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Resilience facilitates adjustment through greater psychological flexibility among Iraq/Afghanistan war veterans with and without mild traumatic brain injury.

Elliott TR, Hsiao YY, Kimbrel NA, DeBeer BB, Gulliver SB, Kwok OM, Morissette SB, Meyer EC. Resilience facilitates adjustment through greater psychological flexibility among Iraq/Afghanistan war veterans with and without mild traumatic brain injury. Rehabilitation Psychology. 2019 Nov 1; 64(4):383-397.

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Abstract:

OBJECTIVES: Although many Iraq/Afghanistan warzone veterans report few problems with adjustment, a substantial proportion report debilitating mental health symptoms and functional impairment, suggesting the influence of personal factors that may promote adjustment. A significant minority also incur warzone-related traumatic brain injury (TBI), the majority of which are of mild severity (mTBI). We tested direct and indirect pathways through which a resilient personality prototype predicts adjustment of warzone veterans with and without mTBI over time. METHOD: A sample of 264 war veterans (181 men) completed measures of lifetime and warzone-related TBIs, personality traits, psychological adjustment, quality of life, and functional impairment. Social support, coping, and psychological flexibility were examined as mediators of the resilience-adjustment relationship. Instruments were administered at baseline, 4-, 8-, and 12-month assessments. Structural equation models accounted for combat exposure and response style. RESULTS: Compared with a nonresilient personality prototype, a resilient prototype was directly associated with lower PTSD, depression, and functional disability, and higher quality of life at all time-points. Warzone mTBIs frequency was associated with higher scores on a measure of functional disability. Indirect effects via psychological flexibility were observed from personality to all outcomes, and from warzone-related mTBIs to PTSD, depression, and functional disability, at each time-point. CONCLUSIONS: Several characteristics differentiate veterans who are resilient from those who are less so. These findings reveal several factors through which a resilient personality prototype and the number of mTBIs may be associated with veteran adjustment. Psychological flexibility appears to be a critical modifiable factor in veteran adjustment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).





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