Barr Nicholas, Corral Rodríguez Andrea
School of Social Work, University of Nevada, Las Vegas.
Psychol Trauma. 2023 Nov;15(8):1355-1366. doi: 10.1037/tra0001450. Epub 2023 Mar 13.
Veterans with nonroutine military discharge (NRD) often have worse psychosocial outcomes than their routinely discharged peers. However, little is known about how subgroups of veterans vary regarding risk and protective factors like PTSD, depression, self-stigma of mental illness, mindfulness, and self-efficacy, and how subgroup characteristics relate to discharge status. We applied person-centered models to detect latent profiles and associations with NRD.
A total of 485 post-9/11 era veterans completed online surveys, and a sequence of latent profile (LPA) models were fitted to the data and examined for parsimony, profile separation, and substantive utility. Following LPA model selection, we applied a series of models to analyze demographic predictors of latent profile membership and associations between latent profiles and the outcome NRD.
LPA model comparison supported a 5-profile solution for the data. We identified a Self-Stigmatized (SS) profile comprising 26% of the sample with mindfulness and self-efficacy below full sample averages and self-stigma, PTSD, and depressive symptoms above sample averages. Those in the SS profile were significantly more likely than a profile approximating full sample averages on indicators to report nonroutine discharge (OR = 2.42, 95% CI [1.15, 5.10]).
Meaningful subgroups were present in this sample of post-9/11 service-era military veterans with respect to psychological risk and protective factors. The SS profile had over 10 times the odds of nonroutine discharge compared to the Average profile. Findings suggest that veterans most in need of mental health treatment face external barriers from nonroutine discharge and an internal stigma barrier to obtaining care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
非常规军事退役（NRD）的退伍军人往往比常规退役的同龄人有更差的心理社会结果。然而，对于退伍军人亚组在创伤后应激障碍（PTSD）、抑郁症、精神疾病自我污名、正念和自我效能等风险和保护因素方面如何存在差异，以及亚组特征与退役状态之间的关系，我们知之甚少。我们应用以人为主的模型来检测潜在剖面以及与NRD的关联。
共有485名9·11事件后时代的退伍军人完成了在线调查，一系列潜在剖面分析（LPA）模型被应用于数据，并对其简约性、剖面分离度和实际效用进行了检验。在选择LPA模型之后，我们应用一系列模型来分析潜在剖面成员的人口统计学预测因素，以及潜在剖面与NRD结果之间的关联。
LPA模型比较支持数据的五剖面解决方案。我们识别出一个自我污名化（SS）剖面，该剖面占样本的26%，其正念和自我效能低于全样本平均值，而自我污名、PTSD和抑郁症状高于样本平均值。在指标上，SS剖面中的人比接近全样本平均值的剖面中的人报告非常规退役的可能性显著更高（优势比=2.42，95%置信区间[1.15，5.10]）。
在这个9·11事件后服役时代退伍军人样本中，在心理风险和保护因素方面存在有意义的亚组。与平均剖面相比，SS剖面的非常规退役几率高出10倍以上。研究结果表明，最需要心理健康治疗的退伍军人面临着非常规退役带来的外部障碍以及获得护理的内部污名障碍。（《心理学文摘数据库记录》（c）2023美国心理学会，保留所有权利）
