title: Postdeployment resilience as a predictor of mental health in operation enduring freedom/operation iraqi freedom returnees.
abstract: BACKGROUND
  Much of the research on the impact of trauma exposure among veterans has focused on factors that increase risk for mental health problems. Fewer studies have investigated factors that may prevent mental health problems following trauma exposure. This study examines resilience variables as factors that may prevent subsequent mental health problems.
  
  
  OBJECTIVE
  To determine whether military service members returning from Afghanistan and Iraq who exhibit higher levels of resilience, including hardiness (encompassing control, commitment, and challenge), self-efficacy, and social support after returning from deployment are less vulnerable to subsequent mental health problems, alcohol, and drug use.
  
  
  METHODS
  A national sample of 512 service members was surveyed between 3 and 12 months of return from deployment and 6-12 months later. Data were collected in 2008-2009 and analyzed in 2013. Regression analyses ascertained whether resilience 3-12 months after return predicted later mental health and substance problems, controlling for demographic characteristics, mental health, and risk factors, including predeployment stressful events, combat exposure, and others.
  
  
  RESULTS
  Greater hardiness predicted several indicators of better mental health and lower levels of alcohol use 6-12 months later, but did not predict subsequent posttraumatic stress symptom severity. Postdeployment social support predicted better overall mental health and less posttraumatic stress symptom severity, alcohol, and drug use.
  
  
  CONCLUSIONS
  Some aspects of resilience after deployment appear to protect returning service members from the negative effects of traumatic exposure, suggesting that interventions to promote and sustain resilience after deployment have the potential to enhance the mental health of veterans.
authors.affiliation: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Health Policy and Management, Boston University School of Public Health, Boston, Massachusetts. Electronic address: susan.eisen@va.gov.
authors.forename: Susan V
authors.initials: SV
authors.lastname: Eisen
authors.affiliation: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Schultz
authors.affiliation: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Health Policy and Management, Boston University School of Public Health, Boston, Massachusetts.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Glickman
authors.affiliation: Division of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts; Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, Veterans Affairs Boston Healthcare System, Boston, Massachusetts.
authors.forename: Dawne
authors.initials: D
authors.lastname: Vogt
authors.affiliation: Bryn Mawr College, Bryn Mawr, Pennsylvania.
authors.forename: James A
authors.initials: JA
authors.lastname: Martin
authors.affiliation: Center for Chronic Disease Outcomes Research and Polytrauma and Blast-Related Injuries QUERI, Minneapolis Veterans Administration Health Care System, Minneapolis, Minnesota.
authors.forename: Princess E
authors.initials: PE
authors.lastname: Osei-Bonsu
authors.affiliation: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Health Policy and Management, Boston University School of Public Health, Boston, Massachusetts.
authors.forename: Mari-Lynn
authors.initials: ML
authors.lastname: Drainoni
authors.affiliation: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Health Policy and Management, Boston University School of Public Health, Boston, Massachusetts.
authors.forename: A Rani
authors.initials: AR
authors.lastname: Elwy
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D003130:Combat Disorders / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D055500:Resilience, Psychological; D012307:Risk Factors; D012944:Social Support; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*