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Prospective associations of perceived unit cohesion with postdeployment mental health outcomes.
Depress Anxiety. 2019 06; 36(6):511-521.DA

Abstract

BACKGROUND

Prior investigations have found negative associations between military unit cohesion and posttraumatic stress disorder (PTSD); however, most relied on cross-sectional data and few examined relationships of unit cohesion to other mental disorders. This study evaluates prospective associations of perceived unit cohesion with a range of mental health outcomes following combat deployment.

METHODS

U.S. Army soldiers were surveyed approximately 1-2 months before deployment to Afghanistan (T0); and 1 month (T1), 3 months (T2), and 9 months (T3) after return from deployment. Logistic regression was performed to estimate associations of perceived unit cohesion at T0 with risk of PTSD, major depressive episode (MDE), generalized anxiety disorder (GAD), alcohol or substance use disorder (AUD/SUD), and suicidal ideation at T2 or T3 among soldiers who completed all study assessments (N = 4,645). Models were adjusted for sociodemographic and Army service characteristics, predeployment history of the index outcome, and deployment stress exposure.

RESULTS

Higher perceived unit cohesion at T0 was associated with lower risk of PTSD, MDE, GAD, AUD/SUD, and suicidal ideation at T2 or T3 (AORs = 0.72 to 0.85 per standard score increase in unit cohesion; P-values < 0.05). Models of incidence of mental disorders and suicidal ideation among soldiers without these problems predeployment yielded similar results, except that perceived unit cohesion was not associated with incident AUD/SUD.

CONCLUSIONS

Soldiers who reported strong unit cohesion before deployment had lower risk of postdeployment mental disorders and suicidal ideation. Awareness of associations of perceived unit cohesion with postdeployment mental health may facilitate targeting of prevention programs.

Authors+Show Affiliations

Department of Psychiatry, University of California, San Diego, La Jolla, California.Department of Psychiatry, University of California, San Diego, La Jolla, California.Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland.Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California.Institute for Social Research, University of Michigan, Ann Arbor, Michigan.Department of Psychology, Harvard University, Cambridge, Massachusetts.Department of Management, Darla Moore School of Business, University of South Carolina, Columbia, South Carolina.Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland.Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland.Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California.Department of Psychiatry, University of California, San Diego, La Jolla, California. Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California. VA San Diego Healthcare System, San Diego, California.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

30694009

Citation

Anderson, Lauren, et al. "Prospective Associations of Perceived Unit Cohesion With Postdeployment Mental Health Outcomes." Depression and Anxiety, vol. 36, no. 6, 2019, pp. 511-521.
Anderson L, Campbell-Sills L, Ursano RJ, et al. Prospective associations of perceived unit cohesion with postdeployment mental health outcomes. Depress Anxiety. 2019;36(6):511-521.
Anderson, L., Campbell-Sills, L., Ursano, R. J., Kessler, R. C., Sun, X., Heeringa, S. G., Nock, M. K., Bliese, P. D., Gonzalez, O. I., Wynn, G. H., Jain, S., & Stein, M. B. (2019). Prospective associations of perceived unit cohesion with postdeployment mental health outcomes. Depression and Anxiety, 36(6), 511-521. https://doi.org/10.1002/da.22884
Anderson L, et al. Prospective Associations of Perceived Unit Cohesion With Postdeployment Mental Health Outcomes. Depress Anxiety. 2019;36(6):511-521. PubMed PMID: 30694009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective associations of perceived unit cohesion with postdeployment mental health outcomes. AU - Anderson,Lauren, AU - Campbell-Sills,Laura, AU - Ursano,Robert J, AU - Kessler,Ronald C, AU - Sun,Xiaoying, AU - Heeringa,Steven G, AU - Nock,Matthew K, AU - Bliese,Paul D, AU - Gonzalez,Oscar I, AU - Wynn,Gary H, AU - Jain,Sonia, AU - Stein,Murray B, Y1 - 2019/01/29/ PY - 2018/10/22/received PY - 2019/01/03/revised PY - 2019/01/04/accepted PY - 2019/1/30/pubmed PY - 2019/10/29/medline PY - 2019/1/30/entrez KW - anxiety disorders KW - major depressive disorder KW - military personnel KW - posttraumatic stress disorder KW - risk factors KW - suicidal ideation SP - 511 EP - 521 JF - Depression and anxiety JO - Depress Anxiety VL - 36 IS - 6 N2 - BACKGROUND: Prior investigations have found negative associations between military unit cohesion and posttraumatic stress disorder (PTSD); however, most relied on cross-sectional data and few examined relationships of unit cohesion to other mental disorders. This study evaluates prospective associations of perceived unit cohesion with a range of mental health outcomes following combat deployment. METHODS: U.S. Army soldiers were surveyed approximately 1-2 months before deployment to Afghanistan (T0); and 1 month (T1), 3 months (T2), and 9 months (T3) after return from deployment. Logistic regression was performed to estimate associations of perceived unit cohesion at T0 with risk of PTSD, major depressive episode (MDE), generalized anxiety disorder (GAD), alcohol or substance use disorder (AUD/SUD), and suicidal ideation at T2 or T3 among soldiers who completed all study assessments (N = 4,645). Models were adjusted for sociodemographic and Army service characteristics, predeployment history of the index outcome, and deployment stress exposure. RESULTS: Higher perceived unit cohesion at T0 was associated with lower risk of PTSD, MDE, GAD, AUD/SUD, and suicidal ideation at T2 or T3 (AORs = 0.72 to 0.85 per standard score increase in unit cohesion; P-values < 0.05). Models of incidence of mental disorders and suicidal ideation among soldiers without these problems predeployment yielded similar results, except that perceived unit cohesion was not associated with incident AUD/SUD. CONCLUSIONS: Soldiers who reported strong unit cohesion before deployment had lower risk of postdeployment mental disorders and suicidal ideation. Awareness of associations of perceived unit cohesion with postdeployment mental health may facilitate targeting of prevention programs. SN - 1520-6394 UR - https://www.unboundmedicine.com/medline/citation/30694009/Prospective_associations_of_perceived_unit_cohesion_with_postdeployment_mental_health_outcomes_ L2 - https://doi.org/10.1002/da.22884 DB - PRIME DP - Unbound Medicine ER -