title: The impact of social support, unit cohesion, and trait resilience on PTSD in treatment-seeking military personnel with PTSD: The role of posttraumatic cognitions.
abstract: The personal resources of social support, unit cohesion, and trait resilience have been found to be associated with posttraumatic stress disorder (PTSD) severity among military personnel. However, the underlying mechanisms of these relationships are unclear. We hypothesized that negative posttraumatic cognitions, which are associated with PTSD, mediate the relationships between these personal resources and PTSD.
  
  
  
  The relationship between PTSD symptom severity and a latent factor comprised of social support, unit cohesion, and trait resilience was evaluated using cross-sectional data from 366 treatment-seeking active duty military personnel with PTSD following deployments to or near Iraq or Afghanistan. Structural equation modeling (SEM) was used to test whether posttraumatic cognitions mediated this relationship.
  
  
  
  The SEM model indicated that (1) a robust latent variable named personal resources (indicated by social support, unit cohesion, and trait resilience) was negatively associated with PTSD severity; (2) personal resources were negatively associated with negative posttraumatic cognitions; (3) negative posttraumatic cognitions fully mediated the association between personal resources and PTSD severity. The final SEM mediation model showed a highly satisfactory fit [χ2(22) = 16.344, p = 0.798; χ2/df = 0.743; CFI = 1; RMSEA = 0.000].
  
  
  
  These findings suggest that among active duty military personnel seeking treatment for PTSD, personal resources (social support, unit cohesion, and trait resilience) may mitigate PTSD severity by reducing negative posttraumatic cognitions.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: yinyinz@mail.med.upenn.edu.
authors.forename: Yinyin
authors.initials: Y
authors.lastname: Zang
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Thea
authors.initials: T
authors.lastname: Gallagher
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Carmen P
authors.initials: CP
authors.lastname: McLean
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Hallie S
authors.initials: HS
authors.lastname: Tannahill
authors.affiliation: Headquarters, Carl R. Darnall Army Medical Center, Fort Hood, TX, USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Yarvis
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Edna B
authors.initials: EB
authors.lastname: Foa
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D008960:Models, Psychological; D015233:Models, Statistical; D010342:Patient Acceptance of Health Care; D055500:Resilience, Psychological; D012720:Severity of Illness Index; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy; D000067453:War Exposure
keywords: Military personnel; PTSD; Posttraumatic cognitions; Resilience; Social support; Unit cohesion