Deployment Risk among GWOT ARNG Women Veterans: Posttraumatic Stress and Resilient Outcomes

Background and Purpose: Although women's participation in military service and deployments put them at risk for posttraumatic stress disorder, most will return from deployments without psychopathology and some with positive adaptations. Compared to men, there is a lack of research examining women's military and deployment experiences, and post-deployment mental health status. This retrospective, cross-sectional study examined the pre-deployment, deployment, and post-deployment risk and protective factors that may influence posttraumatic stress symptoms and resilience among Army National Guard (ARNG) women deployed in support of the Global War on Terrorism (GWOT). The mediating effect of resilience was also examined. For the purposes of this study, resilience was defined as a dynamic, biopsychosocial characteristic that facilitates healthy functioning, personal growth, and positive adaptation to overcome adversity (Connor & Davidson, 2003; Greene & Conrad, 2002; Richardson, 2002).

Methods: Disproportionate stratified random sampling was used to select women who were members of the ARNG in three Mid-Atlantic States during their GWOT deployments. During January and February 2009, 420 self-administered questionnaires were mailed using a modified Tailored Design Method (TDM) (Dillman, 2007). One hundred thirty-two surveys were completed and returned, yielding a response rate of 37%. Nine subscales from the Deployment Risk and Resilience Inventory (King et al., 2003) were used to assess pre-deployment (i.e., prior stressors), deployment (i.e., concerns about life and family disruptions, general harassment, sexual harassment, deployment concerns, combat experiences, post-battle experiences) and post-deployment (i.e., post-deployment stressors, post-deployment social support) factors. The Posttraumatic Stress Disorder Checklist-Military (Weathers et al., 1993) was used to assess posttraumatic stress symptom severity and the Connor-Davidson Resilience Scale (Campbell-Sills & Stein, 2007) was used to assess resilience.

Results: Hierarchical regression analyses indicated that deployment and post-deployment stressors accounted for more of the variance in posttraumatic stress symptom severity than pre-deployment stressors. Pre-deployment factors (i.e., child maltreatment, domestic violence, divorce, death of someone close to them) were positively associated and post-deployment factors (i.e., legal problems, difficulty accessing healthcare, physical/sexual assault, divorce, unemployment) were negatively associated with resilience. Resilience also fully mediated the relationship between post-deployment stressors and posttraumatic stress symptom severity, as post-deployment stressors were no longer significantly associated with posttraumatic stress symptom severity once resilience was included in the model. Proximal stressors may affect the severity of posttraumatic stress reactions during post-deployment, but resilient qualities have the potential to mitigate risk.

Conclusions and Implications: Consistent with resilience theory, findings suggest that deployment and post-deployment stressors as proximal risks are more strongly associated with posttraumatic stress symptom severity than distal risks such as pre-deployment stressors. As a mediator of post-deployment stressors, resilience may be a promising assessment and treatment outcome to identify ARNG women who may be at risk for negative outcomes. Findings identify psychosocial and deployment-related stressors to assess among GWOT ARNG women veterans and provide limited support for the integration of resilience education and training into the National Guard Yellow Ribbon Reintegration Program. Due to limited generalizability, future research is needed to replicate findings in various geographical regions and with larger samples including men and women.