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The COVID-19 pandemic has led to economic turndowns, social restrictions, and family life alterations. The stress induced by the public health crisis and its consequences are beginning to be explored. This study examined stress experiences since the pandemic'sonset in work, financial, social, and health domainsamong a large sample of post-9/11, United States military veterans. The sample, who separated from active-duty service or deactivated from active status in a reserve component in 2016, completed an online survey (n = 3180) in 2020. Participants were 70% White non-Hispanic, 81% male, and had an average age of 38 years. Frequencies and descriptive statistics were calculated. Female veterans and veterans of colour reported significantly higher levels of stress across most life domains. The results suggest White, male, post-9/11 veterans may be somewhat protected from COVID-19 stress, but that the pandemic is exacerbatinghealth and social disparities experienced by post-9/11 veterans of colour and female veterans. Supports and comprehensive care, particularly targeted towardsat-risk populations, are likely needed to provide sufficient resources for resiliency during and after the pandemic., (© 2023 The Authors. Stress and Health published by John Wiley & Sons Ltd.)

Military sexual trauma (MST) is a pervasive problem; this study examined the relationship of the precursory traumas of adverse childhood experiences (ACEs) and warfare exposure with MST. Post-9/11 veterans were surveyed at 3 months and at 24 to 30 months post-military separation. Female veterans who experienced at least 1 ACE but no warfare exposure were significantly more likely to receive unwanted sexual attention. Veterans (males and females) experiencing three or more ACEs but no warfare exposure were significantly more likely to receive unwanted sexual attention and contact. Experiencing only warfare exposure was not related to unwanted sexual attention or contact for females; however, a significant interaction was found between combined warfare exposure, ACEs, and MST for males and females. Veterans who reported warfare exposure and one to two or three or more ACEs were more likely to report unwanted sexual attention and/or contact. Exploration of individual ACEs revealed a significant relationship between childhood sexual abuse and unwanted sexual contact. For females, witnessing domestic violence predicted unwanted sexual contact. There was also a significant interaction between childhood sexual abuse and warfare exposure. Females who experienced both childhood sexual abuse and warfare exposure were significantly more likely to receive unwanted sexual attention and unwanted sexual contact. Albeit a small sample, males who experienced both were also significantly more likely to receive unwanted sexual attention. The findings reveal that precursory traumatic experiences in childhood and the interaction of ACEs and warfare exposure during military service can increase the likelihood of unwanted sexual attention and contact. This research further substantiates the need for screening efforts. It also demonstrates the importance of practitioners engaging in trauma-informed care principles and practices to address the residual effects of previous experiences during sexual trauma or mental health treatment efforts.

Background: Underemployment is a challenge for the civilian workforce and a particular risk for veterans as they transition from military service to civilian employment. Workers' economic and demographic characteristics factor into underemployment risk. Veterans may be at greater risk due to specific economic and demographic factors, transitional factors (e.g., geographic relocation), and characteristics of their military service (e.g., military skill alignment with civilian jobs)., Objectives: Describe underemployment experiences in employed post-9/11 veterans three years after their military transition to the civilian workforce., Methods: The current study uses self-reported underemployment experience data from a longitudinal study of transitioning veterans. This study compares average perceptions of veteran underemployment experiences by specific groups (e.g., by race, gender, and paygrade) using analysis of variance and logistic regression., Results: Veterans reported underemployment in their current jobs based on a perceived mismatch between the skills, education, and/or leadership experience they gained during military service., Conclusions: Veterans who were enlisted rank, identified as non-White, completed a bachelor's degree, and indicated PTSD symptoms reported higher pervasive underemployment. Intervention implications for the results, such as employer and veteran employment supports, are discussed.

Military veterans have greater exposure to adverse childhood experiences (ACEs) than civilians and many also encounter warfare exposures, which can increase the likelihood of mental health problems. The purpose of this study was to test an interaction between childhood traumas and warfare exposures on the mental health of a sample of nearly 10,000 new post-9/11 veterans. Results revealed that male veterans exposed to one or two ACEs, but no warfare, were more likely to experience anxiety, depression, suicidal thinking, and angry outbursts than the reference group (i.e., no ACEs and no warfare exposure). Female veterans exposed to one or two ACEs, but no warfare, were only more likely to experience suicidal thinking. Male and female veterans exposed to three or more ACEs and no warfare were more likely to experience probable posttraumatic stress disorder (PTSD), anxiety, depression, suicidality, and angry outbursts. Among those veterans who experienced corollaries of combat only (e.g., seeing someone killed or seriously wounded), male, but not female veterans were more likely to have probable PTSD, anxiety, and depression. Veterans exposed to warfare (i.e., combat and the corollaries of combat), irrespective of ACEs exposure, were the most likely to report mental health symptoms. Implications for community-based mental health services are discussed., (© 2021 Wiley Periodicals LLC.)

Objective: Adverse childhood experiences (ACEs) are early life experiences of abuse and neglect, and observed violence, among others. For military veterans, both ACEs and combat exposure are associated with mental health problems., Method: This study examines the relationship between ACEs and combat exposure on the current mental health in a large sample of recent post-9/11 U.S. veterans., Results: Fifty-nine percent of female and 39% of male veterans reported exposure to 1 ACE, whereas 44% of female and 25% of male veterans were exposed to multiple ACEs. Female veterans were more likely to experience 4 or more ACEs. ACEs were more consistently associated with mental health problems for male veterans than their female peers. For female veterans, exposure to 1 or 2 ACEs did not increase the odds of having any mental health condition, whereas for males, this level of exposure was associated with probable PTSD and anxiety. Combat patrol events were associated with an increase in the likelihood of having a probable mental health problem, with 2 exceptions-combat patrol events were not associated with depression in male veterans and not associated with alcohol misuse in female veterans. Combat was not associated with alcohol misuse. Experiencing a corollary of combat (e.g., accidents, moral injury) was inconsistently associated with the odds of having a probable mental health problem., Conclusions: This study confirms prior studies demonstrating a relationship between ACEs and combat on subsequent mental health problems. Importantly, 2 different types of combat exposure had differential effects on mental health problems. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Objective: The Veterans Metrics Initiative is a longitudinal survey study examining the military-to-civilian transition of a cohort of new post-9/11 veterans. This study identified the programs and services used by new post-9/11 veterans who screened positive for mental health problems (N=3,295) and factors that predicted use., Methods: The population of veterans who separated from active duty service in the 90 days prior to August-November 2016 (N=48,965) was identified and invited to participate in the study. This study reports results from the first wave of data collected., Results: Complete data were provided by 9,566 veterans. Of these, 34% (N=3,295) screened positive for one or more probable mental health problems. A substantial majority of these veterans also reported having a general medical problem. Results revealed that veterans from junior enlisted ranks were significantly less likely than those from higher ranks to use programs and services. Use of programs and services by male and female veterans was similar. Several racial-ethnic differences also emerged. There was some evidence that veterans may underrecognize their own mental health problems. Veterans who were exposed to combat, had a medical discharge, or reported an ongoing general medical condition were all significantly more likely to report using U.S. Department of Veterans Affairs (VA) health care services., Conclusions: These findings suggest that veterans, particularly those from the junior enlisted ranks-who are most at risk for poor transitions-should be encouraged to use programs and services provided by both the VA and non-VA health care alternatives.

Background: Numerous programs exist to support veterans in their transitions to civilian life. Programs are offered by a host of governmental and non-governmental stakeholders. Veterans report encountering many barriers to program participation. This study identified barrier reduction strategies offered by programs that new post-9/11 veterans reported using, determined which strategies veterans use and value, and examined veteran characteristics that impact their odds of using programs that offer barrier reduction strategies., Method: This study reflects findings from the first wave of data collection of The Veterans Metrics Initiative (TVMI), a longitudinal study examining the military-to-civilian reintegration of new post-9/11 veterans. The websites of programs used by respondents were coded for barrier reduction components. Veterans also indicated which barrier reduction components they found most helpful in meeting their reintegration goals., Results: Of 9566 veterans who participated in Wave 1 data collection, 84% reported using a program that offered at least one barrier reduction component. Barrier reduction components included tangible supports (e.g., scholarships, cash), increased access to programs, decreased stigma, and encouraged motivation to change. Although only 4% of programs that were used by veterans focused on helping them obtain Veterans Administration benefits, nearly 60% of veterans reported that this component was helpful in reaching their goals. Access assistance to other resources and supports was also reported as a helpful barrier reduction component. For instance, approximately 20% of veterans nominated programs that offered transportation. The study also found evidence of a misalignment between the kinds of barrier reduction components veterans valued and those which programs offered. Veterans from the most junior enlisted ranks, who are at most risk, were less likely than those from other ranks to use barrier reduction components. Study limitations and ideas for future research are discussed., Conclusions: Despite the evidence that barrier reduction components enhance access to programs and contribute to program sustainability, many programs used by post-9/11 veterans do not offer them. There was also a misalignment between the barrier reduction strategies that veterans value and the strategies offered by programs. Veteran serving organizations should increasingly implement barrier reduction strategies valued by veterans.

Objective: Large numbers of United States service members and veterans are enrolling in colleges and universities. Many are experiencing posttraumatic stress symptoms secondary to their military service, and these symptoms are associated with academic dysfunction. However, little is known about the mechanism(s) through which posttraumatic stress increases risk for academic difficulties. The goal of the current study was to evaluate perceived interpersonal relationship quality as a mediator of this association., Method: The current study investigated the indirect effect of posttraumatic stress on academic dysfunction through three indices of perceived interpersonal relationship quality (i.e., family distress, family support, and social network support) in a clinical sample of 2,120 student service members and veterans. Participants were further divided into four groups based on relationship status and gender (i.e., partnered women, nonpartnered women, partnered men, and nonpartnered men), and moderation by group was examined., Results: For all four groups, there were significant indirect effects of posttraumatic stress on academic dysfunction through greater family distress and lower social network support. Further, the overall indirect effect of posttraumatic stress on academic dysfunction was stronger for partnered women compared with the three other groups and was attributable to the stronger path from family distress to academic dysfunction for partnered women., Conclusions: Poor perceived relationship quality may be a modifiable risk factor for academic dysfunction among student service members and veterans experiencing military-related posttraumatic stress. Partnered women may be especially well-suited to interventions that enhance the interpersonal context of posttraumatic stress as a way to optimize academic outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Evaluators are challenged to keep pace with the vast array of Veteran support programs operating in the United States, resulting in a situation in which many programs lack any evidence of impact. Due to this lack of evidence, there is no efficient way to suggest which programs are most effective in helping Veterans in need of support. One potential solution to this dilemma is to reconceptualize program evaluation, by moving away from evaluating programs individually to evaluating what is common across programs. The Common Components Analysis (CCA) is one such technique that aggregates findings from programs that have undergone rigorous evaluation at the level of program components (e.g., content, process, barrier reduction). Given that many Veteran programs lack outcome evidence from rigorous studies, an adaptation to CCA is needed. This report examines cross-sectional data from a pilot study using an adapted CCA across five domains of well-being (i.e., employment, education, legal/financial/housing, mental/physical health, and social/personal relationships). The purpose of this preliminary study is to determine the feasibility of eliciting program nominations and program components from Veterans via an online survey. When coupled with a longitudinal research design, this adaptation to CCA will allow for stronger causal claims about the expected impact of different program components within and across a variety of domains., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

This study assessed the effectiveness of employment programs components, which resulted in the identification of content and process components that increase employability. Employment program use was studied among 1172 United States of America military veterans to determine which content (i.e., interviewing skills) and process (i.e., working with a mentor/coach) components influence job attainment during a time of career and identity transition. Components were distilled utilizing a common components analysis approach (Morgan et al., 2018). Associations with finding employment up to 15 months after the military-to-civilian transition were explored. Veterans who engaged with employment programs were primarily accessing the following components: career planning, resume writing, and interviewing skills. However, only a few content components were significantly related to obtaining employment: interviewing (with mentor/coach), resume writing (online tools), translating military to civilian work (with mentor/coach), entrepreneurship (with mentor/coach), and virtual career fairs. Furthermore, not all processes or modes of instruction for content components were associated with success in the job market. Having a mentor/coach was one of the most effective delivery strategies. For example, veterans using programs delivered by a mentor/coach that translated military skills to civilian work were more likely to find a job at 6-9-months (84%) and 12-15-months (91%) post military separation. In addition, risks that predicted lower use of employment program components by veterans were identified such as junior enlisted rank, combat exposure, combat arms occupation, and physical health problems. With these findings, program developers, implementers, and funders can channel efforts towards the utilization of employment programs with effective components.

This study examined how veteran social engagement predicted post-secondary school attainment. Nearly 10,000 post-9/11 veterans, who separated from military service in 2016, were surveyed on the programs/services they used over 4 years following separation. More than half of veterans had obtained a degree within 4 years of separation. A higher proportion of veterans of color and female veterans reported attending only some higher education than White non-Hispanic male veterans. Positive predictors of educational attainment included participating in veterans' centers and veteran-student organizations, while negative predictors included financial and mental health problems. Implications for veteran-serving programs of post-secondary institutions are discussed. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has led to economic turndowns, social restrictions, and family life alterations. The stress induced by the public health crisis and its consequences are beginning to be explored. This study examined stress experiences since the pandemic'sonset in work, financial, social, and health domainsamong a large sample of post‐9/11, United States military veterans. The sample, who separated from active‐duty service or deactivated from active status in a reserve component in 2016, completed an online survey (n = 3180) in 2020. Participants were 70% White non‐Hispanic, 81% male, and had an average age of 38 years. Frequencies and descriptive statistics were calculated. Female veterans and veterans of colour reported significantly higher levels of stress across most life domains. The results suggest White, male, post‐9/11 veterans may be somewhat protected from COVID‐19 stress, but that the pandemic is exacerbatinghealth and social disparities experienced by post‐9/11 veterans of colour and female veterans. Supports and comprehensive care, particularly targeted towardsat‐risk populations, are likely needed to provide sufficient resources for resiliency during and after the pandemic. [ABSTRACT FROM AUTHOR]

A substantial minority of veterans struggle as they reintegrate into civilian life, reporting problems with vocational attainment, legal/financial/housing challenges, physical and mental health conditions, and social/interpersonal issues. While there are thousands of programs and services offered to veterans, little is known about which ones they use. In the current exploratory study, veterans separated from active duty in the prior three-months (48,965) were invited to complete a survey. Two primary questions were addressed: What programs/services did veterans use to assist in their reintegration to civilian life? What specific components/attributes of those programs did veterans report using? A total of 9566 veterans completed the survey. Approximately, two-thirds of veterans used at least one program to enhance their well-being, while one-third reported using multiple programs across multiple domains. Veterans primarily sought assistance for employment and educational advancement. Fewer veterans sought assistance for legal/financial/housing, health, and social functioning challenges. Social service providers and policy makers should be aware of the resources veterans use as they reintegrate into civilian life. Future research should examine factors that predict the use and nonuse of veteran reintegration programs, how use changes over time, and what factors predict program/service use, particularly among veterans at risk for poor transition outcomes. [ABSTRACT FROM AUTHOR]

Transitioning from military to civilian life is challenging for a substantial number of veterans. Successful transitions require veterans to function well in various well-being domains including employment, education, financial, health, and social relationships. There are many programs and services designed to assist veterans transition to civilian life. However, veterans rarely avail themselves of supportive resources. This study examined veteran nonuse of programs and services within the first three months of their transition to civilian life. Results revealed that male veterans often reported that they did not need programs. Female veterans and veterans from the lowest enlisted ranks were more likely to report that they did not know if they were eligible for support programs. A small percentage of veterans indicated they had not found the right program or did not know where to go to get help. Veterans need clear information about available programs, eligibility requirements, where to locate them, and how to identify which programs will benefit them. Future research should focus on what predicts veteran use of programs and services, how use changes over time, and how programs and services should be advertised/marketed to different veteran populations, particularly those at risk for poor transition outcomes. [ABSTRACT FROM AUTHOR]

Developmental theory indicates that success during a major life change requires attention to multiple life domains (e.g., physical health, mental health, employment, financial, and social). This study presents a revised conceptual framework and offers a new empirical model to assess the well-being of post-9/11 veterans as they transition to civilian life. Data from a large sample of post-9/11 veterans surveyed over 2.5 years revealed that post-9/11 veteran transitions were mixed: veterans improved over time in some domains (e.g., employment), stagnated in some (e.g., social), and struggled more over time in others (e.g., physical health). Even in domains with improvement, a large percent of veterans still struggled (e.g., 34% struggled with mental health at Wave 6). Moreover, certain groups tended to struggle more (e.g., enlisted, women, people of color). The conceptual framework and empirical model are intended to stimulate discussion on how best to understand, evaluate, and support veterans’ military-to-civilian transition. [ABSTRACT FROM AUTHOR]