Academic journal article Journal of Counseling and Development : JCD

Posttraumatic Stress in U.S. Marines: The Role of Unit Cohesion and Combat Exposure

Academic journal article Journal of Counseling and Development : JCD

Posttraumatic Stress in U.S. Marines: The Role of Unit Cohesion and Combat Exposure

Article excerpt

The current conflicts in Iraq and Afghanistan have resulted in a number of investigations examining the postdeployment mental health among military personnel serving in these regions. Although the published rates of self-reported mental health problems among service members returning from combat deployments in support of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) have ranged from approximately 19% to 44% (Hoge, Auchterlonie, & Milliken, 2006; Lapierre, Schwegler, & LaBauve, 2007), few doubt that a notable prevalence of mental health issues exists in this population. Some evidence suggests that in subsets of returning service members, posttraumatic stress (PTS) symptoms continue to increase in severity across the months and years after return from combat (Grieger et al., 2006; Orcutt, Erickson, & Wolfe, 2004). Researchers have begun to look into the factors that contribute to the development of mental health conditions, both prior to and following war-zone deployment.

An understanding of these factors could be used to inform a range of topics, notably (a) a service member's suitability for deployment, (b) the mitigation of mental health problems while deployed, and (c) the identification of individuals most at risk for mental health issues on return from combat theater. The aim of the current study was to extend the research into this area by identifying variables predictive of PTS and other mental health outcomes in returning OIF military personnel. For the purposes of this study, PTS was conceptualized as the psychological (i.e., reexperiencing a trauma, avoidance of trauma-related stimuli) and physiological (i.e., exaggerated startle response, insomnia) symptoms that can occur after exposure to a traumatic event. With the available data, a diagnosis of posttraumatic stress disorder (PTSD) could not be made with an acceptable degree of accuracy; thus, PTS was used as a proxy for this anxiety-based response.

Level and intensity of combat exposure is one of the most frequently demonstrated predictors of mental health outcomes (particularly PTS) in theater veterans. For example, Miller, Wolf, Martin, Kaloupek, and Keane (2008) reported that an increase in combat exposure showed a linear relationship to the severity of PTSD symptoms in their sample of 315 male combat veterans who served predominantly in the Vietnam War. Additionally, Hoge et al. (2004) described a linear relationship between the number of firefights in which a soldier had been engaged and the prevalence of PTSD in their sample of OIF/OEF service members. An increase in mental health symptoms as a function of increased combat exposure has also been demonslrated by several other authors (Orcutt et al., 2004; Sharkansky et al., 2000; Smith et al., 2008).

Despite the robust relationship between combat exposure and mental health outcomes, some research indicates that certain factors or experiences might be able to buffer the effects of combat exposure, resulting in less mental illness. One factor that has strong theoretical backing, but mixed empirical support, is unit cohesion, or the degree to which soldiers feel committed to and supported by their military units. Theoretically, greater unit cohesion is expected to mitigate the negative effects of traumatic exposure by providing individuals with social support, acceptance, opportunities for reality testing, and the experience of not being alone in one's suffering (Griffith, 2002). These expected outcomes are based on considerable research on the power of group cohesion and group dynamics. For example, group cohesion has been related to group performance in various settings across numerous studies (for meta-analyses, see Evans & Dion, 1991; Gully, Devine, & Whitney, 1995). Cohesion is a significant predictor of satisfaction and enjoyment with a group (Hogg, 1992) and of outcome in psychotherapy groups (e.g., Joyce, Piper, & Ogrodniczuk, 2007). …

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