Social support and coping as moderators of perceived disability and posttraumatic stress levels among Vietnam theater veterans — Oak Academic Publishing
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Social support and coping as moderators of perceived disability and posttraumatic stress levels among Vietnam theater veterans
The dual purpose of this study is to investigate whether disability predicts posttraumatic stress levels among Vietnam theater veterans, and whether coping and/or social support moder- ates the impact of disability on PTSD levels, after controlling for demographic, pre-military, military, and post-military factors. This research analyzed data from the U.S.’s National Vietnam Veterans Readjustment Study (NVVRS), which was a nationally representative, stratified, random sample of 3,016 Vietnam veterans. The results indicated that disability, emotional support, instrumental support, and wishful – thinking coping significantly predicted PTSD, when controlling for demographic, pre-military, military, and post-military factors. Further, interactions indicated that both emotional social support and problem-solving coping significantly decreased the impact of disability on PTSD levels. Implications of this research are briefly discussed.
Kulka, R.A., Schlenger, W.E., Fairbank, J.A., Hough, R.L., Jordan, B.K., Marmar, C.R. and Weiss, D.S. (1990) Trauma and the Vietnam war generation: Report of findings from the national Vietnam Veterans readjustment study. Brunner/Mazel Publishers, New York.
Kulka, R.A., Schlenger, W.E., Fairbank, J.A., Hough, R.L., Jordan, B.K., Marmar, C.R. and Weiss, D.S. (1990) The national Vietnam veterans readjustment study: Tables of findings and technical appendices. Brunner/Mazel, New York.
Solomon, Z. (1993) Combat stress reaction: The enduring toll of war. Plenum Press, New York.
Wilson, J.P. and Raphael, B., Eds. (1993) International handbook of traumatic stress syndromes. Plenum Press, New York.
Schnurr, P.P. and Green, B.L. (2004) Trauma and health: Physical health consequences of exposure to extreme stress. American Psychological Association, Washington DC.
Zatzick, D.F., Marmar, C.R., Weiss, D.S., Browner, W.S., Metzler, T.J., Golding, J.M., Stewart, A., Schlenger, W.E. and Wells, K.B. (1997) Posttraumatic stress disorder and functioning and quality of life outcomes in a nationally representative sample of male Vietnam veterans. American Journal of Psychiatry, 154(12), 1690-1695.
Shontz, F.C. (1975) The psychological aspects of physical illness and disability. Macmillan Publishing Co., New York.
Wright, B.A. (1983) Physical disability: A psychosocial approach 2nd edition. New York: Harper and Row.
Martz, E. and Livneh, H. Eds. (2007) Coping with chronic illness and disability: Theoretical, empirical, and clinical aspects. Springer, New York.
Department of Veterans Affairs Office on Research and Development, National Institute of Mental Health, and US Army Medical Research and Materiel Command (2006) Mapping the landscape of deployment-related adjustment and mental disorders: A meeting summary of a working group to inform research. Rockville. http://www.research. va.gov/programs/OIF-OEF/deployment-related-adjustment-may06-report.pdf
Blanchard, E.B. and Hickling, E.J. (1997) After the crash: Assessment and treatment of motor vehicle accident survivors. American Psychological Association, Washington, DC.
Miller, L. (1998) Shocks to the system: Psychotherapy of traumatic disability syndromes. W. W. Norton and Co., New York.
Radnitz, L.C., Schlein, S.I., Walczak, S., Broderick, P.C., Binks, M., Tirch, D.D., Willard, J., Perez-Strumolo, L., Festa, J., Lillian, B.L., Bockian, N., Cytryn, A., and Green, L. (1995) The prevalence of posttraumatic stress disorder in veterans with spinal cord injury. SCI Psychosocial Process, 8, 145-149.
Alter, C.L., Pelcovitz, D., Axelrod, A., Goldenberg, B., Harris, H., Meyers, B., Grobois, B., Mandel, F., Septimus, A. and Kaplan, S. (1996) Identification of PTSD in cancer survivors. Psychosomatics, 37(2), 137-143.
Breslau, N. and Davis, G.C. (1992) Posttraumatic stress disorder in an urban population of young adults: Risk factors for chronicity. American Journal of Psychiatry, 49(5), 671-675.
Martz, E. (2005) Associations of posttraumatic stress levels with demographic, disability-related, and trauma- related variables among individuals with spinal cord injuries. Rehabilitation Psychology, 50(2), 149-157.
Martz, E., Birks, K., and Blackwell, T. (2005) The prediction of posttraumatic stress levels by depression among veterans with disabilities. Journal of Rehabilitation, 71(1), 56-61.
O’Donnell, M.L., Creamer, M., Bryant, R.A, Schnyder, U., and Shalev, A. (2003) Posttraumatic disorders following injury: An empirical and methodological review. Clinical Psychology Review, 23, 587-603.
Epstein, R.S. (1993) Avoidant symptoms cloaking the diagnosis of PTSD in patients with severe accidental injury. Journal of Traumatic Stress, 6(4), 451-458.
Jaspers, J.P. (1998) Whiplash and posttraumatic stress disorder. Disability and Rehabilitation, 20(11), 397-404.
Shalev, A.Y. (1992) Posttraumatic stress disorder among injured survivors of a terrorist attack: Predictive value of early intrusion and avoidance symptoms. The Journal of Nervous and Mental Disease, 180(8), 505-509.
Shalev, A.Y., Peri, T., Canetti, L., and Schreiber, S. (1996) Predictors of PTSD in injured trauma survivors: A prospective study. American Journal of Psychiatry, 153(2), 219-225.
Ursano, R.J., Fullerton, C.S., Epstein, R.S., Crowley, B., Kao, T., Vance, K., Craig, K.J., Dougall, A.L., and Baum, A. (1999) Acute and chronic posttraumatic stress disorder in motor vehicle accident victims. American Journal of Psychiatry, 156(4), 589-595.
Helzer, J.E., Robins, L.N., and McEvoy, L. (1987) Posttraumatic stress disorder in the general population. The New England Journal of Medicine, 317(26), 1630-1634.
Buydens-Branchey, L., Noumair, D., and Branchey, M. (1990) Duration and intensity of combat exposure and posttraumatic stress disorder in Vietnam veterans. The Journal of Nervous and Mental Disease, 178(9), 582-587.
Martz, E. and Cook, D. (2001)Physical impairments as risk factors for the development of posttraumatic stress disorder. Rehabilitation Counseling Bulletin, 44(4), 217-221.
Delimar, D. and Sivik, T. (1995) The effect of different traumatic experiences on the development of posttraumatic stress disorder. Military Medicine, 160(12), 635- 639.
Martz, E. (2005) Associations of posttraumatic stress levels with demographic, disability-related, and trauma- related variables among individuals with spinal cord injuries. Rehabilitation Psychology, 50(2), 149-157.
Kaplan, M.S., Huguet, N., McFarland, B.H., and Newsom, J.T. (2007) Suicide among male veterans: A prospective population-based study. Journal of Epidemiology and Community Health, 61, 619-624.
Terr, L.C. (1991) Childhood traumas: An outline and overview. American Journal of Psychiatry, 148(10), 10-20.
Wolfe, J., Keane, T.M. and Young, B.L. (1996) From soldier to civilian: Acute adjustment patterns of returned Persian gulf veterans In R J Ursano and A E Norwood Eds, Emotional aftermath of the Persian gulf war: Veterans, families, communities, and nations, American Psychiatric Press, Washington, DC, 477-499.
Suvak, M.K., Vogt, D.S., Savarese, V.W., King, L.A. and King, D.A. (2002) Relationship of war-zone coping stra- tegies to long-term general life adjustment among Vietnam Veterans: Combat exposure as a moderator variable. Personality and Social Psychology Bulletin, 28(7), 974- 985.
Martz, E., Bodner, T. and Livneh, H. (2009) Coping as a moderator between disability and adaptation among Vietnam theater veterans. Journal of Clinical Psychology, 65(1), 94-112.
Mikulincer, M. and Solomon, Z. (1989) Causal attribution, coping strategies, and combat-related posttraumatic stress disorder. European Journal of Personality, 3, 269-284.
Sutker, P.B., Davis, J.M., Uddo, M. and Ditta, S.R. (1995) War zone stress, personal resources, and PTSD in Persian Gulf war returnees. Journal of Abnormal Psychology, 104(3), 444-452.
Wolfe, J., Keane, T.M., Kaloupek, D.G., Mora, C.A. and Wine, P. (1993) Patterns of positive readjustment in Vietnam combat veterans. Journal of Traumatic Stress, 6(2), 179-193.
Zeidner, M. and Ben-Zur, H. (1994) Individual differences in anxiety, coping, and posttraumatic stress in the aftermath of the Persian Gulf War. Personality and Individual Differences, 16(3), 459-476.
Koenen, K.C., Stellman, J.M. and Stellman, S.D. (2003) Risk factors for course of posttraumatic stress disorder among Vietnam veterans: A 14-year follow-up of American legionnaires. Journal of Consulting and Clinical Psychology, 71, 980-986.
Lawrence, J.W. and Fauerbach, J.A. (2003) Personality, coping, chronic stress, social support, and PTSD symptoms among adult burn survivors. Journal of Burn Care and Rehabilitation, 24, 63-72.
Desmond, D.M. and MacLachlan, M. (2006) Coping strategies as predictors of psychosocial adaptation in a sample of elderly veterans with acquired lower limb amputations. Social Science and Medicine, 62, 208-216.
Hanson, S., Buckelew, S.P., Hewett, J. and O'Neal, G. (1993) The relationship between coping and adjustment after spinal cord injury: A 5-year follow-up study. Rehabilitation Psychology, 38(1), 41-51.
Livneh, H. and Wilson, L.M. (2003) Coping strategies as predictors and mediators of disability-related variables and psychosocial adaptation: An exploratory investigation. Rehabilitation Counseling Bulletin, 46(4), 194-208.
Moore, A.D. and Stambrook, M. (1992) Coping strategies and locus of control following traumatic brain injury: Relationship to long-term outcome. Brain Injury, 6, 89-94.
Moore, A.D. and Stambrook, M. (1994) Coping following traumatic Brain Injury: Derivation and validation of TBI sample Ways of Coping-Revised subscales. Canadian Journal of Rehabilitation, 7, 193-200.
Lazarus, R.S. and Folkman, S. (1984) Stress, appraisal, and coping. New York: Springer.
Thoits, P.A. (1986) Social support as coping assistance. Journal of Consulting and Clinical Psychology, 54(4), 416-423.
Fontana, A. and Rosenheck, R. (1994) Posttraumatic stress disorder among Vietnam theater veterans: A causal model of etiology in a community sample. The Journal of Nervous and Mental Disease, 182(12), 677-684.
Fontana, A. and Rosenheck, R. (1999) A model of war-zone stressors and posttraumatic stress disorder. Journal of Traumatic Stress, 12(1), 111-126.
King, D.W., King, L.A., Gudanowski, D.M., and Vreven, D.L. (1995) Alternative representations of war zone stressors: Relationships to posttraumatic stress disorder in male and female Vietnam veterans. Journal of Abnormal Psychology, 104(1), 184-196.
King, D.W., King, L.A., Foy, D.W., and Gudanowski, D.M. (1996) Prewar factors in combat-related posttraumatic stress disorder: Structural equation modeling with a national sample of female and male Vietnam veterans. Journal of Consulting and Clinical Psychology, 64(3), 520-531.
King, D.W., King, L.A., Foy, D.W., Keane, T.M., and Fairbank, J.A. (1999) Posttraumatic stress disorder in a national sample of female and male Vietnam veterans: Risk factors, war-zone stressors, and resilience-recovery variables. Journal of Abnormal Psychology, 108(1), 164-170.
Weiss, D.S., Marmar, C.R., Schlenger, W.E., Fairbank, J.A., Jordan, B.K., Hough, R.L., and Kulka, R.A. (1992) The prevalence of lifetime and partial post-traumatic stress disorder in Vietnam theater veterans. Journal of Traumatic Stress, 5(3), 365-376.
Keane, T.M., Caddell, J.M., and Taylor, K.L. (1988) Mississippi scale for combat-related posttraumatic stress disorder: Three studies in reliability and validity. Journal of Consulting and Clinical Psychology, 56, 85-90.
Folkman, S. and Lazarus, R.S. (1980) An analysis of coping in a middle-aged community sample. Journal of Heal- th and Social Behavior, 21, 219-239.
Muthén, L.K. and Muthén, B.O. (2009) MPlus users guide. http://www.statmodel.com/ugexcerpts.shtml
Aiken, L. and West, S. (1991) Multiple regression: Testing and interpreting interactions. Sage Newbury, Park.
Kennedy, P., Lowe, R., Grey, N., and Short, E. (1995) Traumatic spinal cord injury and psychological impact: A cross-sectional analysis of coping strategies. British Journal of Clinical Psychology, 34, 627-639.
Moos, R.H. and Holahan, C.J. (2007) Adaptive tasks and methods of coping with illness and disability. In Martz, E. and Livneh, H. Eds., Coping with chronic illness and disability: Theoretical, empirical, and clinical aspects. Springer, New York, 107-126.
King, D.W. and King, L.A. (1991) Validity issues in research on Vietnam veteran adjustment. Psychological Bulletin, 109(1), 107-124.
Lazarus, R.S. (1966) Psychological stress and the coping process. McGraw-Hill, New York
Lazarus, R.S. (1991) Emotion and adaptation. Oxford, New York
Kennedy, P. and Duff, J. (2001) Coping effectively with spinal cord injury. Stoke Mandeville Hospital NHS Trust, United Kingdom.
Kennedy, P., Duff, J., Evans, M. and Beedie, A. (2003) Coping effectiveness training reduces depression and anxiety following traumatic spinal cord injuries. British Journal of Clinical Psychology, 42, 41-52.
Wilson, J.P. and Raphael, B. (Eds.) (1993) International handbook of traumatic stress syndromes. Plenum Press, New York.
Shalev, A., Yehuda, R. and McFarlane, A. (Eds.) (2000) International handbook of human response to trauma. Kluwer Academic/Plenum Publishers, New York.
Friedman, M.J., Keane, T.M., Resick, P.A. (Eds.) (2007) Handbook of PTSD: Science and practice. Guilford Press, New York.
Institute of Medicine of the National Academies (2008) Treatment of posttraumatic stress disorder: An assessment of the evidence. http://books.nap.edu/openbook.php?record_id=11955andpage=R1
McCranie, E.W. and Hyer, P. (2000) Posttraumatic stress disorder symptoms in Korean conflict and World War II combat veterans seeking outpatient treatment. Journal of Traumatic Stress, 13, 427-439.
Page, W.F., Engdahl, B.E., and Eberly, R.E. (1997) Persistence of PTSD in former prisoners of war. In Fullerton, C.S. and Ursano, R.J. (Eds.), Posttraumatic stress disorder: Acute and long-term responses to trauma and disaster. American Psychiatric Association, Washington, DC, US, 147-158.