mental health conditions such as posttraumatic stress disorder following periods of service. Moving beyond trauma-informed practice and embracing a healing-centered approach involving holistic therapies delivered during a retreat-type format has a positive impact on the SWB of service users. Positive changes in SWB were recorded using the Warwick–Edinburgh Mental Well-Being Scale and the lived experiences of the participants. A shared military identity contributes immeasurably to a veteran-centered approach to holistic therapy, healing, and recovery. [ABSTRACT FROM AUTHOR]

Objective: In 2020, Army National Guard members demonstrated greater risk of suicide than their military and civilian counterparts. Though literature on deployment-related experiences and suicidal ideation (SI) is mixed, investigations of specific deployment-related experiences (e.g., injuries) may further elucidate the relationship between deployment and suicide risk. Deployment-related injuries, including pain severity and functional impairment, have been linked to increased risk of SI, and correlates like perceived burdensomeness (PB) and hopelessness. The current study sought to examine the cross-sectional relationship between deployment-related injuries, including pain severity and functional impairment, and severity of SI through PB and hopelessness. Method: Immediately post-deployment, Army National Guard members (N = 2,261) completed validated self-report measures on past-week SI, PB, hopelessness, and single items regarding injury sustained during deployment and associated functional impairment and pain severity. Results: Indirect effect analyses revealed that experience of deployment-related injury was related to SI through PB and hopelessness (R2 =.1993), functional impairment was related to SI through PB, and pain severity was related to SI through PB. Contrary to hypotheses, hopelessness was not associated with SI when PB was simultaneously considered. Conclusions: Army National Guard members who develop a sense of PB related to their injury and functional impairment of that injury may be at increased risk for suicidal ideation. Military suicide-prevention efforts may be potentiated through targeting distorted cognitions such as PB and hopelessness, especially in service members who have been injured. [ABSTRACT FROM AUTHOR]

Experiencing sexual harassment and bullying during military service can lead to negative consequences for a soldier's mental health and life satisfaction, including increased risk of depression, anxiety, and posttraumatic stress. No studies have to date investigated the prevalence and correlates of sexual harassment and bullying among Norwegian Afghanistan veterans, despite the increased global focus on these topics. In 2020, 6,205 Norwegian Afghanistan veterans (8.3% women) completed an online post-deployment survey, including questions about experiences of sexual harassment, bullying, mental health, and life satisfaction. Compared to their male counterparts, female veterans experienced significantly more sexual harassment and bullying during Afghanistan deployment (3.2% vs. 0.04% for experiencing sexual harassment, and 4.0% vs. 1.0% for bullying) and during other military services (14.3% vs. 0.4% for sexual harassment, and 15.9% vs. 3.7% for bullying). Sexual harassment was associated with younger age and experiencing childhood sexual harassment for both women and men, with men also having longer deployments. Bullying was associated with longer deployments and childhood sexual harassment for women, while men who reported bullying more often had longer deployments, held an officer rank, were less inclined to have a spouse/intimate partner, and reported childhood sexual harassment and bullying. Both sexual harassment and bullying were associated with increased risk of mental health problems and reduced life satisfaction for women, but this was only true for bullying among men. Despite lower reported rates of workplace harassment compared to studies from other cultures, this study demonstrates that sexual harassment and bullying in the military can negatively impact soldiers' mental health and life satisfaction. Notably, female veterans' mental health and life satisfaction appear to be particularly affected by sexual harassment during military service, an association not seen in males. This underscores the need for gender-specific, cultural, and context-sensitive prevention and support for workplace harassment experiences. [ABSTRACT FROM AUTHOR]

Self-reported histories of mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) symptoms are prevalent among post-9/11 veterans. Both are associated with subjective and often overlapping symptom complaints, but variably with objective neuropsychological test performances. These outcomes are seldom explored in relation to lifetime mTBI burden. This cross-sectional study examined associations of PTSD and lifetime mTBI with subjective (persistent symptoms after concussion and cognitive complaints) and objective (performances across five cognitive domains) measures among 46 veterans. Within this sample, 20 veterans had Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) confirmed PTSD (PTSD+), whereas 26 demographically-similar participants did not meet criteria (PTSD−). The Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) yielded total mTBI scores ranging from 0 to 8. Regressions showed PTSD was associated with increased subjective symptoms/cognitive complaints, along with reduced verbal fluency, visuospatial memory, and processing speed performances. Lifetime mTBI burden was associated with subjective symptoms, but not with objective cognitive test performance, after controlling for PTSD. No significant interactions were observed. Exploratory correlations suggested that all PTSD symptom clusters were generally associated with the subjective and objective measures. However, fewer significant associations emerged within the PTSD+/− groups separately, with each group yielding somewhat different patterns of relationships. PTSD and increasing mTBI burden are consistently associated with negative subjective symptoms, including cognitive complaints. Each condition likely explains some degree of unique variance in symptom reporting. PTSD is associated with poorer objective cognition on some tasks, including processing speed, executive functioning, and learning/memory. Implications are explored. [ABSTRACT FROM AUTHOR]

Imagery rescripting (ImRs) interventions have been found effective in improving sleep outcomes, although research has mostly focused on civilian, rather than military, samples. The aim of this review was to estimate the overall effectiveness of ImRs interventions for military veterans on primary outcomes of nightmare frequency and sleep quality. A systematic search was conducted in CINAHL, MEDLINE, PsycArticles, PsycINFO, Psychology and Behavioural Sciences Collection and the PTSDpubs database and was completed on 1 November 2021. Randomised controlled trials, nonrandomised trials and pre–post studies of ImRs interventions in veterans with sleep disturbances or nightmares were included. The methodological quality of the studies was assessed using the Effective Public Health Practice Project (EPHPP) tool, and meta‐analysis was performed using Stata. Nineteen articles from 15 empirical studies were included in the review, and data from the 15 studies (involving 658 participants) were included in the meta‐analysis. Meta‐analysis findings indicated that ImRs interventions are associated with significant positive changes from pretreatment to posttreatment for nightmare and sleep quality. Significantly greater improvements were found in ImRs interventions compared to control groups for sleep quality (Hedges' g = −0.65, 95% CI [−1.20, −0.10]) but not for nightmare frequency (Hedges' g = −0.10, 95% CI [−0.34, 0.14]). Overall, the meta‐analysis included a relatively small number of studies with poor methodological quality and considerable heterogeneity; therefore, findings should be cautiously interpreted. Further research should focus on veteran participants with larger samples and from a broader range of sources to determine effectiveness more confidently. [ABSTRACT FROM AUTHOR]

This study evaluated measurement invariance across males and females on the Neurobehavioral Symptom Inventory (NSI) in U.S. military veterans enrolled in the VA Million Veteran Program. Participants (N = 17,059; males: n = 15,450; females: n = 1,609) included Veterans who took part in the VA Traumatic Brain Injury (TBI) Screening and Evaluation Program and completed the NSI. Multiple-group confirmatory factor analyses investigated measurement invariance of the NSI 4-factor model. The configural (comparative fit index [CFI] = 0.948, root mean square error of approximation [RMSEA] = 0.060) and metric (CFI = 0.948, RMSEA = 0.058) invariance models showed acceptable fit. There was a minor violation of scalar invariance (Δχ2 = 232.50, p <.001); however, the degree of noninvariance was mild (ΔCFI = −0.002, Δ RMSEA = 0. 000). Our results demonstrate measurement invariance across sex, suggesting that the NSI 4-factor model can be used to accurately assess symptoms in males and females following TBI. Findings highlight the importance of considering validity of measurement across study groups to increase confidence that a measure is interpreted similarly by respondents from different subgroups. [ABSTRACT FROM AUTHOR]

Examine group differences among women and men United States Veterans with chronic fatigue syndrome (CFS) and chronic pain (CP). Administrative data from the VA Corporate Data Warehouse were derived from a cohort that met criteria for CP in 2018. Differences across sociodemographic characteristics, psychiatric comorbidities, and pain-related healthcare utilization were examined. Analyses included group comparisons (chi-square tests for independence or independent samples t-tests) and effect size differences (Cohen's d or Cramer's V). The period prevalence for comorbid CFS and CP was greater among women Veterans (1.20% vs. 0.61%). Women Veterans with CFS and CP were younger (d = 0.80), more likely to be Black, and less likely to be White (V = 0.13). Women Veterans with CFS and CP were more likely to have fibromyalgia (V = 0.23), headache (V = 0.24), or urogenital, pelvic, and menstrual pain (V = 0.14), and less likely to have neuropathy relative to men; they were also more likely to have depression (V = 0.15) or anxiety (V = 0.13). Comorbid CFS and CP are more prevalent among women Veterans relative to men. Group differences in pain clusters and psychiatric comorbidities may have implications for clinical offerings to women Veterans with these conditions. [ABSTRACT FROM AUTHOR]

Objectives: Growing evidence supports the role of mindfulness in regulating emotions in the general population. However, the interactive network of mindfulness facets and difficulties in regulating emotions is not well understood, which is specifically important for individuals involved in high-risk professions, such as first responders. The aim of this study was to investigate the interactive relations between mindfulness facets (acting with awareness, non-judging, describing, observing, and non-reacting), ability to regulate emotions and alcohol use in a sample of firefighters, including military veterans. Method: A sample of 685 career firefighters, of whom 154 (22.5%) are military veterans, completed measures of mindfulness and difficulties in regulating emotions. The dataset was subjected to network analysis. Results: The mindfulness facet non-judging was negatively related to emotion-regulation challenges, such as nonaccepting attitudes and lack of clarity, and positively related to deficits in goal-directed behaviour. Acting with awareness was negatively related to goal-directed behaviour deficits and impulsivity. Alcohol use was positively linked to impulsivity and negatively linked to describing. Overall, emotion-regulation difficulties were positively linked together, and positive links were found between most mindfulness facets. Directed network analysis found non-judging and emotion-regulation strategy as primary predictors. Non-judging acted as a protective factor, supporting other mindfulness facets, while emotion-regulation strategy exacerbated emotion-regulation challenges acted as a risk factor. Conclusions: This network analysis demonstrated that acting with awareness and a non-judgmental attitude, facets of mindfulness, are linked to better emotion-regulation and may play protective role against impulsivity and alcohol use. [ABSTRACT FROM AUTHOR]

This paper reports on the development and validation of a communication measure designed to assess how military veterans feel toward civilian communication. Specifically, we theorize that some veterans experience a mild negative moral emotion (i.e., contempt) toward civilians' communication habits. The emotion is likely a consequence of intense professional socialization and membership in a totalistic organization. Veterans who served in the military since September 11, 2001 (N = 215) responded to items, which were factor analyzed. Then, in a second study, the scale was validated using another sample of post-9/11 veterans (N = 466). Together, these studies contribute an original communication measure that could help identify whether a veteran will have difficulty reintegrating into civilian work life. The scale could be useful in developing interventions to aid veterans in successful reintegration. Ultimately, the measure holds the potential to promote workplace diversity through the successful inclusion of more veterans in the workforce. [ABSTRACT FROM AUTHOR]

Background: ICD-11 complex post-traumatic stress disorder is a more severe condition than post-traumatic stress disorder, and recent studies indicate it is more prevalent among military samples. In this study, we tested the psychometric properties of the International Trauma Questionnaire, assessed the relative prevalence rates of post-traumatic stress disorder and complex post-traumatic stress disorder in the sample population and explored relationships between complex post-traumatic stress disorder and post-traumatic stress disorder and a range of risk factors. Methods: Survey participants (N = 189) were mental health support-seeking former-serving veterans of the Australian Defence Force (ADF) recruited from primary care. Confirmatory factor analysis was used to test the factorial validity of the International Trauma Questionnaire. Results: The latent structure of the International Trauma Questionnaire was best represented by a two-factor second-order model consistent with the ICD-11 model of complex post-traumatic stress disorder. The International Trauma Questionnaire scale scores demonstrated excellent internal reliability. Overall, 9.1% (95% confidence interval = [4.8%, 13.5%]) met diagnostic requirements for post-traumatic stress disorder and an additional 51.4% (95% confidence interval = [44.0%, 58.9%]) met requirements for complex post-traumatic stress disorder. Those meeting diagnostic requirements for complex post-traumatic stress disorder were more likely to have served in the military for 15 years or longer, had a history of more traumatic life events and had the highest levels of depression, anxiety and stress symptoms. Conclusion: The International Trauma Questionnaire can effectively distinguish between post-traumatic stress disorder and complex post-traumatic stress disorder within primary care samples of Australian Defence Force veterans. A significantly greater proportion of Australian Defence Force veterans met criteria for complex post-traumatic stress disorder than post-traumatic stress disorder. Australian military mental health services should adopt the International Trauma Questionnaire to routinely screen for complex post-traumatic stress disorder and develop complex post-traumatic stress disorder specific interventions to promote recovery in Australian Defence Force veterans with complex post-traumatic stress disorder. [ABSTRACT FROM AUTHOR]

Identifying factors that moderate cognitive outcomes following mild traumatic brain injury (mTBI) is crucial. Prospective memory (PM) is a cognitive domain of interest in mTBI recovery as it may be especially sensitive to TBI-related changes. Since studies show that genetic status – particularly possession of the apolipoprotein E (APOE) ε4 allele – can modify PM performance, we investigated associations between mTBI status and APOE-ε4 genotype on PM performance in a well-characterized sample of Veterans with neurotrauma histories. 59 Veterans (mTBI = 33, Military Controls [MCs] = 26; age range: 24–50; average years post-injury = 10.41) underwent a structured clinical interview, neuropsychological assessment, and genotyping. The Memory for Intentions Test (MIST) measured PM across multiple subscales. ANCOVAs, adjusting for age and posttraumatic stress symptoms, tested the effects of mTBI status (mTBI vs. MC) and ε4 status (ε4+ vs. ε4−) on MIST scores. Veterans with mTBI history performed more poorly compared to MCs on the MIST 15-min delay (p=.002, ηp2 =.160), Time Cue (p =.003, ηp2 =.157), and PM Total (p =.016, ηp2 =.102). Those with at least one copy of the ε4 allele performed more poorly compared to ε4- Veterans on the MIST 15-min delay (p =.011, ηp2 =.113) and PM Total (p =.048, ηp2 =.071). No significant interactions were observed between mTBI and APOE-ε4 status on MIST outcomes (ps>.25). Within the mTBI group, APOE-ε4+ Veterans performed worse than APOE-ε4− Veterans on the MIST 15-min delay subscale (p =.031, ηp2 =.150). mTBI history and APOE-ε4 genotype status were independently associated with worse PM performance compared to those without head injury histories or possession of the APOE-e4 genotype. Performance on the MIST 15-min delay was worse in Veterans with both risk factors (mTBI history and APOE-ε4 positivity). Findings suggest that genetic status may modify outcomes even in relatively young Veterans with mTBI histories. Future research examining longitudinal associations and links to neuroimaging and biomarker data are needed. [ABSTRACT FROM AUTHOR]

Most U.S. military service members are discharged routinely, but about 15% receive non-routine discharges. Little is known about how patterns of arrests prior-to and in-service relate to neuropsychological symptoms acquired through military service, or how these symptoms and patterns are associated with discharge type. We investigated latent group differences in post-9/11 era veterans' patterns of arrests; examined mental health-related predictors of subgroup membership; and modeled associations between latent class structure and non-routine discharge. Veterans with traumatic brain injury, alcohol misuse, and post-traumatic stress disorder, had greater odds of belonging to a high-risk vs. low-risk class with the highest probabilities of arrests in-service. The high-risk class had a 45% chance of non-routine discharge compared with 35% for a stable-risk class and 6% for a low-risk class. Veterans with increased probabilities of arrests in-service compared with pre-service showed the highest odds of mental and behavioral health problems and non-routine discharge. [ABSTRACT FROM AUTHOR]

Introduction The value of using trauma-informed approaches in the way services and systems deliver care is well recognised. This evaluation aimed to consider the value of using a structured 'trauma pathway' to improve trauma informed care within a veterans' high intensity service. Method A mixed-methods design was employed. Practitioners completed questionnaires via an online platform and also attended a focus group to share their views. Qualitative data were analysed using inductive thematic analysis. Results A total of 14 team members were eligible to take part. 14 submitted Pre data, and 8 submitted Post data. There were significant differences between pre and post data relating to consideration of trauma-informed care, and confidence in trauma assessment and intervention skills. However, levels of significance were not met for the differences in confidence around identifying pathways of care. From analysis of the qualitative data three main themes were identified 1) Quality of care and Trauma focus, 2) Practitioner experience and 3) Veteran Experience which are explored within the discussion. Conclusions The use of a structured pathway improved the delivery of a trauma-informed care approach within a high intensity service for veterans, with positive changes in both practitioner and veteran experiences [ABSTRACT FROM AUTHOR]

Copyright of Amazonia Investiga is the property of PRIMMATE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Aid and Attendance (A&A) benefit is a cash entitlement for Veterans who served in the U.S. military to obtain personal care services. Our objective was to identify factors contributing to variation in A&A enrollment across VA Medical Centers (VAMCs). We used VA data to calculate the enrollment rate among older Veterans receiving a VA pension or compensation in 2015, then purposefully sampled social work leaders at 15 VAMCs with the highest (n = 7) and lowest (n = 8) enrollment rates for interviews. All respondents viewed A&A as an important benefit. Participants at high-enrollment sites indicated strong working relationships with Veterans Benefits Administration (VBA) and Veterans Service Organizations (VSOs) with onsite presence and education about A&A facilitate access. Participants at low-enrollment sites indicated they desired education around A&A eligibility criteria and collaboration with VBA/VSOs. VA and non-VA social workers would benefit from education about VBA's benefits, and this requires collaboration with VBA representatives. [ABSTRACT FROM AUTHOR]

Some research indicates that public stigma of posttraumatic stress disorder (PTSD) may be relatively benign compared to other psychiatric conditions. However, the severity of PTSD stigma may vary as a function of the setting—military vs. civilian—for a traumatic event and the type of trauma—sexual assault vs. physical assault—that a person experiences. In an online experiment, 870 participants read vignettes in which a woman protagonist experienced a traumatic assault. The vignettes systematically varied as to (1) the military vs. civilian setting of the assault, (2) the type of assault—sexual vs. physical—that she experienced, and (3) whether she was diagnosed with PTSD in the aftermath of the assault. Measures of self-reported social distance and several affective, attitudinal, and behavioral dimensions of stigma were administered. Results indicated that the presence vs. absence of a PTSD diagnosis substantially increased public stigma across several measures. Less consistent but nevertheless noteworthy effects of setting and type of trauma also emerged. The current results valuably add to the small body of knowledge on PTSD stigma and highlight avenues for future research on this damaging phenomenon. [ABSTRACT FROM AUTHOR]

The transition to veterancy can be psychologically challenging, and although the military provides support, the importance of social connectedness for well‐being is largely unrecognised. The significance of this oversight is highlighted by the Social Identity Model of Identity Change (SIMIC), which conceptualises life change as social identity change. SIMIC has been applied to numerous life transitions, but not to veterancy, although there is evidence that the social and psychological challenges of this transition may be especially profound (e.g., due to the chronically salient, highly structured and largely unique nature of military life and identity). To remedy this, in Study 1 (N = 210), UK‐based veterans completed an online survey. Consistent with SIMIC, social group maintenance and gain predicted mental health via the psychological resources they provided (meaning, self‐esteem, sense of personal control), and group gain was predicted by perceived military support during the transition. Study 2 (N = 14) extended these findings qualitatively through exploration of veterans' transition experiences. These studies are the first to apply aspects of the SIMIC to the veterancy transition, and they show the applicability of SIMIC in this context. They also highlight the need for transition‐related education that includes guidance on group joining and reconnecting. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Because service professionals often lack cultural competence in working with veterans, veterans often perceive such professionals as "not understanding." The authors developed, evaluated, and implemented Veteran Cultural Competence Training (VCCT), combining educational and experiential components in an in-person training focused on building awareness, knowledge, and skills to better work with veterans. Study 1 was a type 1 effectiveness-implementation hybrid trial examining VCCT effectiveness in a sample of social service professionals (N=41) compared with a matched comparison group (N=41) via the Multicultural Counseling Self-Efficacy Scale–Veteran Form (MCSE-V) instrument. In study 2, the authors used the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to conduct a type 2 effectiveness-implementation hybrid trial and implemented VCCT with an expanded population (N=312) during eight training sessions in three U.S. states. Results from study 1 indicated that VCCT significantly increased self-efficacy of trainees in veteran cultural competence compared with the matched group (p<0.001). In study 2, the RE-AIM framework highlighted the importance of building coalitions and utilizing implementation facilitation to maintain fidelity. The within-group effectiveness of VCCT was statistically significant and maintained across settings and professions (p<0.001), and trainees were satisfied with VCCT. Maintenance analysis revealed expansion of VCCT after implementation in terms of the number of training sessions (N=9), regions hosting the training (N=5), staff hired (N=13), and trainee applications (N=1,018). VCCT effectively increases self-efficacy in veteran cultural competence. Gains appeared across different professions, demographic characteristics, and locations. Participation in VCCT may increase professionals' competence in understanding veteran culture, thereby potentially improving veteran services. [ABSTRACT FROM AUTHOR]

Over 36% of post–9/11 era veterans have a disability, but little research has examined wounded veterans' finances. We investigated main and interaction effects of income sources and demographic, military, and mental health characteristics on household poverty and deep poverty to better understand wounded veterans' financial outcomes. Data were drawn from the 2018 Wounded Warrior Survey (n = 33,067). Two logistic regression models investigated direct associations between independent variables and poverty outcomes; predictive margins and average marginal effects were calculated for employment and cash transfers on outcomes. 56% of respondents reported full- or part-time employment, and 17% met criteria for household poverty. Of those, 75% met criteria for deep poverty. Cash transfers were negatively associated with poverty and deep poverty, and part-time employment was positively associated with poverty compared with not working. Employment was insufficient protection against poverty in this sample of wounded veterans—transfers were a critical bulwark. [ABSTRACT FROM AUTHOR]

Private security companies (PSCs) blur the lines between the public and the private sector through the provision of services to state militaries. Based on a multi-modal qualitative content analysis of YouTube recruitment videos aimed at veterans, we show how PSCs also challenge these boundaries through their hiring practices. By relating to veterans' past as hero warriors and by envisioning their future as corporate soldiers, the companies appear as 'like-military' and as allowing ex-militaries to 'continue their mission'. The findings contribute to scholarly debates about the privatization of security. They illustrate that similarly to the public sector, the private is also re-constituted through the military values that veterans introduce. The study adds to the literature on the visualization of war showing how video-based platforms allow security actors such as PSCs to construct their corporate identity in ambivalent ways by appealing to different emotional levels and by giving rise to different narratives. [ABSTRACT FROM AUTHOR]

While the well-being of the Swedish peacekeepers deployed to Bosnia in the 1990s has received a great deal of attention over the years, very little is known about how these military veterans have fared on the labour market after returning home. In this paper, I provide novel evidence on the relationship between military deployment to Bosnia and adverse outcomes on the labour market. The analysis is based on longitudinal administrative data for a sample of 2,275 young Swedish veterans who served as peacekeepers in Bosnia at some point during the years 1993–1999. I follow these veterans for up to 20 years after deployment. Using propensity score matching based on a rich set of covariates, I estimate the effects of deployment on three broad measures of labour market marginalisation: long-term unemployment, work disability, and social welfare assistance. I find no indication of long-term labour market marginalisation for the veterans. Even though the veterans experienced an increase in the risk of unemployment in the years immediately following their return from service, in the long run their attachment to the labour market is not affected negatively. [ABSTRACT FROM AUTHOR]

Veterans with histories of incarceration are at greater risk for poor physical and mental health outcomes, yet prior research in this population has focused on specific subsets of veterans or a narrow range of predictors. We utilized the Bronfenbrenner Socioecological Model as the framework to evaluate correlates of incarceration history in a large sample of Iraq and Afghanistan-era veterans at four levels: demographic, historical, clinical, and contextual. Participants were 2,904 veterans (76.9% male; 49.5% White and 46.5% Black; mean age 38.08, SD = 10.33), 700 of whom reported a history of incarceration. Four logistic regression models predicting history of incarceration were tested, adding demographic, historical, clinical, and contextual variables hierarchically. In the final model, younger age (OR = 0.99, 95% CI = 0.98–1.00), male gender (OR of being female = 0.28, 95% CI = 0.21–0.38), belonging to a historically marginalized group (OR of being White = 0.69, 95% CI = 0.56–0.84), family history of incarceration (OR = 1.47, 95% CI = 1.10–1.94), adult interpersonal trauma (OR = 1.39, 95% CI = 1.28–1.51), problematic alcohol use (OR = 1.03, 95% CI = 1.02–1.05), drug abuse (OR = 1.15, 95% CI = 1.11–1.19), and unemployment (OR for being employed = 0.76, 95% CI = 0.62–0.92) were significantly associated with a history of incarceration. Implications of these findings for developing interventions and supporting systems to effectively target this high-risk population of veterans are discussed. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Research data have consistently shown that military veterans are more likely than the general U.S. population to experience mental health problems, as well as homelessness and unemployment. Additionally, data show exceptionally high attrition rates from mainstream mental health treatments for veterans. While several emerging, alternative programs have great potential to support veterans in dealing with trauma and with the transition to civilian life, there is a paucity of research documenting the effectiveness of these programs. This lack of data prevails partly because of biases within the scientific community, which remains largely ignorant of the pervasive difficulties confronting veterans. Our antidote to this problem is a model of veteran-led research. In this article, we outline a set of principles of veteran-led research that we have developed through our ongoing empirical investigation of the DE-CRUIT treatment program, which uses theatre to address traumatic stress and related problems encountered by veterans. We describe the challenges involved in prioritizing the veteran perspective in conducting research within a mainstream scientific context as well as ways of meeting these challenges in order to use the tools of science to better serve our nation's veterans. [ABSTRACT FROM AUTHOR]

Military veterans have been shown to differ demographically from non-veterans in the criminal justice system. However, relatively little is known about their psychological adjustment, institutional misbehavior, and the efficacy of programing received while incarcerated. Using data taken from a national sample of prison inmates, this study investigates how traumatic events experienced during military service can impact the intensity of negative affect among veterans. Additionally, we examine whether prison misconduct is influenced by military service history and the receipt of substance abuse treatment. Controlling for a host of relevant variables, our results indicate that traumatic events show a significant effect on psychological adjustment only indirectly through veterans who developed post-traumatic stress disorder and that misconduct is lower among those who received an honorable discharge. Overall, these findings suggest that the ability of veterans to resist adverse outcomes may depend on a variety of factors both within and outside the prison environment. [ABSTRACT FROM AUTHOR]

Military veterans often transition into the civilian workforce after serving in a nation's armed forces. The process of integrating this unique class into organizations is directly affected by the social exchanges and interactions in the organization. Utilizing an in-depth interviews-based qualitative study of 40 veterans across 12 different organizations, and integrating social identity theory, we use template analysis to identify a paradox existent in social exchanges with other organizational members where veterans are simultaneously stigmatized and socially aggrandized. These paradoxical experiences interact with veterans' self-conceptualization and social identities to reinforce expectations, cause culture shock and eventual turnover. We present a model of this tension, contributing to literatures on veterans in the workforce, paradox, and social identity theory as well as offering HR perspectives on this phenomenon. [ABSTRACT FROM AUTHOR]

Studies explicitly examining the antecedents of prison victimization are rare relative to other institutional outcomes (e.g., misconduct) and are virtually nonexistent for incarcerated military veterans. In the current study, we employed Firth regression models to predict victimization among a subsample of military veterans housed by the Minnesota Department of Corrections (MnDOC) using a target congruence approach. Inconsistent with prior theory and research, we observed no differences among veterans on the basis of race and physical or mental health disorders. We did, however, observe a relationship between an individual's risk of recidivism as measured by the MnSTARR 2.0 and victimization whereby higher scores corresponded with greater odds of victimization. Implications for theory and correctional policy are discussed and directions for future research are given. [ABSTRACT FROM AUTHOR]

Heroes on the Water is a nonprofit organization providing kayak fishing programs to veterans and their families. The purpose of this study was to explore the impact kayak fishing programs, provided by Heroes on the Water, had on posttraumatic growth in military veterans in the United States. The concept of posttraumatic growth suggests that individuals may experience positive psychological changes after severe traumatic events. Research suggests posttraumatic growth can occur in the form of recognizing personal strengths, new possibilities, relating to others, an appreciation for life, and spiritual changes. Studies also suggest that recreation can aid in facilitation of growth. Additionally, recreation has been considered a complementary form of treatment for veterans, specifically the use of nature-based and outdoor recreation programs. For this study, participants reflected on their experiences before and after engaging in Heroes on the Water using the Posttraumatic Growth Inventory. Though the results cannot be generalized, participants reported an increase in score after participating in Heroes on the Water kayak fishing programs. This study adds to the knowledge about the use of recreation to facilitate growth in veterans and encourages continued research on this topic. [ABSTRACT FROM AUTHOR]

Veteran women are better represented in Congress than non-veteran women, but the reasons for this are unclear. Veteran women may be better represented because they run at higher rates and in more winnable races or because their military service leaves them uniquely qualified to overcome gender and partisan stereotypes. Voters often perceive women as lacking leadership ability and ill-suited to handling national security. However, female veterans have experience that may help them overcome gendered beliefs about their abilities. Using election data from the 2012–2020 U.S. congressional elections, we test whether veteran women gain greater voter support compared to non-veteran candidates and whether veteran women running as Democrats outperform male veteran Democrats. We find only limited evidence that military service wins more votes for candidates of either gender. Among Democrats, prior military service levels the playing field between male and female candidates, but veteran women only outperform veteran men in 2018. [ABSTRACT FROM AUTHOR]

Chronic fatigue syndrome (CFS) is a debilitating illness characterized by persistent fatigue among other symptoms. Pain symptoms are common and included in the diagnostic criteria for CFS but are not required for diagnosis. Despite the association between CFS and pain, few studies have examined CFS in the context of chronic pain (CP) conditions. The current study estimates the period prevalence of comorbid CFS among military Veterans with CP and compares sociodemographic characteristics and CP conditions of Veterans with CP + CFS to those with CP without CFS. This study included Veterans Health Administration (VHA) data on 2,261,030 patients with chronic pain in 2018. Sociodemographic characteristics included age, sex, race, ethnicity, and rurality. Descriptive statistics were used to describe the sample and between-group comparisons included independent samples t-tests and chi-square tests of independence. Effect sizes were also examined. A total of 15,248 (0.67%) of Veterans with CP also had a diagnosis of CFS. Veterans diagnosed with CP + CFS were younger and were more likely to be female, White, non-Hispanic, and rural-dwelling. However, small and weak effect sizes were observed for these differences. The majority of Veterans with CP + CFS had limb/extremity (69.20%) back pain (53.44%), or abdominal/bowel pain (24.11%). As CDC treatment recommendations for CFS include treating pain first, studying CFS in the context of CP is critically important. Veterans diagnosed with CP + CFS appear demographically similar, compared to Veterans with CP without CFS. Examining the utilization of pain-related healthcare services among this group would be a useful next step. [ABSTRACT FROM AUTHOR]

The sociodemographic backgrounds of inmates are essential for understanding their prison experiences and the extent to which they cope with incarceration and recidivate upon release. The notion that military veterans might fare differently from other groups in the correctional system has existed for decades; yet scholars have only recently begun to focus on the effects that prior service has on metrics of prison adjustment and beyond. Increased emphasis on the prison experiences of military veterans necessitates a review of the studies published to date. In the current study, we take stock of the empirical research conducted on incarcerated veterans by systematically reviewing all articles published online between 2000 and 2022. Overall, we find little evidence to support the view that veteran status confers any specific benefits or vulnerabilities during incarceration or following release. However, given the limitations of the studies reviewed, we address several methodological concerns regarding the study of former service members and provide directions for future research. [ABSTRACT FROM AUTHOR]

Objective: Research on 'moral injury'—the psychological wound experienced by military personnel and other 'functionaries' whose moral values are violated—has proliferated in recent years. Many psychological researchers, including those in the UK, have subscribed to an increasingly individualised operationalisation of moral injury, with medicalised criteria that closely mirrors PTSD. This trend carries assumptions that have not been comprehensively verified by empirical research. This study aims to explore UK military veterans' experiences of, and challenges to, their moral values in relation to their deployment experiences, without prematurely foreclosing exploration of wider systemic influences. Method: Twelve UK military veterans who served in Afghanistan and/or Iraq were interviewed, and the data were analysed thematically and reflexively. Results: Three inter‐related themes were generated: (1) 'you've been undermined', (2) 'how am I involved in this?' and (3) 'civilianised'. Conclusions: The analysis suggests that several assumptions privileged in moral injury research may be empirically contradicted, at least in relation to the experiences of UK military veterans. These assumptions include that moral injury is exclusively driven by individual, episodic acts of commission and omission, invariably leads to guilt and necessarily bifurcates into variants of either perpetration or betrayal. Instead, participants understood the moral violations they experienced as socially contingent. Rather than 'treating' moral injury as a disorder of thinking and feeling located within an individual, the socially contextualised understanding of moral injury indicated by this study's findings may prompt the development of psychological and social interventions that understand moral injury as the fallout of what occurs between people and within systems. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined whether UK military veterans are at an increased risk of dementia. We explored the risk of dementia in Scottish military veterans aged up to 73 years in comparison with people who have never served. Methods: Retrospective cohort study of 78 000 veterans and 253 000 people with no record of service, matched for age, sex and area of residence, with up to 37 years follow-up, using Cox proportional hazard analysis to compare risk of dementia in veterans and non-veterans, overall and by subgroup. Results: Dementia was recorded in 0.2% of both veterans and non-veterans overall, Cox proportional hazard ratio 0.98, 95% confidence interval (CI) 0.82–1.19, p = 0.879 (landmark age: 50 years), with no difference for men but increased risk in veteran women and Early Service Leavers. Post-traumatic stress disorder (PTSD) was associated with a higher risk of dementia in both veterans and non-veterans, although possibly to a lesser degree in veterans. A history of mood disorder was strongly associated with developing dementia, greater in veterans than in non-veterans, odds ratio 1.54, 95% CI 1.01–2.35, p = 0.045. Conclusions: There was no evidence to suggest that military service increased the risk of dementia, although this may change as the cohort ages. The well-documented association with PTSD shows no evidence of being stronger in veterans; by contrast, the association of mood disorder with dementia is much stronger in veterans. Healthcare providers should carefully assess the cognitive status of older veterans presenting with depressive illness in order to identify early dementia and ensure optimum management. [ABSTRACT FROM AUTHOR]

A modest but significant number of military personnel sustained injuries during deployments resulting in an altered-appearance (e.g., limb loss and/or scarring). Civilian research indicates that appearance-altering injuries can affect psychosocial wellbeing, yet little is known about the impact of such injuries among injured personnel. This study aimed to understand the psychosocial impact of appearance-altering injuries and possible support needs among UK military personnel and veterans. Semi-structured interviews with 23 military participants who sustained appearance- altering injuries during deployments or training since 1969 were conducted. The interviews were analyzed using reflexive thematic analysis, identifying six master themes. These themes indicate that in the context of broader recovery experiences, military personnel and veterans experience a variety of psychosocial difficulties related to their changed appearance. While some of these are consistent with evidence from civilians, military-related nuances in the challenges, protective experiences, coping approaches, and preferences for support are evident. Personnel and veterans with appearance-altering injuries may require specific support for adjusting to their changed appearance and related difficulties. However, barriers to acknowledging appearance concerns were identified. Implications for support provision and future research are discussed. [ABSTRACT FROM AUTHOR]

Moral injury was originally conceived as a socially‐inflicted wound of betrayal experienced by military veterans (Shay, 1994). However, moral injury has since been redefined by psychological researchers as an individualised, predominantly perpetration‐driven, and psychopathological phenomenon (e.g., Currier et al., 2015; Jinkerson, 2016). However, social scientific researchers (e.g., Hodgson & Carey, 2017; Molendijk, 2019; Wiinikka‐Lydon, 2017) have contested mainstream psychology's medicalisation and decontextualisation of moral injury. This theoretical review integrates insights from across these discourses, and brings them into dialogue with ideas from moral psychology, evolutionary science, and community psychology. The aim of this cross‐disciplinary review is to promote a more holistic understanding of moral injury that does justice to its individual and social dimensions. Drawing on these different theoretical strands, this paper proposes that moral injury can be best understood as a psychological wound to basic human needs for social belonging and cohesion. The implications of this integrative understanding of moral injury for applied psychologists and other societal actors are explored. While the relevance of moral injury to civilian populations such as health and social care professionals is clear (e.g., Dombo et al., 2013; French et al., 2021), this paper focuses on military veterans, whose experiences originally prompted the coinage of the term. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Researchers need approaches for analyzing complex phenomena when assessing contingency relationships where specific conditions explain an outcome only when combined with other conditions. Using a mixed methods design, we paired configurational methods and qualitative thematic analysis to model contingency in veteran community reintegration outcomes, identifying combinations of conditions that led to success or lack of success in community reintegration among US military veterans. This pairing allowed for modeling contingency at a detailed level beyond the capabilities of either approach alone. Our analysis revealed multiple contingent relationships at work in explaining reintegration, including social support, purpose, cultural adjustment, and military separation experiences. This study contributes to the field of mixed methods by pairing a mathematical cross-case method with a qualitative method to model contingency. [ABSTRACT FROM AUTHOR]

Moral injury (MI) is defined as the profound psychological distress experienced in response to perpetrating, failing to prevent, or witnessing acts that transgress personal moral standards or values. Given the elevated risk of adverse mental health outcomes in response to exposure to morally injurious experiences in military members, it is critical to implement valid and reliable measures of MI in military populations. We evaluated the reliability, convergent, and discriminant validity, as well as the factor structure of the commonly used Moral Injury Events Scale (MIES) across two separate active duty and released Canadian Armed Forces samples. In Study 1, convergent and discriminant validity were demonstrated through correlations between MIES scores and depression, anxiety, posttraumatic stress disorder, anger, adverse childhood experiences, and combat experiences. Across studies, internal consistency reliability was high. However, dimensionality of the MIES remained unclear, and model fit was poor across active and released Canadian Armed Forces samples. Practical and theoretical implications are discussed. [ABSTRACT FROM AUTHOR]

The link between military service and crime has been a subject of investigation for several decades. Although research has examined the likelihood of arrest, incarceration, and recidivism across military cohorts, relatively little is known about the circumstances surrounding police contact and suspect behavior at the exact moment of arrest. This is a critical oversight given that what transpires during an arrest can have a marked impact on downstream criminal justice outcomes, including access to diversionary programming like veterans treatment courts. Using a nationally representative survey of prison inmates, this study analyzes veteran and nonveteran self-reports of their arrest controlling for a host of relevant demographic, mental health, and criminal history variables. Findings indicate that veterans are significantly less likely to resist the police at arrest. These results provide further support to the sentiment that military culture and training can have a lasting behavioral influence on those who experience it. [ABSTRACT FROM AUTHOR]

As the number of veterans with dementia continues to increase, support services for those veterans and their caregivers must also increase. Caregivers of veterans with dementia often report high levels of emotional distress in the form of anxiety, exhaustion, and burden that negatively impacts their health and quality of life. This brief descriptive report highlights a Veterans Health Administration (VHA) project in which a social worker trained in palliative care, teaches stress-reduction to caregivers through individual counseling and virtual groups. In two years, 39 caregivers received individual assessment and counseling focused on stress-reduction. Also, five group webinars were held on the topic of self-care that averaged 17 caregivers per group. 24 caregivers completed a survey and results suggested that stress-reduction and self-care may be viable target areas of intervention for caregivers of veterans with dementia in both individual and group formats. More research is needed in this area to improve our knowledge of how stress may be reduced for caregivers and what type of interventions may be effective to help caregivers reduce stress and improve their self-care. [ABSTRACT FROM AUTHOR]

This article examines the diffusion of diversity management policies across large state bureaucracies that operate in a national marketplace of ideas. We analyze organizational antecedents and horizontal, vertical, and vertical-diagonal diffusion mechanisms associated with the degree of diversity management convergence among research universities from 2008-2016. Findings suggest the long-theorized, but rarely measured, non-linear pattern of diffusion explains organizational adoptions and the degree of policy convergence across the system. We also show a vertical-diagonal process whereby policy spills over to influence policy choices in other lower-level governance systems. This spillover may explain how organizations make policy decisions in complex governance arrangements. [ABSTRACT FROM AUTHOR]

Physically or psychologically injured military veterans are motivated and benefited by physical activity or sport that may involve high levels of achievement. The aim of this study was to provide an in-depth insight into the impact of Competitive Motorsport (CM) on physically injured/disabled veterans' subjective well-being and in turn determine if it improves the quality of their lives. This is a qualitative study. Two sets of semi-structured interviews were conducted with 14 male British military veterans including a 6-month follow-up. All participants were subjected to a permanent, moderate or severe, physical injury/disability. Data were analysed in accordance with the principles of Thematic Analysis. Five key elements (familiar environment, team spirit, adrenaline rush, competition and equality) made CM a unique experience for physically injured/disabled veterans. Various psychological and physical benefits were found, including an increased sense of accomplishment, opportunity to socialise in a non-clinical environment, embracement of body image and adoption of a healthier lifestyle. Since physical activity and sport are among growing research on alternative interventions for military veterans, they deserve serious consideration as part of the treatment regimens and rehabilitation programmes to improve physically inured/disabled veterans' physical and mental health. Competitive Motorsport is an effective means of improving physical health and subjective well-being of physically injured/disabled military veterans. Multiple perceived psychological and physical benefits were identified over time, including motivation for living, embracement of body image and adoption of a healthier lifestyle. Competitive Motorsport deserves consideration as part of the treatment regimens and rehabilitation programmes to improve physically injured/disabled veterans' physical and mental health while facilitating transition to civilian life. [ABSTRACT FROM AUTHOR]

Disasters disrupt people's ability to be physically active. Despite the well-known health benefits of physical activity, there is limited understanding of how disasters may affect those who experience constraints to being active, such as people with disabilities. This study explored how one major disaster, the COVID-19 pandemic, affected people with disabilities' participation in leisure-time physical activity (LTPA) and their mental health and well-being. An online survey was completed by 959 participants. Latent class analysis based on four questions asking the impact of COVID-19 on LTPA was used to identify 4 distinct classes: 'Heavily Impacted', 'Adapted', 'Resilient', and 'Radically Changed'. Disability categorisation, veteran status, and gender predicted latent class membership. Results from multinomial regression revealed that the Heavily Impacted members reported significantly lower mean scores for life satisfaction, quality of life, and general health, along with poorer mean scores for loneliness than other groups. In contrast, the Resilient members reported significantly higher mean scores of quality of life and general health than other groups. Qualitative data analysis further suggests that respondents participated in myriad LTPA modes that included somewhat technology adoption. People with disabilities' LTPA was negatively affected by the pandemic, with those most heavily impacted having poorer mental health indices. [ABSTRACT FROM AUTHOR]

Background: Consensus guidelines recommend multimodal chronic pain treatment with increased use of non-pharmacological treatment modalities (NPM), including as first-line therapies. However, with many barriers to NPM uptake in US healthcare systems, NPM use may vary across medical care settings. Military veterans are disproportionately affected by chronic pain. Many veterans receive treatment through the Veterans Health Administration (VHA), an integrated healthcare system in which specific policies promote NPM use. Objective: To examine whether veterans with chronic pain who utilize VHA healthcare were more likely to use NPM than veterans who do not utilize VHA healthcare. Design: Cross-sectional nationally representative study. Participants: US military veterans (N = 2,836). Main Measures: In the 2019 National Health Interview Survey, veterans were assessed for VHA treatment, chronic pain (i.e., past 3-month daily or almost daily pain), symptoms of depression and anxiety, substance use, and NPM (i.e., physical therapy, chiropractic/spinal manipulation, massage, psychotherapy, educational class/workshop, peer support groups, or yoga/tai chi). Key Results: Chronic pain (45.2% vs. 26.8%) and NPM use (49.8% vs. 39.4%) were more prevalent among VHA patients than non-VHA veterans. After adjusting for sociodemographic characteristics, psychiatric symptoms, physical health indicators, and use of cigarettes or prescription opioids, VHA patients were more likely than non-VHA veterans to use any NPM (adjusted odds ratio [aOR] = 1.52, 95% CI: 1.07–2.16) and multimodal NPM (aOR = 1.80, 95% CI: 1.12–2.87) than no NPM. Among veterans with chronic pain, VHA patients were more likely to use chiropractic care (aOR = 1.90, 95% CI = 1.12–3.22), educational class/workshop (aOR = 3.02, 95% CI = 1.35–6.73), or psychotherapy (aOR = 4.28, 95% CI = 1.69–10.87). Conclusions: Among veterans with chronic pain, past-year VHA use was associated with greater likelihood of receiving NPM. These findings may suggest that the VHA is an important resource and possible facilitator of NPM. VHA policies may offer guidance for expanding use of NPM in other integrated US healthcare systems. [ABSTRACT FROM AUTHOR]

Medically unexplained symptoms (MUS) are prevalent among veteran and non-veteran populations. Current biopsychosocial theory implicates a multitude of factors in MUS development and perpetuation. The current study tests whether physical symptom attribution to MUS is associated with perceived symptom severity and bothersomeness and thereby might function to perpetuate MUS, as suggested by existing theory. Military combat veterans (n = 243) answered postal-mail questions about their physical symptoms, severity of experienced symptoms, and attributions of these symptoms to MUS (e.g. Gulf War Illness) versus non-MUS conditions. Independent t-tests showed support for the first hypothesis—that those who experience the symptom and attribute it to MUS will perceive it to be more severe and bothersome than those who experience the symptom but do not attribute it to MUS. Paired-sample t-tests showed support for the second hypothesis—that experienced symptoms attributed to MUS by an individual will be perceived as more severe and bothersome than experienced symptoms the individual does not attribute to MUS. Results highlight a potential role of symptom attribution in MUS perpetuation, through greater perceived severity and bothersomeness of MUS-attributed symptoms. Possible intervention targets may include behavior ramifications, such as coping strategies; more research is needed. [ABSTRACT FROM AUTHOR]

Background: Military personnel face numerous challenges transitioning from military jobs to meaningful civilian employment. Many veterans seek help finding employment, but few veteran employment programs have been rigorously studied. Transitioning veterans generally have access to Local Community Resources (LCR), which include the Veterans Health Administration vocational rehabilitation services, the state-federal Vocational Rehabilitation program, and the Department of Labor's American Job Centers. By contrast, the innovative National Career Coach Program (NCCP) offers intensive career coaching and financial incentives for working. Methods: This study used a randomized controlled design to compare the NCCP and LCR approaches for 208 transitioning service members (recent or pending transition). Researchers conducted interviews by telephone every four months for two years. Outcomes included earnings, months worked, and standardized self-report measures of health and well-being. Findings At two-year follow-up, significantly more NCCP participants had worked in paid employment than LCR participants (95% vs. 83%). NCCP participants averaged $2568 in monthly earnings compared to $1865 for LCR participants, thus averaging $16,872 more total income per participant over the two-year period. Employment outcomes significantly improved between Year 1 and Year 2. NCCP participants also reported significantly greater improvements in both physical and mental health compared to LCR participants. Average monthly earnings correlated with changes in health outcomes. Conclusions: Veterans receiving multi-faceted employment services early in the transition from the military showed sustained benefit over a two-year period with increased earnings over time and improved mental and physical outcomes. Positive employment outcomes may have contributed to improved health outcomes. [ABSTRACT FROM AUTHOR]

This paper details the results of an 18-month program impact evaluation (n = 72) on Armed Services Arts Partnership's "Comedy Bootcamp," a popular stand-up comedy course specifically tailored to military veterans. Based on literature around the benefits of sense of humor and humor training (e.g., 7 Humor Habits), we anticipated that participants in Comedy Bootcamp would show greater well-being relative to a control group, and that this effect would be mediated by an increase in sense of humor (i.e., self-enhancing humor style). Results largely supported the hypotheses, showing that Comedy Bootcamp participants experienced an increased self-enhancing humor style, which in turn yielded improved self-esteem, resilience, depression, and stress (though not anxiety). Further, longitudinal analyses demonstrated the benefits of the program persist at 3- and 6-month follow-ups. Implications and future directions are discussed. [ABSTRACT FROM AUTHOR]

Background: Military members and police officers often operate in high stakes situations and under high levels of physical and psychological stress. Consequently, they may be confronted with morally injurious experiences and develop moral injury. Most treatments for moral injury are cognitive-behavioral, face-to-face treatments, which may be supported by online interventions. Online interventions have shown promise in the treatment of trauma-related psychopathology, but few such interventions for moral injury yet exist. Objective: To develop and conduct a preliminary evaluation of an online treatment module for moral injury in treatment-seeking military veterans and police officers, to be used in conjunction with regular face-to-face treatment. Method: An onlinemodule was developed based on themoral injury literature, using elements from seven existing treatments. A preliminary evaluation was conducted using both quantitative and qualitative methods, and focusing on perceived feasibility, acceptability and engagement of the module, as well as potential benefits and harms. The concept module was evaluated by 15 assessors, including patient representatives, multidisciplinary caregivers and experts. Results: The module was rated favorably, with mean evaluation scores ranging from 7.9 to 8.8 on a 10-point scale. Several suggestions for improvement were made, especially concerning privacy issues, safety instructions, patient-therapist collaborations, and role plays, and the module was adapted accordingly. Conclusion: Using input from literature, patient representatives and experts, we developed an online treatment module for moral injury in military veterans and police officers, to be used in conjunction with face-to-face therapy. Acceptability and feasibility will be further examined in a future pilot study. [ABSTRACT FROM AUTHOR]

Problematic pornography use represents a common feature reported by those with compulsive sexual behavior disorder. While prior research suggests US military veterans may experience disproportional rates of problematic pornography use, few comparative studies exist. Moreover, no measurement invariance analyses between veterans and non-veterans exist on measures designed to assess problematic pornography use. The purposes of the present report were to explore whether differences exist between veteran and non-veteran men on indices of problematic pornography use, determine whether veteran status is associated with an exacerbation of psychological distress in conjunction with problematic pornography use, and establish measurement invariance psychometric data between veteran and non-veteran men on the Brief Pornography Screen (Kraus et al., 2020). We analyzed data drawn from a nationally representative panel of men from the USA (N = 658 non-veterans, N = 186 veterans). When adjusting for age, veteran men experienced significantly more problematic pornography use compared to non-veteran men. A substantial moderation effect was also evident, with veterans experiencing significantly more psychological distress associated with their problematic pornography use (β =.65) compared to non-veterans (β =.29), while adjusting for age and pornography use frequency. The Brief Pornography Screen demonstrated residual invariance (i.e., measurement equivalence of factor structure, loadings, intercepts, and errors) between veteran and non-veteran men. Clinicians working with veterans should explore how pornography use is related to their mental health. The Brief Pornography Screen is an effective tool to assess problematic pornography viewing in veteran and non-veteran men. [ABSTRACT FROM AUTHOR]

Exposure to morally injurious events may have a severe, prolonged negative impact on psychosocial functioning, known as moral injury (MI). Research into the prevalence of MI has mostly focused on event exposure rather than on psychosocial impact. Also, the relationship between MI and post-traumatic stress disorder (PTSD) remains a matter of interest. The aim of this study was to identify MI and PTSD symptom profiles among trauma-exposed, treatment-seeking police officers and military veterans, and to explore demographic and clinical differences between symptomprofiles. Latent class and multinomial regression analyses were conducted in a sample of 1,703 participants, using the Clinician-Administered PTSD Scale for DSM-5 and the Brief SymptomInventory. Four classes of participants were identified, labeled as a MI class (n = 192; 11.27%), a MIPTSD class (n = 565; 33.18%), a PTSD class (n = 644; 37.82%), and a Neither MI-nor PTSD class (n = 302; 17.73%), resulting in 44.45% (n = 757) of participants who met an MI symptom profile with or without PTSD. There were significant differences between the classes in terms of gender as well as PTSD and comorbid psychopathology symptom severity, the latter of which was highest in the MI-PTSD class. In conclusion, a substantial subgroup of trauma-exposed, treatment-seeking police officers and military veterans could be classified as suffering from MI. Routinely screening for MI in treatment-seeking police officers and military veterans is recommended, and interventions aimed at relieving MI in these populations may be indicated. [ABSTRACT FROM AUTHOR]