HSR&D Home » Research » RRP 08-385 – QUERI Project
Impact of Psychiatric Diagnoses and Injury on Vocational Outcomes in OIF Veterans
Christopher R. Erbes, PhD
Minneapolis VA Health Care System, Minneapolis, MN
Funding Period: November 2008 - April 2009
Successful transition of returning soldiers back into civilian life following deployment is a vital concern for the nation and the VA. Civilian reintegration is especially difficult for veterans suffering from physical injuries such as those due to blasts as well as mental health impairments (i.e., PTSD, depression and alcohol or drug addictions), and can also be particularly challenging for National Guard and Reserve soldiers. A return to successful occupational functioning, including the successful return to work or school (RTW/S), represents both a vital outcome for all returning veterans and an important predictor of long-term mental health functioning and disability. The identification of veterans at risk for vocational dysfunction is a high priority.
The objective was to determine pre-deployment, deployment-related, and post-deployment predictors of occupational functioning in a cohort of National Guard soldiers who returned from a combat deployment to Iraq by examining demographic variables, personality, psychiatric diagnosis, trauma exposure, and injury.
This project involved the coding and analysis of an existing data set of self-report and clinical interview responses from a group of National Guard soldiers who provided Time 1 data one month prior to a 16 month deployment to Iraq and again 3-6 months after returning home (Time 2). Of the original sample of 522, 355 participated in full post-deployment data collection. Participants completed measures of personality and demographic/historical variables during pre-deployment data collection. At post-deployment, participants again provided self report data but also completed structured clinical interviews for PTSD, other psychiatric conditions, and occupational functioning. Veteran reports of their most severe stressors were content coded to characterize their deployment experiences and evaluate their relationship with post-deployment occupational functioning. Occupational functioning was operationalized as successful RTW/S (having a job or being enrolled in school and not reporting impaired job functioning) as well as self reported Work/School Role functioning.
Rates of unemployment rose from 8% (pre-deployment) to 16% (post-deployment). Two thirds (65%) of respondents met criteria for successful RTW/S. Post-deployment diagnoses included PTSD and subthreshhold PTSD (13%), Depressive Disorders (15%), and Alcohol Use Disorders (13%). Diagnostic status was not related to occupational status (working versus unemployed) but was related to successful RTW/S, job satisfaction and work/school role functioning. Deployment experiences, including combat exposure, other types of severe stressors identified from content coding, injury, and reported mild TBI were not related to occupational status, successful RTW/S, or job/school role functioning. Gender, race, previous work history, and marital status all predicted indices of occupational functioning.
This study has demonstrated a link between post-deployment mental health diagnoses/symptoms and reduced job satisfaction and successful work or school role functioning among veterans of OIF. Findings indicate a need for further longitudinal study in this area.
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DRA: Military and Environmental Exposures, Mental, Cognitive and Behavioral Disorders
Keywords: Mental Health Care, Operation Enduring Freedom, Operation Iraqi Freedom
MeSH Terms: none