Medicine and Health Sciences Commons^™

Wellness As A Predictor Of Turnover Intention In The Active Duty Military, Thomas Clifford Seguin

Counseling & Human Services Theses & Dissertations

Due to the unique nature of military service compared to civilian professions, military attrition is difficult to predict using methods derived from career development theories, so turnover remains an ongoing concern for the active duty military. For this reason, military attrition, through turnover intention, should be investigated through a novel lens with the intention of capturing an essence of military service which previous methods may have overlooked, namely the holistic construct of perceived wellness. Previous studies have shown how wellness-related factors affect turnover intention, but none has studied the relationship between perceived wellness and turnover intention. The main hypothesis of …

Consensus On Best Practices In Neuroscience-Informed Treatment Of Combat-Related Posttraumatic Stress In Military Veterans: A Delphi Study Of Experts In The Field Of Mental Health, Danielle Lauren Winters

Counseling & Human Services Theses & Dissertations

The purpose of this study was to capture consensus among mental health professionals who work with combat trauma-afflicted veterans and/or utilize a neuroscience-informed counseling approach, about a set of best practices for uniting neuroscience-informed treatment modalities with the treatment of veterans who present with Post Traumatic Stress (PTS). A multi-round Delphi study was used to elicit information from mental health professionals, which led to the proposition of ways in which mental health professionals may more efficiently work with combat veterans while utilizing neuroscience-informed treatments such as Prolonged Exposure Therapy, Eye Movement Desensitization and Reprocessing (EMDR) neuro-informed Cognitive Behavioral therapy (nCBT), …

Moral Injury, Identity Dissonance, And Reintegration: A Compendium Of Reintegration And Survey Of United States Military Veterans, Thomas Hodges

Doctor of International Conflict Management Dissertations

How do military moral injuries affect reintegration? All service members leave the military eventually, but reintegration can be challenging, bringing changes in career, family life, and friendships, potentially prompting a loss of purpose, drive, and connection. Service members may also struggle with a crisis of identity upon separating from the military, feeling their military identity is incompatible with civilian life. While these difficulties are common for service members in reintegration, they may be worsened by moral injury, the adverse biological, social, psychological, and spiritual effects of experiencing an event that deeply offends a person’s sense of right and wrong. People …

The Mediation Effects Of Adaptive Blindness Strategies On The Relation Between Institutional Betrayal From Military Sexual Assault And Mental Health Symptoms, Rachel L. Davies

Psychology Theses & Dissertations

Military sexual assault is a serious and prevalent issue. The frequency with which military sexual assault occurs and the nature of the response to these events within the military system may contribute to institutional betrayal. Institutional betrayal is the failure of an institution, such as the military, to prevent sexual assault from occurring and/or the failure to support a survivor after sexual assault. Adaptive blindness strategies are forms of coping strategies that help individuals navigate a relationship they depend on when there is a betrayal. Two adaptive blindness strategies are self-blame and minimization. Although the adaptive blindness strategies may allow …

Impacts Of Stigma On Female Service Members, Alisha Weatherly-Kershaw

Doctor of Psychology (PsyD)

There are a variety of factors that prevent people from seeking mental health treatment. The stigma associated with mental health disorders or seeking treatment is a primary deterrent. This stigma is particularly impactful within the armed forces when they are assessed for fitness for duty. Because most research examines stigma’s impact on male military members, this study aims to identify the type of stigma that creates the most significant barrier to female service members seeking mental health treatment. Results indicate that stigmatizing perceptions of service members significantly impact female service members holding negative views towards seeking treatment.

The Purple Heart And Suicidal Behaviors In Post-9/11 U.S. Army Combat Veterans With A Traumatic Brain Injury: A Mixed Methods Study, Jayna Moceri-Brooks

Electronic Theses and Dissertations

Military suicide rates remain high, despite years of targeted efforts to prevent suicide. Specifically, Army Combat Veterans who sustained a traumatic brain injury (TBI) while deployed in support of the Global War on Terrorism are at the highest risk for suicide. This dissertation highlights possible causes for suicidal behaviors within this unique group and provides specific military suicide prevention recommendations. The dissertation is organized into three publishable manuscripts: The first manuscript (Chapter 1) is a mixed-methods dissertation research proposal written according to the National Institute of Health proposal guidelines. The second manuscript (Chapter 2) is an integrative review of the …

Sleeping With The Enemy: Examining The Relationship Between Sleep And Pain In Post-9/11 Veterans, John L. Schwartz Jr.

Psychology Theses & Dissertations

United States veterans are a diverse group of individuals, yet as a result of their service, they share a unique set of customs, traditions, and values. Post-9/11 veterans are more likely to experience elevated levels of pain and poor sleep quality compared to their civilian counterparts; however, little is known about how beliefs related to veterans’ pain impact their sleep and how levels of pain acceptance influence the sleep-pain association. This study examined relationships between sleep and pain in a sample of 102 post-9/11 veterans. Results support associations between pain and sleep identified in other populations. Positive correlations were found …

Incarceration And Suicide: Do The Risk Factors Differ For Civilians And Veterans?, Rheannon Gail Ramsey

Dissertations and Theses

Suicide is one of the leading causes of death in United States jails and prisons. Many researchers have looked at suicides in prisons and what can potentially cause suicidal ideation but there are conflicting findings among civilian incarcerated populations and United States military veteran incarcerated populations.

The intent of this study is to examine which risk factors are most prevalent among adults in custody, with a focus on mental health and substance use or abuse and how these risk factors differ between incarcerated civilians and incarcerated veterans. Using survey data from the 2002 Survey of Inmates in Local Jails conducted …

U.S. Military Veterans’ Attitudes And Perceptions Of Mental Healthcare, Bridget Milam Wells

Health, Human Performance and Recreation Undergraduate Honors Theses

The purpose of this research project is to measure whether U.S. military veterans experience any stigma related to mental healthcare and if this is associated with age, length of service, and military branch. U.S. military veterans are a high-risk group for developing mental illnesses. It is believed social stigma and personal attitudes, perceptions and beliefs of mental healthcare may influence whether a veteran will pursue mental healthcare. This cross-sectional study was conducted as an online survey via Qualtrics resulting in 75 total responses. 21 responses were excluded from the analysis due to incompletion or failure to pass the consciousness-awareness test …

Self-Reliance And Self-Efficacy As Determinants Of Mental Health Treatment Seeking Intention In A Sample Of Student Service Members/Veterans, Leigh Holdsambeck

DNP Scholarly Projects

Problem Statement: High rates of mental illness and poor treatment seeking have plagued the military for decades. As an organization that demands resilience, sacrifice, strength, and courage from its members, many servicemembers develop deep-seated self-reliance and self-efficacy. Though essential in many critical situations, these traits often complicate a servicemember's willingness to seek care for a mental health concern. Student servicemembers/veterans (SSM/Vs) are at an increased risk for poor mental health outcomes owing to the compounded stressors of military service and academia. Purpose: To measure the impact of elements of military service, namely self-reliance and self-efficacy, on mental health …

Education On My Healthevet To Increase Access To Psychiatric Healthcare For Veterans, Roxann Hackbarth

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Introduction: Access to mental health care can be challenging for many veterans. The Veterans Health Administration (VHA) developed the patient portal My Healthevet (MHV) to increase access to healthcare services. Despite this program, many veterans still do not take advantage of the portal. The goal of this literature review was to gain knowledge on benefits and barriers of using patient portals, identification of patients who use and do not use patient portals, and interventions to increase the use of patient portals.
Evidence Summary: The use of patient portals, including the VHA portal MHV, helps to increase interactions between clinicians and …

Identifying Relationships Between Upper Extremity Function And Army Combat Fitness Test Scores In The Reserve 'Officers' Training Corps Population, Lianne Marie Shroba

Theses, Dissertations and Capstones

Background: The United States Army is implementing the Holistic Health and Fitness program (H2F), intending to transform the Army's culture of health and fitness. It aims to optimize soldier readiness by improving physical and non-physical performance, decreasing injury rates, and improving rehabilitation after injury. A part of that program includes replacing the current Army Physical Fitness Test (APFT) with the new Army Combat Fitness Test (ACFT). The ACFT consists of six functional events that gauge combat readiness. There is already established literature regarding injury epidemiology as it relates to the previous APFT, but little published work on the ACFT …

Supporting Resilience In Reserve Component Spouses During Deployment: The Impact Of Family Life Cycle Phase And Deployment History On Social Support Needs, Jennifer L. Ceminsky

All Graduate Theses, Dissertations, and Other Capstone Projects

This exploratory study used a researcher developed survey to examine the relative value of instrumental, emotional, and informational support for Reserve Component spouses during deployment. Although all types of support were valued by nearly all study participants, significant differences were found between ratings of helpfulness for each type of support. Emotional support was the support type most valued by 73.1% of spouses in this study. Instrumental support was most valued by21.1%, and only 2.8% of spouses valued informational support most. Regression analyses were used to identify factors that were predictive of value placed on each type of social support. The …

From Military Service To Diakonia: A Training Program For Clergy Ministering To Veterans, Danielle Xanthos

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Many veterans opt to seek the support of clergy before mental health professionals. Most clergy, however, are unfamiliar with the nuances of the veteran culture and experience. Mental health professionals who specialize in working with the veteran population can collaborate with clergy to bridge this gap of care to mutually develop a better understanding of veteran culture and symptoms of mental health conditions common among the veteran population, and by equipping clergy with basic tools that promote psychological and spiritual wellbeing. Special consideration is given to the concept of moral injury and the application of Acceptance and Commitment Therapy, illustrating …

A Meta-Analysis Of Group Treatment Outcomes For Veterans With Substance Use Disorders, Robert “Tony” Dice

Counseling & Human Services Theses & Dissertations

Group therapy is commonly used in the treatment of substance use disorders (SUD). Many studies exist related to the efficacy of group interventions for veterans with SUDs. A meta-analysis and systematic review of the literature addressing the use of group therapy, specifically psychoeducational groups, cognitive behavioral therapy (CBT) groups and support groups, in the treatment of SUDs with veterans was conducted. The following questions guided the research: What are viable treatment outcomes for psychoeducational, CBT, and support groups of veterans with SUDs? and What are the measures that capture outcomes related to psychoeducational, CBT, and support groups of veterans with …

The Effects Of Military Sexual Trauma And Depressive Symptoms On Reintegration, Rachel L. Davies

Psychology Theses & Dissertations

Reintegration is a challenge for many veterans returning to civilian roles after military service. Difficulties range from an assortment of issues such as self-care to community participation. Military sexual trauma may be an experience that alters or changes veterans and result in difficulty in reintegration. Specifically, it was predicted that military sexual trauma would indirectly affect reintegration, via depressive symptoms. In addition, locus of control was predicted to play a role in how military sexual trauma impacts reintegration with external locus of control acting as a buffer. Participants were a cross-sectional community sample of both female veterans who reported having …

Fight, Flight, Or Freezing? Investigating The Immobility Response In Military Veterans, Paige Elizabeth King

UNF Graduate Theses and Dissertations

When the body is faced with threat to life or limb, the autonomic nervous system works to overcome the danger – by either fight, flight, or freezing. While immobility may not appear to be the most logical solution, theories exist that it allows for judgement of the situation and preparation for action. This study investigated the stress response that military veterans, with or without post-traumatic stress disorder (PTSD), demonstrate when shown unpleasant images. Researchers wanted to determine the extent to which veterans would show freezing or immobile responses when under an unpleasant image condition. It was hypothesized that veterans who …

An Examination Of Social Connectedness On Ptsd And Freezing In A Student Military Population, Jessica Marie Ledwith

UNF Graduate Theses and Dissertations

This study investigates the impact of social connectedness (SC) and post-traumatic stress disorder (PTSD) in a military college population, and their relation to physiological measures such as body sway, heart rate (HR), and heat rate variability (HRV). According to previous research, people with PTSD are more likely to exhibit a freezing response to affective images. In the present study, we explore the potential freezing response for military personnel at the levels of PTSD symptom groups and social connectedness. We also investigate the possible buffering effect social connectedness has on the outcome of PTSD and freezing. There was a total of …

Exploring The Effects Service Dogs Have On Veterans With Ptsd, Shelby E. Reeves

Honors Undergraduate Theses

Post-Traumatic Stress Disorder (PTSD) is a mental illness resulting from exposure to a traumatic event. Symptoms of PTSD vary, but those affected commonly experience nightmares, flashbacks, hypervigilance, and trouble sleeping; they may also avoid people or situations that trigger traumatic memories. It is estimated that PTSD affects about 10-30% of all United States veterans. Additionally, traditional treatment methods have an average dropout rate of 25% among military personnel. Inadequate PTSD symptom management may lead to depression, anxiety, suicidality, isolation, unstable relationships, and substance misuse. The purpose of this review is to examine the current research concerning the use of service …

Veterans Using Mindfulness Practice To Cope With Trauma & Operational Stress Injuries, T'Challa Azhar Stuckey

All Theses And Dissertations

Psychological distress due to military operations is impacting returning veterans mentally and physically. The purpose of exploring literature relating to veterans is to determine if mindfulness-based interventions (MBI) are beneficial in managing the symptoms of posttraumatic stress disorder (PTSD). Data generated by the research question “What are the therapeutic benefits of mindfulness-based interventions, if any, in managing the symptoms of PTSD among veterans?” were explored to determine the effectiveness of using mindfulness-based coping skills to manage symptoms such as hyperarousal, intrusive recollections, and avoidance. The studies that were analyzed reported on veterans who have served in the U.S. Armed Forces …

From The Boots On The Ground: A Comparison Of The Attitudes And Beliefs Of Military Members And Mental Health Professionals Regarding The Moral Injury Construct, Karis L. Callaway

Dissertations

An increasing amount of research conducted in recent years indicates that, in addition to Posttraumatic Stress Disorder, moral injury is a key concept to recognize when considering the deployment experiences of service members. Although related to Posttraumatic Stress Disorder, which is a fear-based mental health diagnosis, moral injury is a distinct concept. It acknowledges the possible prolonged negative psychological, social, and spiritual consequences that may occur after experiences that challenge and transgress one’s deeply held moral beliefs. Events such as perpetration of harm, failing to protect or prevent harm, and witnessing or learning about distressing acts committed by influential others …

G.I. Jane Fem Etran Goes Corporate: An Exploration Of Post-9/11 Female Combat Veterans Transitioning To A Civilian Career, Tumona Austin

Dissertations

Purpose: The purpose of this multiple-case study was to explore the experiences of post- 9/11 female combat veterans transitioning from military service to civilian careers, using the Schlossberg transition model factors of situation, self, social support, and strategies.

Methodology: This multiple-case study identified and interviewed post-9/11 female combat veterans transitioning from active-duty to civilian career. Respondents were purposively chosen based on specific criteria and expert panel recommendations.

Findings: Examination of case-study interview data and artifacts from the 3 post-9/11 female combat veterans indicated nine major findings:

1. The factor of situation clearly outweighed the other Schlossberg factors in impact.

2. …

Exploration Of Rape Myths Among Former Military Professionals, Gabrielle Caldara

Electronic Theses and Dissertations

Sexual violence is sometimes considered a taboo topic for discussion, but it gained widespread attention in the media in late 2017 due to the social movements addressing the sexual assault of women. However, sexual violence perpetrated against men lacks publicity in America, and highlights a similar situation in the Armed Forces. A discussion of sexually violent acts committed against men is sometimes impeded by cultural norms. This discrepancy associated with civilian and military communities inspired this exploratory study.

A convenience sample of 520 former American military professionals completed an anonymous online survey to describe their attitudes and beliefs regarding rape …

Efforts To Reduce Concomitant Opioid And Benzodiazepine Prescribing At The Lexington Veterans Affairs Medical Center, Kaitlyn A. Staton

MPA/MPP/MPFM Capstone Projects

The United States is in the throes of an opioid epidemic. Any person who uses an opioid medication may experience an intentional or unintentional overdose. An overdose is more likely to occur when an individual ingests an opioid in combination with certain classes of medications, such as benzodiazepines or nonbenzodiazepines (Z-drugs). These medications are more likely to cause sedation and respiratory depression when taken together. Veterans, due to their unique mental and physical health challenges, are more likely to experience an overdose when they receive a combination of opioid therapy with benzodiazepine or Z-drug therapy as opposed to a single …

From War To Home: The Systematic Issues Operation Enduring And Iraqi Freedom Veterans Face Transitioning With Ptsd, Tiffany D. Ware

Dissertations

Purpose: The purpose of this phenomenological study was to describe the perceptions of Operation Enduring and Iraqi Freedom veterans with PTSD, who are transitioning from active duty to civilian life, regarding their participation in the Disabled Transition Assistance Program.

Methodology: The methodology for this research study will be qualitative from a phenomenological perspective. When thinking of research as it pertains to qualitative methods, it is appropriate to use when a researcher is trying to study the lived experiences of individuals (Flipp, 2014; Patton, 2015). This method will describe perceptions of Operation Enduring and Iraqi Freedom veterans with PTSD, who are …

Using Photovoice To Understand The Meaning Of Social Participation As It Impacts Transitions For Student Veterans, Caitlin Gene Dobson

Theses and Dissertations

Student veterans encounter a variety of social pressures that civilian students do not, making the transition from military life to student civilian challenging. The issue of military personnel transitioning to roles as student veterans is one that is relevant to occupational therapy, as the profession promotes social participation as a meaningful occupation. It has been found that veterans find social relationships to be a critical challenge in the process of transitioning to the university and the civilian world (Plach & Haertlein Sells, 2013).

Additionally, this issue is important to occupational therapy as a factor in promoting mental health. Mental health …

Consult Management At The Va Palo Alto Health Care System: Has The Implementation Of Business Rules Improved Consult Management, And Did It Help Measure Performance For Select Services?, Christine Poblete

Master's Projects

This research project was developed to determine whether the new business rules implemented at the VA Palo Alto Health Care System have resulted in an improvement in the delivery of critical health care services through consults; and whether this process can be used as a Key Performance Indicator (KPI) for measuring performance of clinical services by health care administrators.

Improving Service Delivery Through Provider Training: A Process Evaluation Of The Veterans Affairs Palo Alto Health Care System “Commitment To Serve” Workshop, Ismael Barrera

Master's Projects

As the customer-focused management strategies gradually advances into all of the VISNs [Veterans Integrated Service Networks], the Veterans Health Administration in Palo Alto, California implemented a customer service training program for employees to meet the diverse and complex needs of its customers. This research will analyze whether participants in this training, known as Commitment to SERVE, believe that it is achieving its goal. In other words, does the Veterans Affairs Palo Alto Health Care System (VAPAHCS) staff perceive the Commitment to SERVE workshop as a beneficial customer service training program?

The Relationship Between The Military's Masculine Culture And Service Members' Help-Seeking Behaviors, Rachel Reit

Master's Theses (2009 -)

Since the terrorist attacks on September 11, 2001, over 2.5 million active duty U.S. military service members have deployed to Iraq and Afghanistan (Knobloch & Wilson, 2015). Of those who return as veterans, twenty percent experience serious mental health problems, and only 30-40% of them seek help or treatment (Tanielian & Jaycox, 2008; Wilson, Gettings, Hall, & Pastor, 2015). Recently, the military has increased efforts to encourage help-seeking behaviors among service members and to normalize mental health treatment. However, the military’s masculine culture and emphasis on strength and toughness inhibits the success of these efforts. The present studies investigate the …

A Mixed Methods Analysis Of The Relationship Between Attachment, Post-Traumatic Stress, And Post-Traumatic Growth Among United States Service Members, Chauncy T. Brinton

Dissertations, 2014-2019

The impact of secure military relationships on US service members’ response to trauma during military service was examined in this mixed methods study. Veterans with and without combat exposure evidence a high rate of post-traumatic stress disorder (PTSD) and the military has tried to institute resilience-based programs in anticipation of the psychological challenges experienced by soldiers. At the same time, research has shown that some service members report positive outcomes associated with military service including the phenomena of post-traumatic growth (PTG). The constructs from attachment theory (safe haven and exploration) have begun to be the focus of research with service …