Perceived Barriers to Success and Needs of Student Veterans with PTSD Symptoms

Background:  Currently, there are over one million student veterans, comprising 5% of the higher education student population.  Not only can military cultural differences influence adjustment to college, but Veterans who have supported operations in Iraq and Afghanistan are at risk for a number of psychological and physical problems, including posttraumatic stress disorder (PTSD). Veterans with PTSD report experiencing greater difficulty in the academic setting than those without PTSD.  PTSD symptoms can impact academic performance and adjustment through many factors including an inability to focus and decreased attention span, discomfort with crowded settings, and sleep difficulties. This study aimed to identify potential targets for on-campus interventions to support student Veteran success.

Methods: Using the Posttraumatic Stress Checklist- Military (PCL-M) to assess for subthreshold or full PTSD related to military service, participants meeting this criteria included 72 Iraq and Afghanistan veterans drawn from a larger study examining quality of life and functioning. Using questionnaires developed for the study, veterans who had attended or were attending college were surveyed about perceived barriers to academic success and preferences for mental health related academic support in the form of a proposed college course.

Participants who had attended college rated the degree to which 24 variables representing a range of physical, psychological, social, and structural factors impacted their academic performance on a scale from 0 (not a problem) to 4 (extremely problematic). They were then asked whether or not they would have interest in attending a free college course focused on optimizing success in the classroom and coping with post-deployment stress. If yes, they were asked to rate potential topics on a scale from 0 (not interested at all) to 4 (extremely interested).  Potential course topics consisted of three subscales: mental health concerns, psychosocial stressors, and academic environment.

Results: The majority of participants were male (n = 81, 87.1%) with a mean age of 36.2 (SD = 10.3).  Participants endorsed concerns with all but 4 of the 24 potential barriers.  The most highly problematic concerns were “difficulties sleeping,”, “concerns about finances”, “feeling generally anxious”, feeling down or depressed, “group work/difficulty working in groups”, “combat stress”, and “distractions in class”.  Over half of the sample endorsed being very or extremely likely to enroll in a course. The highest rated topics included understanding and strategies for better sleep, understanding my benefits, and using exercise and relaxation strategies to manage anxiety.

Conclusions and Implications: There was higher reported interest in having support in areas such as sleep and benefits compared to PTSD symptoms. As such, engaging student veterans in discussion of less stigmatizing topics initially may increase understanding of mental health conditions and treatments and serve to subsequently increase the likelihood of engagement in trauma focused treatments for veterans with PTSD.  Despite limitations of a lack of generalizability to student veterans of other eras and self-report, this study provides valuable insight into the perceived needs and interests of student veterans and provides guidance for mental health providers serving student veterans on campus.