Longitudinal study of resilience and mental health in Marines leaving military service
Abstract
Background Despite a growing emphasis on psychological outcomes following military combat, few longitudinal studies have examined the combined role of risk and protective factors in the mental health of combat-exposed military personnel. This study characterizes the impact of resilience scale scores and combat exposure on mental health outcomes among Marines after separating from military service, along with intra-individual changes in mental health status.Methods Data were collected from longitudinal surveys of 475 active duty Marines attending a random sample of mandatory Transition Assistance Program workshops before leaving the military and responding to follow-up mail or web surveys an average of 6 months after returning to civilian life.Results Results revealed distinct risk and protective factors for those meeting screening criteria for mental health problems (depression, anxiety, and PTSD) and functional impairment at follow-up. Primary risk factors included experiencing higher levels of pre-separation combat exposure; post-separation stress across multiple life domains; and experiencing multiple areas of pain post-separation. Protective factors include having higher scores on pre-separation resilience and perceived social support at follow-up indices. We also identified a number of factors associated with change in mental health status from baseline to follow-up.Limitations Generality is limited by a lower than expected follow-up response rate and an exclusively Marine sample.Conclusion The role of resilience appeared to have a greater impact on functional impairment than on mental health symptoms per se. Findings provide important input for enhancing training programs and services intended to promote adjustment from military to civilian life. Additional emphasis on social support and coping with stress-related issues are needed in support of combat veterans.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The risk and protective effects of perceived social support on depression have been widely studied.
“The risk7–10 and protective effects11–15 of percieved social support on depression have been widely studied.”
Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
The Multidimensional Scale of Perceived Social Support
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988) · Journal of Personality Assessment · doi:10.1207/s15327752jpa5201_2 · Cited by 13,339 · see citing works
Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC)
Connor, K. M., & Davidson, J. R. T. (2003) · Depression and Anxiety · doi:10.1002/da.10113 · Cited by 11,793 · see citing works
Positive psychology: An introduction.
Seligman, M. E. P., & Csikszentmihalyi, M. (2000) · American Psychologist · doi:10.1037/0003-066x.55.1.5 · Cited by 11,351 · see citing works
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802 · see citing works
The Construct of Resilience: A Critical Evaluation and Guidelines for Future Work
Luthar, S. S., Cicchetti, D., & Becker, B. (2000) · Child Development · doi:10.1111/1467-8624.00164 · Cited by 9,381 · see citing works
Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene
Caspi, A., Sugden, K., Moffitt, T. E., Taylor, A., Craig, I. W., Harrington, H., McClay, J., Mill, J., Martin, J., Braithwaite, A., et al. (2003) · Science · doi:10.1126/science.1083968 · Cited by 8,120 · see citing works
Lesch, K.-P., Bengel, D., Heils, A., Sabol, S. Z., Greenberg, B. D., Petri, S., Benjamin, J., Müller, C. R., Hamer, D. H., & Murphy, D. L. (1996) · Science · doi:10.1126/science.274.5292.1527 · Cited by 5,162 · see citing works
Resilience in the Face of Adversity
Rutter, M. (1985) · British Journal of Psychiatry · doi:10.1192/bjp.147.6.598 · Cited by 3,616 · see citing works
The metatheory of resilience and resiliency
Richardson, G. E. (2002) · Journal of Clinical Psychology · doi:10.1002/jclp.10020 · Cited by 2,612 · see citing works
Serotonin transporter genetic variation and the response of the human amygdala.
Hariri, A. R., Mattay, V. S., Tessitore, A., Kolachana, B., Fera, F., Goldman, D., Egan, M. F., & Weinberger, D. R. (2002) · Science · doi:10.1126/science.1071829 · Cited by 2,340 · see citing works
The use of the Center for Epidemiologic Studies Depression Scale in adolescents and young adults
Radloff, L. S. (1991) · Journal of Youth and Adolescence · doi:10.1007/bf01537606 · Cited by 1,997 · see citing works
Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006) · JAMA · doi:10.1001/jama.295.9.1023 · Cited by 1,979 · see citing works
Clinical evaluation of a measure to assess combat exposure.
Keane, T. M., Fairbank, J. A., Caddell, J. M., Zimering, R. T., Taylor, K. L., & Mora, C. A. (1989) · Psychological Assessment · doi:10.1037/1040-3590.1.1.53 · Cited by 926 · see citing works
PTSD Checklist—Civilian version (PCL-C)
Weathers, F. W., Litz, B. T., Huska, J. A., & Keane, T. M. (1991) · Cited by 734 · see citing works
An abbreviated PTSD checklist for use as a screening instrument in primary care
Lang, A. J., & Stein, M. B. (2004) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.04.005 · Cited by 584 · see citing works
Richardson, G. E., Neiger, B. L., Jensen, S., & Kumpfer, K. L. (1990) · Health Education · doi:10.1080/00970050.1990.10614589 · Cited by 483 · see citing works
Spitzer, R. L. (1999) · Medical Entomology and Zoology · Cited by 429 · see citing works
Fluoxetine in post-traumatic stress disorder
Connor, K. M., Sutherland, S. M., Tupler, L. A., Malik, M. L., Jonathan, R., & Davidson, T. (1999) · The British Journal of Psychiatry · doi:10.1192/bjp.175.1.17 · Cited by 353 · see citing works
Promoting Psychological Resilience in the U.S. Military.
Meredith, L. S., Sherbourne, C. D., Gaillot, S., Hansell, L., Ritschard, H. V., Parker, A. M., & Wrenn, G. L. (2011) · PubMed Central · Cited by 341 · see citing works
Lesch, K., & Mößner, R. (1998) · Biological Psychiatry · doi:10.1016/s0006-3223(98)00121-8 · Cited by 334 · see citing works
The children of Kauai: Resiliency and recovery in adolescence and adulthood1
Werner, E. E. (1992) · Journal of Adolescent Health · doi:10.1016/1054-139x(92)90157-7 · Cited by 307 · see citing works
SUDAAN language manual, release 10.0
Barnwell, B., Bieler, G. S., & Witt, M. (2008) · Cited by 237 · see citing works
Psychiatric Status and Work Performance of Veterans of Operations Enduring Freedom and Iraqi Freedom
Adler, D. A., Possemato, K., Mavandadi, S., Lerner, D., Chang, H., Klaus, J. R., Tew, J. D., Barrett, D., Ingram, E. P., & Oslin, D. W. (2011) · Psychiatric Services · doi:10.1176/ps.62.1.pss6201_0039 · Cited by 130 · see citing works
2005 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel
Bray, R. M., Hourani, L. L., Olmsted, K. R., Witt, M., Brown, J. M., Pemberton, M. R., Marsden, M. E., Marriott, B. P., Scheffler, S., & Vandermaas-Peeler, R. (2006) · Defense Technical Information Center (DTIC) · Cited by 123 · see citing works
Substance Use, Injury, and Risk‐Taking Dispositions in the General Population
CHERPITEL, C. J. S. (1999) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.1999.tb04032.x · Cited by 118 · see citing works
Substance Use, Injury, and Risk-Taking Dispositions in the General Population
CHERPITEL, C. J. S. (1999) · Alcoholism Clinical and Experimental Research · doi:10.1097/00000374-199901000-00017 · Cited by 107 · see citing works
Harvey, S. B., Hatch, S. L., Jones, M., Hull, L., Jones, N., Greenberg, N. L., Dandeker, C., Fear, N. T., & Wessely, S. C. (2011) · Annals of Epidemiology · doi:10.1016/j.annepidem.2011.05.004 · Cited by 73 · see citing works
Schok, M., Kleber, R. J., & Lensvelt‐Mulders, G. (2010) · Aging & Mental Health · doi:10.1080/13607860903228812 · Cited by 67 · see citing works
McGeary, D. D. (2011) · Military Medicine · doi:10.7205/milmed-d-10-00480 · Cited by 32 · see citing works
Copeland, L. A., Zeber, J. E., Bingham, M. O., Pugh, M. J., Noël, P. H., Schmacker, E. R., & Lawrence, V. A. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.10.017 · Cited by 31 · see citing works
Interventions Following Mass Violence and Disasters
Pennington, H., & Newman, E. (2008) · Journal of Psychological Trauma · doi:10.1080/19322880802126041 · Cited by 23 · see citing works
Ehlers, A., Harvey, A. G., & Bryant, R. A. (2012) · doi:10.1093/med/9780199696758.003.0092 · Cited by 11 · see citing works
Flagged first, then by citations
4 of the 37 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Hou, T., Zhang, T., Cai, W., Song, X., Chen, A., Deng, G., & Ni, C. (2020) · PLOS ONE · doi:10.1371/journal.pone.0233831 · Cited by 287 · see citing works
Ahern, J., Worthen, M., Masters, J., Lippman, S. A., Ozer, E. J., & Moos, R. H. (2015) · PLoS ONE · doi:10.1371/journal.pone.0128599 · Cited by 291 · see citing works
“Although social support has been related to lower risk of mental health and related problems among veterans [31–41], our research brings a nuanced perspective to those findings, highlighting that many veterans face substantial obstacles in navigating to a situation in which they are supported.”
Etiology of depression comorbidity in combat-related PTSD: a review of the literature
Stander, V. A., Thomsen, C. J., & Highfill-McRoy, R. M. (2014) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.12.002 · Cited by 271 · see citing works
“In particular, there have been very few evaluations of the relative impact on military personnel of multiple types of trauma, including childhood abuse, sexual trauma, and other civilian trauma as well as general life stress (Arbisi et al., 2012; Black et al., 2011; Gilbertson et al., 2002; Goodwin et al., 2012; Houra…”
BackgroundResultInfluentialDour, H. J., Wiley, J. F., Roy-Byrne, P., Stein, M. B., Sullivan, G., Sherbourne, C. D., Bystritsky, A., Rose, R. D., & Craske, M. G. (2014) · Depression and Anxiety · doi:10.1002/da.22216 · Cited by 243 · see citing works
Currier, J. M., Farnsworth, J. K., Drescher, K. D., McDermott, R. C., Sims, B. M., & Albright, D. L. (2018) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2170 · Cited by 168 · see citing works
Xu, J., & Ou, L. (2014) · Public Health · doi:10.1016/j.puhe.2014.03.002 · Cited by 136 · see citing works
Lee, J. E. C., Sudom, K. A., & Zamorski, M. A. (2013) · Journal of Occupational Health Psychology · doi:10.1037/a0033059 · Cited by 114 · see citing works
Non-deployment factors affecting psychological wellbeing in military personnel: literature review
Brooks, S. K., & Greenberg, N. (2018) · Journal of Mental Health · doi:10.1080/09638237.2016.1276536 · Cited by 96 · see citing works
“Social support was a protective factor for psychological distress in US Air Force personnel (Lemaire & Graham, 2011) and Marines (Hourani et al., 2012).”
BackgroundCai, W., Pan, Y., Zhang, S.-M., Wei, C., Dong, W., & Deng, G. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.06.018 · Cited by 93 · see citing works
“What’s more, the role of resilience appears to have a greater impact on functional impairment in marines leaving military service, which suggests enhancing training programs and services intended to promote adjustment from military to civilian life (Hourani et al, 2012).”
BackgroundMin, J.-A., Lee, C.-U., & Chae, J.-H. (2015) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2014.07.022 · Cited by 109 · see citing works
“Moreover, prospective studies have revealed that the constructs of resilience and social support predispose as protective factors for depression and/or anxiety disorders after various traumatic experiences [49,50].”
BackgroundPredictors and mental health outcomes of potentially traumatic event exposure
Overstreet, C. M., Berenz, E. C., Kendler, K. S., Dick, D. M., & Amstadter, A. B. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.10.047 · Cited by 84 · see citing works
“Finally, the present study suggests that social support and self-reported resilience are associated with less symptoms of anxiety and depression, consistent with prior studies (Hourani et al., 2012; Liu et al., 2013; Pietrzak and Cook, 2013).”
ResultPostmilitary Adjustment to Civilian Life: Potential Risks and Protective Factors
MacLean, M. B., Til, L. V., Thompson, J. M., Sweet, J., Poirier, A., Sudom, K., & Pedlar, D. (2013) · Physical Therapy · doi:10.2522/ptj.20120107 · Cited by 78 · see citing works
Kegelaers, J., Wylleman, P., van Bree, I. (. N. A., Wessels, F., & Oudejans, R. R. D. (2021) · International Sport Coaching Journal · doi:10.1123/iscj.2020-0066 · Cited by 71 · see citing works
Li, Z., Xin, Y., Zhong, M., Li, Z., Xiang, W., Wu, S., & Xiong, Z. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.664808 · Cited by 79 · see citing works
“Resilience has been positively associated with social support during the aftermath of major disasters: a study of adolescent survivors of the Wenchuan earthquake found that resilience can help protect individuals against mental illness (67, 68).”
BackgroundYoussef, N. A., Green, K. T., Dedert, E. A., Hertzberg, J. S., Calhoun, P. S., Dennis, M. F., Cen, M.-A. M. I. R. E. A. C., & Beckham, J. C. (2013) · Archives of Suicide Research · doi:10.1080/13811118.2013.776445 · Cited by 74 · see citing works
“A prospective study involving 475 combat-exposed, active duty Marines separating from service, found that resilience had a larger effect on individual functioning than on psychological symptoms independently (Hourani et al., 2012).”
BackgroundKahn, J. R., Collinge, W., & Soltysik, R. C. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5800 · Cited by 74 · see citing works
“While veterans face several risk factors for long-term mental health problems, higher interpersonal support is protective [14].”
Transition from military to civilian: Identity, social connectedness, and veteran wellbeing
Flack, M., & Kite, L. (2021) · PLOS ONE · doi:10.1371/journal.pone.0261634 · Cited by 67 · see citing works
“Additionally, avoidant behaviour associated with low social connectedness coupled with the loss and separation is likely to exacerbate transition stress and poor wellbeing [66].”
BackgroundNishimi, K. M., Choi, K. W., Cerutti, J., Powers, A. D., Bradley, B., & Dunn, E. C. (2020) · Psychological Medicine · doi:10.1017/s0033291720001191 · Cited by 64 · see citing works
“Resilience may represent a protective factor that buffers against long-term negative health outcomes often associated with adversity exposure (Hourani et al., 2012).”
BackgroundMental health problems and their related factors among seafarers: a scoping review
Jonglertmontree, W., Kaewboonchoo, O., Morioka, I., & Boonyamalik, P. (2022) · BMC Public Health · doi:10.1186/s12889-022-12713-z · Cited by 64 · see citing works
“Resilience works as a personal resource of resistant stress, growth, and personal development that may foster the ability to cope with the environment [49] among general adults [50] as well as active duty mariners [51].”
Backgroundvan der Meulen, E., van der Velden, P. G., van Aert, R. C. M., & van Veldhoven, M. J. P. M. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2020.112814 · Cited by 63 · see citing works
Identifying factors that contribute to military veterans’ post‐military well‐being
Vogt, D. S., King, M. W., Borowski, S. C., Finley, E. P., Perkins, D. F., & Copeland, L. A. (2021) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12252 · Cited by 51 · see citing works
Nishimi, K. M., Choi, K. W., Davis, K. A., Powers, A. D., Bradley, B., & Dunn, E. C. (2020) · Journal of Traumatic Stress · doi:10.1002/jts.22543 · Cited by 45 · see citing works
“Additionally, though research suggests perceptions of one’s resilience may influence later psychological responses to trauma (Daniels et al., 2012; Hourani et al., 2012), further work should examine the relative importance of perceived capability to be resilient and more objective measures of coping strategies or avai…”
BackgroundResilience, Stress, Stigma, and Barriers to Mental Healthcare in U.S. Air Force Nursing Personnel
Hernandez, S. H. A., Morgan, B. J., & Parshall, M. B. (2016) · Nursing Research · doi:10.1097/nnr.0000000000000182 · Cited by 44 · see citing works
“Study findings with Iraq and Afghanistan veterans support that a higher level of resilience was associated with decreased risk for MH concerns (Hourani et al., 2012).”
BackgroundMethodChiang, H., Chen, K., & Yang, C.-C. (2018) · Journal of Medical Sciences · doi:10.4103/jmedsci.jmedsci_60_17 · Cited by 44 · see citing works
Moral Injury and Spiritual Struggles in Military Veterans: A Latent Profile Analysis
Currier, J. M., Foster, J. D., & Isaak, S. L. (2019) · Journal of Traumatic Stress · doi:10.1002/jts.22378 · Cited by 45 · see citing works
Hiyoshi, A., Udumyan, R., Osika, W., Bihagen, E., Fall, K., & Montgomery, S. (2015) · Social Science & Medicine · doi:10.1016/j.socscimed.2015.03.057 · Cited by 38 · see citing works
Vyas, K. J., Fesperman, S. F., Nebeker, B. J., Gerard, S. K., Boyd, N. D., Delaney, E. M., Webb-Murphy, J. A., & Johnston, S. L. (2016) · Military Medicine · doi:10.7205/milmed-d-15-00585 · Cited by 37 · see citing works
“Although the definition and model of psychological resilience have been repeatedly redefined and reconfigured over time, there is consensus at the broadest level that resilience embodies the ability of an individual to persist in the face of challenges and to bounce back from adversity.(10,15) Using a resilience model…”
BackgroundThe career transition experiences of military Veterans: A qualitative study
Shue, S. A., Matthias, M. S., Watson, D. P., Miller, K. K., & Munk, N. (2021) · Military Psychology · doi:10.1080/08995605.2021.1962175 · Cited by 36 · see citing works
“As suggested and considered by previous research (Greden et al., 2010; Hourani et al., 2012; Johnson et al., 2007), helping Veterans connect with peers (i.e., remain connected to former peers; peer support groups in the community) could benefit the transition process.”
MethodCoenen, P., & van der Molen, H. F. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-049651 · Cited by 31 · see citing works
O’Connor, M., Stapleton, A., O’Reilly, G., Murphy, E., Connaughton, L., Hoctor, E., & McHugh, L. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.03.005 · Cited by 34 · see citing works
Li, Q., Liu, L., Gu, Z., Li, M., Liu, C., & Wu, H. L. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04792-y · Cited by 30 · see citing works
Dialectical coping and well-being among Chinese college students: the mediating role of resilience
Deng, K., Wong, Y. J., Li, J. P. F., & McCullough, K. M. (2020) · Counselling Psychology Quarterly · doi:10.1080/09515070.2020.1783641 · Cited by 24 · see citing works
“Longitudinal research has also supported the notion that greater resilience predicts better mental health (Hourani et al., 2012).”
BackgroundAdversity in Aviation: Understanding Resilience in the Workplace for Female Pilots
Douglas, S. K., & Pittenger, L. M. (2020) · The International Journal of Aerospace Psychology · doi:10.1080/24721840.2020.1763175 · Cited by 23 · see citing works
O’Neal, C. W., Lucier‐Greer, M., Mancini, J. A., Ferraro, A. J., & Ross, D. B. (2016) · Military Medicine · doi:10.7205/milmed-d-14-00740 · Cited by 23 · see citing works
Alschuler, K. N., & Otis, J. D. (2012) · European Journal of Pain · doi:10.1002/j.1532-2149.2012.00180.x · Cited by 21 · see citing works
“This supports the possibility that for patients with chronic pain and PTSD, a solicitous spouse may be considered adaptive, as perceived social support can buffer the effects of PTSD (Hourani et al., 2012).”
BackgroundHoffmire, C. A., Borowski, S. C., & Vogt, D. S. (2023) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12955 · Cited by 18 · see citing works
Emirza, S., & Kozcu, G. Y. (2023) · Nursing and Health Sciences · doi:10.1111/nhs.13018 · Cited by 20 · see citing works
Families serve too: military spouse well-being after separation from active-duty service
Corry, N. H., Joneydi, R., McMaster, H. S., Williams, C. S., Glynn, S. M., Spera, C., & Stander, V. A. (2022) · Anxiety Stress & Coping · doi:10.1080/10615806.2022.2038788 · Cited by 16 · see citing works
“…are those of the author(s) and do not necessarily reflect the views of the Naval Health Research Center and/or the Naval Medical Logistics Command. psychological and socioeconomic outcomes (Brunger et al., 2013; Hourani et al., 2012; Mobbs & Bonanno, 2018; Morin, 2011; Nelson et al., 2016).”
BackgroundRattray, N. A., Flanagan, M., Salyers, M. P., Natividad, D. M., Do, A.-N., Frankel, R. M., Spontak, K., & Kukla, M. (2023) · Journal of Veterans Studies · doi:10.21061/jvs.v9i1.432 · Cited by 16 · see citing works
Impact of childhood maltreatment on adult resilience
Li, C., Lv, G., Liu, B., Ju, Y., Wang, M., Dong, Q., Sun, J., Lu, X., Zhang, L., Wan, P., et al. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05124-w · Cited by 16 · see citing works
“Resilience capacity might be one of the factors that contribute to the recovery process after experiencing adversity and could decrease the risk of developing negative consequences after adverse events [19, 20].”
BackgroundHourani, L. L., Bender, R., Weimer, B., & Larson, G. E. (2012) · Military Medicine · doi:10.7205/milmed-d-11-00421 · Cited by 16 · see citing works
Preparing to lead in combat: Development of leadership self-efficacy by static-line parachuting
Bergman, D. M., Sendén, M. G., & Berntson, E. (2019) · Military Psychology · doi:10.1080/08995605.2019.1670583 · Cited by 14 · see citing works
“coping skills in stress situation can reduce the risk of subsequent traumatological effects like post-traumatic stress disorder (Hourani et al., 2012).”
BackgroundPredictors of susceptibility and resilience in an animal model of posttraumatic stress disorder
Smith-Bell, C. A., Burhans, L. B., & Schreurs, B. G. (2012) · Behavioral Neuroscience · doi:10.1037/a0030713 · Cited by 18 · see citing works
Maunder, R., Rosen, B., Heeney, N. D., Jeffs, L. P., Merkley, J., Wilkinson, K., Hunter, J., Johnstone, J., Greenberg, R. A., & Wiesenfeld, L. A. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-09731-x · Cited by 13 · see citing works
Liu, B., Liu, L., Zou, M., Jin, Y., Song, L., Ren, L., Li, M., Feng, Y., Li, F., & Yang, Q. (2024) · BMC Public Health · doi:10.1186/s12889-024-20907-w · Cited by 10 · see citing works
Predictors of Symptom Increase in Subsyndromal PTSD Among Previously Deployed Military Personnel
Highfill‐McRoy, R. M., Levine, J. A., Larson, G. E., Norman, S. B., Schmied, E. A., & Thomsen, C. J. (2021) · Military Medicine · doi:10.1093/milmed/usab034 · Cited by 10 · see citing works
Individual, Family, and Community Predictors of PTSD Symptoms Following Military Deployment
Olson, J. R., Welsh, J. A., Perkins, D. F., & Ormsby, L. (2018) · Family Relations · doi:10.1111/fare.12343 · Cited by 10 · see citing works
Williams, L., Skomorovsky, A., Wan, C., & Lee, J. E. C. (2022) · Military Behavioral Health · doi:10.1080/21635781.2021.2007184 · Cited by 9 · see citing works
“…research has shown that these types of activities are key for developing resilience and improving veteran well-being in the face of adversity, uncertainty, loss of identity, and other transition challenges (Cox et al., 2018; Hourani et al., 2012; MacLean et al., 2014 ; Schnurr et al., 2009).”
BackgroundCotian, M. D. S., Vilete, L. M. P., Volchan, E., & Figueira, I. L. D. V. (2014) · Jornal Brasileiro de Psiquiatria · doi:10.1590/0047-2085000000009 · Cited by 9 · see citing works
Understanding Resilience as It Affects the Transition from the UK Armed Forces to Civilian Life
Cox, K., Grand-Clément, S., Galai, K., Flint, R., & Hall, A. (2018) · Rand health quarterly · doi:10.7249/rhq-08-02-08 · Cited by 8 · see citing works
Hansen, C., McFarlane, A., Iannos, M., Sadler, N., Benassi, H., Lawrence-Wood, E., Hodson, S., Searle, A., & Van Hooff, M. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112860 · Cited by 7 · see citing works
“reported that higher resilience scores were a protective factor for functional impairment (Hourani et al., 2012).”
BackgroundClarifying the Nature of Resilience: A Meta-Analytic Approach
Grossman, M. R. (2014) · Digital Commons - University of South Florida (University of South Florida) · Cited by 7 · see citing works
Role of Combat Exposure and Insomnia in Student Veterans’ Adaptation to College
McGuffin, J., Riggs, S. A., & Taylor, D. J. (2017) · Behavioral Sleep Medicine · doi:10.1080/15402002.2017.1363041 · Cited by 6 · see citing works
“may also be due to qualities acquired through their service such as maturity, professionalism, and ability to copewith stressors (Hourani et al., 2012; Pietrzak, Johnson, Goldstein,Malley, & Southwick, 2009), whereas”
BackgroundImpact of Online Games on Children's Mental Health
Guerada, K. (2021) · Journal La Medihealtico · doi:10.37899/journallamedihealtico.v2i1.281 · Cited by 6 · see citing works
Health Conditions Among Navy Submariners at the End of Active Duty; A Retrospective Cohort Study
Maguire, B. J., Hughes, L. M., McAdams, D. C., Gilbert, M. K., & Nordness, R. (2022) · Military Medicine · doi:10.1093/milmed/usac063 · Cited by 6 · see citing works
Brcic, J. (2013) · cIRcle (University of British Columbia) · doi:10.14288/1.0165587 · Cited by 6 · see citing works
The Health and Readiness of Service Members: ACEs to PACEs
Lamson, A. L. S., Richardson, N. M., & Cobb, E. L. (2020) · Military Medicine · doi:10.1093/milmed/usz197 · Cited by 5 · see citing works
Smith‐MacDonald, L., Pike, A., Jones, C., & Brémault‐Phillips, S. (2022) · Trauma Care · doi:10.3390/traumacare2020010 · Cited by 5 · see citing works
“Resilience has also been noted to be a protective factor for soldiers leaving the military and transitioning to civilian life, as resilience seemed to mitigate against functional impairments [60].”
BackgroundPedagojik Formasyon Eğitimi Alan Öğrencilerin Yılmazlık ve Tükenmişliklerinin İncelenmesi
Çevik, G. B., DOĞAN, İ., & Yıldız, M. A. (2016) · Mersin Üniversitesi Eğitim Fakültesi Dergisi · doi:10.17860/mersinefd.282395 · Cited by 5 · see citing works
Fox, A. B., Baier, A. L., Alpert, E., Nillni, Y. I., & Galovski, T. E. (2023) · Journal of Women s Health · doi:10.1089/jwh.2023.0078 · Cited by 4 · see citing works
Neural signatures of human psychological resilience driven by acute stress
Watanabe, N., Yoshida, S., Keerativittayayut, R., & Takeda, M. (2026) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2524075123 · Cited by 4 · see citing works
Veteran Mental Health and Employment: The Nexus and Beyond
Nelson, C. B., Abraham, K. M., Miller, E. M., Kees, M. R., Walters, H., Valenstein, M. M., & Zivin, K. (2015) · Springer eBooks · doi:10.1007/978-3-319-21488-7_13 · Cited by 4 · see citing works
Osborne, L. K., Wright, B. J., Bullock‐Yowell, E., Mohn, R. S., & Nicholson, B. C. (2022) · Journal of Employment Counseling · doi:10.1002/joec.12180 · Cited by 3 · see citing works
“Vocational rehabilitation, ACT, or mindfulness based therapies may be helpful additions as suggested by Vossler (2012) in civilian populations.”
BackgroundMethodInfluentialComparison of Urdu Versions of the Resilience Scale and the Resilience Scale for Adults
Hirani, S. S., Lasiuk, G. C., Vliet, K. J. V., van Zanten, S. V., Karmaliani, R., & Norris, C. M. (2018) · Journal of Nursing Measurement · doi:10.1891/1061-3749.26.1.106 · Cited by 2 · see citing works
“The association of resilience and mental health has been widely studied and a significant positive relationship has been established (Canadian Mental Health Association, 2013; Davydov, Stewart, Ritchie, & Chaudieu, 2010; Haddadi & Besharat, 2010; Herrman, 2012; Hourani et al., 2012; Richardson & Waite, 2002; Smith, 20…”
BackgroundDursun, S., & Coulthard, J. (2015) · Springer eBooks · doi:10.1007/978-3-319-21488-7_14 · Cited by 2 · see citing works
Longitudinal study of resilience and mental health in marines leaving military service
Talbott, J. A. (2012) · Yearbook of Psychiatry and Applied Mental Health · doi:10.1016/j.ypsy.2012.07.119 · Cited by 2 · see citing works
Psychosocial Predictors of Resilience in a Military Sample
Jaeschke, A.-M. C. (2016) · doi:10.33915/etd.5873 · Cited by 2 · see citing works
“Additionally, resilience has been explored extensively within Active Duty personnel (Griffith & West, 2013; Hourani et al., 2012; Reivich et al., 2011a; Reivich, Seligman, & McBride, 2011b), and Veterans (Anestis, Khazem, Mohn, & Green, 2015; Green, Calhoun, Dennis, & Beckham, 2010; Hendricks Thomas, Plummer Taylor, H…”
BackgroundInfluentialSaraee, S., Shabani, S., & Решетников, М. (2020) · Advances in Social Sciences Research Journal · doi:10.14738/assrj.77.8707 · Cited by 1 · see citing works
Sakeah, J. K., Addiss, D. G., Feng, C. X., Sakeah, E., Asaana, P., Gyapong, M., Colman, I., & Krentel, A. (2026) · BMJ Public Health · doi:10.1136/bmjph-2025-003437 · Cited by 1 · see citing works
Adverse Childhood Experiences and Disordered Eating in the Military
Cobb, E. L. (2018) · The Scholarship East Carolina University's Institutional Repository (East Carolina University) · Cited by 1 · see citing works
Klassen, K. (2014) · Mspace (University of Manitoba) · Cited by 1 · see citing works
Understanding the Links between Positive Wellbeing and Health
Brown, J. (2015) · UCL Discovery (University College London)
Veterans, PTSD Severity, and Health Conditions Over Time
Wolfe, M. (2017) · The Scholars Repository - LLU (Loma Linda University)
Exploring the impact of career transition on athletes and military personnel : a mixed methods study
Shue, S. A. (2018) · IUScholarWorks (Indiana University) · doi:10.7912/c2207q
Born, J., Lee, J. E. C., MacLean, M. B., Sweet, J., & Til, L. V. (2022) · Military Behavioral Health · doi:10.1080/21635781.2021.2007182
“…research that consistently demonstrates that social support has a positive effect on mental health in military populations (Elbogen et al., 2012; Hourani et al., 2012; Therrien et al., 2016), we hypothesize that increasing social support in these subgroups may lead to sizable improvements in…”
BackgroundBIOETHICS AMIDST THE COVID-19 PANDEMICPreprint
Lea, M. (2023) · doi:10.31219/osf.io/zkemb
21711 Does Online Games Cause Child Mental Health?
Sanyal, A., Thakur, M., Vajpai, R. K., & Agarwal, A. (2025) · De Gruyter eBooks · doi:10.1515/9783111429458-011
Rattray, N. A., Flanagan, M., Frankel, R. M., & Kukla, M. (2026) · Frontiers in Rehabilitation Sciences · doi:10.3389/fresc.2026.1720234
“In addition to financial issue, the results reinforce the importance of social support, which has been shown to be associated with high well-being (46) and may function in a protective fashion (47, 48).”
- Authors
- Hourani, L., Bender, R. H., Weimer, B., Peeler, R., Bradshaw, M., Lane, M., & Larson, G.
- Affiliations
- RTI International (US)
- Naval Health Research Center (US)
- Corresponding author
- Hourani, Laurel
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2012-07
- Volume
- 139
- Issue
- 2
- Pages
- 154-165
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2049791157
- Cited by
- 81
- References
- 37
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 1 · 2023: 9 · 2022: 7 · 2021: 8 · 2020: 9 · 2019: 2 · 2018: 6 · 2017: 5 · 2016: 8 · 2015: 6 · 2014: 6 · 2013: 6 · 2012: 4
- FWCI
- 7.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Social Sciences › Education › Education and Military Integration
- Keywords
- resilience, mental health, combat veterans, Marines, military-to-civilian transition, combat exposure, social support, depression, anxiety, post-traumatic stress disorder, functional disability, pain, risk and protective factors, Transition Assistance Program
- MeSH terms
- Adaptation, Psychological, Adult, Combat Disorders, Female, Humans, Longitudinal Studies, Male, Mental Health, Military Personnel, Models, Psychological, Prospective Studies, Risk Factors, Social Support, Veterans, Resilience, Psychological
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
