Social Work Commons^™

Invarianza De La Escala De Evaluación De Las Relaciones Intrafamiliares En Padres Con Y Sin Migración De Retorno Y Salud Mental [Invariance Of The Intrafamily Relations Evaluation Scale In Parents With And Without Return Migration And Mental Health], María Elena Rivera Heredia, Patricia Andrade Palos, Jaime Fuentes Balderrama, Luis H. Zayas

School of Social Work Faculty Publications and Presentations

Se analizaron las propiedades psicométricas de la Escala de Evaluación de las Relaciones Intrafamiliares (ERI) en padres de familia que retornaron a México y que tienen hijos e hijas menores de edad nacidos en E.E.U.U., así como en padres mexicanos sin experiencia migratoria. Participaron189 padres (92 retornados y 97 sin migración). Se llevaron a cabo Análisis Factoriales Exploratorios y Confirmatorios para derivar una versión culturalmente invariante. Una vez obtenidas las evidencias de invarianza configural, métrica, escalar, estricta y estructural, se encontró mediante un modelo de ecuaciones estructurales que la unión y apoyo familiar se asocian con la sintomatología depresiva y …

“It’S Not That We Care Less”: Insights Into Health Care Utilization For Comorbid Diabetes And Depression Among Latinos, Sharon Borja, Miriam G. Valdovinos, Kenia M. Rivera, Natalia Giraldo-Santiago, Robin Gearing, Luis R. Torres-Hostos

School of Social Work Faculty Publications and Presentations

Despite robust knowledge regarding the socio-economic and cultural factors affecting Latino* access to healthcare, limited research has explored service utilization in the context of comorbid conditions like diabetes and depression. This qualitative study, embedded in a larger mixed-methods project, aimed to investigate perceptions held by Latinos and their social support systems (i.e., family members) regarding comorbid diabetes and depression and to identify barriers and facilitators to their help-seeking behaviors and treatment engagement. Bilingual and bicultural researchers conducted eight focus groups with 94 participants in a large U.S. metropolitan area and were primarily conducted in Spanish. The participants either had a …

Differences In Resilience And Mental Health Symptoms Among Us First Responders With Secure And Insecure Attachment, Donna Schuman, James Whitworth, Jeanine Galusha, Jose Carbajal, Warren Ponder, Kathryn Shahan, Katelyn Jetelina

Faculty Publications

Objective: This observational study aimed to determine whether attachment style predicted first responders' mental health and resilience. Method: Data were from a treatment-seeking sample of first responders (N = 237). Each participant completed six assessments measuring attachment, resilience, generalized anxiety, depression, suicidality, and posttraumatic stress disorder. Results: On the attachment assessment, 25.3%were categorized as secure, 19.0%as dismissive, 25.3% as preoccupied, and 30.4% as fearfully attached. As predicted, securely attached participants had the lowest scores for generalized anxiety, depression, suicidality, and posttraumatic stress disorder and the highest scores on the resiliency measure, followed by dismissive, preoccupied, and fearfully …

Affective Depression Mediates Ptsd To Suicide In A Sample Of Treatment-Seeking First Responders, James Whitworth, Jeanine Galusha, Jose Carbajal, Warren Ponder, Donna Schuman

Faculty Publications

Objective: The aim of this study was to examine the associations of comorbid

posttraumatic stress disorder (PTSD), affective or somatic depression, and

suicide among first responders (FRs). Method: We used baseline data from

FRs (N = 232) who sought services at a nonprofit mental health agency specializing

in treating trauma exposed FRs. We conducted two PROCESS simple

mediation models with PTSD as the predictor, affective depression and somatic

depression as the mediators, and suicidality as the dependent variable.

Results: Affective depression significantly mediated the relationship between

PTSD and suicidality, whereas somatic depression did not. The direct effect …

Mental Health Problems Among Elementary School Students Mandated To E-Learning: A Covid-19 Rapid Review Caveatmandated To E-Learning: A Covid-19 Rapid Review Caveat, Renee M. D'Amore, Angelina N. Halpern, Lauren R. Reed, Kevin M. Gorey

Social Work Publications

Extended lockdowns during the COVID-19 pandemic mandated millions of students worldwide to e- learning and by default made many of their parents proxy homeschool teachers. Preliminary anecdotal, journalistic and qualitative evidence suggested that elementary school children and their parents were probably most vulnerable to this stressor and most likely to experience mental health problems because of it. We responded with a rapid review of 15 online surveys to estimate the magnitude of such risks and their predictors between 2020 and 2021. The pooled relative risk of mental health problems among school children and their parents was substantial (RR = 1.97). …

Validation Of The Pcl-5, Phq-9, And Gad-7 In A Sample Of Veterans, Aazi Ahmadi, Warren Ponder, Jose Carbajal, Donna Schuman, James Whitworth, R Andrew Yockey, Jeanine Galusha

Faculty Publications

Objective: Veterans can present at nongovernment (Department of Defense, Department of Veterans Affairs) mental health agencies with complex symptom constellations that frequently include posttraumatic stress disorder, depression, and generalized anxiety. To date, no veteran study has validated these measures on a treatment-seeking sample of veterans outside the DoD and VA. Methods: We used a treatment-seeking sample of veterans (N = 493) to validate measures that assess these constructs (PTSD Checklist 5, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7). Results: The seven-factor posttraumatic stress disorder hybrid configuration was the best fit. The best fitting model of the depression …

Perinatal Depression And Implementation Of The “Thinking Healthy Program” Support Intervention In An Impoverished Setting Of Lima, Peru: Assessment Before And During The Covid-19 Pandemic, Margot Aguilar, Carmen Contreras, Giuseppe Raviola, Alejandra Sepúlveda, Maricielo Espinoza, Leydi Moran, Lourdes Ramos, Jesús Peinado, Leonid Lecca, Gloria A. Pedersen, Brandon A. Kohrt, Jerome T. Galea

Social Work Faculty Publications

Socios En Salud (SES) implemented the Thinking Healthy program (THP) to support women with perinatal depression before and during the COVID-19 pandemic in Lima Norte. We carried out an analysis of the in-person (5 modules) and remote (1 module) THP intervention. Depression was detected using PHQ-9, and THP sessions were delivered in women with a score (PHQ-9 ≥ 5). Depression was reassessed and pre- and post-scores were compared. In the pre-pandemic cohort, perinatal depression was 25.4% (47/185), 47 women received THP and 27 were reassessed (57.4%), and the PHQ-9 score median decreased from 8 to 2, p < 0.001. In the pandemic cohort, perinatal depression was 47.5% (117/247), 117 women received THP and 89 were reassessed (76.1%), and the PHQ-9 score median decreased from 7 to 2, p < 0.001. THP’s modalities helped to reduce perinatal depression. Pregnant women who received a module remotely also reduced depression.

Differences In Suicidality In Non–Treatment-Seeking And Treatment-Seeking Law Enforcement Officers: A Cross-Sectional Study, Warren N. Ponder, Alaina M. Beauchamp, Donna L. Schuman, Jose Carbajal, Katelyn K. Jetelina, Jeanine M. Galusha

Faculty Publications

Objective: Law enforcement officers (LEOs) are exposed to high levels of occupational trauma and face added stress from heightened public scrutiny and COVID-19, which may result in suicide. It is crucial to understand differences between LEOs who seek treatment and those who do not. Method: We compared LEOs from the same greater metropolitan area who sought treatment with those who did not. Participants completed validated measures assessing posttraumatic stress disorder, generalized anxiety, depression, and suicidality. Results: The treatment-seeking sample scores were higher on all standardized assessments. Bivariate logistic regression results indicated that the non–treatment-seeking sample's odds of experiencing suicidality were …

Pathways From Exposure To Community Violence To Bullying Victimization Among African American Adolescents In Chicago’S Southside, Dexter R. Voisin

Faculty Scholarship

The present study proposes and examines the pathways from exposure to community violence to bullying victimization through the influences of depression, exposure to peer delinquency, and drug use among 638 African American adolescents (aged 12–22) from low-resourced neighborhoods in Chicago’s Southside. The study found that African American adolescents who were exposed to community violence were likely at risk of bullying victimization, depression, exposure to peer delinquency, and drug use. Depression can heighten the risk of bullying victimization. These findings have implications for future research.

Oncology Healthcare Professionals’ Mental Health During The Covid-19 Pandemic, Leeat Granek, Ora Nakash

School for Social Work: Faculty Publications

The paper begins by reviewing the literature on oncology healthcare professionals’ (HCP) mental health. We summarize and present the current data on HCP mental health in order to understand the baseline state of oncology HCPs’ mental health status prior to the COVID-19 pandemic. At each juncture, we will discuss the implications of these mental health variables on the personal lives of HCPs, the healthcare system, and patient care. We follow by reviewing the literature on these parameters during the COVID-19 pandemic in order to better understand the impact of COVID-19 on the overall mental health of HCPs working in oncology. …

Virtual Versus Face-To-Face Cognitive Behavioral Treatment Of Depression: Meta-Analytic Test Of A Noninferiority Hypothesis And Men’S Mental Health Inequities, Carly M. Charron, Kevin M. Gorey

Social Work Publications

Global rates of depression have increased significantly since the beginning of the COVID-19 pandemic. It is unclear how the recent shift of many mental health services to virtual platforms has impacted service users, especially for the male population which are significantly more likely to complete suicide than women. This paper presents the findings of a rapid meta-analytic research synthesis of 17 randomized controlled trials on the relative efficacy of virtual versus traditional face-to-face cognitive behavioral therapy (CBT) in mitigating symptoms of depression. Participants’ aggregated depression scores were compared upon completion of the therapy (posttest) and longest follow-up measurement. The results …

Feasibility Of A School-Based Mental Health Program Implementation To Improve The Status Of Depression And Quality Of Life Of Mothers Of Children With Autism Spectrum Disorders In Urban Bangladesh: Menthol Study, Aliya Naheed, Saimul Islam, Meredith B. Brooks, Mary C. Smith Fawzi, Mir Nabila Ashraf, Helal Uddin Ahmed, M. M. Jalal Uddin, Kamrun Nahar Koly, Jerome T. Galea, Shaheen Akhter, Charles Nelson, Saima Wazed Hossain, Kerim M. Munir

Social Work Faculty Publications

Background: We assessed the feasibility of implementing psychological counseling services (PCS) for mothers of children with autism spectrum disorders (ASD) integrated within special education settings in urban Bangladesh. Method: In two special education schools for ASD in Dhaka City, trained female psychologists screened mothers using the Patient Health Questionnaire (PHQ-9). PCS was administered to all the mothers irrespective of a diagnosis of depression. Mothers with a PHQ-9 score >4 who met criteria for a major depressive episode (MDE) based on the DSM-IV Structured Interview Axis I Disorders (SCID-I) were also administered skill-building training through monthly home visits to support ASD …

Online Social Networking Among Clinically Depressed Young People: Scoping Review Of Potentially Supportive Or Harmful Behaviors, Carolyn L. Elias, Kevin M. Gorey

Social Work Publications

Online social networking sites are ubiquitous and prevalently used by young people. The COVID-19 pandemic demonstrated the potential for such sites to bring isolated people together to support their mental health. Virtual communications, however, are not without risks. Substantial knowledge exists on attendant risks and protections among the general population, but much less seems known about their effects among clinical populations. This scoping review mapped the novel knowledge and knowledge gaps related to online social networking experiences and perceptions of depressed young people, adolescents to emergent adults. It also explored moderators of their social networking supports versus harms. A broad …

Relative Effectiveness Of Online Cognitive Behavioural Therapy With Anxious Or Depressed Young People: Rapid Review And Meta-Analysis, Shikara T. Howes, Kevin M. Gorey, Carly M. Charron

Social Work Publications

Global estimates suggest that 25% and 20% of youth have reported elevated symptoms of depression and anxiety, respectively, since the beginning of the COVID-19 pandemic compared to baseline functioning (Racine et al., 2021). Cognitive behavioural therapy (CBT) has been found to significantly benefit young people experiencing anxiety and depression (Christ et al., 2020). Pandemic-related protocols have led many mental health services to shift to online platforms. We wondered about the comparative efficacy of online versus offline CBT for young people between the ages of 10-25. We responded with a rapid review and meta-analysis of eight randomized controlled trial outcomes. The …

The Effect Of Travel Burden On Depression And Anxiety In African American Women Living With Systemic Lupus, Ashley A. White, Brittany L. Smalls, Aissatou Ba, Trevor D. Faith, Viswanathan Ramakrishnan, Hetlena Johnson, Jillian Rose, Clara L. Dismuke-Greer, Jim C. Oates, Leonard E. Egede, Edith M. Williams

Family and Community Medicine Faculty Publications

The United States has a deficit of rheumatology specialists. This leads to an increased burden in accessing care for patients requiring specialized care. Given that most rheumatologists are located in urban centers at large hospitals, many lupus patients must travel long distances for routine appointments. The present work aims to determine whether travel burden is associated with increased levels of depression and anxiety among these patients. Data for this study were collected from baseline visits of patients participating in a lupus study at MUSC. A travel/economic burden survey was assessed as well as the 8-item Patient Health Questionnaire (PHQ-8) and …

An Evidence Based Practice Guide For Parents And Schools: Supporting Kids And Adolescents' Mental Health During And After Covid-19 Pandemic, Ivanna M. Fuentes Javier

Evidence-Based Social Work Practice Guide Series

Adolescent mental health is important to consider by parents and schools. Parents need to build a strengthened mentality in their children and with the school support, the results would be greater. The active participation of schools is needed in order to support kids' and adolescents' mental health and create parent awareness about mental health. Also, when parents are able to identify early signs of mental health problems, they can prevent it from becoming greater and the school can help parents learn about these early signs. In addition, parents play a fundamental role in identifying symptoms of mental health problems in …

Correlates Of Depression Among Black Girls Exposed To Violence, Dexter R. Voisin

Faculty Scholarship

Depression rates for youth remanded to juvenile detention is double that of the general population and Black girls are especially vulnerable. A dearth of literature analyzes the factors that are correlated with depression among system-involved Black girls, ages 12–17 years old. We utilized personal agency to examine the relationship between risk factors (i.e., abuse history, and fear of condom negotiation) and protective factors (i.e., condom self-efficacy, and perceived social support) that might correlate with depression among Black girls exposed to violence. Findings indicate that fear of condom negotiation, abuse history and low condom self-efficacy are correlated with depressive symptomology while …

A Non-Specialist Depression Care Pathway For Adolescents Living With Hiv And Transitioning Into Adult Care In Peru: A Nested, Proof Of Concept Pilot Study, Jerome T. Galea, Carmen Contreras, Milagros Wong, Karen Ramos, Valentina Vargas, Hugo Sánchez, Renato A. Errea, Leonid Lecca, Molly F. Franke

Social Work Faculty Publications

Background: Adolescents living with HIV (ALWH) are disproportionally impacted by depression, experiencing worse HIV outcomes. Integrated depression and HIV care may support antiretroviral adherence. This study pilot tested for proof of concept a basic depression care pathway for ALWH to inform depression care integration with HIV services in Peru.

Methods: ALWH were screened for depression with the Patient Health Questionnaire-9 (PHQ-9). Participants with PHQ-9 scores of ⩾10 or suicidal ideation (SI) were eligible for Psychological First Aid (PFA) delivered by non-mental health specialists. Participants with PHQ-9 re-assessments of ⩾20 or SI were referred to specialized services.

Results: Twenty-eight (11 female, …

Understanding The Role Of Past Health Care Discrimination In Help-Seeking And Shared Decision-Making For Depression Treatment Preferences, Ana M. Progovac, Dharma E. Cortés, Valeria Chambers, Jonathan Delman, Deborah Delman, Danny Mccormick, Esther Lee, Selma De Castro, María José Sánchez Román, Natasha A. Kaushal, Timothy B. Creedon, Rajan A. Sonik, Catherine Rodriguez Quinerly, Caryn R.R. Rodgers, Leslie B. Adams, Ora Nakash, Afsaneh Moradi, Heba Abolaban, Tali Flomenhoft, Ruth Nabisere, Ziva Mann, Sherry Shu Yeu Hou, Farah N. Shaikh, Michael Flores, Dierdre Jordan, Nicholas J. Carson, Adam C. Carle, Frederick Lu, Nathaniel M. Tran, Margo Moyer, Benjamin L. Cook

School for Social Work: Faculty Publications

As a part of a larger, mixed-methods research study, we conducted semi-structured interviews with 21 adults with depressive symptoms to understand the role that past health care discrimination plays in shaping help-seeking for depression treatment and receiving preferred treatment modalities. We recruited to achieve heterogeneity of racial/ethnic backgrounds and history of health care discrimination in our participant sample. Participants were Hispanic/Latino (n = 4), non-Hispanic/Latino Black (n = 8), or non-Hispanic/Latino White (n = 9). Twelve reported health care discrimination due to race/ethnicity, language, perceived social class, and/or mental health diagnosis. Health care discrimination exacerbated barriers to initiating and continuing …

Racial And Ethnic Comparison Of Ecological Risk Factors And Youth Outcomes: A Test Of The Desensitization Hypothesis, Dexter R. Voisin

Faculty Scholarship

Minority youth, because of structural, ecological, and societal inequalities, are at heightened risk of reporting depression and experiencing negative sanctions associated with delinquency. Sociological theories suggest that greater exposure to ecological risk factors at the peer, family, school and community levels are associated with elevated rates of youth depression and delinquency. Desensitization theory posits that repeated exposures to ongoing stressors result in a numbing of psychological and behavioral responses. Thus, it remains unclear whether racial/ethnic differences exist with regards to how contextual stressors correlate with depression and delinquency. Using a sample of 616 Black, 687 Latinx, and 1,318 White youth, …

Art Adherence Among Men Who Have Sex With Men Living With Hiv: Key Challenges And Opportunities, Dexter R. Voisin

Faculty Scholarship

Purpose of Review: In the USA, gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. High levels of adherence to antiretroviral therapy (ART) can dramatically improve outcomes for persons living with HIV and reduce the risk of HIV transmission to others. Yet, there are numerous individual, social, and structural barriers to optimal ART adherence. Many of these factors disproportionately impact Black MSM and may contribute to their poorer rates of ART adherence. This review synthesizes the key challenges and intervention opportunities to improve ART adherence among MSM in the USA. Recent Findings: Key …

The Importance Of “Being There”: A Qualitative Study Of What Veterans With Depression Want In Social Support, Alan R. Teo, Heather E. Marsh, S. Ono, Christina Nicolaidis, Somnath Saha, Steven K. Dobscha

School of Social Work Faculty Publications and Presentations

Background: Social connectedness exerts strong influences on health, including major depression and suicide. A major component of social connectedness is having individual relationships with close supports, romantic partners and other trusted members of one’s social network. Objective: The objective of this study was to understand how individuals’ relationships with close supports might be leveraged to improve outcomes for primary care patients with depression and at risk for suicide. Design: In this qualitative study, a semi-structured interview guide was used to probe patient experiences, views, and preferences related to social support. Participants: We conducted interviews with 30 primary care patients at …

Yoga-Specific Enhancement Of Quality Of Life Among Women With Breast Cancer: Systematic Review And Exploratory Meta-Analysis Of Randomized Controlled Trials, Daline El-Hashimi, Kevin M. Gorey

Social Work Publications

Physical activities during and after cancer treatment have favorable psychosocial effects. Increasingly, yoga has become a popular approach to improving the quality of life (QoL) of women with breast cancer. However, the extant synthetic evidence on yoga has not used other exercise comparison conditions. This meta-analysis aimed to systematically assess yoga-specific effects relative to any other physical exercise intervention (eg, aerobics) for women with breast cancer. QoL was the primary outcome of interest. Eight randomized controlled trials with 545 participants were included. The sample-weighted synthesis at immediate postintervention revealed marginally statistically and modest practically significant differences suggesting yoga’s potentially greater …

The Impact Of Paternal Involvement And United States Stay Length On Latino Youth's Depressive Symptoms, Christine Marie Bishop, Sara Makki Alamdari

Faculty Publications

Latino youth in the United States are more at-risk for depression than youth of other ethnic backgrounds. This manuscript assesses the impacts of sex, age, United States stay length, and whether or not Latino children of immigrants’ fathers live with them on the youth’s depressive symptoms. For this purpose, data of the Children of Immigrants Longitudinal Study was used. Using multiple regression analysis, the relationships among the aforementioned factors were examined among 1305 immigrant youth who were born in Latin America and Caribbean countries. The results of the study indicated that being male, living with one’s father and longer stay …

Father-Daughter Incest: Comparison Of Treated Cases To Untreated Control Subjects, Keith W. Beard, Jason E. Newsome, Karen V. Harper-Dorton, Stephen L. O'Keefe, Debra H. Young, Sam Swindell, Walter E. Stroupe, Kerri Steele, Megan Lawhon, Shih-Ya Kuo

Faculty & Staff Scholarship

Treatment of father daughter incest (FDI) survivors using the victim advocacy/child welfare approach to FDI that predominates today in the US has never been compared to results in untreated control subjects in any published report. In the present study, thirty-two survivors of FDI who received treatment based on the victim advocacy/child welfare approach to FDI were compared to 32 control subjects who did not receive treatment. No significant differences were found using analysis of variance on 21 scales and subscales. Statistical analysis of the data from all 64 of the FDI survivors showed that items reflecting a poor self-image and …

Depression Education As Primary Prevention: The Erika’S Lighthouse School-Based Program For High School Students, Michael S. Kelly, Heather Freed, Peggy Kubert, Sarah Greibler

Social Work: School of Social Work Faculty Publications and Other Works

Major depression is a treatable and common mental health disorder for youth. Untreated depression is a major risk factor for youth who become suicidal and die by suicide. Recent focus in the school-based literature on creating universal mental health promotion programs have recognized the need for effective depression awareness education programs to assist youth in identifying symptoms of depression in themselves and their peers, and to encourage those youth to seek trusted adults for help. A quasiexperimental design (QED) was employed in two suburban Chicago high schools (n=652) to evaluate the intervention, Real Teenagers Talking About Adolescent Depression (RTTAAD), a …

Stressors, Self-Esteem, Social Activities, And Depression: A Sample Of Patients At A Federally Qualified Health Center Who Experienced Homelessness, Joohee Lee, Morgan W. Bradwell, Michelle Brazeal, Timothy A. Rehner, Stephanie T. Mcleod

Faculty Publications

This study examined the relationships between current stressors and depressive symptoms among Federally Qualified Health Center (FQHC) patients who experienced homelessness, with a particular focus on the role of self-esteem and social activities on these relationships. The sample included patients who visited any clinic site of a FQHC in the southern part of Mississippi and qualified for the Health Care for the Homeless (HCH) Program. Assessments included the Patient Health Questionnaire (PHQ-9), the DUKE Health Profile, and a checklist of stressors. Results of the multivariate analysis using structural equation modeling revealed that ambulation difficulties were related to depressive symptoms directly …

Social Work Trauma Interventions: Dialectical Behavioral Therapy, Kassie Baumann

Senior Honors Theses

According to Lynne Weilart (2013), in her article on the reasons why people seek out therapy, trauma is the number one reason people attend counseling. Many different trauma-informed approaches are designed specifically to address the consequences of trauma and to facilitate healing. Some of these approaches are as follows: Cognitive Behavioral Therapy (CBT); Dialectical Behavioral Therapy (DBT);Mentalization Based Therapy (MBT); Trauma Systems Therapy (TST); Trauma Assessment Pathway (TAP); and Attachment, Self-Regulation, and Competency (ARC) (de Arellano, Danielson, Ko, & Sprauge, 2008). The effectiveness of each trauma intervention will be examined. DBT is one of these trauma interventions that is growing …

Dreamweaver Foundation Impact Study: Fulfilling Lifelong Dreams For Terminally Ill Seniors In Need, Pamela Ashley, Natalie Scarpa

Reports

Dreamweaver Foundation describes their work as “...fulfill(ing) lifelong dreams for terminally ill seniors in need.” This impact study was designed to provide evidence of how the Foundation is making a difference in the lives of the dreamers and their families. This study applied a systematic and objective approach to understanding the impact of the Dreamweaver Foundation by conducting and analyzing interviews with a representative group of dreamers and their families. The richness of their experiences was captured through these interviews and analyzed to identify themes of impact. In order to provide a solid foundation for the interview process, the study …

The Impact Of A Civic Service Program On Biopsychosocial Outcomes Of Post 9/11 U.S. Military Veterans, Monica M. Matthieu, Karen A. Lawrence, Emma Robertson-Blackmore

Social Work Faculty Publications

Volunteering as a health promotion intervention, improves physical health, mental health, and social outcomes particularly in older adults, yet limited research exists for veterans. We conducted a preliminary study to explore whether volunteering impacts a variety of biopsychosocial outcomes, including symptoms of post-traumatic stress disorder (PTSD) and depression, among returning military veterans from Iraq and Afghanistan. A survey enrolling a prospective cohort of United States (U.S.) veterans who served in the military after 11 September 2001 and who participated in a national civic service program was conducted. A total of 346 veterans completed standardized health, mental health, and psychosocial self-report …