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pdfJuly 2010
Resilience, Combat Exposure, and
Mental Health of Military Personnel
Transitioning to Civilian Life
Final Report- Pilot Test Follow-Up Survey
Prepared for
Jerry Larson, Ph.D.
Naval Health Research Center
San Diego, CA
Prepared by
Laurel Hourani
Randy Bender
Russ Peeler
Marian Lane
BeLinda Weimer
RTI International
3040 Cornwallis Road
Research Triangle Park, NC 2770
RTI Project Number 0211675.000.001
CONTENTS
Section
Page
Acknowledgements .................................................................................................................. vi
Abstract ................................................................................................................................... vii
1
INTRODUCTION ........................................................................................................ 1-1
2
Methods ........................................................................................................................ 2-1
2.1 Measures .............................................................................................................. 2-1
2.1.1 Explanatory Variables .............................................................................. 2-1
2.2 Outcomes ............................................................................................................. 2-5
2.3 Data Collection Procedures.................................................................................. 2-8
2.4 Mail Survey.......................................................................................................... 2-9
2.4.1 Web Survey............................................................................................ 2-10
2.5 Data Cleaning and Editing ................................................................................. 2-10
3
RESULTS ..................................................................................................................... 3-1
3.1 Respondents and Response Rates ........................................................................ 3-1
3.2 Nonresponse Bias Analysis.................................................................................. 3-1
3.3 Follow-Up Survey Nonresponse Weighting ...................................................... 3-15
3.4 Psychometric Analysis of Survey Scales ........................................................... 3-16
3.5 Descriptive Statistics .......................................................................................... 3-19
3.6 Estimate of Current Prevalence of Mental Health Outcomes among
Separated Marines ........................................................................................... 3-123
4
DISCUSSION ............................................................................................................... 4-1
4.1.1 Limitations ............................................................................................... 4-3
4.1.2 Recommendations for Future Research and Analyses............................. 4-4
4.2 Next Steps ............................................................................................................ 4-4
5
REFERENCES ............................................................................................................. 5-1
iii
LIST OF TABLES
Number
3-1.
3-2.
3-3.
3-4.
3-5.
3-6.
3-7.
3-8.
3-9.
3-10.
3-11.
3-12.
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3-14.
3-15.
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Page
Comparison of Study Sample to Population of Separating Sailors and Marines
in 2007 ....................................................................................................................... 3-3
Nonresponse Analysis—Navy Sample ...................................................................... 3-4
Nonresponse Analysis—Marine Corps Sample....................................................... 3-10
Confirmatory Factor Analysis Results—Selected Fit Statistics .............................. 3-17
Coefficient Alphas for Individual Scale Factors ...................................................... 3-18
Distribution of Follow-Up Scale Scores for Separated Navy and Marine Corps
Personnel .................................................................................................................. 3-19
Sample Characteristics of Transition Study Participants by Service Branch .......... 3-21
Sample Characteristics of Transition Study Participants by Resilience .................. 3-32
Sample Characteristics of Transition Study Participants by Anxiety Level ............ 3-43
Sample Characteristics of Transition Study Participants by Depression ................. 3-54
Sample Characteristics of Transition Study Participants by Substance Abuse ....... 3-65
Sample Characteristics of Transition Study Participants by PTSD ......................... 3-76
Sample Characteristics of Transition Study Participants by Suicidal Ideation........ 3-87
Sample Characteristics of Transition Study Participants by Any Mental Health
Problem .................................................................................................................... 3-98
Comparison of Separators versus Nonseparators on Various Variables ............... 3-110
Comparison of Consenters versus Nonconsenters on Mental Health Variables.... 3-116
Prevalence and Incidence of Major Mental Health Outcomes .............................. 3-122
Means, Standard Deviations, Reliability Estimates, and Correlations of
Independent and Dependent Variables (N = 764) .................................................. 3-124
Full and Reduced Model Hierarchical Regression Results (N = 764) ................... 3-126
Summary of Logistic Regression Results for Full and Reduced Models of FU
Anxiety (N = 764) .................................................................................................. 3-128
Summary of Logistic Regression Results for Full and Reduced Models of FU
Depression (N = 764) ............................................................................................. 3-129
Relationship of Follow-Up Anxiety and Depression with Individual Stress
Index Components ................................................................................................. 3-131
iv
ACKNOWLEDGEMENTS
The authors wish to thank Kim Aspinwall, Data Collection Task Leader; Carrie Borst,
Project Manager; Sharon Barrell and Richard Hair, Editors; and Jennifer Iriondo-Perez,
Statistician, for their helpful support.
v
ABSTRACT
Since the beginning of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF),
hundreds of thousands of Service members have transitioned from military to civilian life, many
of whom have been exposed to deployment stressors that may have lasting psychological costs.
The goal of this study was to prospectively examine, in Sailors and Marines readjusting to
civilian life, the interrelationships between combat and Service-related variables, a wide range of
other risk and protective factors, and subsequent anxiety and depression symptoms. Participants
were Sailors and Marines attending mandatory Transition Assistance Program (TAP) workshops
while preparing to discharge from the military. All participants completed baseline
questionnaires and were subsequently separated from military service and locatable for a followup survey at approximately 1 year post-separation. Results showed a drop in the overall
prevalence of anxiety and depression for both Sailors and Marines from baseline to follow-up,
but also numerous new cases in both categories (between 9% and 31%). The percentage of
participants reporting new posttraumatic stress disorder (PTSD) symptoms at the time of followup exceeded the percentage reporting symptom reduction between baseline and follow-up. The
strongest risk factors for anxiety and depression at time of follow-up were self-reported stressors,
baseline anxiety or depression symptoms, and risk-taking behaviors. With the exception of social
support, protective factors, including resilience scores, accounted for a relatively minor amount
of the variance compared with risk factors. Findings suggest that additional stress management
and programs to maximize social support should be implemented for transitioning military
personnel.
Key Words: Resilience; military; combat stress; mental health; PTSD
vi
SECTION 1
INTRODUCTION
In 2008, RTI International and the Naval Health Research Center (NHRC) completed the
baseline pilot survey of the Mental Health Assessment of Transitioning Military Personnel
project, a comprehensive examination of stress and mental health indicators in Navy and Marine
personnel who were in the process of separating from the military. A paper-and-pencil
questionnaire was administered to 3,753 active-duty Navy and Marine Corps personnel in the
Transition Assistance Program (TAP) during routine mandatory separation counseling via group
administration. The baseline (BL) survey included selected items from the Post-Deployment
Health ReAssessment (PDHRA), along with additional questions on risk and protective factors
for civilian readjustment and mental health outcomes.
Results from the BL survey showed that past month prevalence rates ranged from 5% for
suicidal ideation among Navy TAP attendees to 52.5% for past year substance abuse among
Marines. Excluding substance abuse, high rates of any mental health symptoms excluding
substance abuse were found among both transitioning Sailors and Marines, with Marine Corps
rates significantly higher than those for the Navy (55% and 40%, respectively).
Rates for depression in transitioning Marines were three times as high as the rates noted
by Hoge and colleagues (2004; 14.7% vs. 49.2%), and rates for anxiety were twice as high
(15.7% vs. 31%). These rates support the concern voiced in several recent reports (e.g., APA,
2007) that many personnel may be first experiencing or admitting to problems upon their
discharge from the military and suggest that the transition process itself may be contributing to
the development and/or exacerbation of mental health symptoms.
To further explore this issue, RTI and NHRC conducted a longitudinal follow-up (FU)
survey, administered an average of twelve months after baseline participants were discharged
from active duty, to assess the prevalence of mental health symptoms among Sailors and Marines
transitioning out of the Service and to identify predictors of mental health resilience and changes
in mental health and resilience over time. This report details the methods and findings of this FU
survey.
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SECTION 2
METHODS
2.1
Measures
In addition to sociodemographic variables (including gender, age, current marital status,
number of dependent children, race/ethnicity, employment status, income, and health care
coverage) and a number of combat and Service-related variables, this study also examined a
large number of additional potential risk and protective factors for mental health outcomes.
2.1.1 Explanatory Variables
Social Support. The Deployment Risk and Resilience Inventory (DRRI) is an inventory
of risk and resilience measures associated with possible military deployment stress-related
reactions that may have implications for veterans’ long-term health (King, King, & Vogt, 2003).
One of the DRRI’s 14 scales was modified and used to assess social support. The15-item
Postdeployment Social Support Scale assesses the extent to which family, friends, coworkers,
employers, and community provide emotional sustenance and instrumental assistance. Emotional
sustenance refers to the extent to which others provide the individual with understanding,
companionship, a sense of belonging, and positive self-regard. Instrumental assistance refers to
the extent to which the individual receives tangible aid such as help to accomplish tasks and
material assistance or resources. Respondents rated 12 of the 15 items on a scale ranging from 1
(strongly agree) to 5 (strongly disagree). For this study, the question timeframe was modified
from ―while you were deployed‖ to ―your current relationships.‖ The items were summed and
turned into trichotomous categorical variables using the first and third quartile split.
Health-Related Quality of Life. The 20-item Medical Outcomes Study (MOS) ShortForm (SF-20) was adapted from longer surveys used successfully in the Health Insurance
Experiment. The SF-20 assesses six important health concepts: physical functioning (six items),
role functioning (two items), social functioning (one item), mental health (five items), current
health perceptions (five items), and pain (one item). Support for the reliability and construct
validity of the SF-20 is provided in previously published documents (Stewart et al., 1988; Ware
& Sherbourne, 1992). For this study, only the concepts of pain, mental health, and current health
perceptions were measured. The MOS Pain Indicator was derived directly from the question that
asked the respondents how much bodily pain they had experienced in the past 4 weeks. Only
four of the five current health perceptions items were used. Two items were reverse scored; the
other two were not. If a respondent was missing two of the four items, the overall score was
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missing. This scale was also trichotomized into a categorical variable using the first and third
quartiles.
Life Events. The 17-item Postdeployment Stressors Scale from the DRRI assesses
exposure to stressful life events after deployment (King et al., 2003). The Postdeployment
Stressors Scale uses ―yes‖ or ―no‖ response options to generally stressful events that are
unrelated to deployment (such as vehicular accidents, physical assaults, and death or serious
illness of a relative) and events that may be related to efforts at reintegration (especially for
National Guard and Reserves), such as job interruption, difficulties in reestablishing family and
community roles, legal or financial difficulties, and divorce. For this study, the question’s time
frame was modified from ―since your last deployment‖ to ―since leaving the military.‖ In
addition, four items were added that assessed stress from problems accessing health care,
controlling temper, being fired, getting divorced/being left by significant other, and having a
serious illness. The Stressors Index is the sum of responses from the items across two questions
and turned into a trichotomous categorical variable using the first and third quartile split.
Combat and Service variables included injury or health problems related to military
experience, and combat exposure. Combat exposure was assessed using 17 items describing
potentially traumatic combat experiences (e.g., ―I saw dead bodies or human remains‖; ―I was
wounded in combat‖). These items were modified from four different measures of combat
trauma, including items used previously in research on recent conflicts (Hoge et al., 2004), the
DRRI (King et al., 2003), and the 7-item Combat Exposure Scale (CES; Keane et al., 1989).
They were adapted so that participants could answer all of them using the same response format.
Additionally, minor modifications were made in consultation with Marine Corps personnel so
that the questions would reflect conditions common in current deployment contexts. For this
study, an item was added regarding questioning of detainees or prisoners. Respondents rated the
frequency with which they had experienced each event on a scale ranging from 1 (never) to 5
(51+ times). Responses are summed across items to compute a total combat trauma score. A
respondent who was missing any of the items also had a missing overall score.
Stress. Participants were asked how much stress they experienced during the past year
due to a variety of circumstances or situations related to work, family, and health, rating each of
the 20 items from 1 (a lot) to 4 (none at all). This item was modified from the original used in the
DoD Survey of Health Related Behaviors Among Active Duty Military Personnel (Bray et al.,
2006). The life event stress (past 12 months) flag was created by summing the number of times a
respondent said ―a lot‖ to 20 different life events.
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Respondents were also asked two items that assessed the amount of stress they
experienced while at work and in their family life since leaving the military. Respondents rated
their stress on a scale from 1 (a lot) to 4 (none at all). If respondents said that they had
experienced ―a lot‖ of the type of stress, they were assigned the flag. The flag for spouse stress
was slightly different; if respondents indicated ―a lot,‖ ―some,‖ or ―a little‖ stress in this domain,
they were assigned the flag.
Overall stress index. The stress index is a sum score of individual domain indicators.
Domains are made up of 2 to 11 individual FU survey items. Each individual domain indicator is
set to 1 when any single item within that domain is endorsed as a source of stress. As a check on
the construction of the stress index, individual items were correlated with all the domain
indicators, and in no case did an individual stress item correlate with another domain indicator
more highly than with its own domain indicator. The nine domains that are summed to create the
stress index are the
Workplace stress domain, comprised of FUQ40_WORKSTRESS,
FUQ47c_INLOAD_STRESS, FUQ47d_DELOAD_STRESS,
FUQ47a_REL_STRESS, FUQ47b_SUPER_STRESS;
Unemployment stress domain, comprised of FUQ68i_LOST_JOB,
FUQ68l_FIREDJOB, FUQ47s_EMPLOYMENT, FUQ47t_JOBSKILLS,
FUQ68d_UNEMP;
Family stress domain, comprised of FUQ45_FAMSTRESS,
FUQ47e_CONFLICT_STRESS, FUQ47f_BABY_STRESS,
FUQ47g_DAYCARE_STRESS, FUQ47n_FAMHLTH_STRESS,
FUQ47o_CHLDBEHAV_STRESS, FUQ63a_GRADES, FUQ63b_BEHAVIOR,
FUQ63c_SOCIAL, FUQ63d_BULLY, FUQ63e_SUBUSE;
Serious Event stress domain, comprised of FUQ68c_FAMDRUG,
FUQ47h_DEATH_STRESS, FUQ67f_CLOSEDEATH, FUQ67e_MENTAL;
Marital stress domain, comprised of FUQ46_SPSTRESS, FUQ47i_DIV_STRESS,
FUQ47j_INFIDELITY_STRESS, FUQ68m_DIVORCE;
Legal stress domain, comprised of FUQ67g_LEGALPROB, FUQ35_ARRESTED,
FUQ36_WARRANTS, FUQ37_PROBATION; and
Money stress domain, comprised of FUQ47k_MONEY_STRESS, FUQ9_BILLS,
FUQ10_MORTGAGE, FUQ11_DEBTS, FUQ47l_HOUSE_STRESS.
Mental Health stress domain being comprised of: FUQ47r_GETALONG,
FUQ68k_TEMPER;
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Health stress domain being comprised of: FUQ47q_HLTHCARE_STRESS,
FUQ68j_PROBCARE, FUQ47m_HEALTH_STRESS, FUQ68n_ILLNESS,
FUQ67d_SURGERY.
Risk-taking/sensation-seeking. This scale includes nine items. These items were the same
as those analyzed in the 1990 National Alcohol Survey (Cherpitel, 1993). The items ask the
respondents to rate how well each of nine statements describes them, with five risk-taking or
impulsivity statements and four sensation-seeking or thrill-seeking statements. The items are
reverse coded (e.g., a response of 4 becomes 1) so that higher scores indicate more risktaking/sensation-seeking. The score is computed as the mean of the converted ratings.
Health Behaviors. Health behaviors were also assessed with several items from the DoD
Survey of Health Related Behaviors Among Active Duty Military Personnel (Bray et al., 2006).
Specifically, the following items were used to measure a variety of health-related behaviors:
Amount of moderate and vigorous physical activity in the past 30 days was indicated by
number of days ranging from ―about every day‖ to ―less than 1 day per week.‖ If a respondent
indicated that they participated in moderate or vigorous physical activity at least 3 days per
week, then they were assigned the physically active flag.
Current cigarette smokers were defined as those who last smoked a cigarette during the
past 30 days. Respondents who had smoked cigarettes in the past 30 days were assigned the flag
for current smoker.
Spirituality. Religious or spiritual practices were measured with three items from the
DoD Survey of Health Related Behaviors Among Active Duty Military Personnel (Bray et al.,
2006) that asked about the number of times respondents attended religious/spiritual services
since leaving the military, degree of agreement that religious/spiritual beliefs are an very
important part of their life, and degree of agreement that their religious/spiritual beliefs influence
how they make decisions in their life. Respondents answer the agreement questions on a scale
from 1 (―strongly agree‖) to 4 (―strongly disagree‖). For the DoD survey, respondents were
categorized as high if they reported ―strongly agree‖ to the latter two items, medium if they
reported either ―strongly agree‖ or ―agree‖ to at least one of these two questions, and low if they
reported either ―disagree‖ or ―strongly disagree‖ to both questions. The question about
attendance was not used in this scale. The Strong Religious Influence variable used in the
modeling is Q46 reverse-coded so that higher values indicated higher self-reported influence of
religious beliefs on life decisions.
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Utilization of Mental Health Services. Use of mental health services was measured using
a modified version of three items from the DoD Survey of Health Related Behaviors Among
Active Duty Military Personnel (Bray et al., 2006). Respondents were asked to report ―yes‖ or
―no‖ on the sources of any mental health services since leaving the military (e.g., mental health
professional at a VA facility, civilian mental health professional, self-help group, religious or
pastoral counseling). In addition, respondents were asked to identify the concerns for which they
sought counseling or therapy in the past 12 months, such as depression, anxiety, family
problems, substance use problems, anger management, stress management, and
combat/operational stress. Perceived need for mental health services in the past 12 months was
measured by a ―yes‖ or ―no‖ item: ―Since leaving the military, have you felt you needed
counseling or therapy from a mental health professional?‖
Physical Health Problems. The Post-Deployment Health Reassessment (PDHRA)
Program (DD Form 2900) is administered during the 3- to 6-month time period after return from
deployment. The content of the PDHRA was designed by DoD and VA clinicians, and it
includes screens for posttraumatic stress disorder (PTSD) symptoms, interpersonal conflict,
alcohol abuse, and depression (DoD, 2006). Three items from the PDHRA—although slightly
modified for this study—were used to assess physical health problems. Respondents were asked
to identify any health concerns or conditions (e.g., chronic cough, ringing in the ears, chest pain
or pressure). For this study, the item was revised to make it more general and current and was
modified to read ―Please mark the items that best describe your current health concerns or
conditions.‖ In addition, respondents were asked to report ―yes‖ or ―no‖ if their doctor ever told
them they had any of the following: asthma, emphysema, or chronic bronchitis; hypertension;
diabetes; respiratory illness; heart attack; high cholesterol; serious wound or injury; depression or
mental health problem; and cancer. Respondents were also asked, ―Since leaving the military,
have you been hospitalized due to a serious illness, medical condition, or injury?‖ If respondents
answered ―yes,‖ they were asked to report the illnesses or medical conditions for which they
were hospitalized.
2.2
Outcomes
Resilience. The Connor-Davidson Resilience Scale (CD-RISC) was used to measure
resilience and resilience trajectories (Connor & Davidson, 2003). This 25-item self-rated
assessment measures resilience and stress coping over the past month and is the first widely used
scale to address the increasingly important topic of resilience. Each item is rated from 0 (―not at
all true‖) to 4 (―true nearly all of the time‖). The scoring range is between 0 and 100. Higher
scores correspond to greater resilience. The scale builds on the work of previous researchers on
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hardiness, action orientation, self-efficacy, confidence, adaptability, patience, and endurance in
the face of adversity. The CD-RISC has been tested in both community and clinical samples and
has demonstrated good internal consistency (Cronbach’s alpha = 0.89) and test-retest reliability
(r = 0.87). Factor analysis has revealed five factors with eigenvalues ranging from 7.47 to 1.07,
as follows: (1) reflects the notion of personal competence, high standards, and tenacity; (2)
corresponds to trust in one’s instincts, tolerance of negative affect, and strengthening effects of
stress; (3) relates to the positive acceptance of change and secure relationships; (4) relates to
control; and (5) relates to spiritual influences. When compared with other measures, the scale
exhibits validity relative to stress and hardiness and reflects different levels of resilience in
differentiated populations. The scale is sensitive to the effects of treatment, and clinical
improvement is accompanied by up to a 25% increase in resilience, depending on the level of
global improvement. According to its developers, the scale demonstrates that resilience is
quantifiable and modifiable and can improve with pharmacologic and psychotherapeutic
interventions (Davidson et al., 2006). Items were reverse scored and summed. If up to five items
were missing, those items were imputed with the mean across the items that were not missing.
Alcohol and Drug Abuse. Current alcohol or drug abuse was measured with a revised
two-item conjoint screen (TICS) for alcohol and other drug abuse or dependence. Research in
patient populations has shown that current alcohol or other drug problems can be detected in
nearly 80% of young and middle-aged people using these items (Brown, Leonard, Saunders, &
Papsouliotis, 2001). This measure has also been used successfully in military population health
research (Hoge et al., 2004). Respondents answered ―yes‖ or ―no‖ to the questions ―Since
leaving the military, have you ever drunk alcohol or used drugs more than you meant to?‖ and
―Have you felt you wanted or needed to cut down on your drinking or drug abuse since leaving
the military?‖ The TICS score is the sum of two items asking about the respondent’s drug and
alcohol use. If respondents scored at least one, out of a possible two, they were given the
indicator for substance abuse.
Need for Further Depression Evaluation. The 20-item Center for Epidemiologic Studies–
Depression Scale (CES-D) (Radloff, 1977) was used to assess depressive symptoms. Intended
for self-report use in a general population, the scale has been used in many studies, including
those with military populations, and has a coefficient alpha of 0.85 (Radloff, 1991). Respondents
are asked if they have felt depressed, happy, lonely, sad, etc., during the past week. For this
study, the response option scale was put in reverse order so that respondents rated their feelings
or behavior on a scale of 1 (―most or all of the time‖) to 4 (―rarely or none of the time‖). Items
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Resilience among Military Personnel, Follow-Up Survey
were summed, and a cutoff score of 16 was used to indicate need for further depression
evaluation. The total score for the scale is missing if more than three of the items were missing.
Need for Further Anxiety Evaluation. Seven items from the Patient Health Questionnaire
(PHQ) were used to assess need for further anxiety evaluation. These items are widely used to
screen for generalized anxiety symptoms (Spitzer, Kroenke, & Williams, 1999; Bray et al.,
2006). Respondents screen positive if they report they had been bothered by feeling nervous,
anxious, or on edge or by worrying a lot about different things for several days in the past month
and had at least three other symptoms for more than half the days. Other symptoms include
getting tired easily; muscle tension, aches, or soreness; trouble sleeping; trouble concentrating;
becoming easily annoyed or irritable; and feeling restless so that it is hard to sit still.
Need for Further Posttraumatic Stress Disorder (PTSD) Evaluation. The presence or
absence of PTSD symptoms was evaluated with the use of the National Center for PTSD
Checklist of the Department of Veterans Affairs–civilian version (PCL-C) (Weathers, Litz,
Huska, & Keane, 1994), which consists of a set of 17 items that ask about experiences related to
PTSD. Items include characteristics such as loss of interest in activities that used to be enjoyable,
being extremely alert or watchful, having physical reactions when reminded of a stressful
experience, and feeling jumpy or easily startled. Respondents are asked to indicate how much
they had been bothered by each of the 17 statements; response options were reverse ordered for
this study and include ―extremely,‖ ―quite a bit,‖ ―moderately,‖ ―a little bit,‖ and ―not at all.‖
Each statement is reversed scored from 0 to 4, and a sum for all items is computed. The standard
cut-off was used such that if the sum is greater than or equal to 50, participants are classified as
positive for PTSD (Lang & Stein, 2005). A second item, though not part of the PCL-C, asked
respondents to indicate how long in general they have experienced these problems. Response
options included ―never,‖ ―less than 1 month,‖ ―1 month,‖ ―2 to 3 months,‖ ―4 to 6 months,‖ or
―7 months or longer.‖
Suicidal Ideation. Respondents were flagged as having suicidal thoughts if they
responded to the PDHRA item that they had ―been bothered by thoughts that [they] would be
better off dead or hurting [themselves] in some way‖ in the past month.
Any Mental Health Problem. If respondents had any of the previously described
indicators (PTSD, depression, anxiety, or suicide ideation), then they were given the flag for any
mental health problem.
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2.3
Data Collection Procedures
The FU survey consisted of a mailed paper-and-pencil questionnaire with the option of
completing the questionnaire via the Web. All participants from the BL survey who had
separated from military service since completion of the BL survey (as identified by loss code in
the CHAMPS database) were eligible for the second phase of study, and their participation in the
FU survey was requested by mail. The time between their transition to civilian life and the FU
survey ranged from 2 to 21 months and averaged 12 months.
Before fielding the FU survey, RTI verified the appropriate mailing address for all
individuals using the following procedures. First, we examined the quality of contact information
(address, phone, and e-mail) provided in the BL questionnaire. If no good address could be
obtained in this manner, cases were sent to RTI’s Tracing Operations (TOPS) unit for batch and
intensive tracing as necessary. Approximately 4.1% of cases sent to batch tracing received
updated address information. Once batch tracing was completed, any cases still needing address
information were sent to intensive tracing. In conducting intensive tracing, RTI’s tracing
operations staff first attempted to contact the selected individual or a member of his or her family
using the contact information the respondent provided on the baseline survey and/or the contact
information the respondent entered into the project Web site after relocating. Additionally, TOPS
tracers used a variety of other procedures in an effort to obtain the sample member’s current
address. These included (1) checking numerous forms of directory assistance for telephone
listings at various addresses; (2) using electronic criss-cross directories to obtain the names and
telephone numbers of current residents or neighbors of the sample members’ previous addresses
and then calling the current residents or neighbors; (3) calling persons with the same unusual
surname in small towns or rural areas to see if they are related to or know the sample member;
(4) contacting current or last known residential sources such as landlords and/or accessing tax
assessors’ records of homeownership; and (5) accessing advanced tracing sources. RTI TOPS
tracers also utilized multiple nationwide databases to locate and verify current addresses,
including credit bureaus, consumer and census-oriented databases, state Department of Motor
Vehicle records, the U.S. Postal Service National Change of Address database, Telematch, death
indices, Social Security files, ProCD, and Internet directory services. During the FU survey
fielding period, any undeliverable mail received by RTI that did not include address updates
from the postal service were also sent for intensive tracing on a periodic basis. Approximately
67.3% of all cases sent for intensive tracing received updated address information.
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2.4
Mail Survey
First Questionnaire Mailing. A first questionnaire packet was sent to all baseline
participants whom we could verify a separation date for in wave one. In wave two we included
all other baseline participants. The packet included a cover letter that reminded participants of
their earlier consent to participate, referenced the online survey option, and provided a unique
login ID, as well as a hardcopy questionnaire and a postage-paid return envelope. Follow-up
questionnaires were litho coded with the participant’s unique ID. Respondents were asked to
provide updated address information in the event the questionnaire had been forwarded but not to
write names or Social Security numbers on the questionnaire.
First Thank You/Reminder Card. Within approximately 1 week of mailing the first
questionnaire packet, RTI mailed a ―thank you/reminder‖ card to all of the sample members.
This mailing thanked respondents for returning their completed questionnaires and prompted
participation from nonrespondents. The postcard also included the online survey URL and the
sample member’s personal login ID. The postcards were folded in half with sealed edges,
thereby concealing the personalized login information (i.e., the IDNUM and PASSWORD) on
the inside surface and preventing the information from being seen through from the outside.
Second Questionnaire Mailing. Within approximately 1 week of mailing the ―thank
you/reminder‖ card, RTI sent a second mailing to all eligible sample members who had not
submitted a completed questionnaire either by mail or by the Web. The second mailing consisted
of a more strongly worded cover letter stressing the importance of the study, a replacement
questionnaire, and a return postage-paid envelope. The cover letter again provided a login ID and
password for respondents to use with the Web survey.
Second Thank You/Reminder Card. Within approximately 1 week of mailing the
second questionnaire packet, we mailed a ―thank you/reminder‖ letter to all of the sample
members who were sent the second questionnaire mailing. The content followed that of the first
thank you/reminder card. Those who (1) had completed the survey, (2) were ineligible, (3) were
nonlocatable (no good address is available, or all addresses found are nondeliverable), (4) had
requested not to be contacted again, and (5) had not completed the survey after the second
reminder mailing were eliminated from subsequent contacts.
Help Desk Hotline. RTI maintained a Help Desk Hotline for the duration of the FU
survey. The hotline was accessible via both a toll-free number as well as a non-toll-free option.
This helpdesk was manned by trained project staff who were available to answer questions about
2-9
Resilience among Military Personnel, Follow-Up Survey
the study, update contact information, reissue passwords, assist respondents in accessing the
Web site, or assist in completing the Web survey.
Receipt of Mail Surveys. Survey materials were returned to our scoring contractor, SC
Data, using preaddressed, prebarcoded business reply envelope. SC Data hand-keyed received
surveys and stored the keyed surveys in locked cabinets in a secured area.
2.4.1 Web Survey
A Web option was offered for the convenience of those subjects who had Internet access.
The web-based survey closely simulated the hardcopy version of the instrument, which was
concurrently mailed to the sample.
E-mail Messages and Reminders. Concurrent with the first questionnaire mailing, an
invitational e-mail was sent to all baseline respondents. Survey reminder e-mails were sent to
participants at the end of the 2nd, 3rd, and 4th weeks of the data collection period.
When participants logged on to the study Web site, they were first asked to log in using
the unique ID and password supplied to them in the lead letter. Next, they viewed a post login
screen that gave more information about the 6-month follow-up and reminded them of their
rights as voluntary research subjects.
2.5
Data Cleaning and Editing
The data cleaning and editing process consisted of the following steps:
One-way frequencies were reviewed to confirm all responses were within the
response categories provided on the survey.
The order of BL survey, FU survey, and separation dates were checked. Cases were
removed from analysis if the individual separated from the military after the FU
survey. The separation date was set to missing for those whose stated separation date
was before the BL survey.
Two-way cross-tabulations between each gate-nest combination of variables were
reviewed for data consistency. This check involved questions 1, 20, 24, 49, 70, and
71. Gate questions are items that determine subsequent instrument routing. Nest
variables are items that are asked or not asked, depending on the response to the gate
questions. If the answer to the gate question is ―No,‖ then any response to the nest
variables were set to missing. If the gate question is missing but the respondent
answered any of the nest questions, then the gate question was recoded to ―Yes.‖
Items were identified requiring data corrections, consistency checks, or logical
imputations:
2-10
Resilience among Military Personnel, Follow-Up Survey
– Items 16, 20, 59, 62, and 71 on the Web version were recoded to fix coding errors
in the Web data.
– If the respondent answered ―Today or during past 30 days‖ to question 28 (―When
was the last time you smoked a cigarette?‖) and answered ―I did not smoke any
cigarettes‖ to question 29, then a new category was created: ―current smoker,
amount unknown‖.
– If the last time the respondent smoked a cigarette was more than 5 weeks ago,
including never smoked cigarettes, and question 29 shows some amount of
cigarettes smoked in the past 30 days then question 29 was recoded to ―I didn’t
smoke any cigarettes.‖
– Responses to ―other-specify‖ questions (20, 24, and 59) were examined, and if the
response given was part of a pre-coded option in the survey, then the ―otherspecify‖ variable was set to missing and the corresponding pre-coded option was
set to ―Yes.‖
– If the respondent answered ―Yes‖ to any of the health coverage options (25a-h),
then item 25i (―I do not have medical insurance…‖) was set to ―No.‖ If the
respondent answered ―No‖ to all of the health coverage options (25a-h), then item
25i (―I do not have medical insurance…‖) was recoded to ―Yes‖.
– For items 6a-k, 67a-g, and 68a-n, if the respondent marked ―Yes‖ to one or more
items and the rest were missing, then the blank items were set to ―No.‖
Removal of duplicate cases from the final data file occurred when 10 respondents
completed at least part of both the paper and Web versions of the survey. The number
of completed items was computed, and item responses were examined to determine
which version, web or paper, was kept in the final data file. In cases where there was
a significant discrepancy in the percentage complete in web and paper forms, the
most complete version was kept. When the web and paper forms were essentially
both completed with the same percentage, the more recent submission was kept
because it had more civilian time and might have been submitted as a revision over
the previous version.
2-11
SECTION 3
RESULTS
3.1
Respondents and Response Rates
A total of 3,753 military personnel (2,362 Sailors and 1,391 Marines) volunteered and
completed an initial baseline (BL) survey. Non-response information was not available on the
BL survey non-respondents who made up 45% of the sampled TAP class attendees. As shown in
Table 3-1, the BL sample distribution of key demographic variables was very similar to that of
all discharged Navy and Marine Corps personnel, obtained from official personnel records for
2007.
A total of 3,446 individuals (2,166 Sailors and 1,280 Marines) subsequently separated
from the military in time to be eligible for the follow–up (FU) survey, and 3,090 (1,966 Sailors,
1,124 Marines) were locatable. Of these, 1,122 (750 Sailors, 372 Marines) individuals
responded, giving an FU response rate of 32.6%. A nonresponse analysis was conducted, and
nonresponse weight adjustments were calculated for all FU analyses to account for FU
nonresponse.
3.2
Follow-up Survey Nonresponse Bias Analysis
Tables 3-2 and 3-3 contain information comparing FU survey respondents and
nonrespondents for both Sailors and Marines. These tables contain a wide variety of BL survey
variables, including mental and physical health, demographic, Service and combat-related stress,
resilience, spirituality, and social support indicators. Chi-square tests were conducted, separately
within each branch of service, on each variable to see if the distributions of respondents and
nonrespondents differed. An asterisk marks each variable where a difference was found at a
p < .05 significance level. Where significant results were found for polytomous response items,
FU logistic regressions were employed to determine exactly where significant differences
existed. These are described below.
Table 3-2 shows that at BL FU, nonrespondent Sailors had higher proportions than
respondents who were showing signs of depression, showing symptoms of at least one mental
health problem, rated themselves ―low‖ on mental health, and were seeking counseling at the
time for anger management. Nonrespondents relative to respondents had larger proportions who
were African American, who were 34 years of age or younger, who were unmarried, or who
were enlisted personnel or warrant officers. Nonrespondents had smaller proportions who were
retiring relative to leaving for expiration of term of service (ETS) or other reasons, had larger
proportions with a previous lifetime trauma, had relatively more reporting ―High‖ life event
3-1
Resilience among Military Personnel, Follow-Up Survey
stress relative to ―Low,‖ had larger proportions of current smokers, and had relatively more
reporting ―a lot‖ of work stress relative to ―a little.‖ Nonrespondents compared to respondents
3-2
Resilience among Military Personnel, Follow-Up Survey
Table 3-1.
Comparison of Study Sample to Population of Separating Sailors and
Marines in 2007
Baseline Respondents‡
Population*
3,753 (100.0%)
56,141 (100.0%)
Navy
2,362 (62.9%)
33,923 (60.4%)
Marines
1,391 (37.1%)
22,218 (39.6%)
Male
3,203 (85.4%)
49,685 (88.5%)
550 (14.6%)
6,456 (11.5%)
White, non-Hispanic
2,260 (60.2%)
36,477 (65.0%)
Black, non-Hispanic
503 (13.4%)
7,442 (13.3%)
Hispanic
646 (17.2%)
7,653 (13.6%)
Other
344 (9.2%)
4,569 (8.1%)
25 or younger
1,823 (48.5%)
25,978 (46.3%)
26 to 34
1,003 (26.8%)
16,022 (28.5%)
927 (24.7%)
14,141 (25.2%)
3,512 (93.6%)
51,488 (91.7%)
241 (6.4%)
4,653 (8.3%)
Married
1,921 (51.2%)
30,705 (54.7%)
Other than married
1,832 (48.8%)
25,436 (45.3%)
Total
Service
Sex
Female
Race/Ethnicity
Age
35 or older
Pay Grade
E1–E9, W1–W5
O1–O6
Marital Status
‡
For the purposes of this table, missing values for each variable were proportionately assigned to the reported
categories.
*Data from the CHAMPS database (see Gunderson, Garland, Miller, & Gorham, 2005).
had smaller proportions that have been deployed for more time—3 or more months in the past 12
months—versus those deployed 2 or fewer months, and had a lower sense of unit cohesion and
post-deployment social support.
3-3
Resilience among Military Personnel, Follow-Up Survey
Table 3-2.
Nonresponse Analysis—Navy Sample
Navy
Measure
Respondents
Nonrespondents
750
1,416
16.4
18.6
31.2
36.9
11.4
13.8
39.2
40.7
7.1
4.9
36.9
42.6
Low
21.5
23.9
Medium
50.9
49.2
High
27.6
27
Low
15.2
21.8
Medium
52.2
49.8
High
32.6
28.4
26.7
27.4
26.3
27.6
Sample Size1
Anxiety
Yes
Depression*
Yes
PTSD
Yes
Substance Abuse Indicator (TICS)
Yes
Suicidal Ideation*
Yes
Any Mental Health Problem* 2
Yes
Resilience
MOS Mental Health Scale*
Any Activity Restriction due to Poor Mental Health Past 30 Days
Yes
Any Receipt of Mental Health Services in the Past 12 Months
Yes
(continued)
3-4
Resilience among Military Personnel, Follow-Up Survey
Table 3-2.
Nonresponse Analysis—Navy Sample (continued)
Navy
Measure
Respondents
Nonrespondents
Concerns for which Counseling Was Sought
Depression
10.1
10.8
8
9.2
Family problems
8.2
9.7
Substance use problems
2.4
3.3
Anger management*
3.1
5.1
6
8
2.7
1.8
5
5.7
77.9
75.6
23.8
24.6
9.3
11.1
Male
80.5
81.8
Female
19.5
18.2
White, non-Hispanic
60.1
55.2
African American, non-Hispanic
13.4
17.3
Hispanic
14.6
17
12
10.5
25 or younger
29.6
43
26 to 34
25.1
31.3
35 or older
45.3
25.7
Anxiety
Stress management
Combat/operational stress
Other (specify)
I did not seek help from a mental health professional in the past 12
months
Feel the Need for Counseling
Yes
Prescribed Medication for Mental Health Issue in Past 12 Months
Yes
Gender
Race/Ethnicity*
Other
Age*
(continued)
3-5
Resilience among Military Personnel, Follow-Up Survey
Table 3-2.
Nonresponse Analysis—Navy Sample (continued)
Navy
Measure
Respondents
Nonrespondents
Family Status*
Not married
41.7
48.9
Married
58.3
51.1
E1–E9, W1–W5
86.9
94.4
O1–O6
13.1
5.6
5.4
6.4
Retirement
41.1
22.5
Expiration of term of service (ETS)
40.3
54
Other
18.6
23.5
31.5
37
46.8
52.9
Low
33.7
30.3
Medium
42.2
41.2
High
24.1
28.5
Low
30.6
27.9
Medium
44.9
43.4
High
24.4
28.6
Pay Grade*
Disability or Separation for a Physical/Mental Condition that Interferes with
Military Service
Yes
Reason for Leaving Military*
Current Smoker*
Yes
Previous Lifetime Trauma*
Yes
Life Event Stress
DRRI Post-Deployment Stressors Index
(continued)
3-6
Resilience among Military Personnel, Follow-Up Survey
Table 3-2.
Nonresponse Analysis—Navy Sample (continued)
Navy
Measure
Respondents
Nonrespondents
Work Stress Indicator
A lot
36.2
41.4
Some
34.6
33.5
A little
22
19
None
7.2
6.1
A lot
23.8
24.8
Some
30
29.1
A little
31.2
27.9
None
15.1
18.1
A lot
24.6
20.1
Some
23.5
23.7
A little
17.2
15.3
None
4.7
4
I do not have a spouse
30
36.9
7
8.5
Moderate
27.8
25.3
Mild
20.9
20.9
21
19.6
23.4
25.7
Low
16.9
17.7
Medium
46.8
45.2
High
36.4
37.1
Family Stress Indicator
Spouse Stress Indicator*
MOS Pain Indicator (past 4 weeks)
Very severe/severe
Very mild
None
MOS Current Health Perception
(continued)
3-7
Resilience among Military Personnel, Follow-Up Survey
Table 3-2.
Nonresponse Analysis—Navy Sample (continued)
Navy
Measure
Respondents
Nonrespondents
Combat Exposure Scale Score
Low
65.1
65.6
24
24.1
10.9
10.3
0
17.3
19
1
22.1
23.7
2
24.8
26.3
3 or 4
21.6
17.8
5 or more
14.2
13.3
58.3
55.1
26
26.6
15.7
18.3
0 months
52.5
51
1 or 2 months
18.9
15.5
3 or 4 months
15.3
16.7
5 to 12 months
13.3
16.8
32.7
33.9
Iraq/Afghanistan
64.7
66.5
Other, Not Iraq or Afghanistan
22.6
19.1
None
12.6
14.4
73.8
73.9
Medium
High
Number of Career Combat Deployments
Number of Months in Past Year on Combat Deployments
0 months
1 to 6 months
7 to 12 months
Number of Months in Past Year on Noncombat Deployment*
Deployment Extension—Ever in Career
Yes
Place of Deployment
Avoidant Coping Strategy
Yes
(continued)
3-8
Resilience among Military Personnel, Follow-Up Survey
Table 3-2.
Nonresponse Analysis—Navy Sample (continued)
Navy
Measure
Respondents
Nonrespondents
Problem-Oriented Coping Strategy
Yes
97.7
96.4
Low
23.5
26.3
Medium
55.1
52.2
High
21.4
21.4
Low
11.5
15.9
Medium
55.9
57.2
High
32.5
26.9
6.6
9.1
Medium
54.1
58.6
High
39.3
32.3
Yes
63.9
66.3
Total Sample
34.6
65.4
Spirituality Indicator
DRRI Deployment Social Support Scale (Unit Cohesion)*
DRRI Post-Deployment Social Support Scale (Personal Social Support)*
Low
Physically Active, Moderate or Vigorous at Least 3 Days/Week
* Significant differences found between respondent and nonrespondent distributions (α = .05)
Note: Nonrespondents include all eligible BL respondents whom we either failed to track or who failed to return a
FU survey.
1
Sample includes all BL respondents who are eligible for the FU survey at the time of FU survey administration.
2
Yes indicates a ―yes‖ on any of the mental health (anxiety, depression, PTSD, or suicidal ideation)
3-9
Resilience among Military Personnel, Follow-Up Survey
Table 3-3.
Nonresponse Analysis—Marine Corps Sample
Marine Corps
Measure
Respondents
Sample Size1
Nonrespondents
372
908
29.1
32.6
44.6
52.3
20.7
27.6
45.7
55.8
9
10.3
52.2
58.3
Low
22.9
30.6
Medium
56.1
48.6
21
20.8
Low
28.4
32.5
Medium
54.1
54.4
High
17.6
13.1
36.6
41.2
32.2
37.5
Anxiety
Yes
Depression*
Yes
PTSD*
Yes
Substance Abuse Indicator (TICS)*
Yes
Suicidal Ideation
Yes
2
Any Mental Health Problem
Yes
Resilience*
High
MOS Mental Health Scale
Any Activity Restriction due to Poor Mental Health Past 30 Days
Yes
Any Receipt of Mental Health Services in the Past 12 Months
Yes
(continued)
3-10
Resilience among Military Personnel, Follow-Up Survey
Table 3-3.
Nonresponse Analysis—Marine Corps Sample (continued)
Marine Corps
Measure
Respondents
Nonrespondents
Concerns for which Counseling Was Sought
Depression
14.2
17.7
Anxiety
10.6
13.8
Family problems
10.1
13.1
Substance use problems*
2.8
7.2
Anger management
9.5
11.9
Stress management
10.3
13
Combat/operational stress
10.1
10.7
5.3
4.9
73.7
67.4
27.8
35
13.1
14.4
Male
88.1
93.4
Female
11.9
6.6
69.3
66.5
6.3
8.7
16.6
19.4
7.9
5.3
25 or younger
59.1
71.1
26–34
29.6
22
35 or older
11.3
7
Not married
53.4
54.9
Married
46.6
45.1
Other (specify)
I Did Not Seek Help from a Mental Health Professional in the Past 12
Months*
Feel the Need for Counseling*
Yes
Prescribed Medication for Mental Health Issue in Past 12 Months
Yes
Gender*
Race/Ethnicity
White, non-Hispanic
African American, non-Hispanic
Hispanic
Other
Age*
Family Status
(continued)
3-11
Resilience among Military Personnel, Follow-Up Survey
Table 3-3.
Nonresponse Analysis—Marine Corps Sample (continued)
Marine Corps
Measure
Respondents
Nonrespondents
Pay Grade*
E1–E9, W1–W5
93.5
96.9
6.5
3.1
8.7
13.3
Retirement
10.4
5.2
Expiration of term of service (ETS)
64.9
64.7
Other
24.8
30.1
40.9
55.2
50.8
54.4
Low
26.4
24.9
Medium
43.7
43.2
High
29.9
31.9
Low
13.4
11.7
Medium
41.1
39
High
45.5
49.3
A lot
52
50.8
Some
28.3
30.1
A little
14.8
15.7
4.9
3.4
O1–O6
Disability or Separation for a Physical/Mental Condition that Interferes with
Military Service*
Yes
Reason for Leaving Military*
Current Smoker*
Yes
Previous Lifetime Trauma
Yes
Life Event Stress
DRRI Post-Deployment Stressors Index
Work Stress Indicator
None
(continued)
3-12
Resilience among Military Personnel, Follow-Up Survey
Table 3-3.
Nonresponse Analysis—Marine Corps Sample (continued)
Marine Corps
Measure
Respondents
Nonrespondents
Family Stress Indicator*
A lot
26.1
34.3
Some
30.1
26.2
A little
27.4
24.3
None
16.4
15.2
A lot
24.9
25.1
Some
19
19.8
A little
8.9
12
None
1.6
2.6
45.5
40.6
Very severe/severe
10.5
13.4
Moderate
39.2
36.5
Mild
23.4
23.2
Very mild
15.1
16.4
None
11.8
10.5
Low
24.9
25.8
Medium
47.4
51.7
High
27.7
22.5
14
16.8
Medium
26.6
27.2
High
59.5
56
0
14.4
19.9
1
28.3
28.8
2
31.3
32.7
3 or 4
22.3
16.7
3.8
1.9
Spouse Stress Indicator
I do not have a spouse
MOS Pain Indicator (past 4 weeks)
MOS Current Health Perception
Combat Exposure Scale Score
Low
Number of Career Combat Deployments*
5 or more
(continued)
3-13
Resilience among Military Personnel, Follow-Up Survey
Table 3-3.
Nonresponse Analysis—Marine Corps Sample (continued)
Marine Corps
Measure
Respondents
Nonrespondents
Number of Months in Past Year on Combat Deployments
0 months
37.3
40.9
1 to 6 months
14.2
16.9
7 to 12 months
48.5
42.2
0 months
66.7
62.5
1 or 2 months
12.8
16.3
3 or 4 months
10.1
8.9
5 to 12 months
10.4
12.3
25.3
20.4
81.9
75.5
5.6
7.2
12.5
17.3
73
81.2
94.1
95.3
33
32.6
Medium
49.3
54.6
High
17.7
12.9
Low
12.5
11.4
Medium
52.2
57.8
High
35.3
30.7
Low
9.1
8.5
Medium
59
66
31.9
25.5
Number of Months in Past Year on Noncombat Deployment
Deployment Extension—Ever in Career
Yes
Place of Deployment
Iraq/Afghanistan
Other, Not Iraq or Afghanistan
None
Avoidant Coping Strategy*
Yes
Problem-Oriented Coping Strategy
Yes
Spirituality Indicator
Low
DRRI Deployment Social Support Scale (Unit Cohesion)
DRRI Post-Deployment Social Support Scale (Personal Social Support)
High
(continued)
3-14
Resilience among Military Personnel, Follow-Up Survey
Table 3-3.
Nonresponse Analysis—Marine Corps Sample (continued)
Marine Corps
Measure
Respondents
Nonrespondents
Physically Active, Moderate or Vigorous at Least 3 Days/Week
Yes
68.2
68.7
Total Sample
29.1
70.9
*Significant differences found between respondent and nonrespondent distributions (α = .05).
Note: Nonrespondents include all those eligible BL respondents whom we either failed to track or who failed to
return a follow-up survey.
1
Sample includes all BL respondents who are eligible for FU survey at the time of FU survey administration.
2
Yes indicates a ―yes‖ on any of the mental health (anxiety, depression, PTSD, or suicidal ideation)
Table 3-3 shows that at BL FU, nonrespondent Marines had higher proportions than
respondents who were showing signs of depression, showing signs of PTSD, were reporting
substance abuse, were seeking counseling at the time for substance abuse, were showing signs of
at least one mental health issue, and had more ―low‖ resilience scores relative to ―medium.‖
Nonrespondents relative to respondents had larger proportions who were male, who were 25
years of age or younger or who reported being enlisted personnel or warrant officers.
Nonrespondents had smaller proportions who were retiring and larger proportions leaving for
ETS or other reasons. They report in relative larger numbers having a physical/mental condition
that interferes with military service and being current smokers. Nonrespondents compared to
respondents had larger proportions that have never had a combat deployment and smaller
proportions that have had three or more combat deployments. They had larger proportions
reporting using avoidant coping strategies and larger proportions scoring in the middle
spirituality category, while smaller proportions scored in the high spirituality category.
Overall, the respondents showed fewer signs of BL mental health and substance abuse
problems, were older, and were more likely to be retirees who have seen more lifetime combat
deployments. These results are troublesome in that they indicate that many individuals who are
already showing signs of mental health and other difficulties at BL are not responding to the FU
survey and are thus not being accounted for in our FU descriptive and modeling analysis.
3.3
Follow-Up Survey Nonresponse Weighting
FU weights were created to reduce bias in the survey estimates produced by the FU
survey nonresponse. RTI’s weighting software GEM (Generalized Exponential Modeling) was
3-15
Resilience among Military Personnel, Follow-Up Survey
used to compute the nonresponse adjustment factor with a model that contains the following
characteristics at BL: race/ethnicity (white, African American, Hispanic, and other), service, age
(25 or younger, 26 to 34, and 35 or older), gender, pay grade (E1–E9/W1–W5, O1–O6), and
marital status. After this adjustment, the weighted sample distribution is the same as the
distribution at BL, relative to the variables used to create the nonresponse weights.
3.4
Psychometric Analysis of Survey Scales
This section contains the results of psychometric analysis on FU survey scales. This
includes factor model fitting to assess whether the theoretical factor structure fits our data,
assessment of the internal consistency of items contained in individual scale factors, and
descriptive statistics describing the distribution of scale scores.
Those scales on the FU survey that met the assumptions of a factor analysis model were
fit to the FU data with the results found in Table 3-4. The fit measure presented include the
Comparative Fit Index (CFI) (Bentler, 1989), the Standardized Root Mean Square Residual
(SRMR), which is the root of the mean of the squared residuals, and the root mean squared error
approximation (RMSEA) coefficient (Steiger & Lind, 1980) along with its 90% confidence
interval. The following criteria, which followed commonly accepted guidelines (Browne &
Cudeck, 1993; Hu & Bentler, 1998, 1999; MacCallum et al., 1996), were applied to decide
whether a scale had a good fit: CFI > .95, SRMR < .08, and RMSEA < .05 for good fit, < .08 for
fair fit, < .10 for mediocre fit. By these standards, the generalized anxiety score, CES-D and CDRISC scales all had good fit. The PCL-C scale with 4 factors was fair, and the MOS (Health
Perception, Mental Health, and Pain) scales, post-deployment social support, and risk-taking and
sensation-seeking scales all had unacceptable fits. MacCallum et al. (1996) describe a test of
close fit, and in all cases these scales were found to fail the test of close fit to the data.
Exploratory factor analysis was conducted in a few cases where the fit was wo rse. For
post-deployment social support, we found that a five-factor model fit best. The first factor had
items indicating the person has someone who will listen to them (items a, b, d, and f); the second
factor indicating the person has friends or relatives who would give them substantial help if
needed has items i and j; the third factor included items dealing with understanding in the work
3-16
Resilience among Military Personnel, Follow-Up Survey
Table 3-4.
Confirmatory Factor Analysis Results—Selected Fit Statistics
Scale
CFI
SRMR
RMSEA
RMSEA_LCL
RMSEA_UCL
Anxiety
0.9811
0.0244
0.0793
0.0628
0.0970
CES-D
0.9577
0.0383
0.0563
0.0521
0.0606
MOS scales
0.8781
0.0735
0.1489
0.1411
0.1568
PCL-C (3 Factor)
0.9144
0.0420
0.1083
0.1036
0.1132
PCL-C (4 Factor)
0.9430
0.0413
0.0892
0.0844
0.0941
Post-dep soc support
0.7755
0.0762
0.1427
0.1357
0.1497
CD-RISC
0.9123
0.0472
0.0761
0.0729
0.0794
RISK scales
0.9250
0.0650
0.1329
0.1231
0.1429
place and loaded items g and h; the fourth factor, which described access to help when needed
with daily chores or when ill, which may signal support in their living situation, had items k and
l; and the fifth factor, which had the two reverse-coded items (c and e), reflected the experience
of not being understood by those around them.
For the risk-taking/sensation-seeking items, we found that a three-factor model fit best.
The first factor contained the sensation-seeking items (f–i), the second factor contained the
impulsiveness items (a, c, and e), while the third factor contained the two risk-taking items (b
and d).
Finally for the MOS scales, we found that a two-factor model is probably best, because
three-factor models tended to have singleton factors, none of which were the MOS pain item.
The two-factor model had a first factor with all the mental health items from Q18 except for (a).
The second factor had all the health perception items from Q17, plus Q18’s item (a), social
limitation due to health, and the pain item (Q15). Thus, the factors split between mental health
and general health, with limitations on social activity and pain more closely tied to general health
issues.
3-17
Resilience among Military Personnel, Follow-Up Survey
Coefficient alphas were also calculated for individual scale factors to measure internal
consistency (see Table 3-5). Most were acceptable, although the Spiritual Influences Factor for
the CD-RISC scale fell below the lowest acceptable level of .70, and the DRRI Post Deployment
Social Support Scale also did not perform very well on this measure. With only two items, the
two-item Spiritual Influences Factor could not be improved by item deletion. The analysis
showed the DRRI Post Deployment Social Support Scale could be improved by removing either
item (c) or (e) from the scale; however, these are the two reverse-worded items, and this likely
indicated that there is a response set operating such that reverse-worded items cannot simply be
reverse coded and have the same distributions as other items. This scale, as the exploratory factor
analysis results described above show, is fairly multidimensional and could probably only be
improved by narrowing its dimensionality, or splitting it into constituent factor scores.
Table 3-5.
Coefficient Alphas for Individual Scale Factors
Scale
Alpha
CES-D Depressive Affect Factor
0.913639
CES-D Well-Being Factor
0.839017
CES-D Somatic Symptoms Factor
0.864834
CES-D Interpersonal Affect Factor
0.782432
PCL-C Reexperiencing Factor
0.939053
PCL-C Avoidance Factor
0.894180
PCL-C Emotional Numbing Factor
0.905823
PCL-C Hyperarousal Factor
0.901968
CD-RISC Persnl Comptnc, Hi Stnds, & Tenacity Factor
0.926673
CD-RISC Trust Instncts, Tolrt Neg Aff & Strthg Strs Effs
0.868875
CD-RISC Pos Acceptc Change, & Sec Relatnshps Factor
0.842203
CD-RISC Control Factor
0.849817
CD-RISC Spiritual Influences Factor
0.647391
DRRI Post Deployment Social Support Scale
0.719240
Generalized Anxiety Score
0.889219
MOS Health Perception Scale
0.890813
MOS Mental Health Scale
0.894014
Risk-Taking Scale
0.881047
Sensation-Seeking Scale
0.912821
3-18
Resilience among Military Personnel, Follow-Up Survey
Table 3-6 contains descriptive statistics for the score distributions of all scales in the FU
survey. This includes some formative scales (e.g., DDRI Post Deployment Social Support Scale,
Life Event Stress Index, Cumulative Civilian Trauma Count, etc.) that were not analyzed using
factor models because they did not follow the assumptions of a factor model. Three scales have
skewness or kurtosis values that were a bit large. The Post-deployment Stress and Cumulative
Civilian Trauma Count scales had slightly higher kurtosis, and the Life Event Stress scale had
slightly higher skewness and kurtosis than would be found in normally distributed data.
Table 3-6.
Distribution of Follow-Up Scale Scores for Separated Navy and Marine
Corps Personnel
Variable
Min
Max
Mean
Std Dev
Skewness
Kurtosis
CD-RISC
0.0
100.0
75.0
18.0
−0.9
1.0
CES-D
0.0
60.0
14.4
12.5
1.2
1.0
Sum of PTSD Items
0.0
85.0
30.8
19.4
0.6
0.0
Anxiety Items from Patient Health
Questionnaire
0.0
1.0
0.2
0.4
1.5
0.2
Post-Deployment Social Support*
4.0
60.0
45.6
9.0
−0.6
0.5
Post-Deployment Stress**
0.0
13.0
2.0
2.1
1.7
3.5
Life Event Stress***
0.0
15.0
1.5
2.3
2.3
6.6
Cumulative Civilian Trauma Count
0.0
21.0
2.7
2.7
1.7
4.1
MOS Mental Health Scale
0.0
100.0
69.8
21.0
−0.9
0.2
MOS Health Perception Scale
0.0
100.0
62.9
27.2
−0.5
−0.7
Risk-Taking Scale
1.0
4.0
2.1
0.8
0.5
−0.1
Sensation-Seeking Scale
1.0
4.0
2.7
0.9
−0.1
−0.7
Two Item Conjoint Scale (TICS)
0.0
2.0
0.4
0.7
1.5
0.7
* Three items shorter than BL survey scale.
** Four items longer than BL survey scale.
*** Contains wording changes and three more items than BL survey scale.
3.5
Descriptive Statistics
Table 3-7 provides sample characteristics for the FU sample and corresponding BL
comparison figures where available. Matching closely the BL profile, the FU survey Navy and
Marine Corps participants are male (Navy 81.2%, Marine Corps 91.9%), White non-Hispanic
(Navy 56.9%, Marine Corps 67.5%), and former enlisted personnel (Navy 91.8%, Marine Corps
95.9%). Table 3-8 through 3-14 present these sample characteristics by resilience (Table 3-8),
anxiety level (Table 3-9), depression (Table 3-10), substance abuse (Table 3-11), PTSD (Table
3-19
Resilience among Military Personnel, Follow-Up Survey
3-12), suicidal ideation (Table 3-13), and any mental health problem (Table 3-14). Key variables
from these tables are used in the models seen in Tables 3-20 - to 3-21.
3-20
Resilience among Military Personnel, Follow-Up Survey
Table 3-7.
Sample Characteristics of Transition Study Participants by Service Branch1
Baseline
Measure
Follow-Up
Navy
Marine Corps
Navy
Marine Corps
2,166.0
1,280.0
750.0
372.0
Male
81.3
91.8
81.2
91.9
Female
18.7
8.2
18.8
8.1
White, non-Hispanic
56.9
67.3
56.9
67.5
African American, non-Hispanic
15.9
8.0
15.9
7.9
Hispanic
16.1
18.6
16.1
18.5
Other
11.1
6.0
11.0
6.1
25 or younger
38.2
67.5
38.3
66.4
26–34
29.1
24.2
29.0
25.0
35 or older
32.8
8.3
32.7
8.6
Not married
46.4
54.4
45.0
55.9
Married
53.6
45.6
55.0
44.1
91.8
95.9
91.8
95.9
8.2
4.1
8.2
4.1
6.0
12.0
6.1
8.9
2–5 months
N/A
N/A
4.8
4.0
6–8 months
N/A
N/A
12.6
11.9
9–11 month
N/A
N/A
20.8
14.8
12–14 months
N/A
N/A
21.0
28.5
15–17 months
N/A
N/A
32.3
31.4
18+ months
N/A
N/A
8.4
9.3
Sample Size2
Gender
Race/Ethnicity
Age
Family Status
Pay Grade
E1–E9, W1–W5
O1–O6
Disability or Separation for a Physical/
Mental Condition that Interferes with
Military Service
Time in Civilian Life3
(continued)
3-21
Resilience among Military Personnel, Follow-Up Survey
Sample Characteristics of Transition Study Participants by Service Branch1
(continued)
Table 3-7.
Baseline
Measure
Single with Dependent Child(ren):
Navy
Follow-Up
Marine Corps
Navy
Marine Corps
N/A
N/A
11.9
9.6
Working full-time (work 35 or more hours
per week on average)
N/A
N/A
56.2
50.8
Working part-time (work fewer than 35
hours per week on average)
N/A
N/A
12.0
15.2
Working as self-employed in own business
or profession
N/A
N/A
2.4
4.2
Unemployed
N/A
N/A
27.8
29.1
An unpaid worker (volunteer)
N/A
N/A
5.3
5.0
Retired
N/A
N/A
16.6
6.3
In school
N/A
N/A
37.5
45.4
A homemaker, housewife, househusband
N/A
N/A
10.8
7.0
Disabled
N/A
N/A
14.8
21.0
Working multiple jobs
N/A
N/A
4.7
6.0
Working temporary job(s)
N/A
N/A
7.2
8.1
Less than $1,000
N/A
N/A
17.4
19.6
$1,000 to $1,499
N/A
N/A
15.3
20.6
$1,500 to $1,999
N/A
N/A
13.2
17.5
$2,000 to $2,999
N/A
N/A
18.3
21.0
$3,000 to $4,999
N/A
N/A
18.5
13.9
$5,000 or more
N/A
N/A
17.3
7.4
Are You Currently Receiving any ServiceRelated Disability Compensation?
N/A
N/A
40.9
53.7
A lot
39.6
51.1
14.9
21.1
Some
33.9
29.6
28.0
26.1
A little
20.0
15.5
25.9
24.7
6.5
3.8
31.2
28.0
Employment Status (Mark all that apply)
Current personal monthly income:
Work Stress Indicator4
None
(continued)
3-22
Resilience among Military Personnel, Follow-Up Survey
Table 3-7.
Sample Characteristics of Transition Study Participants by Service Branch1
(continued)
Baseline
Measure
Navy
Follow-Up
Marine Corps
Navy
Marine Corps
Family Stress Indicator
A lot
24.5
31.9
25.0
31.1
Some
29.4
27.4
25.4
23.6
A little
29.1
25.2
30.7
27.2
None
17.1
15.5
18.9
18.1
A lot
21.7
25.0
18.1
19.0
Some
23.6
19.5
18.6
19.4
A little
15.9
11.1
20.1
17.3
4.3
2.3
10.4
3.8
34.5
42.0
32.9
40.5
8.0
12.5
9.2
15.4
Moderate
26.2
37.3
28.6
34.4
Mild
20.9
23.3
20.9
20.2
Very Mild
20.1
16.0
18.9
16.0
None
24.9
10.9
22.4
14.0
Low
17.4
25.5
19.7
23.8
Medium
45.7
50.5
41.0
44.9
High
36.8
24.0
39.4
31.3
Low
65.4
15.9
66.3
14.2
Medium
24.1
27.0
23.0
25.1
High
10.5
57.1
10.6
60.7
Spouse Stress Indicator
None
I do not have a spouse
MOS Pain Indicator (past 4 weeks)
Very severe/severe
MOS Current Health Perception
Combat Exposure Scale Score
(continued)
3-23
Resilience among Military Personnel, Follow-Up Survey
Table 3-7.
Sample Characteristics of Transition Study Participants by Service Branch1
(continued)
Baseline
Measure
Navy
Follow-Up
Marine Corps
Navy
Marine Corps
Number of Career Combat Deployments
0.0
18.4
18.3
19.0
13.9
1.0
23.2
28.6
24.0
28.7
2.0
25.8
32.3
26.9
31.9
3 or 4
19.1
18.4
19.2
22.0
5 or more
13.6
2.5
10.8
3.4
0 months
56.2
39.8
55.3
34.9
1 to 6 months
26.4
16.1
28.1
15.1
7 to 12 months
17.4
44.1
16.6
50.0
0 months
51.5
63.7
50.3
65.8
1 or 2 months
16.7
15.3
18.9
12.7
3 or 4 months
16.2
9.3
16.8
10.2
5 to 12 months
15.5
11.8
14.0
11.3
33.5
21.8
30.8
25.2
Iraq/Afghanistan
65.9
77.4
64.4
82.5
Other, Not Iraq or Afghanistan
20.3
6.7
21.5
5.4
None
13.8
15.9
14.1
12.1
Currently Have Injuries or Health Problems as a
Result of my Military Experience
N/A
N/A
60.6
72.7
Currently Have Injuries or Health Problems Not
Related to my Service in the Military
N/A
N/A
13.5
12.6
Currently Working Reduced Hours Because of
Illness or Injury
N/A
N/A
4.1
8.0
Money Issues
N/A
N/A
45.2
45.1
Legal Issues
N/A
N/A
3.9
9.0
Number of Months in Past Year on Combat
Deployments
Number of Months in Past Year on Noncombat
Deployment
Deployment Extension—Ever in Career
Yes
Place of Deployment
(continued)
3-24
Resilience among Military Personnel, Follow-Up Survey
Table 3-7.
Sample Characteristics of Transition Study Participants by Service Branch1
(continued)
Baseline
Measure
Navy
Follow-Up
Marine Corps
Navy
Marine Corps
Smoker
35.1
51.1
27.1
34.1
Heavy Drinker
N/A
N/A
8.7
18.5
Since Leaving the Military, Have Your Coworkers or Supervisors Made Negative
Comments about any Recent Changes in your
Appearance, Quality of Work, or
Relationships?
N/A
N/A
8.7
14.9
Since Leaving the Military, Have You Had a
Physical or Mental Condition that Caused You
to Lose Your Job?
N/A
N/A
3.2
5.4
Not employed or 0 job changes
N/A
N/A
57.3
49.6
1 job change
N/A
N/A
23.1
19.1
More than 1 job change
N/A
N/A
19.6
31.3
3 or more times
N/A
N/A
7.8
13.2
1 or 2 times
N/A
N/A
10.1
13.0
0 times
N/A
N/A
82.2
73.7
Since Leaving the Military, Have You had
Problems Sleeping because of Nightmares?
N/A
N/A
16.6
35.4
Since Leaving the Military, Have You had
Problems with Anger, Frustration, Resentment,
Hostility or Losing Your Temper?
N/A
N/A
37.7
58.5
A lot
N/A
N/A
10.2
17.9
Some
N/A
N/A
28.9
29.7
A little
N/A
N/A
30.9
29.3
None at all
N/A
N/A
30.0
23.0
How Many Times Have You Changed Jobs
Since Leaving the Military?
Since Leaving the Military, How Often Have
You Been Late for Work due to Emotional or
Physical Problems?
How Much Trouble Have You had Adjusting to
Civilian Life?
(continued)
3-25
Resilience among Military Personnel, Follow-Up Survey
Table 3-7.
Sample Characteristics of Transition Study Participants by Service Branch1
(continued)
Baseline
Measure
Navy
Follow-Up
Marine Corps
Navy
Marine Corps
Since Leaving the Military Did You Drive a
Car or Other Vehicle when You Had Too Much
to Drink?
Yes, but only 1 time
N/A
N/A
6.0
7.8
Yes, 2 or 3 times
N/A
N/A
8.3
11.0
Yes, more than 3 times
N/A
N/A
4.9
9.4
No
N/A
N/A
80.8
71.8
Yes, 1, 2, or 3+ times
N/A
N/A
3.5
6.5
No
N/A
N/A
96.5
93.5
Yes, 1, 2, or 3+ times
N/A
N/A
5.1
10.7
No
N/A
N/A
94.9
89.3
Not at all
N/A
N/A
22.0
13.3
A little
N/A
N/A
56.8
43.7
Some
N/A
N/A
17.6
28.4
A lot
N/A
N/A
3.7
14.6
Not at all
N/A
N/A
9.4
4.1
A little
N/A
N/A
33.3
23.0
Some
N/A
N/A
40.1
39.3
A lot
N/A
N/A
17.2
33.6
Avoidant Coping Strategy
73.8
78.8
75.4
73.6
Problem-Oriented Coping Strategy
96.8
95.0
97.7
93.9
Since Leaving the Military Did You Drive or
Ride in a Boat, Canoe, or Other Watercraft
when You had Too Much to Drink?
Since Leaving the Military Did You Ride or
Drive a Motorcycle without a Helmet?
Risk-Taking
Sensation-Seeking
(continued)
3-26
Resilience among Military Personnel, Follow-Up Survey
Table 3-7.
Sample Characteristics of Transition Study Participants by Service Branch1
(continued)
Baseline
Measure
Navy
Follow-Up
Marine Corps
Navy
Marine Corps
Spirituality Indicator
Low
25.3
32.7
27.0
38.9
Medium
53.2
53.0
50.9
45.2
High
21.4
14.3
22.1
15.9
Low
14.3
11.8
12.4
12.6
Medium
56.8
56.2
59.0
52.5
High
28.9
32.1
28.6
34.9
8.2
8.7
22.7
26.8
Medium
57.0
63.9
46.2
51.9
High
34.8
27.4
31.1
21.3
Physically Active, Moderate or Vigorous at
Least 3 Days/Week
65.5
68.6
60.7
66.2
Know At Least One Military Veteran to Talk
To about War Experiences or Other Stressful
Deployment Events
N/A
N/A
73.2
74.7
Talking to Another Veteran Helped Me Handle
Stress Better
N/A
N/A
82.5
85.3
Have the Opportunity to Interact with a Group
of Combat Veterans
N/A
N/A
31.6
42.9
Social group
N/A
N/A
55.6
61.4
Support group
N/A
N/A
8.0
11.1
Reserve unit
N/A
N/A
14.2
13.0
Sports team
N/A
N/A
5.1
1.2
Other
N/A
N/A
32.4
36.8
Anxiety
17.9
31.6
15.9
29.5
Depression
34.9
50.0
33.4
47.8
PTSD
13.0
25.6
16.7
29.5
DRRI Deployment Social Support Scale (Unit
Cohesion)
DRRI Post-Deployment Social Support Scale
(Personal Social Support)
Low
What Type of Group(s)? (Mark all that apply.)
(continued)
3-27
Resilience among Military Personnel, Follow-Up Survey
Table 3-7.
Sample Characteristics of Transition Study Participants by Service Branch1
(continued)
Baseline
Measure
Substance Abuse Indicator (TICS)
Navy
Follow-Up
Marine Corps
Navy
Marine Corps
40.2
52.9
26.3
32.7
5.7
9.9
10.0
13.4
Any Mental Health Problem
40.6
56.5
38.8
54.4
Resilience
91.9
90.2
90.2
89.6
Low
19.5
31.3
19.0
30.8
Medium
50.6
54.3
50.6
41.4
High
29.9
14.4
30.3
27.8
Any Activity Restriction due to Poor Mental
Health Past 30 Days
27.1
39.8
33.2
44.2
Any Receipt of Mental Health Services in the
Past 12 Months
27.1
35.9
22.8
35.7
10.5
16.7
10.4
20.2
Anxiety
8.8
12.8
9.3
17.6
Family problems
9.2
12.2
5.6
8.3
Substance use problems
3.0
5.9
1.3
2.5
Anger management
4.4
11.2
4.9
14.3
Stress management
7.3
12.2
6.5
16.3
Combat/operational stress
2.1
10.5
3.8
16.8
Other (specify)
5.4
5.1
3.9
3.3
76.4
69.3
82.2
71.6
Feel the Need for Counseling
24.3
32.9
25.5
36.9
Prescribed Medication for Mental Health Issue
in past 12 months
10.5
14.0
10.3
18.8
Suicidal Ideation
5
MOS Mental Health Scale
Concerns for Which Counseling Was Sought
Depression
I did not seek help from a mental health
professional in the past 12 months
(continued)
3-28
Resilience among Military Personnel, Follow-Up Survey
Table 3-7.
Sample Characteristics of Transition Study Participants by Service Branch1
(continued)
Baseline
Measure
Navy
Follow-Up
Marine Corps
Navy
Marine Corps
Overall, How Satisfied or Dissatisfied are you
with the Quality of Health Care You Have
Received since Leaving the Military?
Very satisfied
N/A
N/A
23.5
18.1
Somewhat satisfied
N/A
N/A
33.9
35.2
Somewhat dissatisfied
N/A
N/A
9.5
12.8
Very dissatisfied
N/A
N/A
7.3
7.7
I have not received any health care since
leaving the military
N/A
N/A
25.7
26.2
A big problem
N/A
N/A
10.7
12.1
A small problem
N/A
N/A
20.2
22.9
Not a problem
N/A
N/A
69.1
65.0
Always
N/A
N/A
22.0
19.3
Usually
N/A
N/A
18.9
17.0
Sometimes
N/A
N/A
19.1
18.6
Never
N/A
N/A
8.2
12.1
I have not needed health care since leaving
the military.
N/A
N/A
31.9
32.9
N/A
N/A
13.4
16.1
I did not have the money to pay for care
N/A
N/A
41.4
36.8
I had to wait on approval from my health
insurance
N/A
N/A
11.9
6.6
Since Leaving the Military, How Much of a
Problem, If Any, were Delays in Health Care
while You Waited for Approval from Your
Health Plan?
Since Leaving the Military, When You Needed
Care Right Away for an Illness, Injury, or
Condition, How Often did You Get Care as
Soon as You Thought You Needed It?
Since Leaving the Military, Was There any
Time When You Needed Medical Care or
Surgery but Did Not Get It?
If yes, what was the main reason you didn’t
get the care you needed?
(continued)
3-29
Resilience among Military Personnel, Follow-Up Survey
Table 3-7.
Sample Characteristics of Transition Study Participants by Service Branch1
(continued)
Baseline
Measure
Navy
Follow-Up
Marine Corps
Navy
Marine Corps
I could not fit it into my schedule
N/A
N/A
1.6
1.5
I could not afford to miss work
N/A
N/A
12.3
6.0
I had to wait too long for an appointment
N/A
N/A
25.4
24.6
I had to drive too far for the medical care
N/A
N/A
1.6
10.5
Other
N/A
N/A
5.7
14.1
N/A
N/A
81.4
79.1
Very satisfied
N/A
N/A
32.5
28.5
Somewhat satisfied
N/A
N/A
46.7
43.7
Somewhat dissatisfied
N/A
N/A
9.6
15.6
Very dissatisfied
N/A
N/A
11.1
12.3
N/A
N/A
6.8
14.3
Declining academic performance or grades
N/A
N/A
12.5
8.4
Disruptive or problem behavior
N/A
N/A
19.0
18.6
Social withdrawal from peers
N/A
N/A
5.5
5.0
Bullying
N/A
N/A
7.0
8.6
Alcohol or drug use
N/A
N/A
3.6
0.5
Do you have Health Coverage?
Overall, How Satisfied or Dissatisfied are you
with the Health Care Available to You?
Are You Currently Receiving Counseling or
Therapy for Mental Health or Substance Abuse
Problems?
Yes
Since Leaving the Military, My Children
Experienced the Following or Behaved in any
of the Following Ways. (Percentages are of
those who have children.)
(continued)
3-30
Resilience among Military Personnel, Follow-Up Survey
Table 3-7.
Sample Characteristics of Transition Study Participants by Service Branch1
(continued)
Baseline
Measure
Total Sample
Navy
62.9
Follow-Up
Marine Corps
37.1
Navy
62.9
Marine Corps
37.1
1
Percentages are column percentages. So, for example, with gender, the percentages under Baseline Navy are the
percentages of those in the Navy at baseline who are male or who are female. Percentages may not add to 100
because of rounding.
2
Sample size for BL consists of all BL respondents who are eligible for the FU survey; for FU it consists of all
eligible respondents.
3
Minimum civilian time is 2 months.
4
At baseline, all respondents were employed by the military. At follow-up, a sizable percentage of the civilian
respondents are unemployed, which affects the work stress percentages.
5
Yes indicates a ―yes‖ on any of the mental health (anxiety, depression, PTSD, or suicidal ideation).
Source: 2007—Status of Transitioning Military Personnel Survey
3-31
Resilience among Military Personnel, Follow-Up Survey
Table 3-8.
Sample Characteristics of Transition Study Participants by Resilience1
Baseline
Follow-Up
High2
Low2
High2
3,087.0
295.0
941.0
98.0
Male
85.3
84.6
84.8
85.5
Female
14.7
15.4
15.2
14.5
White, non-Hispanic
60.9
61.4
63.7
48.4
African American, non-Hispanic
13.1
12.3
11.9
18.7
Hispanic
16.8
17.7
15.5
21.9
9.2
8.5
8.9
11.0
25 or younger
48.2
56.9
48.1
55.4
26–34
26.9
31.8
28.0
24.3
35 or older
24.9
11.3
23.9
20.2
Not married
48.7
56.7
47.5
62.3
Married
51.3
43.3
52.5
37.7
92.9
98.0
93.2
98.0
7.1
2.0
6.8
2.0
7.6
14.3
6.9
10.9
2–5 months
N/A
N/A
4.1
4.9
6–8 months
N/A
N/A
12.7
12.7
9–11 month
N/A
N/A
18.3
18.2
12–14 months
N/A
N/A
24.2
20.9
15–17 months
N/A
N/A
32.3
33.0
18+ months
N/A
N/A
8.4
10.3
Measure
Sample Size3
Low2
Gender
Race/Ethnicity
Other
Age
Family Status
Pay Grade
E1–E9, W1–W5
O1–O6
Disability or Separation for a Physical/ Mental
Condition that Interferes with Military Service
Time in Civilian Life4
(continued)
3-32
Resilience among Military Personnel, Follow-Up Survey
Sample Characteristics of Transition Study Participants by Resilience1
(continued)
Table 3-8.
Baseline
Follow-Up
High2
Low2
High2
Low2
N/A
N/A
9.7
20.2
Working full-time (work 35 or more hours
per week on average)
N/A
N/A
54.7
42.2
Working part-time (work fewer than 35
hours per week on average)
N/A
N/A
13.5
11.8
Working as self-employed in own business
or profession
N/A
N/A
3.2
1.9
Unemployed
N/A
N/A
27.2
43.4
An unpaid worker (volunteer)
N/A
N/A
5.2
5.1
Retired
N/A
N/A
12.8
14.8
In school
N/A
N/A
41.2
34.3
A homemaker, housewife, househusband
N/A
N/A
9.9
6.1
Disabled
N/A
N/A
15.5
32.8
Working multiple jobs
N/A
N/A
5.2
4.1
Working temporary job(s)
N/A
N/A
7.4
11.6
Less than $1,000
N/A
N/A
17.9
23.5
$1,000 to $1,499
N/A
N/A
17.0
24.0
$1,500 to $1,999
N/A
N/A
14.8
16.9
$2,000 to $2,999
N/A
N/A
18.9
18.1
$3,000 to $4,999
N/A
N/A
17.3
11.5
$5,000 or more
N/A
N/A
14.1
6.0
Are You Currently Receiving any ServiceRelated Disability Compensation?
N/A
N/A
45.4
52.4
A lot
42.8
55.1
15.8
30.2
Some
32.5
29.6
27.4
26.4
A little
19.2
11.2
26.2
18.5
5.5
4.1
30.6
25.0
Measure
Single with Dependent Child(ren):
Employment Status (Mark all that apply)
Current personal monthly income:
Work Stress Indicator5
None
(continued)
3-33
Resilience among Military Personnel, Follow-Up Survey
Table 3-8.
Sample Characteristics of Transition Study Participants by Resilience1
(continued)
Baseline
Follow-Up
High2
Low2
High2
Low2
A lot
25.9
42.5
25.0
49.3
Some
29.1
25.2
24.9
20.9
A little
28.9
14.3
31.1
14.9
None
16.1
18.0
19.1
14.9
A lot
22.7
27.8
18.4
21.1
Some
22.5
18.6
18.4
20.3
A little
14.6
8.2
20.1
11.6
3.3
4.5
8.0
7.2
36.9
40.9
35.2
39.8
9.0
16.3
9.3
30.4
Moderate
30.4
28.8
30.0
32.9
Mild
21.9
21.7
21.3
16.6
Very mild
18.6
17.6
19.2
7.3
None
20.1
15.6
20.2
12.8
Low
18.9
37.1
17.0
57.7
Medium
47.3
47.1
43.1
33.9
High
33.8
15.8
40.0
8.4
Low
48.3
46.8
48.7
43.3
Medium
25.6
20.2
22.9
20.2
High
26.1
33.0
28.4
36.5
Measure
Family Stress Indicator
Spouse Stress Indicator
None
I do not have a spouse
MOS Pain Indicator (past 4 weeks)
Very severe/severe
MOS Current Health Perception
Combat Exposure Scale Score
(continued)
3-34
Resilience among Military Personnel, Follow-Up Survey
Table 3-8.
Sample Characteristics of Transition Study Participants by Resilience1
(continued)
Baseline
Follow-Up
High2
Low2
High2
Low2
0.0
17.9
21.6
17.3
22.7
1.0
24.9
29.5
26.5
26.2
2.0
28.1
29.5
28.0
25.1
3 or 4
19.1
15.4
19.9
21.0
5 or more
10.1
4.1
8.3
5.0
0 months
50.1
51.0
48.0
48.8
1 to 6 months
22.7
21.9
23.0
21.2
7 to 12 months
27.2
27.1
29.1
30.0
0 months
56.0
56.4
55.0
64.8
1 or 2 months
16.2
16.2
17.4
12.6
3 or 4 months
13.7
13.4
15.3
9.4
5 to 12 months
14.1
14.1
12.2
13.3
29.6
24.6
28.0
26.1
Iraq/Afghanistan
70.3
70.2
70.9
71.7
Other, Not Iraq or Afghanistan
15.6
10.6
15.5
13.0
None
14.2
19.1
13.7
15.3
Currently Have Injuries or Health Problems as a
Result of my Military Experience
N/A
N/A
63.0
85.0
Currently Have Injuries or Health Problems Not
Related to my Service in the Military
N/A
N/A
13.1
13.1
Currently Working Reduced Hours Because of
Illness or Injury
N/A
N/A
4.6
15.4
Money Issues
N/A
N/A
41.3
73.2
Measure
Number of Career Combat Deployments
Number of Months in Past Year on Combat
Deployments
Number of Months in Past Year on Noncombat
Deployment
Deployment Extension—Ever in Career
Yes
Place of Deployment
(continued)
3-35
Resilience among Military Personnel, Follow-Up Survey
Table 3-8.
Sample Characteristics of Transition Study Participants by Resilience1
(continued)
Baseline
Follow-Up
High2
Low2
Legal Issues
N/A
N/A
5.5
9.5
Smoker
40.2
49.0
29.1
38.8
Heavy Drinker
N/A
N/A
11.9
15.3
Since Leaving the Military, Have Your Coworkers or Supervisors Made Negative
Comments about any Recent Changes in Your
Appearance, Quality of Work, or Relationships?
N/A
N/A
8.3
32.1
Since Leaving the Military, Have You Had a
Physical or Mental Condition that Caused You
to Lose Your Job?
N/A
N/A
2.4
16.7
Not employed or 0 job changes
N/A
N/A
55.2
48.2
1 job change
N/A
N/A
21.5
22.4
More than 1 job change
N/A
N/A
23.3
29.4
3 or more times
N/A
N/A
7.4
29.2
1 or 2 times
N/A
N/A
10.7
15.0
0 times
N/A
N/A
81.9
55.8
Since Leaving the Military, Have You had
Problems Sleeping Because of Nightmares?
N/A
N/A
21.4
44.8
Since Leaving the Military, Have You had
Problems with Anger, Frustration, Resentment,
Hostility or Losing Your Temper?
N/A
N/A
42.4
74.6
A lot
N/A
N/A
10.1
40.4
Some
N/A
N/A
27.7
44.5
A little
N/A
N/A
32.0
11.6
None at all
N/A
N/A
30.2
3.6
Measure
High2
Low2
How Many Times Have You Changed Jobs
since Leaving the Military?
Since Leaving the Military, How Often Have
You Been Late for Work due to Emotional or
Physical Problems?
How Much Trouble Have You had Adjusting to
Civilian Life?
(continued)
3-36
Resilience among Military Personnel, Follow-Up Survey
Table 3-8.
Sample Characteristics of Transition Study Participants by Resilience1
(continued)
Baseline
Follow-Up
High2
Low2
Yes, but only 1 time
N/A
N/A
6.5
7.3
Yes, 2, or 3 times
N/A
N/A
8.9
12.6
Yes, more than 3 times
N/A
N/A
6.4
9.3
No
N/A
N/A
78.2
70.8
Yes, 1, 2, or 3+ times
N/A
N/A
4.8
3.7
No
N/A
N/A
95.2
96.3
Yes, 1, 2, or 3+ times
N/A
N/A
7.4
5.8
No
N/A
N/A
92.6
94.2
Not at all
N/A
N/A
19.7
13.3
A little
N/A
N/A
52.6
42.7
Some
N/A
N/A
20.8
30.2
A lot
N/A
N/A
6.9
13.9
Not at all
N/A
N/A
6.2
17.7
A little
N/A
N/A
28.8
36.6
Some
N/A
N/A
41.3
29.5
A lot
N/A
N/A
23.7
16.2
Avoidant Coping Strategy
75.3
79.0
74.3
81.2
Problem-Oriented Coping Strategy
97.6
82.0
96.7
89.7
Measure
High2
Low2
Since Leaving the Military Did You Drive a Car
or Other Vehicle when You Had Too Much to
Drink?
Since Leaving the Military Did You Drive or
Ride in a Boat, Canoe, or Other Watercraft when
You had Too Much to Drink?
Since Leaving the Military Did You Ride or
Drive a Motorcycle without a Helmet?
Risk-Taking
Sensation-Seeking
(continued)
3-37
Resilience among Military Personnel, Follow-Up Survey
Table 3-8.
Sample Characteristics of Transition Study Participants by Resilience1
(continued)
Baseline
Follow-Up
High2
Low2
High2
Low2
Low
26.2
49.7
29.8
45.5
Medium
53.7
43.8
49.4
42.6
High
20.1
6.6
20.8
11.9
Low
11.6
32.4
11.3
23.4
Medium
56.6
57.4
57.0
56.1
High
31.8
10.2
31.8
20.4
6.4
28.0
18.6
78.0
Medium
59.1
65.7
51.1
21.1
High
34.5
6.4
30.3
0.9
Physically Active, Moderate or Vigorous at
Least 3 Days/Week
67.8
53.9
65.3
38.6
Know at Least One Military Veteran to Talk to
about War Experiences or Other Stressful
Deployment Events
N/A
N/A
76.8
48.5
Talking to Another Veteran Helped Me Handle
Stress Better
N/A
N/A
85.2
59.4
Have the Opportunity to Interact with a Group of
Combat Veterans
N/A
N/A
37.0
27.9
Social group
N/A
N/A
58.6
55.2
Support group
N/A
N/A
7.9
28.6
Reserve unit
N/A
N/A
14.8
0.0
Sports team
N/A
N/A
3.0
4.4
Other
N/A
N/A
35.3
25.4
Anxiety
20.9
43.3
17.3
50.6
Depression
36.8
75.7
32.9
87.2
Measure
Spirituality Indicator
DRRI Deployment Social Support Scale (Unit
Cohesion)
DRRI Post-deployment Social Support Scale
(Personal Social Support)
Low
What type of group(s)? (Mark all that apply.)
(continued)
3-38
Resilience among Military Personnel, Follow-Up Survey
Table 3-8.
Sample Characteristics of Transition Study Participants by Resilience1
(continued)
Baseline
Follow-Up
High2
Low2
High2
Low2
PTSD
15.1
41.6
16.9
62.8
Substance Abuse Indicator (TICS)
43.8
58.8
27.7
37.3
5.7
23.3
8.7
36.2
Any Mental Health Problem
43.0
78.6
38.5
93.3
Resilience
N/A
N/A
N/A
N/A
Low
20.4
56.5
18.1
68.9
Medium
53.5
38.4
49.5
27.5
High
26.1
5.1
32.4
3.6
Any Activity Restriction due to Poor Mental
Health Past 30 Days
29.0
60.8
33.2
75.0
Any Receipt of Mental Health Services in the
Past 12 Months
29.2
42.9
24.5
57.5
10.8
32.7
10.6
46.5
Anxiety
9.0
22.1
9.5
39.7
Family problems
9.7
16.0
6.0
12.7
Substance use problems
3.6
7.8
1.5
4.5
Anger management
6.2
13.9
7.0
21.3
Stress management
8.1
18.9
7.9
31.0
Combat/operational stress
4.7
9.3
6.9
24.2
Other (specify)
5.0
7.8
3.5
5.6
75.5
56.6
81.2
49.6
Feel the Need for Counseling
25.1
51.6
25.6
67.7
Prescribed Medication for Mental Health Issue
in past 12 months
10.5
24.5
11.2
35.1
Measure
Suicidal Ideation
6
MOS Mental Health Scale
Concerns for which Counseling Was Sought
Depression
I did not seek help from a mental health
professional in the past 12 months
(continued)
3-39
Resilience among Military Personnel, Follow-Up Survey
Table 3-8.
Sample Characteristics of Transition Study Participants by Resilience1
(continued)
Baseline
Follow-Up
High2
Low2
Very satisfied
N/A
N/A
23.4
8.0
Somewhat satisfied
N/A
N/A
33.2
38.4
Somewhat dissatisfied
N/A
N/A
10.3
13.7
Very dissatisfied
N/A
N/A
5.9
21.8
I have not received any health care since
leaving the military
N/A
N/A
27.2
18.1
A big problem
N/A
N/A
9.5
26.9
A small problem
N/A
N/A
19.4
36.3
Not a problem
N/A
N/A
71.1
36.7
Always
N/A
N/A
21.8
12.7
Usually
N/A
N/A
17.9
21.3
Sometimes
N/A
N/A
16.9
34.4
Never
N/A
N/A
9.1
16.5
I have not needed health care since leaving
the military.
N/A
N/A
34.2
15.1
N/A
N/A
13.0
30.4
N/A
N/A
41.3
35.6
Measure
High2
Low2
Overall, How Satisfied or Dissatisfied are you
with the Quality of Health Care You have
Received since Leaving the Military?
Since Leaving the Military, How Much of a
Problem, If Any, were Delays in Health Care
while You Waited for Approval from Your
Health Plan?
Since Leaving the Military, when You Needed
Care Right Away for an Illness, Injury, or
Condition, How Often did You Get Care as Soon
as You Thought You Needed It?
Since Leaving the Military, Was There Any
Time when You Needed Medical Care or
Surgery but Did Not Get It?
If yes, what was the main reason you didn’t
get the care you needed?
I did not have the money to pay for care
(continued)
3-40
Resilience among Military Personnel, Follow-Up Survey
Table 3-8.
Sample Characteristics of Transition Study Participants by Resilience1
(continued)
Baseline
Follow-Up
Measure
High2
Low2
High2
Low2
I had to wait on approval from my health
insurance
N/A
N/A
8.5
13.9
I could not fit it into my schedule
N/A
N/A
2.1
0.0
I could not afford to miss work
N/A
N/A
7.5
9.9
I had to wait too long for an appointment
N/A
N/A
27.1
19.8
I had to drive too far for the medical care
N/A
N/A
3.6
12.6
Other
N/A
N/A
9.9
8.1
N/A
N/A
83.7
82.6
Very satisfied
N/A
N/A
33.4
11.5
Somewhat satisfied
N/A
N/A
45.2
42.9
Somewhat dissatisfied
N/A
N/A
10.6
24.3
Very dissatisfied
N/A
N/A
10.8
21.3
N/A
N/A
7.0
34.5
Declining academic performance or grades
N/A
N/A
10.9
15.2
Disruptive or problem behavior
N/A
N/A
18.7
19.0
Social withdrawal from peers
N/A
N/A
5.1
8.6
Bullying
N/A
N/A
6.8
14.6
Alcohol or drug use
N/A
N/A
2.9
0.0
Do You have Health Coverage?
Overall, How Satisfied or Dissatisfied are You
with the Health Care Available to You?
Are You Currently Receiving Counseling or
Therapy for Mental Health or Substance Abuse
Problems?
Yes
Since Leaving the Military, My Children
Experienced the Following or Behaved In Any
of the Following Ways. (Percentages are of
those who have children.)
(continued)
3-41
Resilience among Military Personnel, Follow-Up Survey
Table 3-8.
Sample Characteristics of Transition Study Participants by Resilience1
(continued)
Baseline
Measure
Total Sample
Follow-Up
High2
Low2
91.3
8.7
High2
Low2
90.0
10.0
1
Percentages are column percentages. So, for example, with gender, the percentages under baseline high resilience
are the percentage of those with high resilience at baseline who are male or who are female. Percentages may not
add to 100 because of rounding.
2
High resilience is defined as those individuals with scores greater than 50; low is a resilience score of 50 or less.
3
Sample size for BL consists of all BL respondents who are eligible for the FU survey; for FU it consists of all
eligible respondents.
4
Minimum civilian time is 2 months.
5
At baseline, all respondents were employed by the military. At follow-up, a sizable percentage of the civilian
respondents are unemployed, which affects the work stress percentages.
6
Yes indicates a ―yes‖ on any of the mental health (anxiety, depression, PTSD, or suicidal ideation).
Source: 2007—Status of Transitioning Military Personnel Survey
3-42
Resilience among Military Personnel, Follow-Up Survey
Table 3-9.
Sample Characteristics of Transition Study Participants by Anxiety Level1
Baseline
Follow-Up
Yes2
No2
Yes2
No2
787.0
2638.0
212.0
848.0
Male
81.0
86.5
80.3
86.1
Female
19.0
13.5
19.7
13.9
White, non-Hispanic
60.2
61.0
61.2
61.5
African American, non-Hispanic
13.1
12.9
12.4
12.9
Hispanic
17.8
16.9
17.3
16.5
8.9
9.2
9.2
9.0
25 or younger
53.5
47.8
54.4
47.5
26–34
29.4
26.6
29.7
27.1
35 or older
17.1
25.6
15.8
25.4
Not married
49.3
49.4
53.1
47.9
Married
50.7
50.6
46.9
52.1
96.4
92.4
97.5
92.7
3.6
7.6
2.5
7.3
16.2
5.9
12.5
5.5
2–5 months
N/A
N/A
3.7
4.3
6–8 months
N/A
N/A
8.6
13.6
9–11 month
N/A
N/A
17.8
19.0
12–14 months
N/A
N/A
29.3
22.4
15–17 months
N/A
N/A
31.9
32.4
18+ months
N/A
N/A
8.8
8.4
Measure
Sample Size3
Gender
Race/Ethnicity
Other
Age
Family Status
Pay Grade
E1–E9, W1–W5
O1–O6
Disability or Separation for a Physical/Mental
Condition that Interferes with Military Service
Time in Civilian Life4
(continued)
3-43
Resilience among Military Personnel, Follow-Up Survey
Sample Characteristics of Transition Study Participants by Anxiety Level1
(continued)
Table 3-9.
Baseline
Follow-Up
Yes2
No2
Yes2
No2
N/A
N/A
15.2
9.8
Working full-time (work 35 or more hours
per week on average)
N/A
N/A
44.8
56.0
Working part-time (work fewer than 35
hours per week on average)
N/A
N/A
11.2
14.0
Working as self-employed in own business
or profession
N/A
N/A
1.4
3.6
Unemployed
N/A
N/A
40.5
25.4
An unpaid worker (volunteer)
N/A
N/A
6.1
5.0
Retired
N/A
N/A
9.8
13.6
In school
N/A
N/A
41.6
40.3
A homemaker, housewife, househusband
N/A
N/A
10.8
9.2
Disabled
N/A
N/A
32.8
13.1
Working multiple jobs
N/A
N/A
3.7
5.8
Working temporary job(s)
N/A
N/A
9.7
7.2
Less than $1,000
N/A
N/A
21.2
17.5
$1,000 to $1,499
N/A
N/A
19.2
16.8
$1,500 to $1,999
N/A
N/A
14.7
15.1
$2,000 to $2,999
N/A
N/A
22.0
18.6
$3,000 to $4,999
N/A
N/A
14.9
17.3
$5,000 or more
N/A
N/A
8.0
14.8
Are You Currently Receiving any ServiceRelated Disability Compensation?
N/A
N/A
59.1
42.5
Measure
Single with Dependent Child(ren):
Employment Status (Mark all that apply)
Current personal monthly income:
(continued)
3-44
Resilience among Military Personnel, Follow-Up Survey
Table 3-9.
Sample Characteristics of Transition Study Participants by Anxiety Level1
(continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
A lot
71.9
35.7
38.4
11.9
Some
20.9
35.6
18.1
29.5
A little
6.2
21.9
13.1
28.8
None
1.0
6.8
30.4
29.8
A lot
47.2
21.3
59.9
18.6
Some
29.0
28.5
24.2
24.8
A little
16.0
31.0
7.6
35.3
7.8
19.2
8.2
21.2
A lot
35.7
19.2
34.0
14.4
Some
19.8
22.8
24.5
17.3
A little
8.2
15.9
4.9
23.0
None
2.4
3.9
1.5
9.6
33.9
38.3
35.2
35.7
Very severe/severe
22.2
6.0
33.2
5.9
Moderate
42.1
26.9
36.9
28.6
Mild
19.4
22.6
16.0
22.1
Very mild
9.9
21.0
7.0
20.8
None
6.4
23.5
6.9
22.6
Low
43.5
13.7
51.9
13.0
Medium
45.7
47.9
39.7
43.2
High
10.9
38.4
8.4
43.9
Measure
Work Stress Indicator5
Family Stress Indicator
None
Spouse Stress Indicator
I do not have a spouse
MOS Pain Indicator (past 4 weeks)
MOS Current Health Perception
(continued)
3-45
Resilience among Military Personnel, Follow-Up Survey
Table 3-9.
Sample Characteristics of Transition Study Participants by Anxiety Level1
(continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
Low
38.8
50.5
31.7
51.7
Medium
25.4
25.1
23.0
23.0
High
35.8
24.4
45.3
25.3
0.0
20.5
17.7
19.0
17.2
1.0
24.6
25.4
24.5
26.4
2.0
28.9
27.9
29.1
28.3
3 or 4
18.3
19.0
21.8
19.6
7.7
10.0
5.6
8.4
0 months
47.9
50.8
39.8
49.8
1 to 6 months
21.6
22.9
18.5
24.0
7 to 12 months
30.4
26.4
41.7
26.2
0 months
56.2
55.8
58.7
55.3
1 or 2 months
16.9
16.1
15.4
17.1
3 or 4 months
12.6
14.0
13.8
14.7
5 to 12 months
14.3
14.1
12.2
12.9
31.8
28.4
32.1
27.3
Iraq/Afghanistan
71.1
70.0
73.8
70.4
Other, Not Iraq or Afghanistan
13.4
15.7
12.7
15.7
None
15.5
14.3
13.4
13.8
N/A
N/A
86.6
59.5
Measure
Combat Exposure Scale Score
Number of Career Combat Deployments
5 or more
Number of Months in Past Year on Combat
Deployments
Number of Months in Past Year on Noncombat
Deployment
Deployment Extension—Ever in Career
Yes
Place of Deployment
Currently Have Injuries or Health Problems as a
Result of My Military Experience
(continued)
3-46
Resilience among Military Personnel, Follow-Up Survey
Table 3-9.
Sample Characteristics of Transition Study Participants by Anxiety Level1
(continued)
Baseline
Follow-Up
Measure
Yes2
No2
Yes2
No2
Currently Have Injuries or Health Problems Not
Related to My Service in the Military
N/A
N/A
18.6
11.7
Currently Working Reduced Hours Because of
Illness or Injury
N/A
N/A
16.9
2.6
Money Issues
N/A
N/A
68.4
38.8
Legal Issues
N/A
N/A
10.6
4.6
Smoker
49.5
38.6
37.3
27.9
Heavy Drinker
N/A
N/A
16.1
11.3
Since Leaving the Military, Have Your Coworkers or Supervisors Made Negative
Comments about any Recent Changes in Your
Appearance, Quality of Work, or Relationships?
N/A
N/A
22.7
7.9
Since Leaving the Military, Have You Had a
Physical or Mental Condition that Caused You
to Lose Your Job?
N/A
N/A
13.1
1.6
Not employed or 0 job changes
N/A
N/A
52.7
55.1
1 job change
N/A
N/A
17.4
22.5
More than 1 job change
N/A
N/A
29.9
22.4
3 or more times
N/A
N/A
27.6
5.1
1 or 2 times
N/A
N/A
18.6
9.3
0 times
N/A
N/A
53.8
85.6
Since Leaving the Military, Have You had
Problems Sleeping Because of Nightmares?
N/A
N/A
58.2
15.0
Since Leaving the Military, Have You had
Problems with Anger, Frustration, Resentment,
Hostility or Losing Your Temper?
N/A
N/A
88.3
34.6
How Many Times Have You Changed Jobs
since Leaving the Military?
Since Leaving the Military, How Often Have
You Been Late for Work due to Emotional or
Physical Problems?
(continued)
3-47
Resilience among Military Personnel, Follow-Up Survey
Table 3-9.
Sample Characteristics of Transition Study Participants by Anxiety Level1
(continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
A lot
N/A
N/A
38.1
6.7
Some
N/A
N/A
39.5
26.4
A little
N/A
N/A
17.4
33.6
None at all
N/A
N/A
5.0
33.3
Yes, but only 1 time
N/A
N/A
4.3
7.3
Yes, 2, or 3 times
N/A
N/A
11.6
8.6
Yes, more than 3 times
N/A
N/A
12.9
5.0
No
N/A
N/A
71.1
79.1
Yes, 1, 2, or 3+ times
N/A
N/A
7.4
4.0
No
N/A
N/A
92.6
96.0
Yes, 1, 2, or 3+ times
N/A
N/A
13.3
5.6
No
N/A
N/A
86.7
94.4
Not at all
N/A
N/A
11.5
20.6
A little
N/A
N/A
34.3
56.5
Some
N/A
N/A
31.1
19.1
A lot
N/A
N/A
23.0
3.8
Measure
How Much Trouble Have You had Adjusting to
Civilian Life?
Since Leaving the Military Did You Drive a Car
or Other Vehicle when You Had Too Much to
Drink?
Since Leaving the Military Did You Drive or
Ride in a Boat, Canoe, or Other Watercraft when
You Had Too Much to Drink?
Since Leaving the Military Did You Ride or
Drive a Motorcycle without a Helmet?
Risk-Taking
(continued)
3-48
Resilience among Military Personnel, Follow-Up Survey
Table 3-9.
Sample Characteristics of Transition Study Participants by Anxiety Level1
(continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
Not at all
N/A
N/A
9.6
6.7
A little
N/A
N/A
22.3
31.5
Some
N/A
N/A
30.1
42.1
A lot
N/A
N/A
38.0
19.7
Avoidant Coping Strategy
86.2
72.5
82.0
72.9
Problem-Oriented Coping Strategy
95.1
96.4
95.1
96.4
Low
30.9
27.4
38.0
29.6
Medium
50.6
53.8
45.1
49.8
High
18.4
18.8
16.9
20.6
Low
25.1
9.9
21.4
10.1
Medium
52.7
57.8
53.6
58.0
High
22.2
32.4
25.1
31.8
Low
19.2
5.2
49.5
17.6
Medium
64.7
58.1
40.0
50.6
High
16.1
36.7
10.5
31.8
Physically Active, Moderate or Vigorous at
Least 3 Days/Week
61.6
68.1
52.3
65.6
Know at Least One Military Veteran to Talk to
about War Experiences or Other Stressful
Deployment Events
N/A
N/A
70.9
74.7
Talking to Another Veteran Helped Me Handle
Stress Better
N/A
N/A
71.9
86.5
Have the Opportunity to Interact with a Group
of Combat Veterans
N/A
N/A
40.2
34.8
Measure
Sensation-Seeking
Spirituality Indicator
DRRI Deployment Social Support Scale (Unit
Cohesion)
DRRI Post-deployment Social Support Scale
(Personal Social Support)
(continued)
3-49
Resilience among Military Personnel, Follow-Up Survey
Table 3-9.
Sample Characteristics of Transition Study Participants by Anxiety Level1
(continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
Social group
N/A
N/A
43.2
63.1
Support group
N/A
N/A
22.4
5.6
Reserve unit
N/A
N/A
18.3
12.3
Sports team
N/A
N/A
0.9
4.0
Other
N/A
N/A
35.6
33.7
Anxiety
N/A
N/A
N/A
N/A
Depression
82.7
27.5
86.5
25.6
PTSD
54.7
6.6
65.4
10.1
Substance Abuse Indicator (TICS)
57.8
41.1
43.6
24.9
Suicidal Ideation
18.9
3.8
33.2
5.5
100.0
29.4
100.0
28.7
83.5
93.6
75.5
93.8
Low
62.0
12.4
69.0
11.2
Medium
36.1
56.8
29.5
52.1
1.9
30.7
1.5
36.8
Any Activity Restriction due to Poor Mental
Health Past 30 Days
64.9
22.0
75.8
27.0
Any Receipt of Mental Health Services in the
Past 12 Months
50.8
24.2
57.4
20.1
Depression
30.1
7.6
40.4
7.4
Anxiety
24.3
6.0
34.8
6.7
Family problems
18.9
7.6
12.8
5.0
6.6
3.2
1.9
1.7
Anger management
17.0
3.9
27.1
3.6
Stress management
21.1
5.5
32.8
4.4
Combat/operational stress
14.2
2.5
24.8
4.6
Measure
What Type of Group(s)? (Mark all that apply.)
6
Any Mental Health Problem
Resilience
MOS Mental Health Scale
High
Concerns for which Counseling Was Sought
Substance use problems
(continued)
3-50
Resilience among Military Personnel, Follow-Up Survey
Table 3-9.
Sample Characteristics of Transition Study Participants by Anxiety Level1
(continued)
Baseline
Measure
Other (specify)
Yes2
Follow-Up
No2
Yes2
No2
7.6
4.6
7.1
2.8
54.4
79.7
53.2
84.6
Feel the Need for Counseling
57.2
18.8
66.1
20.3
Prescribed Medication for Mental Health Issue
in Past 12 Months
27.2
7.2
35.2
8.0
Very satisfied
N/A
N/A
17.1
22.8
Somewhat satisfied
N/A
N/A
32.8
34.6
Somewhat dissatisfied
N/A
N/A
16.1
9.2
Very dissatisfied
N/A
N/A
12.3
6.1
I have not received any health care since
leaving the military
N/A
N/A
21.6
27.3
A big problem
N/A
N/A
22.8
8.2
A small problem
N/A
N/A
31.6
18.4
Not a problem
N/A
N/A
45.5
73.4
Always
N/A
N/A
14.5
22.6
Usually
N/A
N/A
19.7
17.8
Sometimes
N/A
N/A
31.6
15.5
Never
N/A
N/A
14.3
8.6
I have not needed health care since leaving
the military.
N/A
N/A
19.9
35.5
I did not seek help from a mental health
professional in the past 12 months
Overall, How Satisfied or Dissatisfied are You
with the Quality of Health Care You Have
Received since Leaving the Military?
Since Leaving the Military, How Much of a
Problem, If Any, were Delays in Health Care
while You Waited for Approval from Your
Health Plan?
Since Leaving the Military, When You Needed
Care Right Away for an Illness, Injury, or
Condition, How Often Did You Get Care as
Soon as You Thought You Needed It?
(continued)
3-51
Resilience among Military Personnel, Follow-Up Survey
Table 3-9.
Sample Characteristics of Transition Study Participants by Anxiety Level1
(continued)
Baseline
Follow-Up
Measure
Yes2
No2
Yes2
No2
Since Leaving the Military, Was there any Time
when You Needed Medical Care or Surgery but
Did Not Get It?
N/A
N/A
27.1
11.2
I did not have the money to pay for care
N/A
N/A
37.2
41.2
I had to wait on approval from my health
insurance
N/A
N/A
12.1
8.1
I could not fit it into my schedule
N/A
N/A
1.0
1.9
I could not afford to miss work
N/A
N/A
12.0
7.0
I had to wait too long for an appointment
N/A
N/A
18.4
29.3
I had to drive too far for the medical care
N/A
N/A
7.3
4.5
Other
N/A
N/A
11.9
8.0
N/A
N/A
82.4
84.2
Very satisfied
N/A
N/A
19.6
34.0
Somewhat satisfied
N/A
N/A
45.2
45.7
Somewhat dissatisfied
N/A
N/A
18.0
10.1
Very dissatisfied
N/A
N/A
17.2
10.1
N/A
N/A
30.6
4.3
If yes, what was the main reason you didn’t
get the care you needed?
Do You Have Health Coverage?
Overall, How Satisfied or Dissatisfied are You
with the Health Care Available to You?
Are You Currently Receiving Counseling or
Therapy for Mental Health or Substance Abuse
Problems?
Yes
(continued)
3-52
Resilience among Military Personnel, Follow-Up Survey
Table 3-9.
Sample Characteristics of Transition Study Participants by Anxiety Level1
(continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
Declining academic performance or grades
N/A
N/A
19.2
9.2
Disruptive or problem behavior
N/A
N/A
33.2
15.2
Social withdrawal from peers
N/A
N/A
13.7
3.2
Bullying
N/A
N/A
17.4
4.9
Alcohol or drug use
N/A
N/A
1.4
3.0
23.0
77.0
21.0
79.0
Measure
Since Leaving the Military, My Children
Experienced the Following or Behaved In Any
of the Following Ways. (Percentages are of
those who have children.)
Total Sample
1
Percentages are column percentages. So, for example, with gender, the percentages under Baseline High Resilience
are the percentage of those with high resilience at baseline who are male or who are female. Percentages may not
add to 100 because of rounding.
2
Yes indicates a positive score based on binary scoring of seven anxiety items from the Patient Health
Questionnaire.
3
Sample size for BL consists of all BL respondents who are eligible for the FU survey; for FU it consists of all
eligible respondents.
4
Minimum civilian time is 2 months.
5
At baseline, all respondents were employed by the military. At follow-up, a sizable percentage of the civilian
respondents are unemployed, which affects the work stress percentages.
6
Yes indicates a ―yes‖ on any of the mental health (anxiety, depression, PTSD, or suicidal ideation).
Source: 2007—Status of Transitioning Military Personnel Survey
3-53
Resilience among Military Personnel, Follow-Up Survey
Table 3-10.
Sample Characteristics of Transition Study Participants by Depression1
Baseline
Follow-Up
Yes2
No2
1,342.0
1,963.0
380.0
627.0
Male
83.6
86.0
83.6
85.2
Female
16.4
14.0
16.4
14.8
White, non-Hispanic
59.1
61.7
58.2
63.4
African American, non-Hispanic
13.1
12.9
14.7
11.6
Hispanic
18.1
16.6
15.9
16.7
9.7
8.8
11.1
8.3
25 or younger
54.3
45.9
50.4
49.4
26–34
28.4
26.9
30.6
25.3
35 or older
17.3
27.2
19.0
25.2
Not married
52.8
47.7
54.8
46.5
Married
47.2
52.3
45.2
53.5
95.9
91.9
97.0
92.1
4.1
8.1
3.0
7.9
13.0
5.3
11.2
5.1
2–5 months
N/A
N/A
3.2
4.8
6–8 months
N/A
N/A
9.1
14.4
9–11 month
N/A
N/A
16.6
19.3
12–14 months
N/A
N/A
27.6
21.5
15–17 months
N/A
N/A
35.0
31.4
18+ months
N/A
N/A
8.5
8.6
Measure
Sample Size3
Yes2
No2
Gender
Race/Ethnicity
Other
Age
Family Status
Pay Grade
E1–E9, W1–W5
O1–O6
Disability or Separation for a Physical/ Mental
Condition that Interferes with Military Service
Time in Civilian Life4
(continued)
3-54
Resilience among Military Personnel, Follow-Up Survey
Table 3-10.
Sample Characteristics of Transition Study Participants by Depression1
(continued)
Baseline
No2
Yes2
No2
N/A
N/A
16.1
7.9
Working full-time (work 35 or more hours
per week on average)
N/A
N/A
50.1
55.3
Working part-time (work fewer than 35
hours per week on average)
N/A
N/A
10.5
15.3
Working as self-employed in own business
or profession
N/A
N/A
2.7
3.6
Unemployed
N/A
N/A
35.8
24.7
An unpaid worker (volunteer)
N/A
N/A
4.7
5.5
Retired
N/A
N/A
10.9
13.6
In school
N/A
N/A
37.6
42.8
A homemaker, housewife, househusband
N/A
N/A
9.9
9.3
Disabled
N/A
N/A
25.6
12.4
Working multiple jobs
N/A
N/A
5.6
5.6
Working temporary job(s)
N/A
N/A
10.4
6.6
Less than $1,000
N/A
N/A
18.9
18.8
$1,000 to $1,499
N/A
N/A
19.8
16.5
$1,500 to $1,999
N/A
N/A
13.6
15.8
$2,000 to $2,999
N/A
N/A
24.5
15.9
$3,000 to $4,999
N/A
N/A
15.8
17.0
$5,000 or more
N/A
N/A
7.4
16.1
Are You Currently Receiving any ServiceRelated Disability Compensation?
N/A
N/A
51.0
43.0
A lot
62.9
32.5
31.2
9.6
Some
26.3
35.9
29.8
26.9
A little
9.6
23.8
12.9
32.1
None
1.2
7.8
26.2
31.4
Measure
Single with Dependent Child(ren):
Yes2
Follow-Up
Employment Status (Mark all that apply)
Current personal monthly income:
Work Stress Indicator5
(continued)
3-55
Resilience among Military Personnel, Follow-Up Survey
Table 3-10.
Sample Characteristics of Transition Study Participants by Depression1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Family Stress Indicator
A lot
43.4
17.2
52.2
13.0
Some
30.5
28.0
27.1
24.0
A little
17.4
34.0
12.8
39.2
8.8
20.8
7.9
23.8
A lot
31.4
18.0
31.2
11.3
Some
20.8
22.7
20.8
17.9
A little
8.8
17.1
7.5
24.8
None
2.3
4.2
2.7
10.5
36.8
38.0
37.9
35.4
Very severe/severe
14.7
6.5
22.5
5.3
Moderate
38.5
25.7
34.3
28.9
Mild
22.4
21.8
19.8
21.6
Very mild
14.4
21.3
13.5
20.2
None
10.1
24.8
9.8
23.9
Low
34.0
11.8
41.5
9.5
Medium
51.5
45.7
46.5
41.2
High
14.4
42.5
12.0
49.3
Low
41.5
51.9
40.4
50.5
Medium
25.8
25.2
21.3
24.8
High
32.7
22.9
38.3
24.7
None
Spouse Stress Indicator
I do not have a spouse
MOS Pain Indicator (past 4 weeks)
MOS Current Health Perception
Combat Exposure Scale score
(continued)
3-56
Resilience among Military Personnel, Follow-Up Survey
Table 3-10.
Sample Characteristics of Transition Study Participants by Depression1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Number of Career Combat Deployments
0.0
20.7
16.8
19.7
16.6
1.0
25.9
24.7
23.9
27.8
2.0
28.1
28.5
28.8
28.8
3 or 4
17.6
19.7
21.5
18.5
7.6
10.4
6.1
8.3
0 months
47.7
51.4
48.1
47.2
1 to 6 months
22.6
22.9
19.9
24.0
7 to 12 months
29.7
25.6
32.0
28.7
0 months
55.2
56.4
58.0
54.0
1 or 2 months
15.4
16.6
14.4
18.8
3 or 4 months
13.7
13.7
14.1
14.9
5 to 12 months
15.7
13.3
13.5
12.3
28.4
29.7
28.9
28.1
Iraq/Afghanistan
68.6
71.7
72.7
69.5
Other, Not Iraq or Afghanistan
14.9
15.1
12.2
17.2
None
16.5
13.2
15.1
13.4
Currently Have Injuries or Health Problems as
a Result of My Military Experience
N/A
N/A
79.4
58.1
Currently Have Injuries or Health Problems
Not Related to My Service in the Military
N/A
N/A
19.2
9.3
Currently Working Reduced Hours Because of
Illness or Injury
N/A
N/A
12.6
1.6
Money Issues
N/A
N/A
63.1
35.6
5 or more
Number of Months in Past Year on Combat
Deployments
Number of Months in Past Year on Noncombat
Deployment
Deployment Extension—Ever in Career
Yes
Place of Deployment
(continued)
3-57
Resilience among Military Personnel, Follow-Up Survey
Table 3-10.
Sample Characteristics of Transition Study Participants by Depression1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Legal Issues
N/A
N/A
10.6
3.0
Smoker
48.8
36.4
36.4
26.2
Heavy Drinker
N/A
N/A
15.7
10.0
Since Leaving the Military, Have Your Coworkers or Supervisors Made Negative
Comments about any Recent Changes in Your
Appearance, Quality of Work, or
Relationships?
N/A
N/A
23.8
3.8
Since Leaving the Military, Have You had a
Physical or Mental Condition that Caused You
to Lose Your Job?
N/A
N/A
9.7
0.5
Not employed or 0 job changes
N/A
N/A
48.9
57.8
1 job change
N/A
N/A
19.3
22.4
More than 1 job change
N/A
N/A
31.9
19.8
3 or more times
N/A
N/A
22.4
2.7
1 or 2 times
N/A
N/A
17.0
8.3
0 times
N/A
N/A
60.6
89.0
Since Leaving the Military, Have You had
Problems Sleeping Because of Nightmares?
N/A
N/A
44.4
12.3
Since Leaving the Military, Have You had
Problems with Anger, Frustration, Resentment,
Hostility or Losing Your Temper?
N/A
N/A
77.9
27.9
A lot
N/A
N/A
30.3
2.9
Some
N/A
N/A
40.4
24.0
A little
N/A
N/A
21.1
36.4
None at all
N/A
N/A
8.2
36.7
How Many Times Have You Changed Jobs
since Leaving the Military?
Since Leaving the Military, How Often Have
You Been Late for Work due to Emotional or
Physical Problems?
How Much Trouble Have You had Adjusting to
Civilian Life?
(continued)
3-58
Resilience among Military Personnel, Follow-Up Survey
Table 3-10.
Sample Characteristics of Transition Study Participants by Depression1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Since Leaving the Military Did You Drive a
Car or Other Vehicle when You had Too Much
to Drink?
Yes, but only 1 time
N/A
N/A
4.6
8.3
Yes, 2 or 3 times
N/A
N/A
13.2
7.0
Yes, more than 3 times
N/A
N/A
11.8
3.5
No
N/A
N/A
70.3
81.2
Yes, 1, 2, or 3+ times
N/A
N/A
7.9
3.0
No
N/A
N/A
92.1
97.0
Yes, 1, 2, or 3+ times
N/A
N/A
9.9
5.5
No
N/A
N/A
90.1
94.5
Not at all
N/A
N/A
12.9
21.8
A little
N/A
N/A
42.4
56.7
Some
N/A
N/A
30.4
17.6
A lot
N/A
N/A
14.2
3.9
Not at all
N/A
N/A
8.0
6.6
A little
N/A
N/A
27.1
30.1
Some
N/A
N/A
35.5
43.1
A lot
N/A
N/A
29.4
20.1
Avoidant Coping Strategy
85.1
69.9
79.8
73.6
Problem-Oriented Coping Strategy
94.9
96.9
94.8
96.7
Since Leaving the Military Did You Drive or
Ride in a Boat, Canoe, or Other Watercraft
when You had Too Much to Drink?
Since Leaving the Military Did You Ride or
Drive a Motorcycle without a Helmet?
Risk-Taking
Sensation-Seeking
(continued)
3-59
Resilience among Military Personnel, Follow-Up Survey
Table 3-10.
Sample Characteristics of Transition Study Participants by Depression1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Spirituality Indicator
Low
30.6
26.7
35.4
29.1
Medium
53.0
53.4
47.5
49.9
High
16.4
19.9
17.1
20.9
Low
21.9
8.0
17.4
10.2
Medium
58.1
56.3
57.2
58.5
High
20.0
35.6
25.4
31.4
Low
16.4
3.2
47.7
11.1
Medium
69.3
54.8
43.8
52.5
High
14.3
42.0
8.6
36.4
Physically Active, Moderate or Vigorous at
Least 3 Days/Week
64.1
68.1
56.6
66.1
Know at Least One Military Veteran to Talk to
about War Experiences or Other Stressful
Deployment Events
N/A
N/A
67.4
77.3
Talking to Another Veteran Helped Me Handle
Stress Better
N/A
N/A
75.8
87.4
Have the Opportunity to Interact with a Group
of Combat Veterans
N/A
N/A
30.3
39.1
Social group
N/A
N/A
48.0
61.9
Support group
N/A
N/A
20.9
3.9
Reserve unit
N/A
N/A
8.3
16.4
Sports team
N/A
N/A
1.1
4.4
Other
N/A
N/A
38.3
32.8
Anxiety
48.2
6.9
48.7
4.8
Depression
N/A
N/A
N/A
N/A
DRRI Deployment Social Support Scale (Unit
Cohesion)
DRRI Post-deployment Social Support Scale
(Personal Social Support)
What Type of Group(s)? (Mark all that apply.)
(continued)
3-60
Resilience among Military Personnel, Follow-Up Survey
Table 3-10.
Sample Characteristics of Transition Study Participants by Depression1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
PTSD
41.7
2.0
53.8
2.7
Substance Abuse Indicator (TICS)
55.6
38.6
40.7
22.3
Suicidal Ideation
16.8
1.2
27.7
1.8
100.0
9.0
100.0
8.3
83.2
96.4
76.5
97.8
Low
53.9
4.3
58.0
2.7
Medium
44.4
59.1
39.4
54.6
1.7
36.6
2.5
42.8
Any Activity Restriction due to Poor Mental
Health Past 30 Days
60.0
14.3
68.7
19.7
Any Receipt of Mental Health Services in the
Past 12 Months
44.9
21.3
49.9
15.1
Depression
25.6
4.5
32.1
3.5
Anxiety
20.1
4.1
27.5
3.8
Family problems
16.7
6.0
12.6
3.1
6.6
2.2
3.3
0.9
Anger management
13.5
2.6
19.6
1.8
Stress management
16.9
4.2
22.7
2.7
Combat/operational stress
10.1
1.9
18.8
2.8
6.5
4.5
5.5
2.6
59.3
83.0
57.7
90.0
Feel the Need for Counseling
50.4
13.2
59.3
12.8
Prescribed Medication for Mental Health Issue
in Past 12 Months
21.8
5.6
28.3
5.0
6
Any Mental Health Problem
Resilience
MOS Mental Health Scale
High
Concerns for which Counseling Was Sought
Substance use problems
Other (specify)
I did not seek help from a mental health
professional in the past 12 months
(continued)
3-61
Resilience among Military Personnel, Follow-Up Survey
Table 3-10.
Sample Characteristics of Transition Study Participants by Depression1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Overall, How Satisfied or Dissatisfied are You
with the Quality of Health Care You Have
Received since Leaving the Military?
Very satisfied
N/A
N/A
14.4
24.9
Somewhat satisfied
N/A
N/A
35.7
34.1
Somewhat dissatisfied
N/A
N/A
14.2
8.5
Very dissatisfied
N/A
N/A
12.7
4.2
I have not received any health care since
leaving the military
N/A
N/A
23.0
28.2
A big problem
N/A
N/A
18.7
6.7
A small problem
N/A
N/A
29.4
16.9
Not a problem
N/A
N/A
51.9
76.3
Always
N/A
N/A
16.0
23.1
Usually
N/A
N/A
20.0
17.3
Sometimes
N/A
N/A
27.6
13.8
Never
N/A
N/A
13.6
8.1
I have not needed health care since leaving
the military
N/A
N/A
22.8
37.7
N/A
N/A
22.5
10.3
N/A
N/A
48.8
28.0
Since Leaving the Military, How Much of a
Problem, If Any, were Delays in Health Care
while You Waited for Approval from Your
Health Plan?
Since Leaving the Military, when You Needed
Care Right Away for an Illness, Injury, or
Condition, How Often did You Get Care As
Soon As You Thought You Needed It?
Since Leaving the Military, was there Any
Time when You Needed Medical Care or
Surgery but Did Not Get It?
If yes, what was the main reason you
didn’t get the care you needed?
I did not have the money to pay for care
(continued)
3-62
Resilience among Military Personnel, Follow-Up Survey
Table 3-10.
Sample Characteristics of Transition Study Participants by Depression1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
I had to wait on approval from my health
insurance
N/A
N/A
8.3
11.6
I could not fit it into my schedule
N/A
N/A
1.7
1.5
I could not afford to miss work
N/A
N/A
5.4
11.6
I had to wait too long for an appointment
N/A
N/A
19.2
34.1
I had to drive too far for the medical care
N/A
N/A
8.1
2.2
Other
N/A
N/A
8.5
10.9
N/A
N/A
83.3
84.2
Very satisfied
N/A
N/A
20.3
36.5
Somewhat satisfied
N/A
N/A
45.1
45.9
Somewhat dissatisfied
N/A
N/A
18.0
8.8
Very dissatisfied
N/A
N/A
16.5
8.8
N/A
N/A
22.5
2.1
Declining academic performance or grades
N/A
N/A
16.9
8.3
Disruptive or problem behavior
N/A
N/A
29.6
13.5
Social withdrawal from peers
N/A
N/A
9.3
3.3
Bullying
N/A
N/A
15.7
2.9
Alcohol or drug use
N/A
N/A
3.0
2.7
Do You have Health Coverage?
Overall, How Satisfied or Dissatisfied are You
with the Health Care Available to You?
Are You Currently Receiving Counseling or
Therapy for Mental Health or Substance Abuse
Problems?
Yes
Since Leaving the Military, My Children
Experienced the Following or Behaved In Any
of the Following Ways. (Percentages are of
those who have children.)
(continued)
3-63
Resilience among Military Personnel, Follow-Up Survey
Table 3-10.
Sample Characteristics of Transition Study Participants by Depression1
(continued)
Baseline
Measure
Total Sample
Yes2
40.6
Follow-Up
No2
Yes2
No2
59.4
38.9
61.1
1
Percentages are column percentages. So, for example, with gender, the percentages under Baseline High Resilience
are the percentages of those with high resilience at baseline who are male or who are female. Percentages may not
add to 100 because of rounding.
2
Yes means the individual met or exceeded the standard cut-off (16) for the CES-D scale.
3
Sample size for BL consists of all BL respondents who are eligible for the FU survey; for FU it consists of all
eligible respondents.
4
Minimum civilian time is 2 months.
5
At baseline, all respondents were employed by the military. At follow-up, a sizable percentage of the civilian
respondents are unemployed, which affects the work stress percentages.
6
Yes indicates a ―yes‖ on any of the mental health (anxiety, depression, PTSD, or suicidal ideation).
Source: 2007—Status of Transitioning Military Personnel Survey
3-64
Resilience among Military Personnel, Follow-Up Survey
Table 3-11.
Sample Characteristics of Transition Study Participants by Substance
Abuse1
Baseline
Follow-Up
Yes2
No2
Yes2
No2
1,541.0
1,889.0
290.0
775.0
Male
88.8
82.3
90.1
82.9
Female
11.2
17.7
9.9
17.1
White, non-Hispanic
63.7
58.6
63.9
60.1
African American, non-Hispanic
10.0
15.3
8.0
14.7
Hispanic
18.1
16.1
19.3
15.9
8.2
10.0
8.7
9.3
25 or younger
58.9
41.3
57.2
46.0
26–34
26.6
27.7
29.0
26.9
35 or older
14.5
31.0
13.8
27.1
Not married
58.2
42.2
60.4
44.5
Married
41.8
57.8
39.6
55.5
94.8
92.2
96.1
92.9
5.2
7.8
3.9
7.1
7.7
8.6
9.0
6.4
2–5 months
N/A
N/A
2.1
5.2
6–8 months
N/A
N/A
9.2
13.7
9–11 month
N/A
N/A
13.6
21.0
12–14 months
N/A
N/A
28.5
21.7
15–17 months
N/A
N/A
37.5
30.3
18+ months
N/A
N/A
9.2
8.1
Measure
Sample Size3
Gender
Race/Ethnicity
Other
Age
Family Status
Pay Grade
E1–E9, W1–W5
O1–O6
Disability or Separation for a Physical/ Mental
Condition that Interferes with Military Service
Time in Civilian Life4
(continued)
3-65
Resilience among Military Personnel, Follow-Up Survey
Table 3-11.
Sample Characteristics of Transition Study Participants by Substance
Abuse1 (continued)
Baseline
No2
Yes2
No2
N/A
N/A
11.5
10.8
Working full-time (work 35 or more hours
per week on average)
N/A
N/A
53.3
54.1
Working part-time (work fewer than 35
hours per week on average)
N/A
N/A
13.3
13.2
Working as self-employed in own business
or profession
N/A
N/A
1.6
3.8
Unemployed
N/A
N/A
29.5
28.0
An unpaid worker (volunteer)
N/A
N/A
4.0
5.7
Retired
N/A
N/A
8.5
14.5
In school
N/A
N/A
44.0
39.5
A homemaker, housewife, househusband
N/A
N/A
7.4
10.3
Disabled
N/A
N/A
19.3
16.2
Working multiple jobs
N/A
N/A
6.7
4.7
Working temporary job(s)
N/A
N/A
11.1
6.1
Less than $1,000
N/A
N/A
18.8
18.2
$1,000 to $1,499
N/A
N/A
19.2
16.8
$1,500 to $1,999
N/A
N/A
17.3
13.9
$2,000 to $2,999
N/A
N/A
17.2
20.0
$3,000 to $4,999
N/A
N/A
18.1
16.3
$5,000 or more
N/A
N/A
9.3
14.9
Are You Currently Receiving Any ServiceRelated Disability Compensation?
N/A
N/A
43.1
46.8
Measure
Single with Dependent Child(ren):
Yes2
Follow-Up
Employment Status (Mark all that apply)
Current personal monthly income:
(continued)
3-66
Resilience among Military Personnel, Follow-Up Survey
Table 3-11.
Sample Characteristics of Transition Study Participants by Substance
Abuse1 (continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Work Stress Indicator5
A lot
51.4
37.8
24.8
14.1
Some
30.4
33.8
27.4
27.4
A little
14.1
21.7
21.1
27.1
4.1
6.7
26.6
31.4
A lot
32.1
23.2
40.8
21.9
Some
27.5
29.6
26.4
24.0
A little
24.6
30.1
20.2
33.2
None
15.8
17.0
12.6
20.9
A lot
23.7
22.3
27.3
14.9
Some
19.8
24.0
17.3
19.6
A little
9.9
17.6
10.8
22.5
None
2.8
4.1
3.1
9.8
43.7
32.0
41.6
33.2
Very severe/severe
10.3
9.1
11.5
11.5
Moderate
30.9
29.9
31.9
30.2
Mild
22.7
21.0
24.8
19.2
Very mild
18.5
18.6
15.1
18.8
None
17.7
21.4
16.7
20.3
Low
22.0
19.1
28.8
18.3
Medium
48.2
46.8
41.7
42.7
High
29.8
34.0
29.6
39.0
None
Family Stress Indicator
Spouse Stress Indicator
I do not have a spouse
MOS Pain Indicator (past 4 weeks)
MOS Current Health Perception
(continued)
3-67
Resilience among Military Personnel, Follow-Up Survey
Table 3-11.
Sample Characteristics of Transition Study Participants by Substance
Abuse1 (continued)
Baseline
Measure
Yes2
Follow-up
No2
Yes2
No2
Combat Exposure Scale Score
Low
43.6
51.6
39.8
50.7
Medium
25.3
25.0
22.2
23.6
High
31.1
23.4
38.0
25.7
0.0
16.7
19.6
18.0
17.3
1.0
26.7
24.1
26.0
25.9
2.0
31.5
25.6
32.8
26.8
3 or 4
18.1
19.4
16.7
21.6
7.1
11.4
6.6
8.4
0 months
42.5
56.3
39.8
50.4
1 to 6 months
25.1
20.5
23.0
23.3
7 to 12 months
32.4
23.2
37.1
26.3
0 months
51.1
59.9
53.8
56.9
1 or 2 months
18.1
14.7
15.5
17.0
3 or 4 months
14.4
13.1
16.4
13.8
5 to 12 months
16.5
12.3
14.3
12.3
30.3
28.2
32.9
26.5
Iraq/Afghanistan
73.3
67.9
73.6
70.0
Other, Not Iraq or Afghanistan
13.7
16.4
12.9
16.5
None
13.0
15.7
13.5
13.6
Number of Career Combat Deployments
5 or more
Number of Months in Past Year on Combat
Deployments
Number of Months in Past Year on Noncombat
Deployment
Deployment Extension—Ever in Career
Yes
Place of Deployment
(continued)
3-68
Resilience among Military Personnel, Follow-Up Survey
Table 3-11.
Sample Characteristics of Transition Study Participants by Substance
Abuse1 (continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Currently Have Injuries or Health Problems as
a Result of my Military Experience
N/A
N/A
66.8
64.3
Currently Have Injuries or Health Problems
Not Related to my Service in the Military
N/A
N/A
14.0
12.5
Currently Working Reduced Hours Because of
Illness or Injury
N/A
N/A
8.5
4.3
Money Issues
N/A
N/A
53.2
41.7
Legal Issues
N/A
N/A
11.4
3.6
Smoker
51.8
32.2
41.4
25.1
Heavy Drinker
N/A
N/A
27.1
6.5
Since Leaving the Military, Have Your Coworkers or Supervisors Made Negative
Comments about any Recent Changes in Your
Appearance, Quality of Work, or
Relationships?
N/A
N/A
16.6
8.5
Since Leaving the Military, Have You had a
Physical or Mental Condition that Caused You
to Lose your Job?
N/A
N/A
5.8
3.4
Not employed or 0 job changes
N/A
N/A
43.0
59.2
1 job change
N/A
N/A
23.2
21.0
More than 1 job change
N/A
N/A
33.9
19.9
3 or more times
N/A
N/A
16.2
7.2
1 or 2 times
N/A
N/A
14.1
9.9
0 times
N/A
N/A
69.7
83.0
N/A
N/A
36.0
18.5
How Many Times Have You Changed Jobs
Since Leaving the Military?
Since Leaving the Military, How Often Have
You Been Late for Work due to Emotional or
Physical Problems?
Since Leaving the Military, Have You had
Problems Sleeping because of Nightmares?
(continued)
3-69
Resilience among Military Personnel, Follow-Up Survey
Table 3-11.
Sample Characteristics of Transition Study Participants by Substance
Abuse1 (continued)
Baseline
No2
Yes2
No2
N/A
N/A
64.5
37.6
A lot
N/A
N/A
17.8
11.3
Some
N/A
N/A
38.1
25.5
A little
N/A
N/A
26.8
31.6
None at all
N/A
N/A
17.3
31.6
Yes, but only 1 time
N/A
N/A
12.0
4.6
Yes, 2 or 3 times
N/A
N/A
21.0
4.5
Yes, more than 3 times
N/A
N/A
18.0
1.8
No
N/A
N/A
49.1
89.1
Yes, 1, 2, or 3+ times
N/A
N/A
11.6
1.7
No
N/A
N/A
88.4
98.3
Yes, 1, 2, or 3+ times
N/A
N/A
10.9
5.7
No
N/A
N/A
89.1
94.3
Not at all
N/A
N/A
8.7
22.8
A little
N/A
N/A
43.2
55.3
Some
N/A
N/A
35.6
16.2
A lot
N/A
N/A
12.5
5.7
Measure
Since Leaving the Military, Have You had
Problems with Anger, Frustration, Resentment,
Hostility or Losing Your Temper?
Yes2
Follow-Up
How Much Trouble Have You had Adjusting to
Civilian Life?
Since Leaving the Military Did You Drive a
Car or Other Vehicle when You had Too Much
to Drink?
Since Leaving the Military Did You Drive or
Ride in a Boat, Canoe, or Other Watercraft
when You had Too Much to Drink?
Since Leaving the Military Did You Ride or
Drive a Motorcycle without a Helmet?
Risk-Taking
(continued)
3-70
Resilience among Military Personnel, Follow-Up Survey
Table 3-11.
Sample Characteristics of Transition Study Participants by Substance
Abuse1 (continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Sensation-Seeking
Not at all
N/A
N/A
4.2
8.7
A little
N/A
N/A
19.0
33.7
Some
N/A
N/A
45.1
37.6
A lot
N/A
N/A
31.7
20.0
Avoidant Coping Strategy
85.9
67.4
84.3
71.1
Problem-Oriented Coping Strategy
95.5
96.6
94.0
97.0
Low
33.1
24.1
36.1
29.6
Medium
54.9
51.7
51.7
47.6
High
12.0
24.2
12.2
22.8
Low
15.5
11.6
13.4
11.9
Medium
58.8
54.7
61.2
55.3
High
25.7
33.6
25.4
32.8
Low
10.2
6.9
29.7
22.1
Medium
63.1
56.6
54.4
45.8
High
26.7
36.5
15.9
32.1
Physically Active, Moderate or Vigorous at
Least 3 Days/Week
69.1
64.6
59.6
64.1
Know at Least One Military Veteran to Talk to
about War Experiences or Other Stressful
Deployment Events
N/A
N/A
70.5
75.1
Talking to Another Veteran Helped Me Handle
Stress Better
N/A
N/A
84.2
83.3
Have the Opportunity to Interact with a Group
of Combat Veterans
N/A
N/A
33.7
36.8
Spirituality Indicator
DRRI Deployment Social Support Scale (Unit
Cohesion)
DRRI Post-deployment Social Support Scale
(Personal Social Support)
(continued)
3-71
Resilience among Military Personnel, Follow-Up Survey
Table 3-11.
Sample Characteristics of Transition Study Participants by Substance
Abuse1 (continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
What Type of Group(s)? (Mark all that apply.)
Social group
N/A
N/A
55.7
59.6
Support group
N/A
N/A
13.5
7.5
Reserve unit
N/A
N/A
14.0
13.3
Sports team
N/A
N/A
1.2
4.1
Other
N/A
N/A
30.0
36.3
Anxiety
29.5
17.6
31.7
16.6
Depression
49.6
33.0
53.6
32.6
PTSD
24.6
11.9
35.5
15.9
Substance Abuse Indicator (TICS)
N/A
N/A
N/A
N/A
9.9
5.1
21.6
7.0
Any Mental Health Problem
55.4
39.1
61.3
37.6
Resilience
88.6
93.5
86.9
91.2
Low
31.2
17.9
36.4
18.3
Medium
50.8
53.1
49.0
46.6
High
18.1
29.0
14.6
35.1
Any Activity Restriction due to Poor Mental
Health Past 30 Days
41.0
24.4
53.9
30.5
Any Receipt of Mental Health Services in the
Past 12 Months
34.6
26.9
40.0
22.5
Depression
15.7
10.3
22.5
10.7
Anxiety
12.5
8.4
20.0
9.4
Family problems
10.7
9.9
10.3
5.1
Substance use problems
7.7
1.1
4.5
0.6
Anger management
9.6
4.7
14.2
6.0
Stress management
11.0
7.6
15.7
7.9
Suicidal Ideation
6
MOS Mental Health Scale
Concerns for which Counseling Was Sought
(continued)
3-72
Resilience among Military Personnel, Follow-Up Survey
Table 3-11.
Sample Characteristics of Transition Study Participants by Substance
Abuse1 (continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Combat/operational stress
6.9
3.9
15.3
5.9
Other (specify)
5.4
5.2
4.7
3.2
70.1
76.8
67.5
82.5
Feel the Need for Counseling
33.3
22.8
41.5
24.9
Prescribed Medication for Mental Health Issue
in Past 12 Months
12.5
11.1
19.2
11.1
Very satisfied
N/A
N/A
17.2
23.3
Somewhat satisfied
N/A
N/A
32.9
35.1
Somewhat dissatisfied
N/A
N/A
14.3
9.4
Very dissatisfied
N/A
N/A
9.1
6.7
I have not received any health care since
leaving the military
N/A
N/A
26.6
25.5
A big problem
N/A
N/A
18.2
8.5
A small problem
N/A
N/A
23.1
20.5
Not a problem
N/A
N/A
58.7
71.0
Always
N/A
N/A
17.9
22.0
Usually
N/A
N/A
16.1
19.1
Sometimes
N/A
N/A
23.4
17.1
Never
N/A
N/A
14.7
7.7
I did not seek help from a mental health
professional in the past 12 months
Overall, How Satisfied or Dissatisfied are You
with the Quality of Health Care You have
Received since Leaving the Military?
Since Leaving the Military, How Much of a
Problem, If Any, were Delays in Health Care
while You Waited for Approval from Your
Health Plan?
Since Leaving the Military, when You Needed
Care Right Away for An Illness, Injury, or
Condition, How Often did You Get Care as
Soon as You Thought You Needed It?
(continued)
3-73
Resilience among Military Personnel, Follow-Up Survey
Table 3-11.
Sample Characteristics of Transition Study Participants by Substance
Abuse1 (continued)
Baseline
No2
Yes2
No2
N/A
N/A
27.9
34.0
N/A
N/A
20.4
12.0
I did not have the money to pay for care
N/A
N/A
44.5
36.4
I had to wait on approval from my health
insurance
N/A
N/A
11.4
8.4
I could not fit it into my schedule
N/A
N/A
0.0
2.6
I could not afford to miss work
N/A
N/A
8.8
9.3
I had to wait too long for an appointment
N/A
N/A
21.7
27.4
I had to drive too far for the medical care
N/A
N/A
7.0
4.6
Other
N/A
N/A
6.5
11.3
N/A
N/A
80.6
85.1
Very satisfied
N/A
N/A
24.8
33.4
Somewhat satisfied
N/A
N/A
41.7
47.2
Somewhat dissatisfied
N/A
N/A
15.7
10.4
Very dissatisfied
N/A
N/A
17.8
9.0
N/A
N/A
15.3
7.2
Measure
I have not needed health care since leaving
the military.
Since Leaving the Military, was there Any
Time when You Needed Medical Care or
Surgery but Did Not Get It?
Yes2
Follow-Up
If yes, what was the main reason you
didn’t get the care you needed?
Do You Have Health Coverage?
Overall, How Satisfied or Dissatisfied are You
with the Health Care Available to You?
Are You Currently Receiving Counseling or
Therapy for Mental Health or Substance Abuse
Problems?
Yes
(continued)
3-74
Resilience among Military Personnel, Follow-Up Survey
Table 3-11.
Sample Characteristics of Transition Study Participants by Substance
Abuse1 (continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Since Leaving the Military, My Children
Experienced the Following or Behaved in Any
of the Following Ways. (Percentages are of
those who have children.)
Declining academic performance or grades
N/A
N/A
16.7
9.7
Disruptive or problem behavior
N/A
N/A
20.7
18.4
Social withdrawal from peers
N/A
N/A
8.7
4.4
Bullying
N/A
N/A
12.3
6.1
Alcohol or drug use
N/A
N/A
6.0
1.7
44.9
55.1
28.7
71.3
Total Sample
1
Percentages are column percentages. So, for example, with gender, the percentages under Baseline High Resilience
are the percentage of those with high resilience at baseline who are male or who are female. Percentages may not
add to 100 because of rounding.
2
Yes indicates individuals having a score of 1 or 2 on the Two Item Conjoint Screen (TICS) measure for alcohol
and drug abuse.
3
Sample size for BL consists of all BL respondents who are eligible for the FU survey; for FU it consists of all
eligible respondents.
4
Minimum civilian time is 2 months.
5
At baseline, all respondents were employed by the military. At follow-up, a sizable percentage of the civilian
respondents are unemployed, which affects the work stress percentages.
6
Yes indicates a ―yes‖ on any of the mental health (anxiety, depression, PTSD or suicidal ideation).
Source: 2007—Status of Transitioning Military Personnel Survey
3-75
Resilience among Military Personnel, Follow-Up Survey
Table 3-12.
Sample Characteristics of Transition Study Participants by PTSD1
Baseline
Follow-Up
Yes2
No2
Yes2
No2
603.0
2813.0
211.0
823.0
Male
84.9
85.4
85.8
84.8
Female
15.1
14.6
14.2
15.2
White, non-Hispanic
56.8
61.7
58.5
63.1
African American, non-Hispanic
15.1
12.6
11.8
12.9
Hispanic
18.3
16.8
18.4
15.6
9.9
8.9
11.3
8.4
25 or younger
57.5
47.2
50.8
48.2
26–34
28.3
27.1
33.0
26.2
35 or older
14.2
25.7
16.2
25.6
Not married
52.6
48.7
58.1
46.4
Married
47.4
51.3
41.9
53.6
96.7
92.6
97.4
92.7
3.3
7.4
2.6
7.3
17.9
6.2
12.9
5.8
2–5 months
N/A
N/A
3.0
4.5
6–8 months
N/A
N/A
10.0
13.4
9–11 month
N/A
N/A
15.6
19.0
12–14 months
N/A
N/A
33.4
21.7
15–17 months
N/A
N/A
30.4
32.7
18+ months
N/A
N/A
7.6
8.7
Measure
Sample Size3
Gender
Race/Ethnicity
Other
Age
Family Status
Pay Grade
E1–E9, W1–W5
O1–O6
Disability or Separation for a Physical/Mental
Condition that Interferes with Military Service
Time in Civilian Life4
(continued)
3-76
Resilience among Military Personnel, Follow-Up Survey
Table 3-12.
Sample Characteristics of Transition Study Participants by PTSD1
(continued)
Baseline
Measure
Single with Dependent Child(ren):
Yes2
Follow-Up
No2
Yes2
No2
N/A
N/A
17.8
8.9
Working full-time (work 35 or more hours
per week on average)
N/A
N/A
49.8
54.1
Working part-time (work fewer than 35
hours per week on average)
N/A
N/A
9.9
14.3
Working as self-employed in own business
or profession
N/A
N/A
2.2
3.4
Unemployed
N/A
N/A
37.0
26.7
An unpaid worker (volunteer)
N/A
N/A
5.0
5.3
Retired
N/A
N/A
11.2
13.3
In school
N/A
N/A
34.2
42.2
A homemaker, housewife, househusband
N/A
N/A
7.8
10.1
Disabled
N/A
N/A
30.2
13.6
Working multiple jobs
N/A
N/A
4.4
5.3
Working temporary job(s)
N/A
N/A
10.6
6.9
Less than $1,000
N/A
N/A
20.4
18.0
$1,000 to $1,499
N/A
N/A
17.7
17.5
$1,500 to $1,999
N/A
N/A
14.0
15.3
$2,000 to $2,999
N/A
N/A
22.5
17.6
$3,000 to $4,999
N/A
N/A
18.1
16.6
$5,000 or more
N/A
N/A
7.2
15.1
Are You Currently Receiving any ServiceRelated Disability Compensation?
N/A
N/A
58.6
42.7
Employment Status (Mark all that apply)
Current personal monthly income:
(continued)
3-77
Resilience among Military Personnel, Follow-Up Survey
Table 3-12.
Sample Characteristics of Transition Study Participants by PTSD1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Work Stress Indicator5
A lot
71.6
38.1
39.7
11.5
Some
20.4
34.7
27.0
27.1
A little
6.7
20.9
10.5
29.2
None
1.3
6.4
22.8
32.2
A lot
50.6
22.3
60.3
18.3
Some
29.4
28.5
23.1
24.8
A little
13.7
30.6
9.5
35.1
6.3
18.6
7.1
21.7
A lot
33.7
20.7
35.2
14.1
Some
19.1
22.7
16.9
19.2
A little
8.4
15.4
5.4
23.0
None
3.0
3.6
2.2
9.4
35.8
37.6
40.3
34.3
Very severe/severe
23.3
6.7
31.7
5.9
Moderate
40.9
28.1
36.9
28.0
Mild
18.1
22.6
18.2
22.0
Very mild
10.5
20.2
7.2
21.2
7.3
22.4
6.0
22.9
Low
48.3
14.3
53.4
12.2
Medium
40.9
48.9
41.3
42.5
High
10.7
36.8
5.3
45.3
Family Stress Indicator
None
Spouse Stress Indicator
I do not have a spouse
MOS Pain Indicator (past 4 weeks)
None
MOS Current Health Perception
(continued)
3-78
Resilience among Military Personnel, Follow-Up Survey
Table 3-12.
Sample Characteristics of Transition Study Participants by PTSD1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Combat Exposure Scale Score
Low
34.2
51.0
27.1
53.1
Medium
21.0
25.9
25.3
22.5
High
44.9
23.1
47.6
24.4
0.0
20.7
17.7
16.3
18.1
1.0
23.9
25.6
22.8
27.0
2.0
30.6
27.6
33.9
26.7
3 or 4
18.0
18.9
20.3
19.9
6.7
10.1
6.7
8.2
0 months
48.2
50.6
41.8
49.4
1 to 6 months
19.3
23.3
18.1
24.4
7 to 12 months
32.5
26.1
40.1
26.2
0 months
58.2
55.6
57.4
55.4
1 or 2 months
14.4
16.5
16.7
17.3
3 or 4 months
11.2
14.1
12.5
14.9
5 to 12 months
16.1
13.7
13.3
12.3
30.7
28.9
33.3
26.5
Iraq/Afghanistan
69.9
70.3
78.0
69.4
Other, Not Iraq or Afghanistan
13.6
15.6
9.2
16.9
None
16.5
14.1
12.9
13.7
N/A
N/A
86.6
59.2
Number of Career Combat Deployments
5 or more
Number of Months in Past Year on Combat
Deployments
Number of Months in Past Year on Noncombat
Deployment
Deployment Extension—Ever in Career
Yes
Place of Deployment
Currently Have Injuries or Health Problems as
a Result of My Military Experience
(continued)
3-79
Resilience among Military Personnel, Follow-Up Survey
Table 3-12.
Sample Characteristics of Transition Study Participants by PTSD1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Currently Have Injuries or Health Problems Not
Related to My Service in the Military
N/A
N/A
18.5
11.4
Currently Working Reduced Hours Because of
Illness or Injury
N/A
N/A
15.5
2.8
Money Issues
N/A
N/A
67.2
38.5
Legal Issues
N/A
N/A
11.8
4.0
Smoker
52.0
38.7
37.3
27.8
Heavy Drinker
N/A
N/A
19.4
10.7
Since Leaving the Military, Have Your Coworkers or Supervisors Made Negative
Comments about Any Recent Changes in Your
Appearance, Quality of Work, or
Relationships?
N/A
N/A
27.3
6.3
Since Leaving the Military, Have You had a
Physical or Mental Condition that Caused You
to Lose Your Job?
N/A
N/A
12.6
1.3
Not employed or 0 job changes
N/A
N/A
46.2
57.1
1 job change
N/A
N/A
21.5
21.9
More than 1 job change
N/A
N/A
32.3
21.0
3 or more times
N/A
N/A
26.8
4.7
1 or 2 times
N/A
N/A
21.0
8.2
0 times
N/A
N/A
52.2
87.1
Since Leaving the Military, Have You had
Problems Sleeping because of Nightmares?
N/A
N/A
57.6
14.6
Since Leaving the Military, Have You had
Problems with Anger, Frustration, Resentment,
Hostility or Losing Your Temper?
N/A
N/A
86.4
34.3
How Many Times Have You Changed Jobs
since Leaving the Military?
Since Leaving the Military, How Often Have
You Been Late for Work due to Emotional or
Physical Problems?
(continued)
3-80
Resilience among Military Personnel, Follow-Up Survey
Table 3-12.
Sample Characteristics of Transition Study Participants by PTSD1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
How Much Trouble Have You had Adjusting to
Civilian Life?
A lot
N/A
N/A
42.7
5.2
Some
N/A
N/A
41.1
26.0
A little
N/A
N/A
11.8
35.2
None at all
N/A
N/A
4.5
33.7
Yes, but only 1 time
N/A
N/A
5.8
7.0
Yes, 2 or 3 times
N/A
N/A
11.5
8.8
Yes, more than 3 times
N/A
N/A
11.6
5.2
No
N/A
N/A
71.1
79.1
Yes, 1, 2, or 3+ times
N/A
N/A
10.4
3.1
No
N/A
N/A
89.6
96.9
Yes, 1, 2, or 3+ times
N/A
N/A
12.1
5.7
No
N/A
N/A
87.9
94.3
Not at all
N/A
N/A
8.0
21.6
A little
N/A
N/A
35.4
56.5
Some
N/A
N/A
35.7
17.8
A lot
N/A
N/A
20.9
4.2
Since Leaving the Military Did You Drive a
Car or Other Vehicle when You had Too Much
to Drink?
Since Leaving the Military Did You Drive or
Ride in a Boat, Canoe, or Other Watercraft
when You had Too Much to Drink?
Since Leaving the Military Did You Ride or
Drive a Motorcycle without a Helmet?
Risk-Taking
(continued)
3-81
Resilience among Military Personnel, Follow-Up Survey
Table 3-12.
Sample Characteristics of Transition Study Participants by PTSD1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Sensation-Seeking
Not at all
N/A
N/A
9.8
6.4
A little
N/A
N/A
24.5
30.8
Some
N/A
N/A
31.2
43.1
A lot
N/A
N/A
34.4
19.7
Avoidant Coping Strategy
88.0
73.0
80.7
73.2
Problem-Oriented Coping Strategy
93.2
96.8
94.0
96.6
Low
28.6
28.0
35.9
30.4
Medium
54.4
52.8
47.7
48.8
High
16.9
19.2
16.4
20.8
Low
25.1
11.0
19.6
10.6
Medium
53.8
57.1
52.3
57.9
High
21.0
31.9
28.1
31.5
Low
22.4
5.4
58.0
14.9
Medium
67.7
57.8
35.6
51.8
High
10.0
36.8
6.4
33.3
Physically Active, Moderate or Vigorous at
Least 3 Days/Week
61.8
67.7
52.0
65.8
Know at Least One Military Veteran to Talk to
about War Experiences or Other Stressful
Deployment Events
N/A
N/A
69.3
75.0
Talking to Another Veteran Helped Me Handle
Stress Better
N/A
N/A
73.4
86.2
Have the Opportunity to Interact with a Group
of Combat Veterans
N/A
N/A
33.6
36.7
Spirituality Indicator
DRRI Deployment Social Support Scale (Unit
Cohesion)
DRRI Post-deployment Social Support Scale
(Personal Social Support)
(continued)
3-82
Resilience among Military Personnel, Follow-Up Survey
Table 3-12.
Sample Characteristics of Transition Study Participants by PTSD1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
What Type of Group(s)? (Mark all that apply.)
Social group
N/A
N/A
43.0
62.3
Support group
N/A
N/A
26.3
5.0
Reserve unit
N/A
N/A
8.8
14.9
Sports team
N/A
N/A
2.5
3.5
Other
N/A
N/A
42.7
32.3
Anxiety
71.3
12.6
62.9
9.1
Depression
93.3
28.9
92.7
23.0
PTSD
N/A
N/A
N/A
N/A
Substance Abuse Indicator (TICS)
62.8
41.2
47.5
23.7
Suicidal Ideation
24.9
3.6
36.4
4.5
100.0
34.3
100.0
27.6
79.2
93.9
71.1
95.3
Low
72.0
13.5
77.0
8.7
Medium
27.5
57.3
20.2
54.8
0.5
29.2
2.8
36.5
Any Activity Restriction due to Poor Mental
Health Past 30 Days
74.7
22.8
78.2
26.1
Any Receipt of Mental Health Services in the
Past 12 Months
57.8
24.6
63.3
18.0
Depression
37.8
7.4
43.5
6.2
Anxiety
30.9
5.9
40.9
4.8
Family problems
22.4
7.7
13.9
4.6
8.3
3.1
3.6
1.2
Anger management
21.4
3.8
29.9
2.6
Stress management
26.2
5.5
32.9
4.1
Combat/operational stress
16.7
2.7
31.6
2.5
6
Any Mental Health Problem
Resilience
MOS Mental Health Scale
High
Concerns for which Counseling Was Sought
Substance use problems
(continued)
3-83
Resilience among Military Personnel, Follow-Up Survey
Table 3-12.
Sample Characteristics of Transition Study Participants by PTSD1
(continued)
Baseline
Measure
Other (specify)
Yes2
Follow-Up
No2
Yes2
No2
7.6
4.8
5.1
3.3
47.7
79.3
46.9
86.6
Feel the Need for Counseling
64.3
19.7
73.0
18.0
Prescribed Medication for Mental Health Issue
in Past 12 Months
33.3
7.3
38.2
6.8
Very satisfied
N/A
N/A
16.9
23.5
Somewhat satisfied
N/A
N/A
37.3
32.5
Somewhat dissatisfied
N/A
N/A
13.5
9.5
Very dissatisfied
N/A
N/A
15.0
5.5
I have not received any health care since
leaving the military
N/A
N/A
17.3
29.0
A big problem
N/A
N/A
23.1
7.8
A small problem
N/A
N/A
30.4
18.0
Not a problem
N/A
N/A
46.5
74.1
Always
N/A
N/A
14.6
22.8
Usually
N/A
N/A
22.7
16.8
Sometimes
N/A
N/A
30.0
15.5
Never
N/A
N/A
15.8
8.3
I have not needed health care since leaving
the military.
N/A
N/A
16.9
36.6
I did not seek help from a mental health
professional in the past 12 months
Overall, How Satisfied or Dissatisfied are You
with the Quality of Health Care You Have
Received Since Leaving the Military?
Since Leaving the Military, How Much of a
Problem, If Any, were Delays in Health Care
while You Waited for Approval from Your
Health Plan?
Since Leaving the Military, when You Needed
Care Right Away for an Illness, Injury, or
Condition, How Often did You Get Care as
soon as You Thought You Needed It?
(continued)
3-84
Resilience among Military Personnel, Follow-Up Survey
Table 3-12.
Sample Characteristics of Transition Study Participants by PTSD1
(continued)
Baseline
Measure
Since Leaving the Military, was there Any
Time when You Needed Medical Care or
Surgery but Did Not Get It?
Yes2
Follow-Up
No2
Yes2
No2
N/A
N/A
25.4
11.4
I did not have the money to pay for care
N/A
N/A
39.8
40.2
I had to wait on approval from my health
insurance
N/A
N/A
13.1
8.0
I could not fit it into my schedule
N/A
N/A
0.0
2.6
I could not afford to miss work
N/A
N/A
8.6
8.0
I had to wait too long for an appointment
N/A
N/A
20.4
27.1
I had to drive too far for the medical care
N/A
N/A
10.2
3.1
Other
N/A
N/A
7.8
11.0
N/A
N/A
85.6
82.9
Very satisfied
N/A
N/A
23.4
33.5
Somewhat satisfied
N/A
N/A
43.8
44.9
Somewhat dissatisfied
N/A
N/A
15.9
11.0
Very dissatisfied
N/A
N/A
16.9
10.6
N/A
N/A
32.2
3.4
If yes, what was the main reason you didn’t
get the care you needed?
Do You have Health Coverage?
Overall, How Satisfied or Dissatisfied are You
with the Health Care Available to You?
Are You Currently Receiving Counseling or
Therapy for Mental Health or Substance Abuse
Problems?
Yes
(continued)
3-85
Resilience among Military Personnel, Follow-Up Survey
Table 3-12.
Sample Characteristics of Transition Study Participants by PTSD1
(continued)
Baseline
Measure
Yes2
Follow-Up
No2
Yes2
No2
Since Leaving the Military, My Children
Experienced the Following or Behaved in Any
of the Following Ways. (Percentages are of
those who have children.)
Declining academic performance or grades
N/A
N/A
19.4
9.1
Disruptive or problem behavior
N/A
N/A
34.2
14.5
Social withdrawal from peers
N/A
N/A
11.5
3.7
Bullying
N/A
N/A
15.9
5.3
Alcohol or drug use
N/A
N/A
0.7
3.2
17.7
82.3
21.6
78.4
Total Sample
1
Percentages are column percentages. So, for example, with gender, the percentages under Baseline High Resilience
are the percentage of those with high resilience at baseline who are male or who are female. Percentages may not
add to 100 because of rounding.
2
Yes indicates a score greater than or equal to 50 on PTSD Checklist of the Department of Veterans—civilian
version (PCL-C).
3
Sample size for BL consists of all BL respondents who are eligible for the FU survey; for FU it consists of all
eligible respondents.
4
Minimum civilian time is 2 months.
5
At baseline, all respondents were employed by the military. At follow-up, a sizable percentage of the civilian
respondents are unemployed, which affects the work stress percentages.
6
Yes indicates a ―yes‖ on any of the mental health (anxiety, depression, PTSD, or suicidal ideation).
Source: 2007—Status of Transitioning Military Personnel Survey
3-86
Resilience among Military Personnel, Follow-Up Survey
Table 3-13.
Sample Characteristics of Transition Study Participants by Suicidal
Ideation1
Baseline
Measure
Sample Size3
Yes2
Follow-Up
No2
Yes2
No2
242.0
3,096.0
117.0
941.0
Male
80.8
85.4
82.1
85.3
Female
19.2
14.6
17.9
14.7
White, non-Hispanic
60.2
60.9
57.4
62.0
African American, non-Hispanic
12.9
12.6
10.6
13.1
Hispanic
15.8
17.2
17.3
16.6
Other
11.2
9.2
14.7
8.3
25 or younger
59.1
48.0
57.0
48.0
26–34
27.0
27.4
24.7
28.1
35 or older
13.9
24.6
18.3
23.9
Not married
58.5
48.9
59.2
47.9
Married
41.5
51.1
40.8
52.1
95.9
92.9
97.9
93.2
4.1
7.1
2.1
6.8
23.1
7.0
13.8
6.3
2–5 months
N/A
N/A
3.1
4.1
6–8 months
N/A
N/A
12.2
12.5
9–11 month
N/A
N/A
15.4
19.2
12–14 months
N/A
N/A
30.3
23.0
15–17 months
N/A
N/A
30.9
32.5
18+ months
N/A
N/A
8.1
8.6
Gender
Race/Ethnicity
Age
Family Status
Pay Grade
E1–E9, W1–W5
O1–O6
Disability or Separation for a Physical/Mental
Condition that Interferes with Military Service
Time in Civilian Life4
(continued)
3-87
Resilience among Military Personnel, Follow-Up Survey
Table 3-13.
Sample Characteristics of Transition Study Participants by Suicidal
Ideation1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
N/A
N/A
17.7
10.1
Working full-time (work 35 or more hours
per week on average)
N/A
N/A
46.2
54.6
Working part-time (work fewer than 35
hours per week on average)
N/A
N/A
10.1
13.8
Working as self-employed in own
business or profession
N/A
N/A
2.3
3.3
Unemployed
N/A
N/A
39.9
27.1
An unpaid worker (volunteer)
N/A
N/A
6.2
5.1
Retired
N/A
N/A
7.5
13.4
In school
N/A
N/A
43.5
40.2
A homemaker, housewife, househusband
N/A
N/A
9.8
9.5
Disabled
N/A
N/A
31.7
15.3
Working multiple jobs
N/A
N/A
4.7
5.4
Working temporary job(s)
N/A
N/A
6.5
7.9
Less than $1,000
N/A
N/A
24.5
17.5
$1,000 to $1,499
N/A
N/A
22.1
16.8
$1,500 to $1,999
N/A
N/A
13.7
15.2
$2,000 to $2,999
N/A
N/A
19.9
19.2
$3,000 to $4,999
N/A
N/A
13.5
17.1
$5,000 or more
N/A
N/A
6.4
14.2
Are You Currently Receiving any ServiceRelated Disability Compensation?
N/A
N/A
58.6
44.4
Measure
Single with Dependent Child(ren):
Employment Status (Mark all that apply)
Current personal monthly income:
(continued)
3-88
Resilience among Military Personnel, Follow-Up Survey
Table 3-13.
Sample Characteristics of Transition Study Participants by Suicidal
Ideation1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
A lot
69.3
41.8
34.2
15.2
Some
22.4
33.2
23.1
27.7
A little
6.6
19.2
17.4
26.6
None
1.7
5.7
25.3
30.4
A lot
50.4
25.3
62.4
22.9
Some
28.3
28.9
18.0
25.6
A little
14.2
28.7
8.9
31.9
7.1
17.2
10.7
19.6
A lot
32.9
22.0
34.2
16.4
Some
16.7
22.5
15.0
19.4
A little
7.9
14.8
7.3
20.7
None
2.1
3.7
0.0
8.9
40.4
37.1
43.5
34.7
Very severe/severe
18.6
8.8
30.3
9.2
Moderate
38.0
29.8
36.9
29.7
Mild
19.4
21.9
22.6
20.7
Very mild
15.3
19.0
5.2
19.4
8.7
20.5
5.0
21.1
Low
42.1
18.6
60.9
16.1
Medium
45.8
47.7
34.2
43.7
High
12.1
33.7
4.9
40.2
Measure
Work Stress Indicator5
Family Stress Indicator
None
Spouse Stress Indicator
I do not have a spouse
MOS Pain Indicator (past 4 weeks)
None
MOS Current Health Perception
(continued)
3-89
Resilience among Military Personnel, Follow-Up Survey
Table 3-13.
Sample Characteristics of Transition Study Participants by Suicidal
Ideation1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
Low
40.6
48.7
33.6
49.3
Medium
24.4
25.2
24.4
23.0
High
35.0
26.1
42.0
27.7
0.0
26.5
17.6
20.6
17.2
1.0
28.2
25.0
26.4
26.0
2.0
21.8
28.5
30.3
28.3
3 or 4
18.1
18.9
18.3
20.2
5.5
10.0
4.4
8.3
0 months
51.7
50.1
53.1
47.1
1 to 6 months
18.1
22.9
17.0
23.7
7 to 12 months
30.3
27.0
30.0
29.2
0 months
57.1
56.1
64.9
55.1
1 or 2 months
14.3
16.3
12.4
17.1
3 or 4 months
12.2
13.7
8.8
15.2
5 to 12 months
16.4
13.8
14.0
12.6
23.2
29.5
36.8
27.2
Iraq/Afghanistan
63.0
71.0
72.3
71.1
Other, Not Iraq or Afghanistan
14.3
15.3
8.5
16.0
None
22.6
13.7
19.3
12.9
Measure
Combat Exposure Scale Score
Number of career Combat Deployments
5 or more
Number of Months in Past Year on Combat
Deployments
Number of Months in Past Year on
Noncombat Deployment
Deployment Extension—Ever in Career
Yes
Place of Deployment
(continued)
3-90
Resilience among Military Personnel, Follow-Up Survey
Table 3-13.
Sample Characteristics of Transition Study Participants by Suicidal
Ideation1 (continued)
Baseline
Follow-Up
Measure
Yes2
No2
Yes2
No2
Currently Have Injuries or Health Problems as
a Result of my Military Experience
N/A
N/A
89.9
62.1
Currently Have Injuries or Health Problems
Not Related to my Service in the Military
N/A
N/A
24.6
11.7
Currently Working Reduced Hours Because of
Illness or Injury
N/A
N/A
18.3
4.0
Money Issues
N/A
N/A
68.5
42.1
Legal Issues
N/A
N/A
16.9
4.5
Smoker
51.5
40.4
35.8
29.2
Heavy Drinker
N/A
N/A
14.9
12.0
Since Leaving the Military, Have Your Coworkers or Supervisors Made Negative
Comments about any Recent Changes in Your
Appearance, Quality of Work, or
Relationships?
N/A
N/A
29.6
8.6
Since Leaving the Military, Have You had a
Physical or Mental Condition that Caused You
to Lose Your Job?
N/A
N/A
13.2
2.7
Not employed or 0 job changes
N/A
N/A
47.3
55.4
1 job change
N/A
N/A
19.7
21.8
More than 1 job change
N/A
N/A
33.0
22.8
3 or more times
N/A
N/A
31.0
7.1
1 or 2 times
N/A
N/A
16.6
10.6
0 times
N/A
N/A
52.4
82.4
Since Leaving the Military, Have You had
Problems Sleeping because of Nightmares?
N/A
N/A
53.2
19.9
Since Leaving the Military, Have You had
Problems with Anger, Frustration, Resentment,
Hostility or Losing Your Temper?
N/A
N/A
87.3
40.1
How Many Times Have You Changed Jobs
since Leaving the Military?
Since Leaving the Military, How Often Have
You Been Late for Work due to Emotional or
Physical Problems?
(continued)
3-91
Resilience among Military Personnel, Follow-Up Survey
Table 3-13.
Sample Characteristics of Transition Study Participants by Suicidal
Ideation1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
A lot
N/A
N/A
42.8
9.4
Some
N/A
N/A
34.5
28.5
A little
N/A
N/A
18.1
31.8
None at all
N/A
N/A
4.6
30.3
Yes, but only 1 time
N/A
N/A
5.7
6.8
Yes, 2 or 3 times
N/A
N/A
12.6
8.8
Yes, more than 3 times
N/A
N/A
13.6
5.7
No
N/A
N/A
68.1
78.6
Yes, 1, 2, or 3+ times
N/A
N/A
5.9
4.5
No
N/A
N/A
94.1
95.5
Yes, 1, 2, or 3+ times
N/A
N/A
6.7
7.3
No
N/A
N/A
93.3
92.7
Not at all
N/A
N/A
12.7
19.6
A little
N/A
N/A
32.5
54.2
Some
N/A
N/A
38.8
19.5
A lot
N/A
N/A
16.0
6.8
Measure
No2
How Much Trouble Have You had Adjusting
to Civilian Life?
Since Leaving the Military Did You Drive a
Car or Other Vehicle when You had Too Much
to Drink?
Since Leaving the Military Did You Drive or
Ride in a Boat, Canoe, or Other Watercraft
when You had Too Much to Drink?
Since Leaving the Military Did You Ride or
Drive a Motorcycle without a Helmet?
Risk-Taking
(continued)
3-92
Resilience among Military Personnel, Follow-Up Survey
Table 3-13.
Sample Characteristics of Transition Study Participants by Suicidal
Ideation1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
Not at all
N/A
N/A
10.1
7.0
A little
N/A
N/A
25.5
30.0
Some
N/A
N/A
35.8
40.3
A lot
N/A
N/A
28.6
22.7
Avoidant Coping Strategy
88.4
74.4
82.3
74.1
Problem-Oriented Coping Strategy
94.2
96.4
94.1
96.4
Low
31.3
27.9
34.2
31.3
Medium
51.5
53.2
47.5
49.2
High
17.2
18.9
18.3
19.6
Low
31.2
12.0
19.6
11.4
Medium
50.3
57.2
55.8
57.6
High
18.5
30.8
24.6
31.0
Low
25.4
6.9
56.1
20.0
Medium
65.2
59.2
38.7
49.6
9.4
33.9
5.2
30.4
Physically Active, Moderate or Vigorous at
Least 3 Days/Week
66.0
66.5
51.4
64.1
Know at Least One Military Veteran to Talk to
about War Experiences or Other Stressful
Deployment Events
N/A
N/A
59.7
75.6
Talking to Another Veteran Helped Me Handle
Stress Better
N/A
N/A
67.9
85.2
Have the Opportunity to Interact with a Group
of Combat Veterans
N/A
N/A
32.8
36.3
Measure
No2
Sensation-Seeking
Spirituality Indicator
DRRI Deployment Social Support Scale (Unit
Cohesion)
DRRI Post-deployment Social Support Scale
(Personal Social Support)
High
(continued)
3-93
Resilience among Military Personnel, Follow-Up Survey
Table 3-13.
Sample Characteristics of Transition Study Participants by Suicidal
Ideation1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
Social group
N/A
N/A
44.9
59.6
Support group
N/A
N/A
36.4
6.3
Reserve unit
N/A
N/A
3.6
14.9
Sports team
N/A
N/A
0.0
3.7
Other
N/A
N/A
45.4
33.3
Anxiety
59.8
20.1
61.7
15.9
Depression
90.4
36.1
90.8
31.9
PTSD
59.5
14.1
69.2
15.6
Substance Abuse Indicator (TICS)
61.4
43.7
55.7
25.5
Suicidal Ideation
N/A
N/A
N/A
N/A
100.0
41.2
100.0
37.1
71.7
92.8
68.4
92.8
Low
70.2
19.8
71.5
17.3
Medium
27.3
54.1
24.9
50.4
2.5
26.1
3.6
32.3
Any Activity Restriction due to Poor Mental
Health Past 30 Days
79.3
28.2
81.5
31.9
Any Receipt of Mental Health Services in the
Past 12 Months
59.9
27.9
63.3
23.1
Depression
48.9
9.8
47.7
9.8
Anxiety
33.2
8.4
39.4
9.0
Family problems
23.8
8.9
19.4
5.0
Substance use problems
10.6
3.4
4.6
1.4
Anger management
26.0
5.2
29.8
5.7
Stress management
30.6
7.3
32.6
7.4
Combat/operational stress
14.0
4.4
28.4
6.2
Measure
What Type of Group(s)? (Mark all that apply.)
6
Any Mental Health Problem
Resilience
MOS Mental Health Scale
High
Concerns for which Counseling Was Sought
(continued)
3-94
Resilience among Military Personnel, Follow-Up Survey
Table 3-13.
Sample Characteristics of Transition Study Participants by Suicidal
Ideation1 (continued)
Baseline
Measure
Other (specify)
Yes2
Follow-Up
No2
Yes2
No2
6.4
5.2
6.6
3.3
43.0
76.6
47.2
82.1
Feel the Need for Counseling
76.9
23.5
74.5
24.2
Prescribed Medication for Mental Health Issue
in Past 12 Months
36.8
9.9
37.1
10.6
Very satisfied
N/A
N/A
21.8
21.4
Somewhat satisfied
N/A
N/A
27.0
35.2
Somewhat dissatisfied
N/A
N/A
18.0
10.0
Very dissatisfied
N/A
N/A
14.3
6.6
I have not received any health care since
leaving the military
N/A
N/A
18.8
26.8
A big problem
N/A
N/A
25.6
9.4
A small problem
N/A
N/A
31.0
19.8
Not a problem
N/A
N/A
43.4
70.8
Always
N/A
N/A
13.5
21.8
Usually
N/A
N/A
23.5
17.6
Sometimes
N/A
N/A
31.5
17.2
Never
N/A
N/A
13.6
9.3
I have not needed health care since
leaving the military.
N/A
N/A
18.0
34.0
I did not seek help from a mental health
professional in the past 12 months
Overall, How Satisfied or Dissatisfied are You
with the Quality of Health Care You Have
Received since Leaving the Military?
Since Leaving the Military, How Much of a
Problem, If Any, were Delays in Health Care
while You Waited for Approval from Your
Health Plan?
Since Leaving the Military, when You Needed
Care Right Away for an Illness, Injury, or
Condition, How Often did You Get Care as
Soon as You Thought You Needed It?
(continued)
3-95
Resilience among Military Personnel, Follow-Up Survey
Table 3-13.
Sample Characteristics of Transition Study Participants by Suicidal
Ideation1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
N/A
N/A
30.1
12.5
I did not have the money to pay for care
N/A
N/A
39.6
39.7
I had to wait on approval from my health
insurance
N/A
N/A
11.4
9.1
I could not fit it into my schedule
N/A
N/A
0.0
2.0
I could not afford to miss work
N/A
N/A
7.5
9.3
I had to wait too long for an appointment
N/A
N/A
20.3
26.6
I had to drive too far for the medical care
N/A
N/A
12.1
3.6
Other
N/A
N/A
9.0
9.6
N/A
N/A
87.4
83.3
Very satisfied
N/A
N/A
18.9
32.1
Somewhat satisfied
N/A
N/A
44.5
45.8
Somewhat dissatisfied
N/A
N/A
16.0
11.5
Very dissatisfied
N/A
N/A
20.6
10.5
N/A
N/A
32.6
6.7
Measure
Since Leaving the Military, was there any
Time when You Needed Medical Care or
Surgery but Did Not Get It?
If yes, what was the main reason you
didn’t get the care you needed?
Do You Have Health Coverage?
Overall, How Satisfied or Dissatisfied are You
with the Health Care Available to You?
Are You Currently Receiving Counseling or
Therapy for Mental Health or Substance Abuse
Problems?
Yes
(continued)
3-96
Resilience among Military Personnel, Follow-Up Survey
Table 3-13.
Sample Characteristics of Transition Study Participants by Suicidal
Ideation1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
Declining academic performance or
grades
N/A
N/A
23.8
9.6
Disruptive or problem behavior
N/A
N/A
37.5
16.5
Social withdrawal from peers
N/A
N/A
19.4
3.6
Bullying
N/A
N/A
26.4
5.1
Alcohol or drug use
N/A
N/A
4.0
2.5
7.2
92.8
11.3
88.7
Measure
No2
Since Leaving the Military, My Children
Experienced the Following or Behaved in any
of the Following Ways. (Percentages are of
those who have children.)
Total Sample
1
Percentages are column percentages. So, for example, with gender, the percentages under Baseline High Resilience
are the percentages of those with high resilience at baseline who are male or who are female. Percentages may not
add to 100 because of rounding.
2
Yes indicates a positive score based on binary scoring of seven anxiety items from the Patient Health
Questionnaire.
3
Sample size for BL consists of all BL respondents who are eligible for the FU survey; for FU it consists of all
eligible respondents.
4
Minimum civilian time is 2 months.
5
At baseline, all respondents were employed by the military. At follow-up, a sizable percentage of the civilian
respondents are unemployed, which affects the work stress percentages.
6
Yes indicates the individual responded positively to the suicidal ideation question on the baseline or follow-up
survey.
Source: 2007—Status of Transitioning Military Personnel Survey
3-97
Resilience among Military Personnel, Follow-Up Survey
Table 3-14.
Sample Characteristics of Transition Study Participants by Any Mental
Health Problem1
Baseline
Measure
Sample Size3
Yes2
Follow-Up
No2
Yes2
No2
1,524.0
1,747.0
430.0
563.0
Male
83.2
86.7
83.2
85.6
Female
16.8
13.3
16.8
14.4
White, non-Hispanic
58.9
62.2
60.0
62.7
African American, non-Hispanic
13.3
12.4
13.0
12.3
Hispanic
18.4
16.4
16.7
16.5
9.4
9.0
10.4
8.5
25 or younger
53.6
45.4
52.5
48.0
26–34
28.2
26.9
29.4
25.4
35 or older
18.2
27.7
18.1
26.6
Not married
51.8
48.0
55.9
45.2
Married
48.2
52.0
44.1
54.8
96.1
91.2
97.0
91.9
3.9
8.8
3.0
8.1
12.7
4.8
10.4
5.3
2–5 months
N/A
N/A
3.5
4.6
6–8 months
N/A
N/A
9.7
14.7
9–11 month
N/A
N/A
17.3
18.7
12–14 months
N/A
N/A
26.7
22.0
15–17 months
N/A
N/A
33.7
31.7
18+ months
N/A
N/A
9.1
8.3
Gender
Race/Ethnicity
Other
Age
Family Status
Pay Grade
E1–E9, W1–W5
O1–O6
Disability or Separation for a Physical/Mental
Condition that Interferes with Military Service
Time in Civilian Life4
(continued)
3-98
Resilience among Military Personnel, Follow-Up Survey
Table 3-14.
Sample Characteristics of Transition Study Participants by Any Mental
Health Problem1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
N/A
N/A
14.8
8.1
Working full-time (work 35 or more hours
per week on average)
N/A
N/A
49.8
55.1
Working part-time (work less than 35
hours per week on average)
N/A
N/A
10.5
16.4
Working as self-employed in own business
or profession
N/A
N/A
2.4
3.8
Unemployed
N/A
N/A
36.2
23.5
An unpaid worker (volunteer)
N/A
N/A
5.2
5.6
Retired
N/A
N/A
10.1
14.5
In school
N/A
N/A
37.6
42.8
A homemaker, housewife, househusband
N/A
N/A
9.4
9.9
Disabled
N/A
N/A
24.6
11.7
Working multiple jobs
N/A
N/A
5.4
5.6
Working temporary job(s)
N/A
N/A
9.6
7.1
Less than $1,000
N/A
N/A
19.4
18.6
$1,000 to $1,499
N/A
N/A
19.8
16.2
$1,500 to $1,999
N/A
N/A
13.2
16.4
$2,000 to $2,999
N/A
N/A
23.3
15.7
$3,000 to $4,999
N/A
N/A
16.7
16.5
$5,000 or more
N/A
N/A
7.7
16.6
Are You Currently Receiving any ServiceRelated Disability Compensation?
N/A
N/A
50.7
42.0
Measure
Single with Dependent Child(ren):
No2
Employment Status (Mark all that apply)
Current personal monthly income:
(continued)
3-99
Resilience among Military Personnel, Follow-Up Survey
Table 3-14.
Sample Characteristics of Transition Study Participants by Any Mental
Health Problem1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
A lot
62.7
29.7
30.6
8.3
Some
26.2
37.2
28.8
26.9
A little
9.7
25.0
14.2
33.1
None
1.5
8.2
26.4
31.7
A lot
42.1
15.9
50.9
10.8
Some
30.3
28.1
27.2
23.1
A little
18.3
34.7
13.1
41.9
9.3
21.4
8.7
24.2
A lot
31.3
16.6
31.1
9.8
Some
20.7
23.1
20.4
17.6
A little
9.1
17.9
7.5
26.8
None
2.7
4.0
2.8
10.9
36.2
38.5
38.3
35.0
Very severe/severe
14.9
5.6
20.5
5.2
Moderate
38.6
24.5
36.4
26.6
Mild
21.9
22.1
20.8
21.3
Very mild
14.4
21.9
12.8
21.7
None
10.1
26.0
9.5
25.2
Low
33.6
10.1
39.5
8.1
Medium
51.2
45.3
47.0
40.0
High
15.3
44.6
13.5
51.9
Measure
No2
Work Stress Indicator5
Family Stress Indicator
None
Spouse Stress Indicator
I do not have a spouse
MOS Pain Indicator (past 4 weeks)
MOS Current Health Perception
(continued)
3-100
Resilience among Military Personnel, Follow-Up Survey
Table 3-14.
Sample Characteristics of Transition Study Participants by Any Mental
Health Problem1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
Low
41.7
52.4
39.1
52.0
Medium
25.8
25.2
22.9
24.3
High
32.5
22.5
38.0
23.8
0.0
20.1
16.6
19.4
16.8
1.0
25.3
25.0
24.6
27.3
2.0
28.3
28.5
28.9
28.8
3 or 4
18.2
19.6
20.8
18.8
8.2
10.3
6.3
8.4
0 months
47.8
51.6
45.7
48.6
1 to 6 months
22.6
22.8
20.2
24.2
7 to 12 months
29.6
25.6
34.1
27.2
0 months
55.3
56.5
57.3
54.1
1 or 2 months
15.9
16.4
15.0
19.4
3 or 4 months
13.3
13.9
14.8
13.8
5 to 12 months
15.5
13.2
12.9
12.7
29.5
29.1
29.6
27.6
Iraq/Afghanistan
69.4
71.6
72.5
69.8
Other, Not Iraq or Afghanistan
14.6
15.5
13.2
16.5
None
16.1
12.8
14.3
13.7
Measure
Combat Exposure Scale Score
Number of Career Combat Deployments
5 or more
Number of Months in Past Year on Combat
Deployments
Number of Months in Past Year on Noncombat
Deployment
Deployment Extension—Ever in Career
Yes
Place of Deployment
(continued)
3-101
Resilience among Military Personnel, Follow-Up Survey
Table 3-14.
Sample Characteristics of Transition Study Participants by Any Mental
Health Problem1 (continued)
Baseline
Follow-Up
Measure
Yes2
No2
Yes2
No2
Currently Have Injuries or Health Problems as
a Result of my Military Experience
N/A
N/A
79.7
55.6
Currently Have Injuries or Health Problems
Not Related to my Service in the Military
N/A
N/A
19.1
8.5
Currently Working Reduced Hours Because of
Illness or Injury
N/A
N/A
11.5
1.5
Money Issues
N/A
N/A
61.7
34.3
Legal Issues
N/A
N/A
9.7
3.1
Smoker
47.6
36.4
36.8
25.4
Heavy Drinker
N/A
N/A
15.8
9.9
Since Leaving the Military, Have Your Coworkers or Supervisors Made Negative
Comments about any Recent Changes in Your
Appearance, Quality of Work, or
Relationships?
N/A
N/A
21.4
3.9
Since Leaving the Military, Have You had a
Physical or Mental Condition that Caused You
to Lose Your Job?
N/A
N/A
8.7
0.2
Not employed or 0 job changes
N/A
N/A
49.7
58.3
1 job change
N/A
N/A
19.7
22.4
More than 1 job change
N/A
N/A
30.6
19.3
3 or more times
N/A
N/A
20.9
2.0
1 or 2 times
N/A
N/A
17.0
7.4
0 times
N/A
N/A
62.0
90.6
Since Leaving the Military, Have You had
Problems Sleeping because of Nightmares?
N/A
N/A
43.5
9.9
Since Leaving the Military, Have You had
Problems with Anger, Frustration, Resentment,
Hostility or Losing Your Temper?
N/A
N/A
76.4
24.2
How Many Times Have You Changed Jobs
since Leaving the Military?
Since Leaving the Military, How Often Have
You Been Late for Work due to Emotional or
Physical Problems?
(continued)
3-102
Resilience among Military Personnel, Follow-Up Survey
Table 3-14.
Sample Characteristics of Transition Study Participants by Any Mental
Health Problem1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
A lot
N/A
N/A
27.6
2.6
Some
N/A
N/A
40.3
22.1
A little
N/A
N/A
24.3
35.5
None at all
N/A
N/A
7.9
39.8
Yes, but only 1 time
N/A
N/A
4.9
8.4
Yes, 2 or 3 times
N/A
N/A
13.2
6.5
Yes, more than 3 times
N/A
N/A
11.1
3.4
No
N/A
N/A
70.7
81.7
Yes, 1, 2, or 3+ times
N/A
N/A
7.8
2.6
No
N/A
N/A
92.2
97.4
Yes, 1, 2, or 3+ times
N/A
N/A
10.0
4.9
No
N/A
N/A
90.0
95.1
Not at all
N/A
N/A
12.3
22.2
A little
N/A
N/A
43.0
58.0
Some
N/A
N/A
30.0
17.1
A lot
N/A
N/A
14.7
2.7
Measure
No2
How Much Trouble Have You had Adjusting
to Civilian Life?
Since Leaving the Military Did You Drive a
Car or Other Vehicle when You had Too Much
to Drink?
Since Leaving the Military Did You Drive or
Ride in a Boat, Canoe, or Other Watercraft
when You had Too Much to Drink?
Since Leaving the Military Did You Ride or
Drive a Motorcycle without a Helmet?
Risk-Taking
(continued)
3-103
Resilience among Military Personnel, Follow-Up Survey
Table 3-14.
Sample Characteristics of Transition Study Participants by Any Mental
Health Problem1 (continued)
Baseline
Follow-Up
Yes2
No2
Not at all
N/A
N/A
7.2
6.7
A little
N/A
N/A
26.8
30.1
Some
N/A
N/A
36.0
44.0
A lot
N/A
N/A
30.1
19.2
Avoidant Coping Strategy
84.3
68.5
80.2
72.7
Problem-Oriented Coping Strategy
95.3
96.7
94.8
96.7
Low
30.1
27.0
36.4
27.8
Medium
51.9
54.2
46.6
51.2
High
17.9
18.8
16.9
21.0
Low
21.0
7.4
16.7
9.9
Medium
57.1
56.8
56.9
58.6
High
21.9
35.8
26.5
31.5
Low
15.8
2.6
45.1
9.5
Medium
67.7
54.5
44.9
52.7
High
16.6
42.9
10.1
37.8
Physically Active, Moderate or Vigorous at
Least 3 Days/Week
63.2
69.0
56.3
67.9
Know at Least One Military Veteran to Talk to
about War Experiences or Other Stressful
Deployment Events
N/A
N/A
69.0
77.0
Talking to Another Veteran Helped Me Handle
Stress Better
N/A
N/A
76.8
87.7
Have the Opportunity to Interact with a Group
of Combat Veterans
N/A
N/A
32.6
38.3
Measure
Yes2
No2
Sensation-Seeking
Spirituality Indicator
DRRI Deployment Social Support Scale (Unit
Cohesion)
DRRI Post-deployment Social Support Scale
(Personal Social Support)
(continued)
3-104
Resilience among Military Personnel, Follow-Up Survey
Table 3-14.
Sample Characteristics of Transition Study Participants by Any Mental
Health Problem1 (continued)
Baseline
Follow-Up
Yes2
No2
Yes2
No2
Social group
N/A
N/A
50.1
62.0
Support group
N/A
N/A
18.3
3.7
Reserve unit
N/A
N/A
13.8
13.7
Sports team
N/A
N/A
1.7
4.4
Other
N/A
N/A
36.3
33.6
Anxiety
51.9
0.0
50.0
0.0
Depression
88.6
0.0
88.7
0.0
PTSD
39.8
0.0
51.5
0.0
Substance Abuse Indicator (TICS)
54.4
38.1
40.8
20.8
Suicidal Ideation
16.5
0.0
26.9
0.0
Any Mental Health Problem
N/A
N/A
N/A
N/A
Resilience
84.7
96.4
78.2
98.8
Low
49.7
3.2
53.8
1.3
Medium
47.7
57.5
42.0
53.5
2.6
39.3
4.2
45.2
Any Activity Restriction due to Poor Mental
Health Past 30 Days
57.1
12.6
66.1
17.5
Any Receipt of Mental Health Services in the
Past 12 Months
43.8
20.2
47.5
13.9
Depression
23.9
4.0
29.7
3.0
Anxiety
18.7
3.7
26.0
3.0
Family problems
16.0
5.8
11.6
3.0
6.1
2.2
2.9
1.0
Anger management
12.7
2.3
17.9
1.7
Stress management
15.9
3.8
21.5
2.1
9.8
1.5
17.6
2.5
Measure
What Type of Group(s)? (Mark all that apply.)
6
MOS Mental Health Scale
High
Concerns for which Counseling Was Sought
Substance use problems
Combat/operational stress
(continued)
3-105
Resilience among Military Personnel, Follow-Up Survey
Table 3-14.
Sample Characteristics of Transition Study Participants by Any Mental
Health Problem1 (continued)
Baseline
Measure
Other (specify)
Yes2
Follow-Up
No2
Yes2
No2
6.5
4.4
5.3
2.5
60.8
84.0
60.2
90.8
Feel the Need for Counseling
48.2
11.5
57.3
10.4
Prescribed Medication for Mental Health Issue
in Past 12 Months
21.1
4.6
27.0
4.0
Very satisfied
N/A
N/A
15.1
25.6
Somewhat satisfied
N/A
N/A
34.6
34.8
Somewhat dissatisfied
N/A
N/A
15.0
7.2
Very dissatisfied
N/A
N/A
11.7
4.3
I have not received any health care since
leaving the military
N/A
N/A
23.6
28.1
A big problem
N/A
N/A
18.2
6.3
A small problem
N/A
N/A
28.6
15.9
Not a problem
N/A
N/A
53.2
77.7
Always
N/A
N/A
16.4
23.4
Usually
N/A
N/A
19.0
17.6
Sometimes
N/A
N/A
27.4
13.0
Never
N/A
N/A
13.2
8.0
I have not needed health care since leaving
the military.
N/A
N/A
24.0
37.9
I did not seek help from a mental health
professional in the past 12 months
Overall, How Satisfied or Dissatisfied are you
with the Quality of Health Care You Have
Received since Leaving the Military?
Since Leaving the Military, How Much of a
Problem, If Any, were Delays in Health Care
while You Waited for Approval from Your
Health Plan?
Since Leaving the Military, when You Needed
Care Right Away for an Illness, Injury, or
Condition, How Often Did You Get Care as
soon as You Thought You Needed It?
(continued)
3-106
Resilience among Military Personnel, Follow-Up Survey
Table 3-14.
Sample Characteristics of Transition Study Participants by Any Mental
Health Problem1 (continued)
Baseline
Follow-Up
Measure
Yes2
No2
Yes2
No2
Since Leaving the Military, was there any Time
when You Needed Medical Care or Surgery but
Did Not Get It?
N/A
N/A
22.4
9.4
I did not have the money to pay for care
N/A
N/A
45.8
29.6
I had to wait on approval from my health
insurance
N/A
N/A
8.1
12.9
I could not fit it into my schedule
N/A
N/A
1.5
1.8
I could not afford to miss work.
N/A
N/A
7.0
12.9
I had to wait too long for an appointment
N/A
N/A
19.2
33.6
I had to drive too far for the medical care
N/A
N/A
8.6
0.0
Other
N/A
N/A
9.8
9.1
N/A
N/A
82.3
84.7
Very satisfied
N/A
N/A
21.6
37.2
Somewhat satisfied
N/A
N/A
44.9
46.1
Somewhat dissatisfied
N/A
N/A
17.6
8.0
Very dissatisfied
N/A
N/A
15.9
8.7
N/A
N/A
20.4
1.8
Declining academic performance or grades
N/A
N/A
16.6
8.1
Disruptive or problem behavior
N/A
N/A
28.6
13.4
Social withdrawal from peers
N/A
N/A
8.9
3.3
Bullying
N/A
N/A
15.3
2.5
If yes, what was the main reason you
didn’t get the care you needed?
Do You Have Health Coverage?
Overall, How Satisfied or Dissatisfied are You
with the Health Care Available to You?
Are You Currently Receiving Counseling or
Therapy for Mental Health or Substance Abuse
Problems?
Yes
Since Leaving the Military, My Children
Experienced the Following or Behaved in any
of the Following Ways. (Percentages are of
those who have children.)
(continued)
3-107
Resilience among Military Personnel, Follow-Up Survey
Table 3-14.
Sample Characteristics of Transition Study Participants by Any Mental
Health Problem1 (continued)
Baseline
Measure
Alcohol or drug use
Total Sample
Follow-Up
Yes2
No2
Yes2
No2
N/A
N/A
3.1
2.7
46.6
53.4
44.7
55.3
1
Percentages are column percentages. So, for example, with gender, the percentages under Baseline Any Mental
Health Problem Yes are the percentages of those indicating any mental health or substance abuse problem at
baseline who are male or who are female. Percentages may not add to 100 because of rounding.
2
Yes indicates a ―yes‖ on any of the mental health (anxiety, depression, PTSD, or suicidal ideation).
3
Sample size for BL consists of all BL respondents who are eligible for the FU survey; for FU it consists of all
eligible respondents.
4
Minimum civilian time is 2 months.
5
At baseline, all respondents were employed by the military. At follow-up, a sizable percentage of the civilian
respondents are unemployed, which affects the work stress percentages.
6
Yes indicates the individual responded positively to the suicidal ideation question on the baseline or follow-up
survey.
Source: 2007—Status of Transitioning Military Personnel Survey
Table 3-15 shows a comparison of BL measures for Sailors and Marines who had
formally left the military (Separators) versus those who remained in the military at the time of
our FU survey (Nonseparators). In general, Separators and Nonseparators are comparatively
similar, although Separators reported slightly higher levels of anxiety (22.9% vs. 18.7%) and for
receipt of mental health services in the past 12 months (30.4% vs. 25.7%)
Table 3-16 presents BL measures for sample members who provided consent to access
their medical records (Consenters) versus those who did not give this permission
(Nonconsenters). A review of the measures shows high similarity between Consenters and
Nonconsenters.
A cross-tabulation of major mental health outcomes by Navy and Marine Corps
participants is provided in Table 3-17. Percentages of both the Sailors and Marines reporting
anxiety and depression decreased from BL to FU, with Marine Corps anxiety rates dropping
from 31.6% to 29.5%. Depression rates dropped from 34.9% to 33.4% at FU in the Navy sample
and from 50.0% to 47.8% in the Marine Corps sample. Incidence rates showed that a significant
percentage of personnel showing no evidence of generalized anxiety at BL met screening criteria
at FU (9.1% of those who had been in the Navy and 18.6% of those who had been in the Marine
3-108
Resilience among Military Personnel, Follow-Up Survey
Corps). Incidence rates for depression (20.3%) in the former Navy sample were twice those for
anxiety and were also elevated (31.4%) in the Marine Corps sample.
3-109
Resilience among Military Personnel, Follow-Up Survey
Table 3-15.
Comparison of Separators versus Nonseparators on Various Variables*
Separators
Sample Size1
Nonseparators
3,472
281
Navy
63
62.3
Marine Corps
37
37.7
22.9
18.7
40.5
42.6
17.6
15.5
44.8
45
7.2
6.2
46.5
47.4
25
22.2
Medium
50.1
50.9
High
24.9
26.9
23.8
25.4
52
48
24.2
26.5
31.8
31.7
30.4
25.7
Service Branch
Anxiety
Yes
Depression
Yes
PTSD
Yes
Substance Abuse Indicator (TICS)
Yes
Suicidal Ideation
Yes
Any Mental Health Problem2
Yes
Resilience
Low
MOS Mental Health Scale
Low
Medium
High
Any Activity Restriction due to Poor Mental Health Past 30 Days
Yes
Any Receipt of Mental Health Services in the Past 12 Months
Yes
(continued)
3-110
Resilience among Military Personnel, Follow-Up Survey
Table 3-15.
Comparison of Separators versus Nonseparators on Various Variables*
(continued)
Separators
Nonseparators
Concerns for which Counseling Was Sought
Depression
12.8
8
Anxiety
10.3
7.3
Family problems
10.3
8.8
4
4.6
Anger management
6.9
4.2
Stress management
9.1
5.7
Combat/operational stress
5.2
5
Other (specify)
5.3
4.2
73.8
77
27.4
25.4
11.7
7.4
Male
85.2
85.7
Female
14.8
14.3
White, non-Hispanic
60.7
53.1
African American, non-Hispanic
13.1
17.7
Hispanic
17
19.9
Other
9.2
9.4
25 or younger
48.8
44.7
26–34
27.1
24.5
24
30.8
Not married
49.3
43.4
Married
50.7
56.6
Substance use problems
I did not seek help from a mental health professional in the past 12
months
Feel the Need for Counseling
Yes
Prescribed Medication for Mental Health Issue in Past 12 Months
Yes
Gender
Race/Ethnicity
Age
35 or older
Family Status
(continued)
3-111
Resilience among Military Personnel, Follow-Up Survey
Table 3-15.
Comparison of Separators versus Nonseparators on Various Variables*
(continued)
Separators
Nonseparators
93.3
97.2
6.7
2.8
8.2
5.8
21
27
Expiration of term of service (ETS)
54.8
52.6
Other
24.2
20.4
40.9
35.5
51.9
53.6
Low
29.3
32.6
Medium
42.3
37.6
High
28.5
29.7
Low
22.7
32.6
Medium
42.4
36.6
High
34.9
30.8
A lot
43.8
42.7
Some
32.3
34.8
A little
18.5
19.4
5.5
3.2
Pay Grade
E1–E9, W1–W5
O1–O6
Disability or Separation for a Physical/Mental Condition that Interferes with
Military Service
Yes
Reason for Leaving Military
Retirement
Current Smoker
Yes
Previous Lifetime Trauma
Yes
Life Event Stress
DRRI Post-deployment Stressors Index
Work Stress Indicator
None
(continued)
3-112
Resilience among Military Personnel, Follow-Up Survey
Table 3-15.
Comparison of Separators versus Nonseparators on Various Variables*
(continued)
Separators
Nonseparators
Family Stress Indicator
A lot
27.3
29
Some
28.7
31.2
A little
27.6
25.1
None
16.5
14.7
A lot
23
22.3
Some
22.2
26.3
A little
14.1
14.4
3.6
4
37.2
33.1
9.6
8.6
Moderate
30.4
30.7
Mild
21.7
21.8
Very mild
18.6
16.8
None
19.6
22.1
Low
20.5
17.6
Medium
47.5
46.8
32
35.6
Low
48.1
49.1
Medium
25.1
26.5
High
26.8
24.4
0
18.3
15.2
1
25.1
24.3
2
28.1
27.9
3 or 4
18.9
18.8
9.5
13.8
Spouse Stress Indicator
None
I do not have a spouse
MOS Pain Indicator (past 4 weeks)
Very severe/severe
MOS Current Health Perception
High
Combat Exposure Scale Score
Number of Career Combat Deployments
5 or more
(continued)
3-113
Resilience among Military Personnel, Follow-Up Survey
Table 3-15.
Comparison of Separators versus Nonseparators on Various Variables*
(continued)
Separators
Nonseparators
Number of Months in Past Year on Combat Deployments
0 months
50.4
48.6
1 to 6 months
22.4
26.8
7 to 12 months
27.2
24.6
0 months
56.1
49.5
1 or 2 months
16.2
20.7
3 or 4 months
13.6
13.5
5 to 12 months
14.1
16.4
29.2
28.5
Iraq/Afghanistan
70.1
70.7
Other, Not Iraq or Afghanistan
15.4
17.8
None
14.5
11.5
75.6
71.8
96.1
96.1
Low
28.1
26.5
Medium
53.1
53.1
High
18.8
20.4
Low
13.3
7.7
Medium
56.4
59.3
High
30.2
33.1
8.4
5.8
Medium
59.4
60.5
High
32.2
33.7
Number of Months in Past Year on Noncombat Deployment
Deployment Extension—Ever in Career
Yes
Place of Deployment
Avoidant Coping Strategy
Yes
Problem-Oriented Coping Strategy
Yes
Spirituality Indicator
DRRI Deployment Social Support Scale (Unit Cohesion)
DRRI Post-deployment Social Support Scale (Personal Social Support)
Low
(continued)
3-114
Resilience among Military Personnel, Follow-Up Survey
Table 3-15.
Comparison of Separators versus Nonseparators on Various Variables*
(continued)
Separators
Nonseparators
Yes
66.7
66.9
Total Sample
92.5
7.5
Physically Active, Moderate or Vigorous at Least 3 Days/Week
* Separators include those individuals who separated from the military during an interval that allowed their followup survey to be administered during our data collection window.
1
Consists of all eligible BL Navy and Marine respondents.
2
Yes indicates a ―yes‖ on any of the mental health (anxiety, depression, PTSD, or suicidal ideation)
3-115
Resilience among Military Personnel, Follow-Up Survey
Table 3-16.
Comparison of Consenters versus Nonconsenters on Mental Health
Variables*
Consenters
Nonconsenters
2,750
1,003
Navy
63.7
60.9
Marine Corps
36.3
39.1
22.3
23.4
40
42.3
17.2
18.1
45.8
42.2
7.2
7
46.1
47.9
Low
23.8
27.3
Medium
51.3
47.1
High
24.9
25.6
Low
23.3
25.7
Medium
52.2
50.3
High
24.5
24
31.7
32
30.4
28.9
Sample Size1
Service Branch
Anxiety
Yes
Depression
Yes
PTSD
Yes
Substance Abuse Indicator (TICS)
Yes
Suicidal Ideation
Yes
2
Any Mental Health Problem
Yes
Resilience
MOS Mental Health Scale
Any Activity Restriction due to Poor Mental Health Past 30 Days
Yes
Any Receipt of Mental Health Services in the Past 12 Months
Yes
(continued)
3-116
Resilience among Military Personnel, Follow-Up Survey
Table 3-16.
Comparison of Consenters versus Nonconsenters on Mental Health
Variables* (continued)
Consenters
Nonconsenters
Concerns for which Counseling Was Sought
Depression
12
13.4
Anxiety
9.5
11.5
10.5
9.3
Substance use problems
4.1
3.9
Anger management
6.9
6.2
Stress management
8.8
9.2
Combat/operational stress
5.4
4.7
Other (specify)
5.2
5.1
73.6
75.4
27.3
27
11
12.6
Male
86.6
81.5
Female
13.4
18.5
White, non-Hispanic
61.5
56.4
African American, non-Hispanic
12.9
14.8
Hispanic
16.9
18.3
8.7
10.5
25 or younger
48.6
48.4
26–34
26.8
27.3
35 or older
24.6
24.3
Not married
49.3
47.6
Married
50.7
52.4
Family problems
I did not seek help from a mental health professional in the past 12
months
Feel the Need for Counseling
Yes
Prescribed Medication for Mental Health Issue in Past 12 Months
Yes
Gender
Race/Ethnicity
Other
Age
Family Status
(continued)
3-117
Resilience among Military Personnel, Follow-Up Survey
Table 3-16.
Comparison of Consenters versus Nonconsenters on Mental Health
Variables* (continued)
Consenters
Nonconsenters
Pay Grade
E1–E9, W1–W5
94.3
91.7
5.7
8.3
8
8.1
Retirement
21.3
21.8
Expiration of term of service (ETS)
54.9
53.9
Other
23.7
24.3
42.2
35.9
52.8
49.8
Low
29.4
29.9
Medium
42.6
40
28
30.1
Low
23.9
22.1
Medium
41.4
43.7
High
34.7
34.2
A lot
43.3
44.9
Some
32.7
31.6
A little
18.9
17.5
5.1
6
O1–O6
Disability or Separation for a Physical/Mental Condition that Interferes with
Military Service
Yes
Reason for Leaving Military
Current Smoker
Yes
Previous Lifetime Trauma
Yes
Life Event Stress
High
DRRI Post-deployment Stressors Index
Work Stress Indicator
None
(continued)
3-118
Resilience among Military Personnel, Follow-Up Survey
Table 3-16.
Comparison of Consenters versus Nonconsenters on Mental Health
Variables* (continued)
Consenters
Nonconsenters
Family Stress Indicator
A lot
27.5
27.2
Some
29
28.6
A little
26.7
29.3
None
16.8
15
A lot
22.9
22.9
Some
22.5
22.4
A little
13.6
15.5
3.6
3.4
37.3
35.8
9.7
9.2
Moderate
29.6
32.8
Mild
22.2
20.4
Very mild
18.2
19.4
None
20.4
18.3
Low
19.6
22
Medium
47.7
46.9
High
32.7
31.1
Low
47.9
48.9
Medium
25.9
23.4
High
26.2
27.7
Spouse Stress Indicator
None
I do not have a spouse
MOS Pain Indicator (past 4 weeks)
Very severe/severe
MOS Current Health Perception
Combat Exposure Scale Score
(continued)
3-119
Resilience among Military Personnel, Follow-Up Survey
Table 3-16.
Comparison of Consenters versus Nonconsenters on Mental Health
Variables* (continued)
Consenters
Nonconsenters
Number of Career Combat Deployments
0
17.6
19.4
1
25.4
24.1
2
27.5
29.9
3 or 4
19.1
18.4
5 or more
10.4
8.2
0 months
50.4
50.1
1 to 6 months
22.7
22.9
27
27.1
55
57.5
1 or 2 months
16.9
15.4
3 or 4 months
13.8
13
5 to 12 months
14.3
14.1
29.8
27.4
71
67.8
Other, Not Iraq or Afghanistan
14.9
17.3
None
14.1
14.9
75.9
73.8
96.4
95.4
29
25.3
Medium
52.6
54.2
High
18.3
20.5
Number of Months in Past Year on Combat Deployments
7 to 12 months
Number of Months in Past Year on Noncombat Deployment
0 months
Deployment Extension—Ever in Career
Yes
Place of Deployment
Iraq/Afghanistan
Avoidant Coping Strategy
Yes
Problem-Oriented Coping Strategy
Yes
Spirituality Indicator
Low
(continued)
3-120
Resilience among Military Personnel, Follow-Up Survey
Table 3-16.
Comparison of Consenters versus Nonconsenters on Mental Health
Variables* (continued)
Consenters
Nonconsenters
DRRI Deployment Social Support Scale (Unit Cohesion)
Low
12.8
13.2
Medium
56.9
55.8
High
30.3
31
7.9
8.8
Medium
59.7
58.8
High
32.3
32.4
67
65.8
73.3
26.7
DRRI Post-deployment Social Support Scale (Personal Social Support)
Low
Physically Active, Moderate or Vigorous at Least 3 Days/Week
Yes
Total Sample
* Consenters include those individuals who signed the consent on the baseline survey to allow us to access their
medical records and other CHAMPS data.
1
Consists of all eligible BL Navy and Marine respondents.
2
Yes indicates a ―yes‖ on any of the mental health (anxiety, depression, PTSD or suicidal ideation)
3-121
Table 3-17.
Prevalence and Incidence of Major Mental Health Outcomes
Navy
Outcome
Marine Corps
Relative Risk1
Prevalence
Baseline
Follow-Up
Incidence
Medium
Baseline
Follow-Up
Incidence
Medium
Generalized Anxiety Symptoms
17.86
15.86
9.07
1.4
1.86
31.61
29.46
18.55
1.23
1.72
Depression Symptoms
34.93
33.43
20.26
0.96
1.28
50.04
47.83
31.36
0.98
1.24
PTSD Symptoms
12.98
16.74
12.13
1.71
2.67
25.59
29.52
17.73
2.55
3.33
Substance Abuse Symptoms
40.2
26.33
14.44
1.11
1.74
52.9
32.67
19.55
1.16
1.44
10.03
8.33
1.49
1.86
9.92
13.41
8.37
1.7
2.42
Suicidal or Self-Harming Ideation
5.67
High
Relative Risk1
Prevalence
High
40.6
38.79
24.8
1.1
1.28
56.48
54.37
33.5
1.07
1.35
Any Mental Health Problem (including
substance abuse)
62.29
52.61
34.13
1.12
1.4
76.12
63.41
43.87
1.02
1.2
Resilience
91.92
90.23
48.96
1.03
0.99
90.18
89.65
62.08
0.9
0.88
1
Relative risk is defined relative to the combat exposure scores that were assigned to three categories with ―low‖ equal to no combat exposure. In each column, the reference for
the relative risk statistic is the ―low‖ category of combat exposure.
Resilience among Military Personnel, Follow-Up Survey
3-122
Any Mental Health Problem
(excluding substance abuse)
Resilience among Military Personnel, Follow-Up Survey
3.6
Estimate of Current Prevalence of Mental Health Outcomes among Separated
Marines
To explore the factors that were associated with anxiety and depression at FU, we fit
multiple and hierarchical logistic regression models for each of these two outcomes, initially
with a set of fourteen independent variables. Table 3-18 lists those used in the analysis, arranged
according to the classifications used in the hierarchical regression discussed below. All
continuous covariates were recentered to have a mean of zero. Automatic variable selection was
applied to the full list (stepwise, forward, and backward methods) to further reduce possible
multicollinearity by identifying a minimal model. All three methods arrived at the same reduced
models for each outcome, albeit the reduced models for anxiety and depression, each containing
six variables, differed slightly from each other.
To understand the relative contributions of various sets of covariates conditional on other
sets being in the model, we performed a hierarchical logistic regression on both the full and
reduced model covariate sets. In the first step for the full model, we entered the demographic
variables (gender, unemployment, marital status, and income at FU) into the model. In the
second step, we included the combat and Service-related variables (military-related injury and
combat exposure). In the third step, we added the risk factors (BL anxiety or depression,
nonmilitary injury, stress index, risk-taking/sensation-seeking, and strong religious influence).
Finally, in the fourth step, we added the protective factors (deployment social support, FU postdeployment social support, and BL resilience score). The same procedure was used for the
reduced models using only the variables that remained in that model at each step.
The analysis sample size is 764 after cases with any missing data were removed, 513 of
which are Sailors and 251 are Marines. The largest drop in the sample available for the logistic
modeling (close to 200 cases) occurs because of the inclusion of variables in the model that were
only asked of the subset of respondents who had a deployment. The analysis sample had the
following characteristics. Most individuals had 9 to 17 months’ experience as civilians by the
time the FU survey was taken; the average time in civilian life for the sample was 12.8 months
(12.6 Navy, 13.3 Marine Corps). Women were 15.2% (18.3 Navy, 8.8 Marine Corps), 35.4%
(38.5 Navy, 29.0 Marine Corps) were non-White or Hispanic, and 10.2% (12.1 Navy, 6.4 Marine
Corps) were officers. Most (53.1%, 36.6 Navy, 86.8 Marine Corps) had had some combat
exposure, and 45.9% personnel (36.6 Navy, 64.1 Marine Corps) had been on a combat
deployment for at least 5 months in the past year before the BL survey. On the BL survey, 27.6%
(27.3 Navy, 28.1 Marine Corps) indicated that they had sought counseling, and 26.8% (26.5
Navy, 27.5 Marine Corps) had received some sort of mental
3-123
Table 3-18.
Variable
Means
Std.
Dev.s
1
2
4
5
6
7
8
—0.01
—-
-0.08*
-0.05
-0.2***
-0.05
-0.09*
0.03
0.14***
0.27***
-0.01
—0.3***
-0.12***
—-0.14***
—-
0.21***
0.35***
0.2***
0.36***
-0.1**
0.03
-0.06
-0.05
-0.08*
-0.05
-0.11**
-0.07
-0.17***
-0.13***
0.93
0.17***
—-
0.59
-0.09*
-0.13***
-0.05
-0.03
0.06
0.02
0.08*
-0.01
2.86
2.12
3.78
1.24
0.51***
0.24***
0.51***
0.18***
0.06
-0.14***
-0.1**
-0.05
-0.06
-0.15***
-0.13***
-0.13***
-0.21***
-0.05
2.66
1.77
-0.07
-0.04
0.12**
0.09*
0.1**
0.03
40.22
21.08
-0.1**
-0.13***
-0.14***
0.07*
0.07
45.15
15.66
-0.33***
-0.44***
0.03
0.1**
75.32
27.05
-0.1**
-0.22***
-0.02
0.00
0.20
0.37
1.13
1.92
0.71
0.84
0.59
0.47
—0.5***
0.07
-0.01
.78-.91
-0.02
-0.05
1.51
3.41
1.34
0.88
2.96
0.83
0.00
-0.04
-0.22***
5.89
0.40
17.49
0.86
1.87
3
9
10
11
-0.04
—-
0.21***
0.27***
0.28***
0.09**
-0.14***
-0.05
—0.26***
0.91
-0.04
-0.05
-0.06
0.02
0.00
-0.12**
—-
0.22***
-0.02
0.06
-0.27***
0.06
-0.13***
-0.02
0.09*
0.94
0.11**
0.17***
0.18***
-0.21***
-0.3***
0.06
-0.42***
-0.08*
0.03
0.15***
0.72
0.17***
0.12***
0.00
-0.1**
-0.34***
0.06
-0.11**
0.03
0.23***
0.3***
0.28***
Note. FU = follow-up, BL = baseline. Reliability estimates appear on the diagonal, as appropriate.
* p <.05, ** p <.01, *** p <.001, Statistical significance is based on an assumption of random sampling from the population.
12
13
14
15
16
0.95
Resilience among Military Personnel, Follow-Up Survey
3-124
1. FU Anxiety
2. FU Depression
3. Gender
4. FU Invol.
Unemployed
5. FU Marital Status
6. FU Income
7. Mil.-Related
Injury
8. Combat Exposure
9. BL Anxiety or
Depres.
10. Nonmilitary
Injury
11. FU Stress Index
12. FU RiskTak/Sens-Seek
13. Strong Religious
Inf.
14. Depl. Social
Support
15. FU Post-depl.
Soc. Sup
16. BL Resilience
Means, Standard Deviations, Reliability Estimates, and Correlations of Independent and Dependent Variables
(N = 764)
Resilience among Military Personnel, Follow-Up Survey
health services in the past year. Baseline survey scales indicated significant anxiety-related
symptoms for 20.1% (17.8 Navy, 27.1 Marine Corps) and depression-related symptoms for
34.0% (30.2 Navy, 41.81 Marine Corps).
Table 3-18 contains descriptive statistics for all the variables in the analysis. The majority
of the risk and protective factors were significantly correlated with both depression and anxiety
outcomes; the exceptions being: strong religious influence, unemployment, marital status,
income, and gender (among those with FU anxiety). FU anxiety and depression were highly
correlated (r = .50). Scale reliabilities, shown on the diagonal where appropriate, were generally
high.
Table 3-19 presents the hierarchical logistic regression results of FU anxiety and
depression symptoms for both the full and reduced models. Demographic variable sets accounted
for about 2% of the variance in FU anxiety in both the full and reduced models. Combat and
other Service-related variable sets account for an additional 24% of the variance in FU anxiety in
the full model and 17% in the reduced model, in each case this is net of the variance already
accounted for by demographic variables. Risk factors account for the largest amount of variance
in FU anxiety, ―explaining‖ an additional 44% of the variance in the full model and an additional
51% in the reduced model. The risk factor accounting for most of this variance among the risk
factors is the stress index, accounting for 36 to 43% of the remaining variance in anxiety in these
models. Finally, protective factors account for about an additional 1% of the variance in anxiety
remaining in both the full and reduced models after accounting for variance with demographic,
combat/service, and risk factor variables. Including all four areas in the full model accounts for
72% of the variance in FU anxiety, while in the reduced model, these account for 70%.
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Resilience among Military Personnel, Follow-Up Survey
Table 3-19.
Full and Reduced Model Hierarchical Regression Results (N = 764)
Full Models
Nested Modela
Reduced Models
R2
Effect Size (f2)b
D
0.0185
0.019
D,C
0.2621
D,C,R
D,C,R,P
Nested Modela
R2
Effect Size (f2)b
D
0.0149
0.015
0.330
D,C
0.1843
0.208
0.7037
1.490
D,C,R
0.6927
1.654
0.7183
0.052
D,C,R,P
0.7037
0.037
D
0.0227
0.023
D,C
0.2198
0.253
C
0.1279
0.147
D,C,R
0.6936
1.546
C,R
0.6772
1.702
D,C,R,P
0.7469
0.211
C,R,P
0.7370
0.227
Anxiety Models
Depression Models
a
(See Table 3-2) D = demographics, C = combat and service variables, R = risk factors, P = protective factors.
b
Cohen’s f2 (Cohen, 1988) interpretation guidelines: >.02 = small, >.15 = medium, >.35 = large effect size.
In the models of FU depression, similar results are found. The demographic variable set
accounted for about 2% of the variance in FU depression in the full model. The reduced model
did not contain any demographic variables for the depression model. Combat and other Servicerelated variable sets account for an additional 20% of the variance in FU depression in the full
model and 13% in the reduced model, beyond that variance accounted for by demographic
variables. Again, risk factors account for the largest amount of variance in FU depression,
―explaining‖ an additional 48% of the variance in the full model and 55% in the reduced model,
net the variance already accounted for by demographic and combat/service variables. The risk
factor accounting for the bulk of the variance is the stress index, accounting for 40 to 46% of the
variance in depression in these models, net the variance already accounted for by demographic
and combat/service variables. Finally, protective factors account for an additional 5% of the
variance in depression in the full and 6% in the reduced model, net the variance already
accounted for by demographic, combat/service and risk factor variables. Including all four areas
in the full model accounts for 75% of the variance in FU depression, while in the reduced model
these account for 74%.
Tables 3-20 and 3-21 show the bivariate and multiple logistic regression results. The fit
statistics for the full and reduced multiple logistic models indicate that both models fit well for
both outcomes. Pseudo R2 statistics are 70 to 75% in all four models. In each outcome, the
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Resilience among Military Personnel, Follow-Up Survey
reduced model accounted for nearly the same percentage of the variance in outcome as the full
model did.
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Resilience among Military Personnel, Follow-Up Survey
Table 3-20.
Summary of Logistic Regression Results for Full and Reduced Models of FU
Anxiety (N = 764)
BV
Parameter
Category
Intercept
DF
B
Full
OR
B
Reduced
OR
B
OR
1
.
.
-2.86
.
-2.90
.
Gender
Female
1
0.24
1.60
0.45
2.47
0.35
2.00
FU Invol. Unemployed
Yes
1
0.03
1.05
-0.29
0.56
.
.
FU Marital Status
Not married
1
-0.01
0.98
-0.14
0.76
.
.
1
-0.05
0.95
0.04
1.29
.
.
1
0.74
4.38
0.41
2.28
0.45
2.47
1
0.04
1.05
0.01
1.42
.
.
FU Income
Mil.-Related Injury
Yes
Combat Exposure
BL Anxiety or Depres.
Yes
1
0.90
6.05
0.70
4.05
0.64
3.61
Nonmilitary Injury
Yes
1
0.28
1.76
0.07
1.15
.
.
FU Stress Index
1
0.64
1.90
0.49
40.04
0.49
40.20
FU Risk-Tak/Sens-Seek
1
0.81
2.25
0.57
4.07
0.62
4.67
Strong Religious Inf.
1
-0.16
0.85
-0.28
0.37
.
.
Depl. Social Support
1
-0.02
0.98
0.00
1.12
.
.
FU Post-depl. Soc.Sup
1
-0.09
0.91
-0.05
0.23
-0.04
0.31
BL Resilience
1
-0.02
0.98
0.01
1.81
.
.
Note. FU = follow-up; BV = bivariate; DF = degrees of freedom; B = logistic regression coefficient; OR = odds
ratio; BL = baseline.
Full model global test statistics are as follows: likelihood ratio χ2(14) = 885.19 (p < .0001), score χ2(14) statistic =
825.89 (p < .0001), Wald χ2(14) = 484.08 (p < .0001); Hosmer & Lemeshow goodness of fit χ2(8) = 14.21 (p =
.0764). For the reduced model these are likelihood ratio χ2(6) =851.87 (p < .0001), score χ2(6) statistic = 793.70 (p <
.0001), Wald χ2(6) = 479.69 (p < .0001); Hosmer & Lemeshow goodness of fit χ2(8) = 10.66 (p = .2217).
Nagelkerke’s pseudo R2 for full model is.72 and for the reduced model is.70.
Note. OR Unit is the amount of change in the independent variable that the odds ratio estimate refers to. For
continuous variables, this is set to 2 SDs (e.g., from 1 SD below to 1 SD above the mean). For binary variables, it
is set at one and represents the change between the two categories. The reference category for FU Anxiety is not
having symptoms suggestive of anxiety disorder.
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Resilience among Military Personnel, Follow-Up Survey
Table 3-21.
Summary of Logistic Regression Results for Full and Reduced Models of FU
Depression (N = 764)
BV
Parameter
Category
Intercept
Full
Reduced
DF
B
OR
B
OR
B
OR
1
.
.
1.50
.
1.70
.
Gender
Female
1
-0.06
0.88
-0.17
0.71
.
.
FU Invol. Unemployed
Yes
1
0.20
1.49
-0.01
0.97
.
.
FU Marital Status
Not
married
1
0.16
1.37
0.11
1.24
.
.
1
-0.06
0.94
0.09
1.69
.
.
1
0.48
2.63
0.20
1.49
0.24
1.62
1
0.04
1.04
0.01
1.53
.
.
FU Income
Mil.-Related Injury
Yes
Combat Exposure
BL Anxiety or Depres.
Yes
1
0.79
4.81
0.47
2.57
0.46
2.53
Non-military Injury
Yes
1
0.39
2.16
0.27
1.71
.
.
FU Stress Index
1
0.59
1.80
0.44
28.70
0.44
27.09
FU Risk-Tak/Sens-Seek
1
0.54
1.72
0.23
1.75
0.29
2.04
Strong Religious Inf.
1
-0.08
0.92
-0.01
0.97
.
.
Depl. Social Support
1
-0.02
0.98
0.00
0.99
.
.
FU Post-depl. Soc. Sup
1
-0.12
0.88
-0.07
0.10
-0.07
0.10
BL Resilience
1
-0.03
0.97
-0.01
0.52
-0.01
0.50
Note. FU = follow-up; BV = bivariate; DF = degrees of freedom; B = logistic regression coefficient; OR = odds
ratio; BL = baseline.
Full model global test statistics are as follows: likelihood ratio χ2(14) = 1,010.28(p < .0001), score χ2(14) statistic =
872.95 (p < .0001), Wald χ2(14) = 573.05 (p < .0001); Hosmer & Lemeshow goodness of fit χ2(8) = 11.76 (p =
.1620). For the reduced model these are likelihood ratio χ2(6) =982.97 (p < .0001), score χ2(6) statistic = 857.04 (p <
.0001), Wald χ2(6) = 572.77 (p < .0001); Hosmer & Lemeshow goodness of fit χ2(8) = 3.76 (p = .8780).
Nagelkerke’s pseudo R2 for full model is.75 and for the reduced model is.74.
Note. OR Unit is the amount of change in the independent variable that the odds ratio estimate refers to. For
continuous variables, this is set to 2 SDs (e.g., from 1 SD below to 1 SD above the mean). For binary variables, it
is set at one and represents the change between the two categories. The reference category for FU Depression is
not having symptoms suggestive of a depression disorder.
The logistic regression coefficients for bivariate regressions of each variable in the
models with the two outcomes are provided and followed our expectations for the effect the
independent variable should have on the dependent variable. A comparison of these coefficients
with the full model coefficients demonstrates that some multicollinearity was likely still at work,
as several coefficients switched signs; however, the reduced models contain no such cases of
switching signs.
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Resilience among Military Personnel, Follow-Up Survey
As shown in Table 3-20, the highest odds ratio in either multivariate model for FU
anxiety, as well as in the bivariate regressions, is that for the FU stress index. The odds ratio of
FU anxiety for someone who is two standard deviations higher on the stress index (close to the
shift from having no stress reported to having stress in about four areas of one’s life) than a
comparison person is over 40 times higher in both models. Those with BL anxiety or depression
symptoms and those with higher risk-taking or sensation-seeking have similar odds ratios and
fall in the second or third place for odds ratio size, all close to 4.0. Gender is next in the full
model, and having a military-related injury is next in the reduced model, both odds ratios
between 2.0 and 2.5, with females and those with such injuries more likely to have symptoms of
anxiety.
Table 3-21 contains the odds ratios from the full and reduced FU depression models,
again with bivariate results included as well. The variables with the highest estimated odd ratios
for FU depression agree substantially with the FU anxiety results. The FU stress index has an
odds ratio around 27 in both models. Those having either had symptoms of depression or anxiety
at BL, having a military-related injury, or reporting risk-taking have an odds ratio of about 2 of
showing signs of depression at FU. Odds ratios for all four of these variables are roughly
proportionate in size but somewhat smaller than respective estimates for the FU anxiety models.
Finally, since the stress index showed the greatest association with the reporting of
anxiety or depression symptoms at FU, we further examined the components of that index. Table
3-22 shows the association between the FU anxiety and depression measures and the nine
constituent components of the stress index. It reports the proportion of respondents reporting
anxiety and depression symptoms at FU, conditional on whether they reported stress in a given
stress index component. The strength of the effect of each stress area can be seen by the ratio of
the two percentages, and the tetrachoric correlations have been included as a measure of
association between the binary indicators of stress in an area and each of the binary FU
outcomes. The rows of the table are ordered by the value of this measure of association for the
FU anxiety indicator. The reader will note the associations for FU depression do not follow the
same ranking.
These data show that, across the board, stress in any of these domains results in higher
levels of anxiety and depression symptoms. The largest associations occur with stress in the
mental health issues, family, health, and work stress domains, in that order. The largest
associations with depression symptoms at FU are in the family, work, marital, mental health
issues, and health domains. In these top-listed domains, the rates of anxiety symptoms at FU are
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Resilience among Military Personnel, Follow-Up Survey
Table 3-22.
Relationship of Follow-Up Anxiety and Depression with Individual Stress
Index Components
Follow-Up Anxiety
Follow-Up Depression
Stress
Absent (%)
Stress
Present (%)
Assoc*
ASE
Stress
Absent (%)
Stress
Present (%)
Assoc*
ASE
Mental Health
14.60
57.29
0.61
0.031
31.69
67.30
0.47
0.034
Family
8.19
38.86
0.61
0.027
21.00
59.95
0.59
0.025
Health
12.33
44.72
0.56
0.029
28.40
60.96
0.47
0.030
Work
13.13
42.03
0.51
0.031
27.71
62.82
0.50
0.029
Marital
13.01
37.12
0.46
0.032
26.33
59.50
0.49
0.028
Financial
10.47
30.71
0.44
0.032
24.28
49.19
0.40
0.029
Unemployment
11.82
28.99
0.38
0.033
26.61
46.42
0.32
0.031
Legal
17.43
36.83
0.33
0.039
31.55
63.77
0.44
0.034
Death or
Serious
14.90
30.43
0.32
0.035
30.24
47.96
0.28
0.032
Stress Area
Note. The measure of association is a tetrachoric correlation. ASE is the asymptotic standard error for the tetrachoric
correlation.
Sample questions used in forming each stress area follow:
Mental Health Issues Stress: Since leaving the military, how much stress did you experience from each of
the following? Getting along with others
Family Stress: During the past 12 months, how much stress did you experience in your family life?
Health Stress: Since leaving the military, how much stress did you experience from each of the following?
Problems obtaining appropriate/necessary health care
Work Stress: During the past 30 days, how much stress did you experience at work?
Marital Stress: Since leaving the military, how much stress did you experience from each of the following?
Divorce or breakup
Financial Stress: Since leaving the military, how much stress did you experience from each of the
following? Problems with money
Unemployment Stress: Since leaving the military, I have lost my job
Legal Stress: Since leaving the military I have experienced stressful legal problems (for example, being
sued or suing someone else).
Death or Serious Problem—Someone Close: Since leaving the military I have experienced the death of
someone close to me.
Since leaving the military I have experienced a serious surgery or operation.
three to four times higher when stress in one of these areas is present as when absent, and for FU
depression symptoms, the presence of stress increases them two to three times higher.
3-131
SECTION 4
DISCUSSION
This study assessed the prevalence and incidence of mental health outcomes among
Sailors and Marines who have recently transitioned from military service to civilian life and
identified risk and protective predictors for these outcomes. To our knowledge, this is the first
time a comprehensive longitudinal examination of stress and mental health indicators has been
made in this highly vulnerable group.
Results of this longitudinal study revealed some interesting comparisons between BL and
FU survey administrations. For example, the finding that a greater percentage of participants
reported new PTSD symptoms at the time of FU (i.e., did not report PTSD symptoms at the time
of the BL survey but did so in the FU survey) points to the often latent effects of PTSD, not
immediately visible upon return from deployment or transition from Service. This finding
supports the APA (2000) description of the delayed onset of PTSD (at least 6 months have
passed between the traumatic event and the onset of symptoms) and addresses the need for
ongoing surveillance of personnel who have undergone traumatic experiences during their
military service. Also found were relatively higher prevalence rates of depressive and anxiety
symptoms thus focusing the bulk of analyses on the bivariate and multivariate relationships of
these 2 main outcomes.
Overall, these analyses found that although a substantial number of participants met
criteria for new depression and anxiety after leaving the military, there was a slight decrease in
current (past week) prevalence of both depression and generalized anxiety symptoms from
predischarge to 1-year postdischarge. Nevertheless, baseline rates for both Navy and Marine
Corps were much higher than those reported for troops returning from recent combat areas. Of
particular note was the finding that half of transitioning Marines met screening criteria for
depression symptoms. Rates for depression in the baseline survey among transitioning Marines
were more than three times as high (i.e., 50.0%) as the 14.7% noted by Hoge et al. (2006) based
on data collected from the official Post-Deployment Health Assessment, which uses only two
questions from the Patient Health Questionnaire, and were twice the rates for anxiety (31.6%
versus 15.7%). Although differences in the psychometric properties of the two screening
instruments are likely to account for some variability in rates, such higher rates in personnel
about to be discharged may be expected given that a larger proportion of those screening positive
for a mental disorder leave the Service than those screening negative (Hoge et al., 2006), and
because there is frequently a considerable lag between combat exposure and development of
mental disorders (Andrews et al., 2007). This lag, which has been noted to extend 4 to 7 months
4-1
Resilience among Military Personnel, Follow-Up Survey
after injury in personnel who served in Iraq, has also been noted previously for depression
among Marines (Grieger et al., 2006). The observed rates support the concern voiced in several
previous reports (APA, 2007; Task Force) that many personnel may be first experiencing or
admitting to problems upon their discharge from the military and that the transition process itself
may be contributing to the development or exacerbation of mental health symptoms. Indeed,
rates among both Sailors and Marines were about twice as high as those reported by Seal et al.
(2009) for Iraq and Afghanistan veterans enrolled in VA health care, suggesting a potentially
large number of symptomatic veterans who are not accessing military health resources.
The higher prevalence and incidence rates in Marine Corps TAP attendees relative to
Navy TAP attendees is not surprising given the varying sociodemographic and operational
exposure profile of the two groups. As shown in results from the baseline survey (Hourani et al.,
2008), Marines reported higher levels of combat exposure and longer deployments than Navy
personnel, and both combat and injury exposure remained important predictors of both anxiety
and depression among former active duty military personnel after controlling for
sociodemographic differences. Also seen at baseline and consistent with the civilian
psychological literature, for example Agaibi and Wilson (2005), high levels of life event
stressors, work stress, disability or poor perceived health, low personal social support, and low
resilience had strong predictive associations with mental health outcomes. Not all these
associations, however, continued in the current follow-up analysis. Although most studies have
examined such risk factors for PTSD among military personnel (see Maguen, Suvak, & Litz,
2006), this study examined this larger set of both distal and proximal risk factors than previously
examined in prospective studies of combat veterans (e.g., Larson, Highfill-McRoy, & BoothKewley, 2008; Wells et al., 2010 ), in addition to examining the more prevalent anxiety and
depression outcomes. The addition of these risk factors accounted for approximately 50% of
additional variance between those meeting screening criteria for anxiety or depression symptoms
and those without, beyond the variance already accounted for by sociodemographic and combat
and military-related injury/health. This result is consistent with a recent finding from a crosssectional survey of Marines back from war, which found that deployment-related stressors, such
as concerns or problems back home and lack of privacy, had a stronger association with PTSD
than did combat exposure (Booth-Kewley, Larson, Highfill-McRoy, Garland, & Gaskin, 2010).
Indeed, two-thirds of those reporting stress in the social domain reported depression symptoms,
and in all but three stress domains, over half of those reporting the presence of that stress in their
lives reported depression symptoms. Also of interest were the relatively high odds ratios for the
risk-taking scale, indicating that those with high risk-taking and/or sensation-seeking scale scores
were four times as likely to also meet criteria for generalized anxiety and twice as likely to meet
4-2
Resilience among Military Personnel, Follow-Up Survey
screening criteria for depression symptoms. Risk-taking behaviors may be a warning sign for
mental health problems and could be used in programs designed to identify high-risk individuals
for additional screening and intervention, especially because such behaviors may come to the
attention of family and peers before coming to the attention of military health providers and may
carry less of a help-seeking stigma than the more somatic or emotional symptoms of these
disorders.
The present study also included a larger number of protective factors than other studies
and examined their relative importance to demographic, Service-related, and other risk factors
over time. Protective factors, including deployment social support, FU post-deployment social
support, and BL resilience score, were shown to be modestly related to mental health outcomes
of anxiety and depression, when they were forced in as a block at the last step of a logistic
regression model.1 Nevertheless, the final models with individual variables, each adjusted for the
other variables in the model, indicate that post-separation social support has a strong protective
influence against both anxiety and depression. Of interest was the relatively little impact of the
resilience scores given renewed emphasis by military researchers in building resilience
(Friedman, 2006; King, King, Fairbank, Keane, & Adams, 1998; U.S. Department of Defense
Task Force on Mental Health, 2007). Strong social support appeared to be the more meaningful
protective factor when other variables were taken into account and suggests that attempts to
maximize social support during and following deployment may lead to improved outcomes in
the future. An investigation of general social support, unrelated to deployment status, should be
undertaken to gain a more global view of the effects of this construct, and programs aimed at
bolstering social support should be implemented for transitioning military personnel.
4.1.1 Limitations
Several limitations of the current study should be noted. Although the sample was a
purposive one and may not be representative of all transitioning Navy and Marine Corps
personnel, the similarity of the sample distribution on key demographic variables to those of
separating personnel obtained from the Career History Archival Medical and Personnel System
(CHAMPS) database provides additional confidence in the findings. Along with this, the
decision to participate in the baseline survey (55% response rate) and the decision to return the
follow-up survey (38% response rate) should lead one to be cautious about generalizing these
results beyond this sample. It should be noted, however, that the response rate for the baseline
1
We found the protective and noncombat/military risk factor blocks shared a great deal of the same variability in the
two outcomes. This became evident when we tried reversing this risk factor block with the protective factor
blocks in the hierarchical regression as a check and found the protective factors accounted for a larger amount of
the variance than they had when added in last.
4-3
Resilience among Military Personnel, Follow-Up Survey
survey surpassed the mean response rate of 45% found for paper surveys by Shih & Fan (2008),
and that the follow-up survey rate was slightly better than the 34% they found for Internet
surveys. It should also be noted that the survey measures were all self-reported and may be
subject to memory errors and that the screening instruments, although validated in other samples
and used extensively in other military mental health research, cannot be equated with clinical
diagnoses.
Despite these limitations, it is clear that a large number of transitioning military personnel
are experiencing symptoms of relatively common psychological disorders, and that transitional
services need to be alert to their psychological needs. Since separation counseling courses are
mandated for Marines and used by a majority of Sailors, with the addition of a formalized
routine screening, VA referral, and follow-up program, they could provide an opportunity to
intervene programmatically in reducing the risk and psychologically protecting this highly
vulnerable and growing population.
4.1.2 Recommendations for Future Research and Analyses
Further research is needed to delve more deeply into the factors affecting transitioning
military personnel. Our experience with the BL and FU survey administration for this research
suggests that future endeavors should include additional survey content that may shed additional
light on these factors. For example, research could include job type or category as an additional
moderator of mental health outcomes, especially as related to deployment and other combatrelated factors, as different operational demands associated with the type of military job
performed may affect levels of stress and subsequent mental health. Similarly, more detailed
information regarding the deployment cycle may provide a more robust representation of how
deployment affects personnel. Knowledge of deployment recency, including length and theater
of most recent deployment and whether the most recent deployment involved combat situations,
would be helpful in evaluating the proximal relationship between deployment and the
development of mental health problems.
Additionally, a more global assessment of social support, not only as related to
deployment, may provide a more complete picture of the potential of this construct as a
protective factor against mental health issues such as anxiety, depression, and PTSD.
4.2
Next Steps
As an immediate next step, an exploration of the development and implementation of
additional stress management programs to maximize social support for post-deployment and
transitioning personnel should be undertaken to facilitate the transition process for these
4-4
Resilience among Military Personnel, Follow-Up Survey
personnel. The TAP workshops currently mandated for all separating personnel would be an
ideal venue for such programs, since these workshops are designed to teach the skills necessary
for success in the civilian world and prepare transitioning personnel for the challenges they will
face. The curriculum for these workshops includes a number of invaluable courses already; the
addition of stress management and social support modules would further benefit participants in
their preparation for civilian life and the stresses they may face there.
As observed from the current study, separating Marines report higher rates of mental
health issues than their Navy counterparts; therefore, future research should focus on this
population in particular to explore more fully the factors affecting these personnel. In-depth
knowledge of additional factors affecting this population, especially as related to job type,
deployment-related factors, and social support, could lead to the enhancement of existing
policies and programs and the consideration of supplemental programs aimed at combating risk
factors to the overall well-being of these personnel.
4-5
SECTION 5
REFERENCES
Agaibi, C. E., & Wilson, J. P. (2005). Trauma, PTSD, and resilience: A review of the literature.
Trauma, Violence, & Abuse, 6, 195–216.
American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental
disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.
American Psychological Association (APA). (2007, February). Presidential Task Force on
Military deployment services for youth, families and service members. The psychological
needs of U.S. military service members and their families: A preliminary report.
Washington, DC: American Psychological Association. Retrieved 5/12/2010 from
http://www.ptsd.ne.gov/publications/military-deployment-task-force-report.pdf
Andrews, B., Brewin, C. R., Philpott, R., & Stewart, L. (2007). Delayed-onset posttraumatic
stress disorder: A systematic review of the evidence. American Journal of Psychiatry,
164, 1319–1326.
Bentler, P. M. (1989). EQS, Structural equations, program manual, program version 3.0, Los
Angeles: BMDP Statistical Software.
Booth-Kewley, S., Larson G. E., Highfill-McRoy R. M., Garland, C. F., & Gaskin, T. A. (2010).
Correlates of posttraumatic stress disorder symptoms in Marines back from war. Journal
of Traumatic Stress, 23, 69–77.
Bray, R. M., Hourani, L. L., Rae Olmsted, K. L., Witt, M., Brown, J. M., et al. (2006). 2005
Department of Defense Survey of Health Related Behaviors Among Active Duty Military
Personnel. Research Triangle Park, NC: RTI International.
Brown, R. L., Leonard, T., Saunders, L. A., & Papasouliotis, O. (2001). A two-item conjoint
screen for alcohol and other drug problems. The Journal of the American Board of
Family Practice, 14(2), 95–106.
Browne, M. W. & Cudeck, R. (1993). Alternative ways of assessing model fit. In: Bollen, K. A.
& Long, J. S. (Eds.) Testing structural equation models. pp. 136–162. Beverly Hills, CA:
Sage.
Cherpitel, C. J. (1993). Alcohol, injury, and risk taking behavior: Data from a national sample.
Alcoholism: Clinical and Experimental Research, 17, 762–766.
Cohen, J. (1988) Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, New
Jersey: Lawrence Erlbaum Associates.
Connor, K. M., Davidson, J. R. T. (2003). Development of a new resilience scale: The ConnorDavidson Resilience Scale (CD-RISC). Dep Anx, 18, 76–82.
5-1
Resilience among Military Personnel, Follow-Up Survey
Davidson, J., Watkins, L., Owens, M., Krulewicz, S., Connor, K., Carpenter, D., Krishnan, R., &
Nemeroff, C. (2005). Effects of paroxetine and venlafaxine XR on heart rate variability in
depression. Journal of Clinical Psychopharmacology, 25, 480–484.
Department of Defense. (2006, January). Post-deployment health reassessment (PDHRA).
http://www.pdhealth.mil/dcs/downloads/PDHRABackground_Paper4_9Jan06_03_22_06.
pdf
Friedman, M. J. (2006). Posttraumatic stress disorder among military returnees from Afghanistan
and Iraq. American Journal of Psychiatry, 163, 586–593.
Grieger, T. A., Cozza, S. J., Ursano, R. J., Hoge, C., Martinez, P. E., Engel, C. C., & Wain, H. J.
(2006). Posttraumatic stress disorder and depression in battle-injured soldiers. American
Journal of Psychiatry, 163, 1777–1783.
Gunderson, E. K. E., Garland, C. F., Miller, M. R., & Gorham, E. D. (2005). Career history
archival medical and personnel system. Military Medicine, 170, 172–175.
Hoge, C. W., Auchterlonie, J. L., & Miliken, C. S. (2006). Mental health problems, use of mental
health services, and attrition from military service after returning from deployment to
Iraq or Afghanistan. JAMA, 295, 1023–1032.
Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., Koffman, R. L. (2004).
Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New
England Journal of Medicine, 351, 13–22.
Hourani, L., Larson, J., Lane, M., Peeler, R., Weimer, B., Bender, R., & Reyes, C. (2008,
March). Resilience, combat exposure, and mental health of military personnel
transitioning to civilian life. Technical Report of Baseline Survey, RTI International,
Research Triangle Park, NC.
Hu, L. & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis:
Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.
Hu, L. & Bentler, P. M. (1998). Fit indices in covariance structure modeling: sensitivity to
underparameterized model misspecification. Psychological Methods 3, 424–453.
Keane, T., Fairbank, J., Caddell, J., Zimering, R., Taylor, K., & Mora, C. (1989). Combat
Exposure Scale. http://www.ptsd.va.gov/professional/pages/assessments/ces.asp
King, D. W., King, L. A., & Vogt, D. S. (2003). Manual for the Deployment Risk and Resilience
Inventory (DRRI): A collection of measures for studying deployment-related experiences
of military veterans. Boston, MA: National Center for PTSD.
King, L. A., King, D. W., Fairbank, J. A., Keane, T. M., & Adams, G. A. (1998). Resiliencerecovery factors in post-traumatic stress disorder among female and male Vietnam
veterans: Hardiness, postwar social support, and additional stressful life events. Journal
of Personality and Social Psychology, 74, 420–434.
5-2
Resilience among Military Personnel, Follow-Up Survey
Lang, A. J., & Stein, M. B. (2005). An abbreviated PTSD checklist for use as a screening
instrument in primary care. Behavior Research and Therapy, 43, 585–594.
Litz, B. T., King, L. A., King, D. W., Orsillo, S. M., & Friedman, M. J. (1997). Warriors as
peacekeepers: Features of the Somalia experience and PTSD. Journal of Consulting and
Clinical Psychology, 65, 1001–1010.
MacCallum, Browne, & Sugawara (1996). Power analysis and determination of sample size for
covariance structure modeling. Psychological Methods 1(2), 130–149.
Maguen, S., Suvak, M., & Litz, B. T. (2006). Predictors and prevalence of posttraumatic stress
disorder among military veterans. In A. B. Adler, C. A. Castro, & T. W. Britt (Eds.),
Military life: The psychology of serving in peace and combat (Vol 2, pp. 141–169).
Westport, CT: Praeger Security International.
Radloff, L. S. (1991). The use of the Center for Epidemiological Studies Depression Scale in
adolescents and young adults. Journal of Youth and Adolescence, 20, 149–166.
Radloff, L. S. (1977). A self report depression scale for research in the general population.
Applied Psychological Measurement, 1, 385–401.
Seal, K. H., Metzler, T. J., Gima, K. S., Bertenthal, D., Maguen, S., & Marmar, C. R. (2009).
Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans
using Department of Veterans Affairs health care, 2002–2008. American Journal of
Public Health, 99, 1651–1658.
Spitzer, R. L., Kroenke, K., & Williams, J. B. (1999). Validation and utility of a self-report
version of PRIME-MD: The PHQ primary care study. Primary care evaluation of mental
disorders. Patient Health Questionnaire. Journal of the American Medical Association,
282, 1737–1744.
Steiger, J. H. & Lind, J. C. (1980). Statistically based tests for the number of common factors.
Paper presented at the annual meeting of the Psychometric Society, Iowa City, IA.
Stewart, A. L, Hays, R. D., & Ware, J. E. (1988). The MOS short-form general health survey.
Reliability and validity in a patient population. Medical Care, 26, 724–735.
U.S. Department of Defense Task Force on Mental Health. (2007). An achievable vision: Report
of the Department of Defense Task Force on Mental Health. Falls Church, VA: Defense
Health Board.
Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36).
I. Conceptual framework and item selection. Medicare Care, 30, 473–483.
Weathers, F. W., Litz, B. T., Huska, J. A., & Keane, T. M. (1994). The PTSD checklist-civilian
version (PCL-C). Boston, MA: National Center for PTSD.
5-3
Resilience among Military Personnel, Follow-Up Survey
Wells, T. S., LeardMann, C. A., Fortuna, S. O., Smith, B., Ryan, M. A., Boyko, E. J., et al.
(2010). A prospective study of depression following combat deployment in support of the
wars in Iraq and Afghanistan. American Journal of Public Health, 100, 90–99.
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| File Type | application/pdf |
| File Title | Month 200X |
| Author | RTI_Doc |
| File Modified | 2011-01-06 |
| File Created | 2011-01-06 |