Objectives: Civilian reintegration is the process of military personnel transitioning back into personal and organizational roles following deployment. Our newest generation of veterans is faced with the task of reintegrating into potentially disrupted family, social, and occupational roles. Civilian reintegration may be particularly challenging for National Guard and Reserve (NGR) component service members. A key feature of the reintegration process in this population is the transition away from and back to civilian employment. Issues related to employment, including job concerns, job change, job stress and job support, may be important risk factors in the development of post-deployment mental health symptoms. The aim of this dissertation research was to examine, in a cohort of NG military veterans returning to civilian work after deployment to Iraq, these job-related issues and their role in the development of post-deployment mental health symptoms. Methods: We utilized prospective, longitudinal data from the Readiness and Resilience in National Guard Soldiers (RINGS) study, a study of risk and protective factors associated with post-deployment functioning. Pre-deployment data was collected in a cohort of 522 National Guard soldiers from a single brigade one month prior to deployment to Iraq (Time 1). Troops were deployed from March 2006 to July 2007. Post-deployment data was collected by mailed self-report questionnaires 2-3 months after brigade return (Time 2), and again approximately one and two years later (Times 3 and 4). A total of 424 veterans (81%) completed Time 2 questionnaires, 343 veterans (66%) completed Time 3 questionnaires, and 296 veterans (57%) completed Time 4 questionnaires. A smaller occupational cohort completed two interviews following completion of the Time 2 and Time 3 mailed questionnaires; a total of 355 completed an interview after Time 2 that gathered information on pre-deployment work history and current occupational status. Of those, 297 (84%) completed a second interview on occupational functioning after completing the mailed questionnaire at Time 3, and 208 (59%) completed the final mailed questionnaire at Time 4. Both dissertation papers estimated models with the same dependent variables, post-traumatic stress disorder (PTSD) as assessed with the PTSD Checklist - Military Version (PCL-M), and depression, as assessed with the Beck Depression Inventory-II (BDI-II). Linear regression models were employed to examine the effects of job concerns, job stress, and job support on post-deployment symptoms of PTSD and depression. A "differences-in-differences" model was used to determine whether a post-deployment civilian job change affects post-deployment symptoms of PTSD and depression.Results: We found significant correlations and significance in multivariate models controlling for demographics and combat exposure between job concerns and symptoms of both depression and PTSD; this was particularly true when job concerns were assessed prior to deployment. Job change had no significant effect on symptoms of either PTSD or depression, in contrast to our hypotheses. Finally, results indicated that perceived job stress and poor coworker support contribute to symptoms of depression in NG veterans over two years after returning from Iraq. Job stress may also contribute to an increase in symptoms of PTSD in some NG veterans.Conclusions: NGR veterans face unique challenges post-deployment as their military service is relatively part-time and they retain commitments to civilian jobs despite involvement in protracted or multiple deployments. We've identified the pre-deployment time period as a potential time to address latent civilian reintegration issues related to employment uniquely experienced by NG service members, namely job concerns regarding leaving and returning to civilian employment. In addition, we've shown that employment-related strains and stressors are associated with the development of post-deployment mental health symptoms; job stress and poor coworker support contribute to symptoms of depression in NG veterans over two years after returning from Iraq. In addition, job stress may also contribute to an increase in symptoms of PTSD in some NG veterans not already experiencing symptoms in the early post-deployment time period. Overall, this research provides insights that have important implications for research and practice in this special population of veterans.
University of Minnesota Ph.D. dissertation. December 2013. Major: Environmental Health. Advisors: Patricia M. McGovern and Bryan E. Dowd. 1 computer file (PDF); ix, 133 pages.
Schult, Tamara Marie Knudson.
The effects of job-related strains and stressors on mental health symptoms in National Guard veterans returning from Iraq.
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