Impact of Perceived Social Support on Mental Health, Quality of Life, and Disability in Post–9/11 U.S. Military Veterans

• Author: Christopher Schroth,Eric Proescher,Justin E. Greenstein,K. Luan Phan,Holly M. Passi,Darrin M. Aase
• DOI: 10.1177/0095327X20919922
• Published date: 01 January 2022
• Date: 01 January 2022
• Subject Matter: Articles

2022, Vol. 48(1) 115 –135

Impact of Perceived

Social Support on

Mental Health, Quality

of Life, and Disability in

Post–9/11 U.S.

Military Veterans

Eric Proescher

1,2

, Darrin M. Aase

1,2,3

, Holly M. Passi

1

,

Justin E. Greenstein

1,2

, Christopher Schroth

4

,

and K. Luan Phan

1,3

Abstract

This study examined the impact of perceived social support on mental health and

psychosocial functioning in combat veterans after military deployment, including

veterans with post-traumatic stress disorder (PTSD) and veterans with comorbid

PTSD and alcohol use disorder. Veterans (n¼139; female ¼23) completed self-

report and clinician-administered measures of social support, mental and physical

health, functional impairment, and quality of life. The cohort was divided into high,

medium, and low perceived social support based on averages of the total score from

the Multidimensional Scale of Perceived Social Support. Relative to the low per-

ceived social support group, the high perceived social support group reported fewer

symptoms of PTSD, anxiety, and depression. The high perceived social support

group also reported a more diverse and embedded social network, less disability,

1

Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL, USA

2

Department of Psychiatry, University of Illinois at Chicago, IL, USA

3

Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA

4

Cooperative Studies Program Coordinating Center, Edward Hines, Jr. VA Hospital, IL, USA

Corresponding Author:

Eric Proescher, Mental Health Service Line, Jesse Brown VA Medical Center, 820 S. Damen Ave., Chicago,

IL 60612, USA.

Email: eric.proescher2@va.gov

Armed Forces & Society

ªThe Author(s) 2020

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/0095327X20919922

journals.sagepub.com/home/afs

Article

116 Armed Forces & Society 48(1)

and better quality of life. Of note, the high and low perceived social support groups

did not differ on age, gender, education, race ethnicity, or combat trauma exposure.

These findings highlight that perceived social support may play an important role in

the treatment of postwar veterans as they transition back to civilian life.

Keywords

health care, veterans, reserve component, consequences

Background

The wars in Afghanistan and Iraq together make up the longest sustained lengths of

U.S. combat operations (Congressional Research Service, 2019). However, less than

1%of the population of the United States is directly impacted by these combat

operations. Although post–9/11 veterans have not received the hostile public senti-

ment that some Vietnam veterans endured, most civilians know very little about their

experiences or concerns. Furthermore, these wars are unique from previous wars in

their reliance on the National Guard and Reserves; longer duration of deployments;

the frequency of multiple redeployments; types of injuries sustained; and broader

effects of these conflicts on the service members, their families, and their commu-

nities (Institute of Medicine, 2013). Additionally, while the majority of the U.S.

military is non-Hispanic White (57%), Black and Latino adu lts are increasingly

represented. In 2017, 16%of U.S. military members were Black and 16%were

Hispanic/Latino, 4%were Asian, and an additional 6%were identified as “other”

or unknown (Barroso, 2019).

Approximately three quarters of post–9/11 veterans were deployed and are twice

as likely as those who served before them to have deployed (Parker et al., 2019).

Over a third of veterans (35%) indicate they knew and served with someone who was

seriously injured and 30%knew and served with someone killed in battle. Among

combat veterans, 57%report witnessing someone from their unit affiliation being

seriously wounded or killed (Parker et al., 2019). While most combat veterans do not

go on to develop the signature wounds of post-traumatic stress disorder (PTSD;

estimates range from 1 to 30%) or traumatic brain injury (prevalence estimated at

22%), there are still significant postdeployment challenges encompassing both clin-

ical issues (such as substance abuse, anxiety, and depression) and functional con-

cerns including potentially stressful transitions to family, work, and/or academic

settings (Institute of Medicine, 2013). Additionally, rates of PTSD are higher in

diverse previously deployed post–9/11 veteran populations with increased risk of a

positive screen for PTSD among veteran affairs (VA) health care users (OR ¼2.71),

African Americans (OR ¼1.61), those who served in the Army (OR ¼2.67), and

those on active duty (OR ¼1.69; Dursa et al., 2014). For many veterans, the impact

2Armed Forces & Society XX(X)