The proposed longitudinal study aims to better understand the functioning of returning Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) OEF/OIF veterans over time and to identify potentially malleable resilience factors associated with higher levels of functioning. A total of 300 returning OEF/OIF veterans will be followed for a one-year period. Veterans will complete a baseline assessment, followed by three follow-up assessments (two self-report assessments mailed at 4- and 8-months post-baseline and a one-year in-person follow-up assessment that repeats many of the baseline clinician-administered assessments). Multiple functional outcomes will be evaluated, including occupational, family, social, and physical functioning.
The specific aims i nclude: 1) identifying whether a """"""""dose-response"""""""" relationship exists between level of exposure to stressors (pre-deployment, deployment-related, and post-deployment) and functioning over time;2) examining whether potentially malleable resilience factors predict higher levels of functioning in returning veterans over time;3) examining whether psychopathology predicts lower levels of functioning in returning veterans over time;4) testing the theoretical model that psychopathology partially mediates the effects of stress, social support, coping, and neurocognition on functioning over time;5) examining whether changes in the use of healthy coping strategies, social support, post-deployment stress, and psychopathology predict changes in functioning over time;and 6) exploring whether stress, social support, coping, neurocognition, and psychopathology have differential effects on specific aspects of functioning (e.g., occupational, family, social, and physical functioning) over time. The long-term aim of this research is to develop evidence-based prevention and treatment programs designed to assist returning OEF/OIF veterans with achieving optimal functioning when reintegrating into civilian life. In keeping with the VHA's goal of operationalizing principles of recovery and rehabilitation in treatment planning, this research should provide a platform of empirical data to assist with the further development of meaningful treatment intervention and prevention programs to assist OEF/OIF veterans with the post-war readjustment process over time.

Public Health Relevance

Functional recovery is of the utmost importance to evaluate in our returning Operation Enduring and Iraqi Freedom veterans so that we can better understand what happens during the readjustment process from warzone to civilian life and the needs of our veterans. Although most soldiers are resilient, concerning rates of PTSD (12-20%) and depression (14-15%) have been found, and as many as 24-35% report drinking more alcohol than they intended (Hoge et al., 2004). The current study proposes to follow returning veterans for a one-year period to evaluate factors that influence the readjustment process and functional impairment. This information should guide the development of early intervention and treatment programs to help readjustment.

National Institute of Health (NIH)
Veterans Affairs (VA)
Non-HHS Research Projects (I01)
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Psychological Health & Social Reintegration (RRD4)
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Olin Teague Veterans Center
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Kimbrel, Nathan A; Wilson, Laura C; Mitchell, John T et al. (2017) ADHD and nonsuicidal self-injury in male veterans with and without PTSD. Psychiatry Res 252:161-163
Martindale, Sarah L; Morissette, Sandra B; Kimbrel, Nathan A et al. (2016) Neuropsychological functioning, coping, and quality of life among returning war veterans. Rehabil Psychol 61:231-9
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Dahm, Katherine A; Meyer, Eric C; Neff, Kristin D et al. (2015) Mindfulness, Self-Compassion, Posttraumatic Stress Disorder Symptoms, and Functional Disability in U.S. Iraq and Afghanistan War Veterans. J Trauma Stress 28:460-4
Elliott, Timothy R; Hsiao, Yu-Yu; Kimbrel, Nathan A et al. (2015) Resilience, traumatic brain injury, depression, and posttraumatic stress among Iraq/Afghanistan war veterans. Rehabil Psychol 60:263-76
Wilson, Laura C; Kimbrel, Nathan A; Meyer, Eric C et al. (2015) Do child abuse and maternal care interact to predict military sexual trauma? J Clin Psychol 71:378-86
Wilson, Laura C; Simmons, Brittany L; Leheney, Emma K et al. (2015) Does military sexual trauma moderate the impact of critical warzone experiences? Psychiatry Res 229:596-8
Hiraoka, Regina; Meyer, Eric C; Kimbrel, Nathan A et al. (2015) Self-Compassion as a prospective predictor of PTSD symptom severity among trauma-exposed U.S. Iraq and Afghanistan war veterans. J Trauma Stress 28:127-33
Kimbrel, Nathan A; Morissette, Sandra B; Meyer, Eric C et al. (2015) Effect of the 5-HTTLPR polymorphism on posttraumatic stress disorder, depression, anxiety, and quality of life among Iraq and Afghanistan veterans. Anxiety Stress Coping 28:456-66
Kimbrel, Nathan A; Gratz, Kim L; Tull, Matthew T et al. (2015) Non-suicidal self-injury as a predictor of active and passive suicidal ideation among Iraq/Afghanistan war veterans. Psychiatry Res 227:360-2

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