BACKGROUND: Despite a growing emphasis on psychological outcomes following military combat, few longitudinal studies have examined the combined role of risk and protective factors in the mental health of combat-exposed military personnel. This study characterizes the impact of resilience scale scores and combat exposure on mental health outcomes among Marines after separating from military service, along with intra-individual changes in mental health status. METHODS: Data were collected from longitudinal surveys of 475 active duty Marines attending a random sample of mandatory Transition Assistance Program workshops before leaving the military and responding to follow-up mail or web surveys an average of 6 months after returning to civilian life. RESULTS: Results revealed distinct risk and protective factors for those meeting screening criteria for mental health problems (depression, anxiety, and PTSD) and functional impairment at follow-up. Primary risk factors included experiencing higher levels of pre-separation combat exposure; post-separation stress across multiple life domains; and experiencing multiple areas of pain post-separation. Protective factors include having higher scores on pre-separation resilience and perceived social support at follow-up indices. We also identified a number of factors associated with change in mental health status from baseline to follow-up. LIMITATIONS: Generality is limited by a lower than expected follow-up response rate and an exclusively Marine sample. CONCLUSION: The role of resilience appeared to have a greater impact on functional impairment than on mental health symptoms per se. Findings provide important input for enhancing training programs and services intended to promote adjustment from military to civilian life. Additional emphasis on social support and coping with stress-related issues are needed in support of combat veterans.
BACKGROUND: Despite a growing emphasis on psychological outcomes following military combat, few longitudinal studies have examined the combined role of risk and protective factors in the mental health of combat-exposed military personnel. This study characterizes the impact of resilience scale scores and combat exposure on mental health outcomes among Marines after separating from military service, along with intra-individual changes in mental health status. METHODS: Data were collected from longitudinal surveys of 475 active duty Marines attending a random sample of mandatory Transition Assistance Program workshops before leaving the military and responding to follow-up mail or web surveys an average of 6 months after returning to civilian life. RESULTS: Results revealed distinct risk and protective factors for those meeting screening criteria for mental health problems (depression, anxiety, and PTSD) and functional impairment at follow-up. Primary risk factors included experiencing higher levels of pre-separation combat exposure; post-separation stress across multiple life domains; and experiencing multiple areas of pain post-separation. Protective factors include having higher scores on pre-separation resilience and perceived social support at follow-up indices. We also identified a number of factors associated with change in mental health status from baseline to follow-up. LIMITATIONS: Generality is limited by a lower than expected follow-up response rate and an exclusively Marine sample. CONCLUSION: The role of resilience appeared to have a greater impact on functional impairment than on mental health symptoms per se. Findings provide important input for enhancing training programs and services intended to promote adjustment from military to civilian life. Additional emphasis on social support and coping with stress-related issues are needed in support of combat veterans.
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