Associations Between Mindfulness, PTSD, and Depression in Combat Deployed Post-9/11 Military Veterans

Abstract

Combat experiences predict PTSD and depression in U.S. military veterans. However, few studies have investigated associations between mindfulness and these constructs. We examined main, direct, and indirect effects for mindfulness and combat experiences on veterans’ PTSD and depressive symptoms and investigated the explanatory value of mindfulness on outcome variance in these models. A total of 485 post-9/11 era military veterans with previous combat deployments residing in four major US cities completed online surveys asking about their combat experiences, mindfulness, and mental health. Two multivariable ordinary least squares regression models were specified to investigate main effects of mindfulness and combat experiences on veterans’ PTSD and depressive symptoms. Path models examined direct and indirect effects of combat experiences and mindfulness on these outcomes. There were significant associations for mindfulness (β = − 0.68, p < 0.001), (β = − 0.67, p < 0.001) and combat experiences (β = 0.12, p < 0.001), (β = 0.09, p < 0.001) with PTSD and depression respectively. In both models, the addition of the mindfulness parameter significantly increased model R2. Path analysis demonstrated significant direct effects for mindfulness and combat experiences and indirect effects for combat experiences on PTSD and depressive symptoms through the mindfulness pathway. The associations of mindfulness with PTSD and depressive symptoms were greater in magnitude than the associations for combat experiences, and mindfulness explained a large and significant proportion of the variance in outcomes. Additional longitudinal research investigating how mindfulness skills and strategies may buffer against risk for PTSD and depression posed by combat experience is warranted in this high risk population.