title: Longitudinal study of resilience and mental health in Marines leaving military service.
abstract: 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.
  
  
  CONCLUSIONS
  Generality is limited by a lower than expected follow-up response rate and an exclusively Marine sample.
  
  
  CONCLUSIONS
  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.
authors.affiliation: RTI International, 2769 Pleasant Acres Drive, Virginia Beach, VA 23453, United States. Hourani@rti.org
authors.forename: Laurel
authors.initials: L
authors.lastname: Hourani
authors.forename: Randall H
authors.initials: RH
authors.lastname: Bender
authors.forename: Belinda
authors.initials: B
authors.lastname: Weimer
authors.forename: Russ
authors.initials: R
authors.lastname: Peeler
authors.forename: Michael
authors.initials: M
authors.lastname: Bradshaw
authors.forename: Marian
authors.initials: M
authors.lastname: Lane
authors.forename: Gerald
authors.initials: G
authors.lastname: Larson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003130:Combat Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008889:Military Personnel / Q000523:psychology*; D008960:Models, Psychological; D011446:Prospective Studies; D055500:Resilience, Psychological; D012307:Risk Factors; D012944:Social Support; D014728:Veterans / Q000523:psychology*