Understanding Combat Veteran Adaptation via Social-Cognitive Factors: Testing Relationships among Emotion Dysregulation, Coping Self-Efficacy Appraisals, and Negative Worldview

Abstract

Background. The current study was conducted to increase understanding of factors that promote or deter post-combat adaptation. In total, five research questions were posed and tested, leading to examination of how difficulties with emotion regulation, post-deployment coping self-efficacy (PDCSE), and disrupted worldview work in-concert to influence post-combat adaptation (as measured by PTSD severity, depression severity, and quality of life perceptions). Methods. The final sample included cross-sectional data for 123 OEF/OIF veterans who were referred for assessment and/or treatment in an outpatient clinic in a Veterans Affairs Medical Center. Path analysis, employing bootstrapping re-sampling, was used to test hypotheses, yielding metrics for model fit, direct effects, and hypothesized indirect effects. Results. Overall findings demonstrated that each of the models tested were a good fit for explaining post-combat adaptation outcomes, with the final integrated model (including combat exposure, difficulties with emotion regulation, PDCSE, and negative worldview) explaining 49% of the variance in PTSD, 60% of the variance in depression severity, and 42% of the variance in quality of life, respectively. Findings across all models demonstrated that emotion dysregulation played a significant role in promoting worse post-combat adaptation, and that this effect primarily worked through alterations in PDCSE and negative worldview. Conclusions. This study concludes with interpretation of findings via theory and the extant literature. Future research and intervention implications are discussed, including the need to focus post-combat therapies on altering PDCSE and negative worldview, and more broadly, on factors that diminish meaningful life for combat veterans.