Are Sleep Problems Less Stigmatizing for Soldiers Than PTSD?
Substantial rates of mental health difficulties have been reported among active duty military personnel. These difficulties include posttraumatic stress disorder (PTSD) and insomnia. Although efficacious research-based treatments for these conditions are increasingly available, stigma associated with mental health difficulties may serve as a substantial barrier for accessing this care. Little research has been conducted to examine levels of stigma among active duty soldiers or to examine stigma regarding particular disorders. It may be that certain difficulties, such as sleep problems, are less stigmatizing and may serve as a means through which care for disorders commonly associated with sleep difficulties, such as PTSD can be accessed. The purpose of this study was to examine differential rates of stigma for insomnia and PTSD. It was hypothesized that Soldiers would be more likely to endorse perceived barriers to care for insomnia than for PTSD.
A total of 25 active duty service members completed a brief survey that included 10 items assessing stigma associated with insomnia and PTSD. Participants were recruited through briefings provided on post. Participation in the study was voluntary. Chi-Square analyses were utilized to examine differences in the frequency in which Soldiers endorsed agreement with perceptions of barriers for care.
In contrast to hypotheses, Soldiers endorsed perceived barriers to care for insomnia and PTSD at similar levels for 7 of the 10 items. However, 40% (n = 10) of the sample agreed that unit members would have less confidence in them if they received behavioral health treatment for PTSD whereas only 24% (n = 6) agreed to this item regarding insomnia. Similarly, 36% (n = 9) endorsed believing unit leadership would treat a Soldier differently for getting treatment for PTSD whereas 20% (n = 5) endorsed this item for insomnia. Only 12% (n = 3) endorsed that it would be too embarrassing to get behavioral treatment for insomnia or for PTSD. These differences were not significant, but analyses were limited by a small sample size. Data collection is on-going and results will be presented on the complete data set.
Conclusions and Implications:
Overall, similar levels of perceived stigma and barriers to care were reported for insomnia and for PTSD. These findings have implications for treatment planning and for informing providers and military leadership about methods to increase engagement in treatment by those who are likely to benefit.