Despite the repeal of "Don't Ask, Don't Tell" (DADT) over a decade ago, military processes and policies continue to function as significant structural and institutional barriers to research aimed at optimizing resources for military couples and families with marginalized sexual identities. Such research is essential given the apparent mental health and related disparities among lesbian, gay, bisexual, and those with other marginalized sexual identities (LGB+) active-duty service members (SMs), as well as the absence of appropriately tailored resources to support these members of the military community. In this paper, we review the empirical literature on the experiences and psychological health of LGB+ military couples, revealing severe limitations in our understanding of these diverse military romantic partnerships. We illuminate process-related barriers to conducting this essential research through an illustrative case example. Our review concludes with specific recommendations for reform and advocacy distinguished by coordinated efforts inclusive of all five military branches, policymakers, military leaders, researchers, and LGB+ stakeholders.
The United States (U.S.) military has focused on increasing service members' (SM) mental and social fitness to bolster resiliency (successful role performance). The Resiliency Model of Role Performance posits that individual assets and social connections account for SM's differential success in meeting military demands and personal obligations. We used a U.S. Air Force (AF) active-duty dataset to test for a direct, positive relationship between cognitive fitness and both formal and informal social connections, and the impact on successful role performance. We also tested for potential moderating influences of formal and informal social connections on role performance among SMs with low vs. high cognitive fitness. Data were collected from a non-probability purposive sample of AF SMs and civilians (N = 59,094) who completed the Support and Resiliency Inventory between November 4, 2011 and January 7, 2014. We focused on the married active-duty subsample (n = 29,387). We employed multivariate hierarchical regression analysis across three models to explore the direct and interactive influence of cognitive and social fitness on resiliency. Controlling for military demographic characteristics, we found a positive linear relationship between cognitive fitness and resiliency and between informal and formal support and resiliency. Informal social support moderated the association between cognitive fitness and resiliency, compensating for resiliency among SMs with lower cognitive fitness. Study findings support current military resilience-building initiatives and underline the importance of prioritizing informal social support in U.S. military settings.
Veterans navigating the military-to-civilian transition appear at elevated risk for suicide. However, research on the transition-suicide association often fails to consider co-occurring risk factors. The independent association of time since military discharge and suicide among veterans therefore remains unclear. Data from 1,495 post-Vietnam community veterans provided estimates of suicide risk, military-based stressful experiences, connection to military identity, and recency of military discharge. Hierarchical regression analyses examined independent, incremental utility of factors associated with suicide risk after controlling for quality of life, age, and duration of military service among the total veteran sample and a subsample discharged from military service within five years prior. The resulting model explained 41% of variance in suicide risk in the total veteran sample and 51% of variance in suicide risk in the recently discharged subsample. Recency of discharge, combat exposure, moral injury, poor quality of life, and poor psychological wellness showed statistically significant, independent associations with suicide risk, whereas connection to military identity did not show significant, independent associations. Results highlight the salience of the military-to-civilian transition as an independent risk factor for veteran suicide even after controlling for military-based stressful experiences, military identity, quality of life, age, and service duration.
Military sexual assault (MSA) is a prevalent issue among military personnel that has been linked to adverse mental and physical health outcomes, including posttraumatic stress disorder (PTSD) and suicidal thoughts and behaviors. The present study sought to investigate the relationship between MSA and nonsuicidal self-injury (NSSI) in a national sample of Gulf War-I Era U.S. veterans. The study analyzed data from 1,153 Gulf War-I veterans collected through a cross-sectional survey that assessed demographic information, clinical outcomes, military background, and history of MSA and NSSI. MSA was found to be significantly associated with NSSI at the bivariate level (OR = 2.19, p < .001). Further, MSA remained significantly associated with NSSI (AOR = 2.50, p = .002) after controlling for relevant demographics and clinical outcomes. Veterans with a history of MSA were approximately two and half times more likely to engage in NSSI than veterans who had not experienced MSA. The present findings provide preliminary evidence linking MSA and NSSI. Further, the findings highlight the importance of assessing MSA and NSSI in veteran populations, particularly among those seeking treatment for PTSD.
Grit, or the passionate pursuit of long-term goals, is an important predictor of performance and success across various domains, including within some military contexts. Whether grit predicts such outcomes at a military service academy during a multi-year period of prolonged uncertainty, however, is unknown. Using institutional data collected prior to the COVID-19 pandemic onset, we assessed how well grit, physical fitness test scores, and entrance examination scores predicted performance in academic, military, and physical domains, as well as on-time graduation for 817 cadets from the West Point Class of 2022. This cohort spent more than 2 years of their time at West Point functioning under the uncertainty of pandemic-related conditions. Multiple regression results showed that grit, fitness test, and entrance examination scores were all significant predictors of performance outcomes in the academic, military, and physical domains. Results from binary logistic regression showed that, in addition to physical fitness, grit scores significantly predicted graduation from West Point and accounted for unique variance. Consistent with results from pre-pandemic studies, grit was an important predictor of performance and success for West Point cadets even under pandemic conditions.
The U.S. Military Academy at West Point places young men and women in a highly demanding world of extreme mental and physical challenges. As such, it provides an excellent natural laboratory in which to study how people respond and adapt to highly stressful conditions. The present study explores the role of personality hardiness and coping as stress resilience resources in new (freshmen) cadets at West Point, while also considering sex differences. Using survey methods, N = 234 cadets were assessed during their first year at West Point. Measures included personality hardiness, coping strategies, health symptoms, and number of hospitalizations for all causes. Results show that female cadets are higher in hardiness and emotion-focused coping, as well as somewhat higher in symptoms reports. For the total group, hardiness is linked to better health, both in terms of symptoms reports and hospitalizations. Multiple regression results indicate symptoms are predicted by lower hardiness, higher avoidance coping, and female sex. Conditional process path analysis reveals that the effect of hardiness on symptoms is mediated by emotion-focused coping, and that emotion-focused coping can have both positive and negative effects. This study confirms hardiness is an important stress resilience resource for both men and women in the highly stressful first year at West Point. These findings lend further support to a growing body of evidence that hardiness influences health in part via the coping strategies that people choose to apply in dealing with stressful situations.
This is the first study to compare active-duty soldiers and student civilian samples during the first three months of the Ukrainian-Russian war in relation to moral injury and its association with PTSD, anxiety and depression. A total of 350 participants, including 191 active-duty soldiers of the Ukrainian Armed Force (UAF), who were on the frontline during the full-scale invasion of Russian troops in February 2022, and 159 students from different HEIs in Volyn oblast, were recruited into the study through their attendance at the Ukrainian Psychotrauma Center. Prior to the in-person group-intervention program of psychosocial support for military and civil populations at the Ukrainian Psychotrauma Center, moral injury, PTSD, depression, and anxiety were assessed. Results showed significantly higher moral injury, PTSD, depression, and anxiety scores in civilian students, with a two-way ANOVA indicating a significant impact of female gender in civilians only. A hierarchical regression indicated that moral injury is a predictor of PTSD symptoms in both active-duty and civilian student groups. However, previous family trauma of genocide is associated with PTSD symptoms in active soldiers only. The findings of the current study could contribute insights for clinical practice for combatants and civilians during the current war.
Leadership plays a key role in the well-being of military personnel, either contributing to health improvement or, conversely, becoming a source of stress. In the present study we propose that security providing leadership can reduce work stress in the military context. Furthermore, we suggest that security-providing leaders exert their positive influence on work stress by creating a psychological safety climate and preventing organizational dehumanization. A sample of 204 members (72.5% men) of the Spanish Air Force volunteered to participate in this empirical study and completed an online questionnaire and both the direct and indirect structural equation models were analyzed. Results show a negative relationship between security providing leadership and work stress. Additionally, organizational dehumanization and psychological safety climate act as mediators in this relationship. These results support this novel approach to leadership in the military context. They also offer new ways to create better organizational environments. By treating their subordinates in a personalized manner and supporting them, security-providing leaders can improve employees' perceptions of psychological safety climate and combat feelings of organizational dehumanization, which, in turn, can reduce work stress.
Previous research has indicated that a Rational Emotive Behavior Therapy (REBT)-Informed Group focused on changing irrational beliefs to address comorbid depression and anxiety (as well as anger and guilt) in a combat Veteran population diagnosed with Posttraumatic Stress Disorder (PTSD) demonstrated significant reductions in depression and PTSD symptoms at posttreatment. However, mechanisms of change associated with improvement have not been evaluated. REBT theory suggests that a decline in irrational beliefs predicts a decrease in PTSD, depression, and anxiety symptoms. This study aimed to test this tenet of REBT theory in a naturalistic treatment setting. Participants (N = 86) were post-9/11 combat Veterans, engaged in the REBT-Informed Group between October 2016 and February 2020. Results of hierarchical multiple regression analyses indicated that a reduction in irrational beliefs predicted notable decreases in PTSD, depression, and anxiety symptoms controlling for several covariates. This study extends previous research demonstrating the success of the REBT-Informed Group with combat Veterans and gives support to REBT theory regarding the effect of a decline in irrational beliefs. Future directions include replication of findings with Veterans who experienced military sexual trauma (MST), pre-9/11 Veterans, those at other military or Veterans Affairs (VA) medical centers, and civilians to determine generalizability.